Between Art and Science: Essays in Psychotherapy and Psychiatry

Between Art and Science: Essays in Psychotherapy and Psychiatry

Between Art and Science: Essays in Psychotherapy and Psychiatry

Between Art and Science: Essays in Psychotherapy and Psychiatry


In the first collection of his essays to be published, Jeremy Holmes discusses the wider application of psychotherapy within psychiatry and suggests that psychoanalysis needs to escape from its esotericism by taking into account contemporary advances in cognitive science, family therapy and the realities of psychiatric work in a public health setting. Illustrating his arguments with literary as well as clinical examples, he emphasizes the importance of creativity in psychotherapy and the connections between the artistic and psychotherapeutic impulse.


The eclectic psychotherapist

When I first entered psychiatry as a rather callow Laingian (Laing 1960) twenty years ago, I was advised it would be as well to choose what sort of psychiatrist I wanted to be. My mornings, I was told, would be spent on the wards of the mental hospital, but the afternoons could be devoted to psychoanalysis, research or golf. Since then there have been remarkable changes in both psychiatry and psychotherapy. The dissolution of the institutions has meant that most psychiatrists work not in mental hospitals but from District General Hospital units, as I now do, spending large parts of their day in the GP Practices, Day Hospitals and Community Mental Health Centres which comprise ‘the Community’ (see Part IV). At the same time there has been an explosion of interest in psychotherapy. It can no longer be seen as a gentlemanly, post-prandial pastime; nor, given the proliferation of different forms of therapy, can there be any simple equation between psychotherapy and psychoanalysis.

Nevertheless, the themes of that half-joking initiatory comment have not entirely disappeared. In the house of psychiatry there are many mansions: psychotherapeutic, biological and social. These are far less divided among themselves than they were, but there is still much mutual suspicion and misunderstanding. That division of the day into two halves epitomises the hybrid character of psychiatric work - and the difficulty of trying to combine a psychiatric and a psychotherapeutic vision persists (see Chapter 14). Similarly the psychotherapies show endemic fissiparity: it is not enough for one to be a psychotherapist: one must also establish whether one is a psychoanalyst, an analytic psychotherapist, a systemic therapist, a cognitive therapist or a behaviourist.

These tribal groupings within psychiatry and psychotherapy can either be seen as marking the confusion and uncertainty of disciplines still in the early stages of their evolution, or as reflecting an inherent richness and pluripotentiality. It is worth noting that the divisions within both psychiatry and psychotherapy have lessened since an acceptable ‘container’ has been created - the Royal College of Psychiatrists and the United Kingdom Standing Committee for Psychotherapy respectively (see Chapter 2).

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