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Dear Sirs,
I read Dr Garza-Guerrero's contributions on this subject and Mrs Laufer's response (2004) with interest, but felt the dialogue had made a sticky start, with suggestions of rigidity and mockery and an answering sense of hurt pride. Towards the end of a term of office as Dean of Studies at the Tavistock and Portman Clinics, London, UK, I would like to reflect on some of the themes addressed and the emotional turmoil they entail. The way forward for psychoanalysis might be eased by resort to a familiar methodology—the case study. Many psychoanalytic institutions are grappling with the complex predicaments the authors adumbrate, and we could learn by reflecting on what we already know from experience.
The Tavistock Centre provides state-funded psychoanalytic psychotherapy services, and trains psychotherapists and mental-health staff for the UK's National Health Service (NHS) work. Many training programmes are academically validated through collaboration with universities, and the Centre also undertakes a wide range of research. To take up some of Dr Garza-Guerrero's themes, I believe this organisation is part of ‘the movement’, a working clinic, a scientific centre, a clinic-based training institution, and pursues a social mission with respect to mental health in society. Staff groups identify differentially with these dimensions, so we have ‘monks’, theologians, worker-priests, missionaries, cardinals, dissenters and a few flagellants … This creates an organisational life with many inherent tensions, multiple hierarchies in the institutional mind, and perpetual internal uncertainty. This can be wearing, but who said organisational life should be easy? Knowing about these tensions and respecting their inevitability is essential to sustain creativity. Some core tensions are between: psychoanalysis and its ‘applications’ in mental-health work; the internal life of the organisation and its outward engagement with mental-health policy and politics; nourishing the p