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This slim volume is written by a clinician now a psychoanalyst, who started out his professional career as a mental health nurse and went on to train as a psychoanalytic psychotherapist at the Tavistock Centre. The 10 chapters are built on work he carried out offering teaching, supervision and consultation during his 20-year NHS career at the Tavistock, as well as his own clinical work with the typically disturbed and disturbing patients with serious mental health problems that those of us, like me, who work in the NHS are very familiar with.
Again, like I did, he turned to psychoanalysis to try and make sense of the troubling experiences one is exposed to when opening oneself to such patients. If we do not open ourselves to our patients, we do them a serious disservice. If we are to open ourselves to our patients, he emphasizes that we all need the help of a well-functioning team, containing some members with more experience than us, and makes a case for psychoanalytically informed thinking to understand their impact on us, and the use of this understanding in the service of providing better care for our patients. He also emphasizes the necessity of a third figure to enable clinicians caught in the thick of it, to regain some separation and capacity to think, turning to Britton's (1989) ideas about the oedipal situation.
The challenge Evans faces is making these very complex theories, internal psychic worlds and transference and countertransference relationships accessible to an interested audience with less exposure to reading psychoanalytic ideas. At times I thought he did this well, at other times I thought he expected too much perhaps of the reader. In particular, I think the use of psychoanalytical technical language may put people with little prior knowledge off, which is a shame. I feel a little extra work on his use of language could make the ideas more manageable without being patronizing to colleagues.
Evans starts by summarizing mainly Kleinian psychoanalyt