This paper explores an innovative therapeutic service established to support witnesses and core participants in Public Inquiries examining systemic failures of state institutions. Drawing on the experience of developing and leading this service across multiple settings, I outline the distinct clinical, ethical and organisational challenges of working therapeutically within the specific constraints of these contexts.
This presentation discusses themes emerging from Inquiries into the Grenfell Tower Fire, institutional abuse within the immigration detention system, and other large-scale miscarriages of justice. I analyse the adaptations that have facilitated engagement with participants as they prepare to give evidence, deliver and hear testimony about traumatic events and manage the aftereffects of these processes. I explore the challenges of working creatively within the spaces of hearing rooms, community engagement events, and other often contested sites. Embedding services within these contexts necessitates a flexible reconfiguration of the therapeutic frame and a collective practice of coordinated teamwork, negotiating complex relationships with multiple non-clinical stakeholders, including legal staff, campaign groups, civil servants, and interpreters. Finally, I examine the tension between active solidarity and analytic neutrality as a key issue within these projects.
The psychosocial approach that I outline here calls for dynamic practice beyond the conventional boundaries of clinical work, sensitive and responsive to spatiality, political positioning and engagement with the wider networks of relationships that are formative of these contexts.
This paper explores the accessibility of psychoanalysis through two routes: accessibility to psychoanalytic language and accessibility to low fee supervision. It talks about how accessible supervision enabled us to continue training while offering low fee psychoanalytic work, extending what we had received to others. The paper draws on the work of ‘The Psychodynamic Spectrum’ (TPS), a collective of psychotherapists with a psychoanalytic orientation. It combines accessible supervision with low-fee clinical work. TPS is depicted as a case to explore how trainees acclimatize to psychoanalysis in institutions.
As a beginner, entering psychoanalysis felt like entering a language we didn’t yet speak. It raised the question: while psychoanalysis can and should be made accessible, is there something impenetrable about it? There is a pressing need for institutions to address psychoanalysis’ impenetrability. And it is no secret that psychoanalysis has been critiqued for being elitist. Not only by way of charging exorbitant fees, but in its very theoretical language. This is not overtly said but implied and the trainee is innocently implicated in this— in jumping hoops, extending the goal posts; knowing that one is ‘always arriving’ so to speak. When such a trainee steps into the clinic, what are they bringing to the patient? This needs to be investigated, for each of us who have travelled the journey.
TPS emerged from our desire to be able to think psychoanalytically despite questioning if we were equipped with the language. We collaboratively trained ourselves in working with the queer and with the works of psychoanalytic scholars. We engaged with a socioeconomically diverse patient population. In doing so, we argue that making psychoanalysis accessible need not come at the cost of its complexity.
Maytree Sanctuary for The Suicidal offers a non-medical, short-term residential crisis service. It offers guests a free one-off four-night, five-day stay in a terraced townhouse in North London, during which they engage with volunteers and psychotherapeutically informed/trained staff befrienders, both in one-to-one sessions and group, and domestic activities. Drawing on psychoanalytic, cognitive analytic, group and somatic models, Maytree provides encounters outside of traditional psychotherapeutic spaces, providing a potentially transformative experience to guests, based on a renewal of resilience and hope.
In this paper, staff will introduce the Maytree model and reflect on the challenges and opportunities of providing short-term residential therapeutic work to patients in suicidal crisis. Two main strands of the work of Maytree will be discussed. 1) The creation and provision of a therapeutic milieu, through the emphasis on a family style home, shared meals, and co-created spaces. 2) The mobilisation of institutional and collective transferences, as guests engage with a diverse range of staff and volunteers in terms of ethnicity, cultural heritage, gender, sexuality, age, class across their stay, providing the opportunity for multiple and heterogenous therapeutic engagements. Theoretical frameworks such as Henri Rey’s ‘brick mother,’ D.W. Winnicott’s ‘holding’ and Francois Tosquelles’ ‘transferential constellations’ will be used to help to frame the Maytree model. Finally, a composite clinical case will be discussed to show how the Maytree’s expanded frame provides a rich, dynamic and continually co-created location for work, enactments, and psychoanalytic thinking.
This article presents the Favela of Psychoanalysis, an initiative that articulates psychoanalytic practice and training, public mental health services, social movements, and forms of community organization developed within Brazilian favelas. The discussion begins with the historical and political genealogy of the word favela, tracing its emergence through the colonial and slaveholding formation of Brazil and the resistance of Canudos. We argue that the word favela carries and transmits a memory of resistance, displacement, and collective forms of organizing life.
