Inside Out and Outside In: The Frame as the Border for Analytic Work
What I propose to consider is how the border provided by the analytic frame can either enable consideration of the ‘outside in’ or disable it.
In this paper I shall present my view that boundaries are where the work happens (provide references) and attempt to show how an acceptance of this principle can enable the analyst to become aware of the impact of the external world on the patient in contrast to the way the patient might be projecting aspects of their inner world onto the external world. I shall propose that the history of psychoanalysis has emphasised this latter phenomenon at the expense of a sensitive understanding of the importance of the external world in the development of the mind.
The paper will describe a psychoanalytic view of the development of the mind and a description of the claim that boundaries are where the work happens to provide a basis on which an analyst will feel free to work either with the inside projected out or the outside imposing itself on the internal world of the patient. I shall use the experiences of group relations conferences and working with groups and organisations as illustration of how my own psychoanalytic work has been impacted in a way that I believe to be beneficial to both patient and analyst.
In contrast I shall be considering the way that the development of teaching psychoanalysis has been limited by a misunderstanding of the focus of the work that derives from an unconscious belief shared by training institutions of a gold standard that should be protected.
Philip STOKOE is a psychoanalyst, working with adults and couples in his private practice; besides he is also an Organisational Consultant, providing consultation to a wide range of organisations. He was a senior manager in a range of health and social care settings since 1978, including St Charles Youth Treatment Centre; Family Welfare Association; Kensington and Chelsea Social Service Department, Brent Adolescent Centre and finally working in the Adult Department of the Tavistock & Portman NHS Foundation Trust between 1994 and 2012, where he was appointed Clinical Director in 2007. He has been responsible for the creation of innovative services; designing a treatment system for very dangerous adolescents held in a Youth Treatment Centre; developing a model for understanding organisations called the Healthy Organisation Model from which, he created an innovative intervention for teams and organisations, the short course intervention, which combines teaching and consultation; he designed the Primary Care Psychotherapy Consultation Service (PCPCS), and these ideas have led to a radically different approach to training psychiatric nurses, which ran at City University. He designed two Masters courses and was the co-designer of the Couple Psychotherapy Training at the Tavistock Clinic. He is a member of the European Psychoanalytic Federation Forum on Institutional Matters (since 13/9/15), which studies the nature of psychoanalytic institutions. He has written and taught on a wide range of subjects. His book, The Curiosity Drive: Our Need for Inquisitive Thinking, was published by Phoenix Publishing House in 2020 and short-listed for the Gradiva Award for Best Book in 2021.