Preface to Steve Wilson’s paper “Therapeutic communities in mental hospitals”

Citation

Haigh, R. (2012), "Preface to Steve Wilson’s paper “Therapeutic communities in mental hospitals”", Therapeutic Communities: The International Journal of Therapeutic Communities, Vol. 33 No. 1. https://doi.org/10.1108/tc.2012.62033aaa.002

Preface to Steve Wilson’s paper “Therapeutic communities in mental hospitals”

Article Type: Preface From: Therapeutic Communities: The International Journal of Therapeutic Communities, Volume 33, Issue 1

I have been asked to write a short introduction to this paper as a result of the peer review process, and I am very happy to do so. I understand that the problem for reviewers was that it was too long, and too old – and it needed setting in a more contemporary context.

Unfortunately, I completely disagree with these complaints. “Too long” is sometimes a persecutory academic mechanism to shut people up (perhaps when they have “difficult” opinions), although I do acknowledge that some papers submitted to Therapeutic Communities are padded out with impenetrable waffle and need radical surgery, but this is not one of them. “Too old” is an even worse criticism – as our modern “everything must be less than five years old to be taken seriously” academic culture trashes the human importance of matters like continuity, attachment and dependability – and replaces it with commercial, superficial and market-driven imperatives. Also there has been no supportive infrastructure for any new work of the depth and complexity that a field like therapeutic communities needs – so there has been nobody around, in a position like Steve Wilson was, to look at these things for the last couple of decades.

On a more optimistic note, there are two new breeds of TC researchers now actively starting to collect their data. One is following a quantitative tradition (we can expect results before long of an RCT that seems to be well-conducted and close to getting its target number recruited), and the other is qualitative: four PhD students, all doing qualitative research into therapeutic communities, were at Nottingham’s Institute of Mental Health yesterday (23 February 2012) participating in the final ATC conference looking back at 40 years of the TC movement, and thinking about where it might go in the future.

What Steve Wilson writes about in this paper are timeless themes of power, authority and impotence in the face of ignorance, the nitty-gritty detail of how these dynamics caused anti-therapeutic resistance a couple of decades ago, and how they were thought about and managed. Today we are in the midst of the same themes being played out in the world of NHS commissioning, “strong management” of Foundation Trusts, the dominance of CBT models of therapy and biomedical models of psychiatry, and an overarching managerialism of all areas of life, possibly related to modernity and globalisation.

For me at least, it is instructive and somewhat reassuring to see how, in protecting the day-to-day clinical work from the forces of darkness (or maybe “evil” as Google would see them), it has always been thus. Even if the paper is too long and too old for more “modern” journals, I am glad it has found a congenial home in Therapeutic Communities.

Rex HaighProject Lead, ‘Enabling Environments’, Royal College of Psychiatrists Centre for Quality Improvement.