Drawing the Line

The Cassel Hospital is a highly specialist, centrally funded NHS service for patients experiencing severe and enduring mental health problems, often with a background of complex trauma. Patients work in a psychoanalytically informed therapeutic community on the difficulties that have marred their lives. Psychosocial nurses, a social worker, group and individual psychotherapists, psychiatrists, a community doctor and the patients themselves all make a contribution to the running of this complex treatment setting which aims to engage patients at every level, from the healthy, functioning parts of their minds to the unconscious conflicts that wreak havoc from places beyond their rational control. It is also a setting in which cups need to be washed, dinner cooked, food shopped for, meetings attended and so on. And it is itself situated in a much larger context with its own demands and expectations.

Where does authority lie in such a complex system? And what is its role? Does it help or hinder? Do we need it? Who needs it? Who exerts it? We will explore these questions from a variety of perspectives, theoretical, clinical and organisational.