Perverting the course of therapy: the fetishization of governance in mental health services.

Research output: Contribution to journalArticlepeer-review

493 Downloads (Pure)


In this paper, I draw on Freudian and Lacanian psychoanalytic theory toconsider the notion of perversion and fetishisation within the context ofcontemporary UK public mental health services which have been subject toNew Public Management restructuring. Offering an organisational caseexample based on clinical experience within an expanded NHS mental healthservice, I explore how services that are subject to neo-liberal regulatory andperformance management systems sponsor a perverse organisational solutionto the anxieties and difficulties of dealing with psychologically distressedpatients. I conclude that theorising the unconscious dynamics of perversionand fetishism may provide an opportunity to rethink governmentality,offering a potentially fruitful means of addressing recent political concernsabout the negative impact of a ‘target culture’ on public sector health services.

© 2014, published by Taylor & Francis. This is an author produced version of a paper published in Psychoanalytic Psychotherapy, 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
JournalPsychoanalytic Psychotherapy
Issue number3
Publication statusPublished - 18 Jul 2014

Cite this