Breakdown and development - A clinical case study
In this paper I will attempt to describe the treatment of a seriously ill patient in a National Health Service (NHS) clinic who suffered from recurrent depressive disorder with co-morbidity, repeated breakdowns and was at risk of suicide. The purpose of writing a clinical case study
is to illustrate the vital importance of a psychoanalytically-informed approach in the treatment of a very ill patient in the public sector. At a time when there is a decrease in the provision of long-term psychoanalytic psychotherapy my aim is to illustrate its value in the understanding
and treatment of complex disorders, a perspective that seems to be under constant threat from internal and external pressures and at risk of being sidelined as a non-evidence-based form of treatment. I will try to describe the different stages in the treatment; from referral through to the
beginning of treatment, its interruption, the patient's breakdown and admission, and finally his return to treatment upon discharge. The ending will be discussed with a view to highlighting some of the patient's internal movements enabled by the work undertaken.
Keywords: NHS services; breakdown; psychoanalytic psychotherapy; severely disturbed patients
Document Type: Research Article
Affiliations: Tavistock and Portman NHS Foundation Trust, London, UK
Publication date: 01 June 2011
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