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A psychoanalytic psychotherapist working within psychiatry: covert and overt functions

  • Julian Stern

Extract

Within psychiatric practice, psychotherapy occupies a unique role. Not only is it a mode of treatment for some patients, it is also an explanatory model; not only is the psychotherapist called upon to fulfil numerous overt functions within the institution, there are also all sorts of other functions which a psychotherapist may be called upon or expected to fulfil, some more welcome and appropriate than others.

Within medicine the choice of becoming a psychiatrist is often seen as feminine, unscientific, perhaps unsafe and slightly illicit. The same applies within psychiatry, to the choice of psychotherapy, and the decision to leave behind dopamine and clozapine for immeasurable, bizarre, unconscious objects. This paper will describe some of the overt and covert roles in the life of a consultant psychotherapist within the National Health Service (NHS) and then in more detail elucidate these roles with two examples from clinical practice.

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References

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1.Balint, M. The Doctor, the Patient and his illness. London:Tavistock Publications 1957
2.Freud, S. On Psychotherapy. Standard Edition VII, London, Hogarth Press 1905
3.Bateman, A, Holmes, J. Introduction to Psychoanalysis: Contemporary Theory and Practice. Routledge, London 1995
4.Stern, JM. Functions of a Psychotherapy Department in a psychiatric hospital: refracted through the lenses of trainee psychiatrists. Psychoanalytic Psychotherapyl 1994; 8(2):169183
5.Fabricius, J. Psychoanalytic understanding and nursing-a supervisory workshop with nurse tutors. Psychoanalytic Psychotherapy 1995; 9(1):1729
6.Stern, JM. Group processes in a case discussion workshop for Community Psychiatric Nurses. Journal of Psychiatric and Mental Health Nursing 1996 3;6: 366–360
7.Grant, S, Holmes, J, Watson, J. Guidelines for Psychotherapy Training as part of General Professional Training. Royal College of Psychiatrists Document. Psychiatric Bulletin 1993; 17: 695698

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