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Tip: To sort articles by source…

PEP-Web Tip of the Day

After you perform a search, you can sort the articles by Source. This will rearrange the results of your search, displaying articles according to their appearance in journals and books. This feature is useful for tracing psychoanalytic concepts in a specific psychoanalytic tradition.

For the complete list of tips, see PEP-Web Tips on the PEP-Web support page.

Clacey, R. (2020). Turning the Tide: The Psychoanalytic Approach of the Fitzjohn's Unit to Patients with Complex needs edited by David Bell. Published by Routledge, Abingdon, 2018; 162 pp, £21.99 paperback. Brit. J. Psychother., 36(1):156-158.

(2020). British Journal of Psychotherapy, 36(1):156-158

Turning the Tide: The Psychoanalytic Approach of the Fitzjohn's Unit to Patients with Complex needs edited by David Bell. Published by Routledge, Abingdon, 2018; 162 pp, £21.99 paperback

Review by:
Robert Clacey

Mr M (referred to in chapter 3 of this book) asks his therapist what 'exactly’ he means, in response to his therapist's suggestion that he uses a particular mental mechanism to feel safe. This question 'What exactly do you mean?’ was one that I found myself returning to again and again as I read this book - who 'exactly’ are these 'patients with complex needs’ for whom the psychoanalytic approach of the Fitzjohn's Unit is being described?

I thought that I had found part of the answer in David Bell's clear and concise introduction where he describes the difference between nomothetic (where objects that are similar are grouped together in a single category, as in disease classification) and ideographic (where the aim is to capture the unique qualities of an individual case) levels of description. At this point I thought that my desire for an exact description of the patient group served by this unit, based on psychoanalytic or psychiatric classifications, was going to be frustrated, but in the long run this was going to be a helpful experience. I was going to have to work a little harder to answer my own question.

Paradoxically I then felt somewhat frustrated by Birgit Kleeberg's chapter 'Finding a way in: The work of the Fitzjohn's Unit’, which includes a more detailed look at who the patients are. Most commonly, in terms of psychiatric diagnoses, Fitzjohn's Unit patients are classified as having recurrent depression, specific personality disorder, and bipolar affective disorder, with the most common presentation being comorbidity between personality disorder and serious affective disorder.

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