The Favela of Psychoanalysis also draws on Freud’s proposal for free psychoanalytic clinics and training, historically connected to the experience of Red Vienna and the development of public psychoanalytic clinics. Rather than simply bringing psychoanalysis into marginalized territories, the initiative seeks to construct forms of transmission and clinical practice from within the favela, in dialogue with its knowledge, social movements, residents, and public health workers.
The project is based in União de Vila Nova, in the Pantanal area of São Paulo, and in Vila Prudente, one of the city’s oldest favelas. It brings together psychoanalysts, public mental health professionals, and favela residents through programs in psychoanalytic clinical practice, psychoanalytic training, therapeutic accompaniment, mental health reception and care, and group and institutional work. The initiative also organizes seminars and short courses.
The Favela of Psychoanalysis is thus conceived as a clinical, political, and territorial experience in which psychoanalysis encounters the historical transmission of resistance embedded in the favela itself.
The history of psychoanalytic free clinics is often narrated through Western European and North American contexts, where psychoanalysis developed alongside private medical practice and where free or low-cost clinics emerged as attempts to broaden access to treatment. Much less attention has been paid to countries whose histories of mental healthcare followed markedly different trajectories. This paper considers the case of Lithuania and asks what the notion of “free” psychoanalysis might mean in a post-socialist context.
Under Soviet rule, mental healthcare was formally incorporated into a system of state provision, while psychoanalysis remained marginalised or absent from official psychiatric and psychological practice. Following the restoration of independence in 1990, psychoanalytic and psychodynamic approaches gradually re-entered the therapeutic landscape. Yet unlike the historical contexts in which psychoanalytic free clinics became established, psychoanalysis in Lithuania developed within a rapidly transforming social and economic environment shaped by marketisation, professionalisation, and the emergence of private therapeutic services.
Drawing on psychoanalytic, psychosocial, and historical literature, this paper explores how questions of accessibility, public provision, and therapeutic culture can be reconsidered through the Lithuanian case. Rather than treating access to psychoanalysis solely as a matter of cost, it examines how historical experience, cultural attitudes towards mental health, and the legacy of post-socialist transformation shape who seeks, receives, and feels entitled to psychological help.
The Lithuanian case suggests that the future of psychoanalytic accessibility may require a broader understanding of what constitutes a barrier to treatment. By bringing a post-socialist perspective into discussions of free clinics, the paper argues that psychoanalytic debates about access must attend not only to economic inequality but also to the historical and cultural conditions through which therapeutic subjects are formed.
This paper aims to provide preliminary documentation and analysis of how psychotherapists in the NYC Free Clinic experience, and reimagine the psychotherapeutic frame. While the frame in psychotherapeutic work (and especially the psychoanalytic clinic) is often understood by the setting of the dyadic encounter in consulting rooms such as a time limit, a monetary rate, and a limit on the content shared in the hour by the therapist, we extend the frame to include the political history in which the NYC Free Clinic came into existence. Therefore, we speculate that the frame of this psychotherapeutic clinic is shaped by the NYC Free Clinic’s commitments to a free Palestine, prison abolition, and more broadly individuals impacted by political violence. We consider how this historical frame may come into tension (by way of anxiety, fantasy and desire within the dyadic work for example) with the assumed frames endemic to the practice of psychotherapy and psychoanalysis that compliment or contradict the aims and desires of the clinic itself. This provisional analysis includes oral histories and clinical vignettes of 3 NYC Free Clinic therapists. By focusing on the analyst’s/therapist’s experience we follow psychoanalyst Gaberiel Tupinambá’s understanding of the analyst’s role not “as passive receptacle whose unbiased ears function like sensitive seismographs” but rather how the therapist attends to the experience with the patient where both are caught in the maelstrom of political contradictions which demands either a retreat back to the safety of analytic/psychotherapeutic knowledge or risk coming into contact with an “open, common, and real” (see Tupinambá, Politics in the Clinic) space which produces new signification for both patient and therapist alike. We hope the outcome of this research will help promote an atmosphere where NYC Free Clinic therapists can speak freely to their associations with their work and how these associations may have something new to say against the assumed institutional theories of psychoanalysis and its atomizing effect.
