Editorial

Our papers in this issue of Psychoanalytic Psychotherapy span the life-cycle, with reports of work with a child and his mother, with staff caring for adult populations of psychotic and borderline patients, and with a team caring for the elderly mentally ill. O'Connor is in the all-too-unusual position of a psychoanalyst who maintains her identity as a general psychiatrist, heading a team caring for psychotic patients on the intensive-care unit of a general psychiatric hospital. Her psychoanalytic perspective, rather than being in opposition to a drug-based model, helps staff to use medication more appropriately and effectively instead of reactively, as her clinical examples show.

Much as O'Connor is concerned with introducing dimensions of meaning into an over-rigid medical model, Evans is concerned with a debased and formulaic use of certain psychotherapeutic ideas. Again, on the wards he describes, staff for reasons of comfort and familiarity have stopped listening and thinking about what is going on between them and their patients, and can benefit from a fresh outside view.

Giving lively and detailed clinical material from parallel work with a child and his mother, Barth argues for the value of his model. In this work he has to bear in mind the complex meshing of intrapsychic and interpersonal dynamics, his binocular view both enriching and multiplying the complexity of his work.

At the other end of life, Ardern and colleagues describe some work in Old Age Psychiatry teams where a psychoanalytic perspective is available. This report is welcome and timely as the Old Age Psychiatry section of the APP develops.

Finally, Sigrell's team from Sweden uses Malan's model for researching dynamic change to assess outcome in ten patients. The incorporation of this rigorous and clinically-meaningful outcome project into a psychotherapy training is to be applauded.