Psychoanalysis and Psychotherapy
Samuel Tuke, Description of the Retreat (facsimilie), £15.95
Samuel Tuke, Description of the Retreat (Facsimilie Edition)
DESCRIPTION OF THE RETREAT
AN INSTITUTION NEAR YORK
For Insane Persons of the
SOCIETY OF FRIENDS
The Modes of Treatment
AND A STATEMENT OF CASES
by Dr Samuel Tuke
This is a facsimilie edition of the founding document of humane treatment of the mentally ill in Britain
In 1796 William Tuke and his fellow Quakers opened The Retreat and embarked on a revolution in the humane treatment of people suffering from mental illness. A Descnption of the Retreat published in 1813 by Tuke's grandson Samuel became one of the founding documents of modern psychiatry. Personal relationships and social expectations were seen as the keys to therapeutic change. Moral treatment, as the evolving approach came to be called, spread widely, influencing legal, administrative and clinical practice in the UK and the USA. Yet by the end of the 19th century moral treatment had all but vanished, debased by the sheer size of the county asylums and overshadowed by biological and individualistic approaches to treatment.
The middle decades of the 20th century saw a revival of interest in the psychosocial aspects of mental illness, spurred on by the studies of sociologists, psychiatrists and psychoanalysts who were fascinated by the power of psychiatric institutions to harm or help those who lived in them. In the final decades of the 20th century it seems that the pendulum has once more swung towards an individualistic approach to mental illness. We need now to ask how the social values that gave rise to moral treatment can again be caught hold of to steer us towards a new response to the presence of mental illness in our society.
To mark the occasion of its 200th anniversary, The Retreat in collaboration with Process Press is republishing Samuel Tuke's seminal work, together with Hunter and Macalpine's Introduction to the 1964 edition and an entirely new foreword by Kathleen Jones. As it embarks on its third century The Retreat is working to rediscover its role as a seedbed for innovative ideas and practice in the treatment of mental health problems, building on, but not constrained by its past.
Process Press 'only purity of means can justify the ends
ISBN 1-89920-904-2 £15.95 + £1.50 postage & packing
The Story of a Mental Hospital: Fulbourn, 1858-1983
by David Clark
The entire text of this book is available on-line.
Current policies about 'care in the community' of the mentally ill, along with lurid accounts of abuses, have led to the impression that the old, custodial mental hospitals outside big cities were all dreadful 'bins' where human dignity was sacrificed to staff routines. The author was head of a traditional institution near Cambridge for three decades, during which it became internationally renowned for enlightened practices and the nurturing of patients' rights and welfare. He tells the history of the hospital from its founding in the nineteenth century and includes, in his own time, the advent of tranquillisers, unlocking the wards, administrative therapy, therapeutic communities, internal wrangles and relations with the community. It is a moving story, part autobiography, part narrative history, and full of touching incidents, reflecting the best tradition of the caring professions. It can be argued that the work being done in some institutions of this kind compares favourably with many current policies for the care of the mentally ill.
'Little has been written by insiders about those great public mental hospitals which, until recently, held in Britain 100,000 patients. Hence everyone interested in recent psychiatry and the role played in it by the psychiatric hospital will be delighted that David Clark has recorded his personal memories of a life-time spent in running a large, public psychiatric institution. Trained at Maudsley Hospital, Clark joined the Fulbourn Hospital, on the outskirts of Cambridge, back in the 1950's ; he stayed on and transformed the institution...
'In a book doubling as a history of the hospital and an autobiography Clark discusses the changes he was able to effect and his thoughts about the present crisis in psychiatric care. A rich irony reveals itself: our age, which has seen the agitation for the closing of traditional asylums come to fruition, has also been the time when many of them have been, at long last, most therapeutically innovative and succesful.
'Frank, modest and written with a wry sense of humour David Clark's account of a career in Fulbourn is a rare document, fascinating to read and invaluable as historical evidence. It is a pleasure to see it in print.'
- from the foreword by Roy Porter, deceased, formerly Professor of the Social History of Medicine, Wellcome Institute, London, author of Mind Forg'd Manacles Editor of The Faber Book of Madness and Co-Editor of Discovering the Meaning of Madness.
