A psychoanalytic psychotherapist working within psychiatry: covert and overt functions

Within psychiatric practice, psychotherapy occupies a unique role. Not only is it a mode of treatment for some patients, it is also an explanatory model; not only is the psychotherapist called upon to fulfil numerous overt functions within the institution, there are also all sorts of other functions which a psychotherapist may be called upon or expected to fulfil, some more welcome and appropriate than others. Within medicine the choice of becoming a psychiatrist is often seen as feminine, unscientific, perhaps unsafe and slightly illicit. The same applies within psychiatry, to the choice of psychotherapy, and the decision to leave behind dopamine and clozapine for immeasurable, bizarre, unconscious objects. This paper will describe some of the overt and covert roles in the life of a consultant psychotherapist within the National Health Service (NHS) and then in more detail elucidate these roles with two examples from clinical practice.