'IAPT, anxiety and envy: a psychoanalytic view of NHS primary care mental health services today'.

Rosemary Rizq

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Abstract

The government’s response to the Layard (2004) report has been to implement the ‘Improving Access to Psychological Therapies’ (IAPT) programme within Primary Care Trusts in the NHS. In this paper, I argue that the IAPT programme’s explicit commitment to ‘wellbeing work’ risks distorting the unconscious anxiety-containing function that society traditionally allocates to mental health practitioners. Drawing on the social defence paradigm of Menzies-Lyth (1959) and later work by Stein (2000), I use an organisational case example to explore some of the unconscious dynamics within an IAPT service and explore how mechanisms such as defensive splitting and projective identification within the multi-disciplinary team result in psychotherapists coming to represent an unwanted, vulnerable and expendable aspect of the service. I contend that psychotherapists may serve an important function as unconscious ambassadors of a split-off affective aspect of IAPT primary care mental health services, and that as such they will urgently need to ensure they do not succumb to burnout or unhelpful ways of working and relating within the team.

© The author. British Journal of Psychotherapy © 2011 BAP and Blackwell Publishing Ltd. This is an author produced version of a paper, uploaded in accordance with the publisher’s self- archiving policy. The final published version (version of record) is available online at the link below. Some minor differences between this version and the final published version may remain. We suggest you refer to the final published version should you wish to cite from it.
Original languageEnglish
Pages (from-to)37-55
JournalBritish Journal of Psychotherapy
Volume27
Issue number1
DOIs
Publication statusPublished - 2011

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