David H. Clark studied Medicine at King's College, Cambridge and Edinburgh University, trained in psychiatry at the Maudsley Hospital, was appointed Medical Superintentdent of the Fulbourn Hospital in 1953 and from 1971 until 1983 was Senior Consultant Psychiatrist at the Hospital. He is the author of Administrative Therapy (Tavistock, 1964), Social Therapy in Psychiatry (Penguin, 1974; 2nd ed. Churchill Livingstone, 1982) and Descent into Conflict 1945: A Doctor's War (Book Guild, 1995).
Pp. xiv + 248 Price: £19.95 plus £1.50 postage and packing.
Lost for Words: The Psychoanalysis of Anorexia and Bulimia
by Em Farrell
The entire text of this book is available on-line.
About eighty per cent of women suffer from Sub-Clinical Eating Disorder, and twenty per cent will manifest full-blown anorexia or bulimia during their lifetime. This is the first overview of the psychoanalytic and psychodynamic literature on these disorders.
Anorexics and bulimic are lost for words. They feel they have no way to communicate effectively. They have not found the words to express and name the turmoil of their experience to themselves or others. This leaves them in a world where neither food not words can provide nourishment and sustenance. This book explores the nature of anorexia and bulimia, paying particular attention to the issues of mortality and the complexities of the mother-daughter relationship. It stresses the importance for technique of understanding the violent and agonising nature of these individuals' inner worlds. The author has worked with over 180 women with eating disorders. The history of theories and treatments of eating disorders is thoroughly canvassed, and the book provides the most comprehensive review of the psychoanalytic literature in print. It draws, in particular, on the Kleinian tradition and the work of Winnicott. Em Farrell is a psychoanalytic psychotherapist in private practice. She lectures and is a tutor at Regent's College School of Psychotherapy and Counselling and has been a member of the Eating Disorders Workshop at the Tavistock Clinic.
'This fine book explores in both a sophisticated and accessible way the inner experience of patients with eating disorders. The author is to be congratulated for her nuanced appreciation of the self-alienation that is so common in these patients and the challenges that this presents in the treatment setting. The book details the maturation of the psychoanalytic perspective on these conditions as well as the variety of current points of view. The author's own perspective is Kleinian, an orientation that she represents with thoughtfulness and convincing clinical immediacy. 'Em Farrell's book is a valuable addition to our evolving literature and is one that is deserving of admiration and broad readership. I recommend it highly.'
- Harvey J. Schwartz, M.D., psychoanalyst, editor of Bulimia: Psychoanalytic Treatment and Theory
'What an excellent piece of work it is... It puts forward a persuasive argument about the meaning of eating disorders and a convincing case for how such problems should be understood in the therapy... I feel I would have benefited from reading it some years ago.'
- Paul Gordon, psychotherapist, Philadelphia Association, London.
LOST FOR WORDS Pp. 120 PRICE: £9.95 plus £1.50 postage Available by mail order only directly from the publisher
Sanctuary: The Arbours Experience of Alternative Community Care
edited by Joseph H. Berke, Chandra Masoliver and Thomas J. Ryan
Sanctuary is not simply a physical place of safety. It is a state of mind. Since its foundation in 1970, the Arbours Association has been providing sanctuary for people in great emotional turmoil, without their having to be seen, called or treated as 'mentally ill'. It has grown to include three residential communities, a crisis centre, a psychotherapy service and a psychotherapy training programme. This book commemorates 25 years of work of the Arbours. It includes historical accounts and reflections by therapists, students and residents about this highly original approach to providing refuge within specialised therapeutic communities for people in severe distress. The Arbours has often intervened on behalf of the most disturbed, the most chaotic, the most self- destructive individuals. They are often labelled 'borderline' or 'psychotic' in conventional psychiatric classifications, people whom other psychotherapists and facilities would not approach psychotherapeutically. One of the most striking features of this book is the detailed descriptions of the individual, group and institutional dynamics that provide the foundation of the Arbours' practical and theoretical accomplishments.
The distinguished psychoanalyst, Dr. Nina Coltart, who contributes the concluding chapter, has written, 'I continued to observe the growth of Arbours with great admiration. They built a thorough analytic training for their students, created a low fee clinic for patients, established and nurtured their community houses, ran the Crisis Centre and earned themselves a unique and respected place on the London therapy scene.'
