A view from the visitors' gallery

As Director of the National Mental Health Development Unit, I get many invitations to give papers or run workshops at conferences. It is rare, however, that I opt to stay for the whole of a two-day event, particularly when this takes place over a weekend. This raises the question of why did Psychoanalytic Psychotherapy NOW attract me and how did the experience match the expectation?

As always, there are multiple levels at which such questions can be responded to. At a professional level, psychoanalytic and psychodynamic approaches had not featured strongly in my early career as a practising clinical psychologist and trainer who then moved into service development and management and more recently into national policy implementation. My clinical training in the 1970s was actively antagonistic to these models and offered little to inform my practice, although paradoxically this may have created the roots of my curiosity to know more. While I had a number of colleagues who pursued further training in these areas, I preferred to move from the clinical to the organizational arena, where again I was impressed by contributions from those working within this paradigm at an organizational level.

More recently within the National Institute for Mental Health in England (NIMHE) and subsequently the National Mental Health Development Unit (NMHDU), which have had responsibility on behalf of the Department of Health for the roll out of the Improving Access to Psychological Therapies (IAPT) Programme, I have had direct exposure to a more politicized reaction from those within the psychoanalytic and psychodynamic communities. Initially much of this reaction was overtly hostile, based on the premise that at best IAPT was an overly-simplistic response to widespread personal and social malaise, through to it being seen as a cynical attempt by government to usurp psychotherapy to deliver political goals. In time I came into contact with people who, while remaining cautious about IAPT, cou