Editorial

As I write this at the beginning of July, the United Kingdom is reeling from the results of the vote to leave the European Union. Amidst the political uncertainty and economic limbo, one question is foremost for many of us: What will be the future of our National Health Service (NHS) and other public services which are already struggling with insufficient resources and the relentless pressure to reorganise and become more ‘efficient’? As history accelerates with political allegiances, institutional structures and media opinions changing so rapidly, it seems to me that the psychoanalytic attitude offers a degree of psychic stability in its understanding of these momentous events. Psychoanalysis has always been subversive, on the fringes of mainstream debate, but quietly challenging our notions of free will and conscious choice. Brexit can be seen through the psychoanalytic lens as representing a fundamental breach in our epistemic trust of society, exposing the mayhem of the collective unconscious running riot in the absence of an adequate container.

The papers in this issue of Psychoanalytic Psychotherapy reveal the paradox of psychoanalytic thinking: by the exposition of unconscious truths which disturb the status quo, new understandings of the individual, institution or society may emerge which enhance resilience and provide the necessary containment to survive and grow. This is aptly illustrated in the paper by James Johnston, Vikram Luthra, Lackson Mzizi and Alastair Cardno – ‘Medical psychotherapy consultation: Psychoanalytic psychiatry for the patient and professional’. This describes how a medical psychotherapy consultation service informed by psychoanalytic practice has developed to offer help to acute and community mental health teams in an NHS trust in thinking about patients with whom the teams feel stuck. Johnston and his colleagues have developed a model of consultation that they call a ‘psychoanalytically informed sandwich’: the bread is the meeting wit