Response to ‘Containment lost’ by Andrew Briggs

This is a response to Andrew Briggs’ paper presented to the ACP Conference in June 2017. Briggs’ paper, sobering, pessimistic and challenging, looks at the emotional pressures on child psychotherapists in Child and Adolescent Mental Health Services (CAMHS) as a result of the imposition of the internal market in the NHS. He posits that this has caused the loss of organisational containment, not just for child psychotherapists, but for all those clinicians who work in CAMHS. Briggs writes that this loss of containment is evident in clinicians’ experience of meaninglessness in their work and that this meaninglessness may lead to the despair of the death instinct. For Briggs, this goes along with the loss of professional identity as a once favoured discipline. He compares this fall from grace to Satan’s as described in Milton’s Paradise Lost. If, as he suggests, there has been a strong sense of being the favoured discipline, then maybe a dependence had grown in the profession whereby this loss now feels like a terrible abandonment. The author of this response sees hope amidst the despondency being forced upon workers in the NHS and makes the case for us to engage and resist in a number of practical ways.