Editorial

This issue of Psychoanalytic Psychotherapy starts with two papers illustrating the importance of the psychoanalytic perspective in the National Health Service from two different angles. Bateman shows how some very disturbed psychotic and borderline patients, who have in many cases exhausted the possibilities of more standard psychiatric management, can be helped in a psychoanalytically-oriented day hospital. He shows how such work depends vitally on continuous attention to the gross splitting processes which will be enacted within the institution. Fabricius shows how psychoanalytic ideas can be applied outside a psychotherapy service to support and enrich the work and thinking of groups of nurse tutors responsible for training the next generation of nurses. I think that the immense value of such work is hard to quantify, and thus it is always under threat when costs are being cut, particularly as the pain and disturbance caused by such thinking must always threaten the peace of institutional defences. Aronowitsch & Crafoord are also concerned with teaching, this time the teaching of psychotherapists themselves. Again, traditional models are challenged in this Swedish centre, which is experimenting with a format fostering the initiative of the trainees, and countering the tendency towards regressive passivity.

Two papers follow on child psychotherapy. Acquarone describes sensitive work with a mother and her infant with cerebral palsy. She shows how the mother is helped to begin to mourn the loss of the normal expected baby, to allow some separation from her handicapped baby, whose own unique personality can then begin to establish itself. Oclander describes an enterprise, sadly now blighted by cuts, where children of divorcing parents are helped in brief psychotherapy to begin to express, and work through, their traumatic experiences.

Finally, Rosen and Barrows both give us clinical case-studies. Rosen's patient is initially inhibited, both in having a baby and in wide