SANCTUARY ISBN 0-899209-10-8 Pp. 212 PRICE: £15.95 plus £1.50 postage
by Robert M. Young
The entire text of this book is available on-line.
What enhances and constricts mental space - space for reflection, for feeling, for being open to experience and relationships? The author addresses this question in the light of two issues: first, how we locate psychoanalysis in the history of thought about nature and human nature; second, which psychoanalytic approaches are most useful and resonant with our experience. He then turns to key concepts which bear upon these issues: culture and cultural studies, the analytic space, primitive processes, projective identification and transitional phenomena. In each case he gives a careful exposition of the history of the concept and the debates about it scope and validity, in individual and social terms, including applications to racism, virulent nationalism and group relations [Bion, Jaques, Menzies Lyth]. These expositions have been called 'models of exegesis', 'brilliant', and 'masterful' by readers of the manuscript, and the book has been described as 'a good read' and 'just what is needed' to make these concepts accessible to students, practitioners and others interested in cultivating human civility. Among its other merits it is arguably the most accessible exposition of basic Kleinian ideas. Particular attention has been paid to the kinds of accounts of human experience which are most
'a formidably erudite book... in every way outstanding' - Harold Searles
'fascinating, readable and important... so full of information that I expect to be referring to it frequently' - Michael Fordham
'an important and unusual book' - Jane Kitto
'excellent...' - R. D. Hinshelwood
MENTAL SPACE ISBN 1-899209-00- x Pp. viii + 200 PRICE: £15.95 (British pounds) plus £1.50 pounds postage.
Some Comments on Mental Space
'Your writing is in every way outstanding...In Mental Space you have written a formidably erudite book, a book rendered accessible to my pedestrian mind by the unusual clarity with which your book is written... Your book is precious to me. It is superb.'
- Harold Searles, psychoanalyst, author of Countertransference and My Work with Borderline Patients
It is excellent as a discourse on psychoanalytic topics that all butt up against other scientific, moral and political ones. It seems to me extremely suited to the kind of student on the burgeoning university degrees, as it so effectively claims a valid position for modern psychoanalytic ideas within the much wider terrain of intellectual life.'
- R. D. Hinshelwood, psychoanalyst, author of A Dictionary of Kleinian Thought and What Happens in Groups
'I have now finished reading your book, finding it quite fascinating, readable and important. There are not many people like you who combine a real knowledge of philosophy, the history of ideas, sociology, etc. with psychoanalysis, so that so many ideas that I had touched on were richly filled out. It also resonated of course with the idea of the collective unconscious but brought down out of the cloud of mythology into human existence... it is so full of information that I expect to be referring to it frequently.'
- Michael Fordham, Jungian analyst, co-editor of The Collected Works of Jung, author of The Making of an Analyst
'[In Mental Space Robert Young] ranges from foundational issues (how to think about mental space itself) to such delicate and complex cultural issues as racism, demonstrating throughout great sophistication and originality - without ever losing a direct, conversational style that helps the reader to be consistently engaged with the argument.'
- E. V. Wolfenstein, psychoanalyst, political scientist and author of The Victims of Democracy: Malcolm X and the Black Revolution
'I think it is a first rate and brilliant piece of work, and an important contribution to the psychoanalytic literature, especially the section on factors which restrict and foster mental space. I have made it required reading for all my psychotherapy students.'
- Brett Kahr, Lecturer in Psychotherapy, Regent's College, London
'It is a serious and well-executed attempt to locate psychoanalysis, particularly Kleinian psychoanalysis, in the history of ideas, in culture and in the social world, and to treat it in an interdisciplinary manner. To my knowledge this is a unique undertaking. ...The discussion of groups and group processes is particularly illuminating. The author admirably maps the development of such thinking, which is too little known outside the world of group relations and group therapy and points the way for future work in this area. A further strength of the book is the way in which it places psychoanalysis in the history of ideas about the mind and human nature... The chapters on psychotic anxieties, projective identification and countertransference are models of exegesis. The writer's command of the literature, both psychoanalytic and non-psychoanalytic, is enviable... The book speaks of much that ought to be regarded as essential to any serious study in this area, yet is all too frequently ignored.
