Moving psychotherapy into community settings: Alexis Brook's life's work

For 6 months after I joined the Adult Department of the Tavistock Clinic in October 1971, Dr Alexis Brook was a member of the Department whom I knew only vaguely. However, I gradually warmed to him as we drank our coffees in the staff common room. He was the Head of another Intake Team down the corridor, but his friendly, warm chats in the common room about human nature, politics, a lively interest in ordinary matters, like his strong objections to the type and colour of roof that was being installed on the houses across the street, made me wish to work with him. I must have mentioned this to my supervisors, Judith Stephens and Jane Temperley, who worked in Alexis Brook's Intake team, because some time later Alexis asked me to join the Community Unit. This Unit was important for the Adult Department because it carried psychoanalytic psychotherapy to the outside world as an outward-looking community-based approach to mental health problems. This was Alexis's forte – introducing psychodynamic work into community-based clinics and departments, and in the case of this particular workshop, to general practice. Alexis already had a wide reputation for his methods of enlarging psychological understanding of patients and relationships between patients and their professional carers in ophthalmology, general psychiatry and social work.

Alexis explained the purpose of the Unit as part of a project of psychotherapy attachments to general practice. These attachments, he said, were different from normal secondments; they were experimental. The project attempted to answer the question: ‘what contribution could a psychotherapist, spending three hours a week in a general practice, make to the mental health of patients attending that practice?’. It was clear, he often said, that the psychotherapist would not simply transport a method of work from the psychotherapy consulting room to general practice. A new role and a new method of work would have to be devised to optimize the opportu