R. D. HINSHELWOOD

Hinshelwood se ha propuesto recoger los hilos teóricos del pensamiento de Klein, aunque sin dejar de exponer los lugares de la clínica práctica que fueron su matriz generadora. La primera parte del diccionario está compuesta por trece ensayos ordenados según su articulación conceptual. Se pueden leer como una introducción al pensamiento kleiniano. Parten de un ensayo sobre la técnica del juego, y terminan en una exposición de la identificación proyectiva, acaso la noción más novedosa, en cuya matizada arquitectura culmina el análisis del problema de la trasferencia. Son espléndidas las páginas dedicadas a la revolucionaria idea de fantasía inconciente, asociada con la de objeto interno. La segunda parte -con abundantes referencias cruzadas y remisiones a los artículos de la primera parte, articuladas con las elaboraciones de conceptos kleinianos aportadas por discípulos de la brillante psicoanalista- incluye exposiciones de Bion, Segal, Money-Kyrle, Bick y Rosenfeld, entre otras, cada una con novedosos desarrollos de aspectos fundamentales de la teoría.

Psychiatric institutions have always been places of fear and awe. Madness impacts on family, friends and relatives, but also those who provide a caring environment, whether in large institutions of the past, or community care in the present. This book explores the effects of the psychotic patient's suffering on carers and the culture of psychiatric services. Suffering Insanity is arranged as three essays. The first concerns staff stress in psychiatric services, exploring how the impact of madness demands a personal resilience as well as careful professional support, which may not be forthcoming. The second essay attempts a systematic review of the nature of psychosis and the intolerable psychotic experience, which the patient attempts to evade, and which the carer must confront in the course of daily work. The third essay returns to the impact of psychosis on the psychiatric services, which frequently configure in ways which can have serious and harmful effects on the provision of care. Inparticular, service may succumb to an unfortunate schismatic process resulting in sterile conflict, and to an assertively scientific culture, which leads to an unwitting depersonalization of patients. Suffering Insanity makes a powerful argument for considering care in the psychiatric services as a whole system that includes staff as well as patients; all need attention and understanding in order to deliver care in as humane a way as possible. All those working in the psychiatric services, both in large and small agencies and institutions, will appreciate that closer examination of the actual psychology and interrelations of staff, as well as patients, is essential and urgent.