- Paul Gordon, psychotherapist, Philadelphia Association, London; formerly Reviews Editor, British Journal of Psychotherapy
'I have the feeling that I have known the essence of what you are saying all my life... for me your book is full of thoughts that I hope to follow through, and sources I hope to refer to; also your philosophic and political understanding is a boon to me...'
- Diana Bremner, psychotherapist, Lincoln Centre and Institute for Psychotherapy
'It has stimulated me as much as anything I have read in some time.'
- Charles Lloyd, theologian, Southern Methodist University
'[Robert Young] has played a major role in the development of psychoanalytic studies... As a teacher of psychoanalytic concepts, and of philosophical and sociological ideas as they bear upon thinking about human nature, I would think he is without equal. He combines a depth and scope of knowledge with an extraordinary facility for producing lucid and telling synopses of bodies of work, and a unique alertness to the connections and contrasts between different positions, both within psychoanalysis and between psychoanalytic ideas and their correlates in the wider culture.'
- Barry Richards, Professor of Communications, Bournemouth University, author of Images of Freud and Disciplines of Delight
'This book is an account of an extraordinary exploration in which Young charts the various mental spaces which we can inhabit: cultural, mental, analytic, primitive, projective, ambiguous and potential. By so mapping out mental worlds Young offers a new synthesis of psychoanalytic thinking as it can interpenetrate our cultural and social lives individually, in groups, in institutions and in society. With an erudition spanning the psychoanalytic literature and cultural and historical studies he has infused them with a new vitality that forces the reader to acknowledge that the unconscious is part of everyday life and not just located in theconsulting room. 'And this is the great service that Young has rendered the reader. In a prose style that is not off-putting, as much of the literature is couched in, he persistently places before us the fact that we order our lives to avoid psychotic anxieties. Furthermore, he reaffirms the Kleinian view that 'our group behaviour and institutional arrangements are quite specifically and exquisitely designed to avoid consciously experiencing psychotic anxieties' (p. 156). But he presents his thoughts not as bizarre undigested objects but as necessary insights for understanding life in contemporary institutions and societies. 'There is an excitement present in the pages that evokes a fresh understanding of, for instance, life in the workplace. Just as reading George Steiner or Lewis Mumford brings alive the desire to try and make sense of life on the tragic plane, Young has conveyed a considered perspective that lifts the reader from the trivial plane, to use a distinction made by Arthur Koestler. Young offers no facile solutions for salvation from our psycho-cultural "ills" but provides a model of, and for, trying to internalise the social world as it is and persists in trying to understand the complexity of what we conventionally call external reality through revelation - no matter how uncomfortable and irksome to acknowledge. 'In making available his thinking, which is securely grounded in psychoanalysis, he has pointed a way to illuminating the world of business and why, for example, we have an unconscious tendency to select narcissistic leaders to run commercial enterprises. At the same time, he offers the stoic hope that by enlarging and deepening our understanding of mental space we may bring into being institutions and societies that reflect the human wish to be creative and not completely destructive.'
-Gordon Lawrence, group relations consultant, Director of Imago East-West, author of Exploring Individual and Organisational Behaviour and To Surprise the Soul
'I finished reading your book on the flight home. I am still very much under the impression of it. It inspired me, which is an experience I had not had for a very long time. I keep re-reading parts of it and the more I do it, the more deep meaning I discover. A major quality of this book is the easy way in which it introduces major issues, its capacity of being academic yet vivacious. In a word, it embodies what it argues for. Congratulations!'
- Toma Tomov, President, Bulgarian Psychiatric Association; Deputy Director, New Bulgarian University
'I was captivated by brilliance wherever I looked. How I admire and envy the clarity with which you can hold other people's ideas and present them as the background of your own understanding of things... Reading the chapters on the racial other, on transitional and cultural space, on the nature of the social influence and the nature of intellectual and cultural endeavour... I don't think I have ever been as clear about any of them before.'
- Josephine Klein, London Centre for Psychotherapy
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___ Samuel Tuke, Description of the Retreat (Facsimilie), £15.95
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