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This remarkable book began as the collective effort of several colleagues, foremost among them Paul Williams and Lord Alderdice, at the Belfast Centre for Psychotherapy. At that time there was a growing desire in Ireland and England to provide psychoanalytically oriented specialist services and training in psychotherapy to psychiatrists and all other mental health professionals. A conference was convened in Belfast in 2008, entitled “Psychoanalytic Therapy of Severe Disturbance.” We can rightly assume that Cathal e Cassidy (Chair of the Royal College of Psychiatrists and the All Ireland Institute of Psychiatry) captures the experience of the conference's many attendees when she states in her foreword: “I have found the application of psychoanalytic understanding at its most useful when clinical decisions are at their most challenging and demanding” (p. viii).
The book includes Lord Alderdice's welcome address to the 2008 Belfast conference. He introduces himself as both a psychiatrist and a psychotherapist. His introduction immediately positions psychological treatments as essential in the treatment of the severely disturbed. He goes on to describe his 25-year mission to “build up an understanding of psychoanalytic ideas and how to apply them” (p. xiii). Reading this book will remind us that there are skilled psychoanalysts, psychiatrists, and psychotherapists who place a mission such as Lord Alderdice's at the heart of all clinical considerations.