Psychotherapy and the NHS: time for a rethink?

In the early 2000s I spent three years working as an honorary psychoanalytic psychotherapist in an NHS mental health trust as part of my analytic training. Back then, this was the time-honoured route to becoming a psychotherapist. What was particularly interesting about this experience was that I saw my first patient for three years and […]

Should talking treatments aim to cure people?

One of the current obsessions in the world of talking treatments is the notion of ‘outcomes’ – preferably measurable ones. In the UK this is being led by the Improving Access to Psychological Therapies (IAPT) programme and is closely linked to the ideology of evidence-based practice. I use the term ‘ideology’ deliberately because there is […]

What is psychotherapy?

If you had asked this question one hundred years ago the answer would have been simple: psychotherapy was just another term for psychoanalysis – Freud’s ‘talking cure’.  Since that time, however it’s become increasingly difficult to define psychoanalysis itself let alone psychotherapy, of which there are now literally hundreds of variants, and most of which […]


It has to be said that psychoanalysis is rather different from other talking therapies.  In fact, strictly speaking it’s not a ‘therapy’ at all, although it can have therapeutic effects.  The term ‘therapy’ has an interesting etymology, and is often defined as ‘healing’.  Psychoanalysis, however, does not aim to heal.  If anything, it can open […]

On being lost for words

For me, this is, ultimately, what brings people to psychoanalysis.  What does this mean, i.e. to be lost for words?  Not being able to speak?  Maybe. Or is it rather a matter of being able to speak almost too well – except that nothing is really said at all? Many people in analysis can speak […]

Mental health and the web

It might seem somewhat ironic (and possibly hypocritical) to be posting a piece on the possible downside of the web in relation to mental health.  After all, my hope is that people who are interested in mental health will read it – on the web!  However, life is full of irony, not to say hypocrisy […]

Is psychoanalysis a science?

I’ve just been re-reading Freud’s An Outline of Psycho-Analysis1 which was his last attempt to give a concise exposition of his ideas and their clinical application.  This paper was written in 1938, very near to the end of Freud’s life.  I think this in itself is significant because by this time psychoanalysis was becoming established, […]

On choosing a therapist

Paradoxically, perhaps, it’s probably never been more difficult to find, let alone choose, a psychotherapist.  This has nothing to do with ‘supply’: if anything the ‘market’ is saturated with talking therapists of all persuasions.  Furthermore, the web has now made it easy to search for a therapist in a particular area, with particular skills and […]

What are words worth?

Not a lot if you believe people like Ewan Morrison, who has argued that (i) the advent of self e-publishing marks the end of the world of writing and publishing as we know it1 and (ii) self e-publishing is the latest economic bubble, following on from the dotcom and sub-prime ones.2 I think Morrison has […]

Digital therapy?

There is an interesting paper by Phil Brown and colleagues ‘Skills are not enough’  The basic thrust of Brown et al’s argument is that the world is now entering a second phase of globalisation (the first was in the 1980s and early 1990s), in which management and knowledge work is no longer the exclusive province […]