Recently I attended an academic research conference at which the subject under discussion was mental health difficulties and treatment programmes. It was an interesting conference in many respects, and as always one of the most interesting aspects of it was the diversity of the academic research interests in this area and the variety of disciplines who are making a contribution to the field. It was the conversations that took place at coffee, lunch and tea that were equally as engaging as the more formal timetable.
I was hoping that there might be opportunities to let people know that my book would be out soon and was on the look-out for people who might have an interest in reading it and suggesting that their students and colleagues read it.
There were a lot of people who fitted this criteria, far too many to speak to during the course of one day. There were psychologists, mental health nursing tutors, occupational therapy tutors, child psychotherapy tutors, adult psychotherapy tutors, social work professors. Outside of these mainstream mental health education programmes there were more avant-garde researchers and teachers. There was someone who is involved in a garden project, the philosophy being that a connection with the natural world is an essential component of mental well-being. There was someone who is part of a ‘green’ project which promotes outdoor exercise as healthy activity as therapy, not only for the body but also the mind. This project is also linked to the philosophies of eco-psychotherapists who I believe take their principles from Buddhism and integrate these with a belief that we have a profound connection to the natural world that can help us to integrate our mental and spiritual selves.
Of the academics and teachers to whom I spoke, all of them acknowledged the need to introduce into the teaching and research an appreciation of the emotional aspects of mental health, the relationship aspects of well-being. They were all saying in different ways that the essential component of well-being is a meaningful connection to other people and to world around us. As we talked I asked them if they taught anything about unconscious processes on their courses, if they thought about unconscious defence mechanisms, or unconscious communication. On the whole they did not. On the whole the emphasis is on conscious processes. There is clearly awareness that the mind-body connection is an unconscious connection but it is not spelt out and the process of this connection is not given consideration. There is clearly an awareness that connection with others is good for all of us, but no one seems to be asking why this is so, or how this aspect of healing works in the internal world of an individual. It is taken as a given.
I was able to say to one or two people that I had written a book that I hoped might be useful to their students and is about just such processes. It was striking that this news was greeted with great enthusiasm. Yes indeed such a book would be very helpful, it sounded as though it was just what was required, they had only been saying the other day that they needed to teach more on their courses about emotional connection between people, more about the emotional burden of working with mental health difficulties, more about how we can sometimes recognize ourselves in others, even those from whom we consider ourselves to be very different. But they were unsure about how to go about this, where to start, how to frame such an aspect of their courses.
I was able to say that I thought my book would help with this because it does explain as straightforwardly as possible those concepts which help us to consider how unconscious processes work, how emotional experience gets laid down in the foundations of the personality, not just at a neurological level but also at an unconscious psychological level.
I am somewhat dismayed to find that the enormous contributions that psychoanalysis has made to an understanding of the world of mental health are somehow ignored by those working in the field. I am dismayed that psychoanalysis is not thoroughly integrated into the thinking of clinicians in the field. I think that this is because it has become such an esoteric discipline it has come to be thought of as something that can only be comprehended by the few. I also think that this is an elitist and false claim. I think it is absolutely possible for anyone with an interest in how people function psychologically and emotionally to comprehend psychoanalytic principles and to make good use of them in their ordinary and extraordinary encounters and relationships with others. The ideas simply have to be conveyed in a way that makes ordinary sense.
I also think that it is vital that this happens. I think that clinicians working in the field of mental health desperately need the support and nourishment that comes from having a robust model of the mind from which to work. I think that psychoanalysis is the most robust frame that we have available and it needs to be more widely available to clinicians at all levels of contact with those in distress.
In the Centre for Psychoanalytic Studies at the University of Essex we have been running a course for mature students in work with vulnerable children, adolescents and adults, which is founded on psychoanalytic principles. It is called ‘Therapeutic Communication and Therapeutic Organisations.’ But I could not find papers or books that explained the basic concepts in simple terms, or outside of the psychoanalytic consulting room. I know that my students are eagerly awaiting delivery of Everyday Life and the Unconscious Mind because they have found some of the concepts confused and confusing. This is partly because the concepts are sophisticated, but also because the only papers available are those that use the work in the consulting room as their central theme, and this situation is not easily recognizable or transferable to other types of encounter.
My students are looking for something that can help them to keep a degree of clarity. Anyone who works in the field of mental health is looking for clarity in a world of confusion and distress. An understanding of some of the fundamental principles of psychoanalysis offers the best clarity that we can achieve, but it needs to be conveyed usefully. I hope I have made a contribution to that aim.
Everyday life and the Unconscious Mind does not say anything new in the field of psychoanalysis. But it does try to introduce psychoanalysis to a new audience – well, actually to an audience that has been there all along but has not been identified as such. It introduces psychoanalysis to A level students, who are just beginning to choose their career paths, to care workers in residential establishments, to social care support workers who undertake some of the most difficult and important work in our society, and to learning support assistants who are tasked with finding an effective way to communicate with some of the most troubled and distressed children in our schools. Anyone who finds that their job or role involves needing to get alongside someone in distress, will find that psychoanalysis has something to say about that endeavour that is helpful and nourishing.
I was talking at an open day to a father of a potential student. He told me that he manages a warehouse. When I had explained the basic concepts on which the course is based, he said that he thought that he would like to join the course as he often has to manage employees who’s work is compromised by their personal emotional difficulties and he finds it hard to know how to make sense of their behaviour sometimes. I think he was right.
I wish I had had these concepts under my belt when I was a social worker. I know that they would have made an enormous difference to how I could think about the situations that I encountered, how I chose to talk with the people that I was expected to help, and how I could manage work-place relationships.
Bob Hinshelwood has very generously given the book his endorsement and said that my book is “a book for the present generation of people working in the toughest of environments with the toughest of kids in care.” But it is not just for them, but for anyone who has not come across psychoanalysis and works with people in distress and this could be in a variety of settings.
I hope it is useful and I hope it is engaging.
I especially hope that my students can make use of it.
Hannah Curtis is a senior psychoanalytic psychotherapist with twenty years experience in private practice. She is also a lecturer in the Centre for Psychoanalytic Studies at the University of Essex. She is a wife, mother and grandmother who passionately believes that an understanding of psychoanalytic principles can enrich and deepen the everyday encounters and relationships that people experience as they go about their working, family and social lives. Her book Everyday life and the Unconscious Mind is published this week by Karnac Books.