Psychotic processes and community care: The difficulty in finding the third position

Publisher Website
Google Scholar
Abstract
This paper describes a woman who is both damaged and damaging. The mental disorder/disturbance felt by this woman generates levels of anxiety that she cannot contain, and this anxiety is passed onto the others who constitute her community. For community care to work it must be possible within the community system to identify, think about and manage the anxieties generated by such mental disturbance. The new legislation of community care may encourage us to ignore the reality of mental illness and issues of power, conflict and pain, and their underlying anxieties. Current examples are given of the acute anxieties felt by many workers in the field which, if uncontained, lead to defensive anti-task strategies. When disturbance is projected and disowned it is put out of mind and may then be passed between parts of the system. Even though it may no longer be possible, except as a short term measure, to put the mentally ill out of sight in mental hospitals, the mental disturbance and those in whom it is located may still be marginalised. The paper proposes a model of community care which encompasses mental illness, professional workers and the community. These three elements are seen as the corners of a triangular space which theoretically becomes the container of mentally disturbing anxieties and within which these anxieties can be addressed, thought about and managed It is argued that this model could enable workers to foresee some difficulties and to address others in a manner that would lead to greater containment and more effective management of mental illness in the community

This publication has 1 reference indexed in Scilit: