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For the first time, accompanying this issue of Psychoanalytic Psychotherapy is a Supplement consisting of conference proceedings. The APP hopes that this will help the thinking generated at ‘Future Directions of Psychotherapy in the NHS’, held jointly with The Royal College of Psychiatrists in February, to continue and to develop.
The project described by Trijsburg from the Netherlands, based on a questionnaire survey of attitudes to training requirements, particularly concerning the necessity of a substantial training therapy, is of considerable relevance to some of our current preoccupations in the APP. These latter concern the wish to increase the availability of psychoanalytic psychotherapy and the accessibility of trainings, and engage more committed people in the work of the APP, expanding into a regional structure, while at the same time continuing to stand for high standards of training and practice in the profession.
Garelick & Wiener also present an organisation exposed to challenge, and show how struggles within a psychotherapy service towards openness and self-scrutiny in the face of an external review led to some helpful developments.
Chiesa gives us a clinical paper which revisits the old idea of ‘transference as resistance’ from a new angle, showing, with clinical material, how a paranoid, subtly erotised, transference can be used defensively. Shields, who also uses clinical material well to illustrate his theme, is concerned with the meanings of the fee in treatment.
Finally, Temple, Walker & Evans's paper shows us an important example of psychoanalytic psychotherapists willing to struggle at the limits of treatability, with a group of people very stuck with their psychosomatic disorders, in a general hospital setting.