Response

Reading the articles by Bent Rosenbaum and Alison Summers aroused a range of responses in me as they did when they were presented at the invigorating conference of ISPS UK (International Society for Psychological and Social Approaches to Psychosis) on research into psychodynamic psychotherapy for psychosis held in 2014. The future of the application of psychoanalytic understandings in the treatment of psychosis looks decidedly grim in the UK. Many psychodynamic psychotherapy departments have been substantially reduced, if not shut down, in the last decade. A major consequence is that even fewer psychiatrists than in the past will be exposed to psychoanalytic understanding of severe mental disturbance and are therefore unlikely to use such understandings themselves or support and create favourable circumstances for non-medical professionals to do so.

The paradox is that recent generations of UK psychoanalysts have made such substantial contributions to understanding the psychotic mind. One only has to think of the following names: Bion (1957), Segal (1950), Rosenfeld (1985), Sohn (1995), Freeman (2001) and Lucas (2009). These contributions could provide mental maps to assist practitioners orientate themselves in the complex world of psychosis and in making sense of their emotional reactions and actions, and of their fellow clinicians, as well as organisational responses. Looking outside of the UK, Nordic colleagues such as Yrjö Alanen (1997), Johan Cullberg (2006) and Bent Rosenbaum et al. (2012) have all been inspiring in translating psychoanalytic understandings into practical and humane services.

Summers gives a most detailed inside account of the ISPS UK attempt to begin to turn the tide and start a research project that might gain in momentum in researching psychodynamic approaches to psychosis in the UK and improve the much needed evidence base. As a member of that group myself, it now looks as if we should have listened to King Canute's experience. What was most