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In the current economic climate where psychotherapy and psychiatry posts are increasingly at risk of being frozen when they fall vacant, centres of learning and training have been falling prey to a need, part rational, part fearful, to justify their existence. ‘Having’ knowledge or providing a space for study and treatment is no longer felt to be adequate. ‘Going to the Community’, with the implication that the institution itself is not part of the community, then appears to be the only solution. However, there is a positive aspect to this move. It means thinking very carefully about which sections of the community are unable or unwilling to make use of psychotherapeutic help, as well as encouraging bridges that need to be made.
A few years ago I assessed for psychotherapy a 14-year-old boy who arrived with spiky purple hair and black leather trousers covered with safety pins and chains. It was standard attire for what has been called ‘punk’ in Britain but had never before been seen within the Clinic. His striking visual appearance brought home very concretely the fact that few adolescents came for psychotherapy whose appearance and clothing indicated membership of a particular subculture. Every adolescent department sees a noticeable variety of styles of clothing but there is a significant difference between the normal range of adolescent styles and those singling out the individual to be a member of a particular group.
Curiosity about why such adolescents came so rarely, underlined by a growing wish to meet more community needs, then led to the convening of a Working Group on Adolescent Subculture at the Tavistock Clinic. In the three years I convened that group I was able to add to the small amount of clinical data by visiting a small group in a