Letter to the Editor

DEAR DR FORDHAM,

It was good of you to send me a copy of your review of Therapeutic Consultations, and to give me a chance to say something about it.

I shall limit what I say to facts about Donald's way of working, because it seems to me that some of your conclusions about what is reported here are misleading in the total context of his actual practice.

• 1You suggest that his cases must have been 'ruthlessly selected' on the basis of good enough environmental provision. This is absolutely untrue. He simply always took what came, and as it came. His interest and eagerness for exploration were endless, as you must know. He would always rather take on a case than sit down and write a paper. Clinical work was always by choice a priority for him.

• With regard to the environmental factors in the treatment situation, he worked outwards, gathering from the child what support was available and from whom, and how it was being used by the child. Then, in his contact with the parents or other people in the child's life, he enabled them to understand how they were being used and this almost always increased their effectiveness and relieved their sense of guilt. It certainly increased their confidence both in themselves and in the child. In my view, Donald's special gift was his capacity to get into touch with and to mobilize the strengths and capacity for growth in his patients, and he could find life in the most unlikely places. If there was nothing to build on he himself would try and supply enough of what was needed to keep things going in the direction of healthy development. These cases he would usually see on an 'on demand' basis, and I can think of many such. In other words, Donald accepted the limits of the real situation, and was not looking for perfection or complete cure and was not afraid of failure. Many of these cases were referred to colleagues for long-term treatment, and because Donald had to some degree 'failed' in the initial interview this does not see