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Murray Jackson's introduction to this seminal work states that ‘this book is not meant to be a treatise on psychoanalysis, but an exercise in psychoanalytic psychiatry aimed at the integration of psychoanalytic knowledge within clinical psychiatry and psychotherapy’ (p. 6). This statement, which is offered as an apology for not doing full justice to all the analytic writings on psychosis, seems to me to stand alone as a laudable aim. The author's capacity to attempt this task reflects his own background. Born in Australia, he trained in England at the Maudsley Hospital as a psychiatrist. His interest in somatic and psychotic conditions led him to the work of Jung, and he trained as an analytic psychologist. Further clinical work in child and adult psychiatry and his awareness of Melanie Klein's work led to his training as a psychoanalyst with the British Society. While maintaining an analytic practice, he worked at the Maudsley Hospital as a consultant. There he further developed a unit where psychoanalytic principles, in conjunction with biomedical knowledge, were used to treat patients with severe mental illness.
This work was described in his book Unimaginable storms, written with Paul Williams.
The present book, described as a sequel to the above, stems from the author's experience of teaching and supervision in Scandinavia after retirement from the British National Health Service. The psychiatric system he describes in Scandinavia is very different from that in the United Kingdom today. Here, with a few notable exceptions, the use of psychodynamic psychotherapy as part of the treatment of patients with psychotic conditions is very unusual. By contrast, the Scandinavian psychiatric establishment has been widely influenced by a psychotherapeutically-orientated ‘need-adapted’ approach to the treatment of patients with schizophrenia, originally described by Alanen . This model of care was applied to the treatment of all patients with new schizophrenic illnesses in No