making room for madness in mental health: the psychoanalytic understanding of psychotic communications
On 24th February 2018, as part of our Audiences with Authors series, we hosted Marcus Evans presenting his book 'Making Room for Madness in Mental Health: The Psychoanalytic Understanding of Psychotic Communications'. The event was chaired by Christina Wieland. The talk was recorded and can be watched above.
Marcus Evans argues that in addition to providing a helpful treatment for patients with serious psychological difficulties, a psychoanalytic approach offers an important model for understanding staff-patient relationships. A psychoanalytic approach can also give mental health professionals a language for describing their experiences of, and interaction with, their patients. Importantly it can help in the day-to-day management of patients and their sometimes challenging symptoms and behaviours.
Evans argues that the diagnosis and active interventions employed by psychiatry need to be accompanied by a receptive psychological approach to treatment and care. Mental health professionals need to be interested in the meaning of their patient’s symptoms together with verbal and physical communications, which convey important information about the patient’s internal world and underlying conflicts. His work and thinking is illuminated throughout the book by lively clinical vignettes, supported by accessible accounts of key psychoanalytic theory.
Working with people who have mental illness can be rewarding and enlightening but it can also be frightening, boring, frustrating, anxiety provoking and stupefying. At times actions taken by staff may be driven and dominated by a wish to control provocative or disturbing elements of the patients’ mind. Staff and patients alike need to begin to understand these disruptive and destructive elements of their own thinking. Psychoanalysis offers a model for thinking about and providing meaning for, the anxieties that drive us ‘out of our minds’, and this can reduce the risk of thoughtless action. To some extent this involves putting the madness back into mental health.
Marcus Evans is a psychoanalyst & consultant adult psychotherapist at the Tavistock & Portman NHS Foundation Trust with 35 years of experience in mental health as a practitioner, lecturer and manager. He first worked as a psychiatric nurse. He became head of the nursing discipline at the Tavistock & Portman NHS Trust and developed the nursing discipline and later took on the post of Associate Clinical Director of the adult & adolescent departments between 2011 & 2015.
Marcus has supervised designed developed and taught outreach courses for front line mental health staff in various settings for the last 25 years in many mental health trusts. He was also one of the founding members of the Fitzjohns Service for the treatment of patients with severe and enduring mental health conditions and/or personality disorder in the adult department.
He now works as consultant adult psychotherapist in the Portman clinic. His passion is the application of psychoanalytic ideas to the treatment and care of patients in mental health settings.
His book "Making Room for Madness in Mental Health: The Psychoanalytic Understanding of Psychotic Communication", published by Karnac in 2016, is available for purchase here.