Primitive mind of state

The unseen frame in professional cultures

“…The corpus of works currently being generated by the Tavistock Clinic and by the Ecole de psychosomatique de Paris are examples of the fruits of relatively robust cultures in psychoanalytic psychotherapy and psychoanalysis respectively (eg Marry et al 1963, Bell 1996, Milton 1997, Williams 1997, Milton 1998, Felman 1998, Garland 1998, Dechaud-Ferbus & Porte 1998, Anderson 2000, Garelick 2000, Richardson & Hobson 2000. Conversely, there is the everpresent pitfall of deifying past leadership and clinging to it, now as a stabilised organ[sat[on or cult.…”

“…In Britain, there is enormous pressure from a very prevalent kind of National Health Service ideology which Bell (1996), in a memorable analysis of the political legacy of Thatcherism, has described as embodying the pathology of narcissism. This ideology, Bell observes, deeply hates human need and 214 Downloaded by [George Mason University] at 22:23 10 June 2016 vulnerability, which are therefore projected and then attacked in a manner comparable to that of the patient who is pathologically narcissistic.…”

“…Various authors have noted the destructive effects in Britain of the burgeoning governmental and bureaucratic encroachment on professional autonomy, since the late-1980s, in teaching, medicine, nursing and social work (Howe 1992, Bell 1996, Menzies-Lyth 1999, O'Neill 1999, Davies 2000. Bollas & Sundelson (1995) have meanwhile underlined the anomalous position of the psychoanalyst or psychoanalytic psychotherapist, whose core professional psychoanalytic identity may be complicated or entirely eroded by an overlapping identification with another profession.…”

“…The force of Bell's (1996) article on narcissistic pathology in the Health Service is to demonstrate that a description of the intrapsychic organisation of patients in psychoanalysis who suffer from narcissistic pathology can be extrapolated to function as a highly cogent analysis at an institutional level. I think that Steiner's (1993) discussion of the psychic retreat of the narcissistic patient can be read in this light.…”

Commentary

“…A successful acceptance of old age is the tolerance of dependence. The National Service Framework for Older People (Department of Health, 2001), reflecting a society in which independence is prized and dependence regarded with contempt (see Bell, 1996), unwittingly reinforces the 'dependence is bad, independence is good' paradigm. Sadly, the dependability of National Health Services 'from cradle to grave' is now open to serious doubt.…”