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Born in 1911 and dying in 1990, shortly after the publication of this book, Tom Main was a man whose energy, creativity, and pioneering spirit infused his life, his work, and his writings. Best known, perhaps, as Medical Director of the Cassel Hospital from 1946-1976, he had previously worked in army psychiatry during the war, and later, in the ‘70s, was instrumental in founding the Institute of Psychosexual Medicine, of which he was Life President. A psychoanalyst, he was passionately committed to the applications of psychoanalysis, and to the understanding of the workings of different social systems.
Tom Main's writings were numerous, and the task of selection for this volume must have been onerous. Whatever the complexities of the task, the result of Jennifer Johns’ work is a collection of essays that are beautifully coherent, and that vividly convey the development of many of the author's ideas. The papers are of both historical and contemporary interest, and together with Eric Rayner's excellent introduction, make for stimulating, exciting, and enjoyable reading.
For those who, like me, have often skimmed through an introduction, impatient to get on with ‘the book’, it is worth emphasising that this one merits a closer look. In it, Eric Rayner, himself introduced to psychoanalysis by Tom Main, both imparts a lively sense of Tom Main's forceful, passionate and compassionate character and puts the paper into a social and historical context. We learn how, for example, benefitting from Bion's experience of the Northfield Experiment (an army psychiatric hospital), Tom Main began to develop his own ideas about the hospital as a therapeutic institution when he himself worked at Northfield. These ideas came into fruition once at the Cassel Hospital, where he developed the idea of a therapeutic community. For Tom Main, the essence of a therapeutic community lay in the self-scrutinizing process: in the individual, between people, and within and between different levels of