Editorial

Welcome to the final issue of Psychoanalytic Psychotherapy for 2014, which contains three substantial papers, each highly relevant to the journal's core values in addressing the theory, research and applications of psychoanalytic psychotherapy within the public sector.

In the first paper, entitled ‘Towards a relational affective theory of personality disorder’ Susan Mizen introduces a novel and innovative model of personality disorder based on her extensive clinical experience of working in psychotherapy services in the National Health Service (NHS), initially at the Cassel Hospital in London, and subsequently in the psychoanalytic psychotherapy service she set up in Devon. Here she has adapted the Cassel's therapeutic residential and community treatment model for personality-disordered patients detained under the Mental Health Act and presenting with the most severe psychopathology, levels of co-morbidity and risk. Mizen is remarkable in having put forward a successful business case to the local commissioners which argued that her new service, offering local intensive psychotherapeutic work with patients with severe and complex personality disorders, would be cheaper and more effective than the locked placements, many of which were private and far from the patients' homes, where the patients were placed at that time. This important achievement, however, provides only the background context for this paper in which Mizen proposes an important new theory of personality disorder and in which she demonstrates an impressive ability in applying complex psychoanalytic concepts to make sense of some of the most disturbed symptoms and behaviours with which her patients present. Her theory focuses on a psychoanalytic understanding of the ‘claustro-agoraphobic’ dynamics of the defensive structure underlying these patients' apparently different and discrete diagnostic categories, which links the patient's symptomatic manifestations to their personality structure as a whole. Mize