I have worked as a consultant in the NHS, privately, and in national leadership roles. I have been researching the nature of suicide and suicide bereavement for over 16 years. My focus is on applying psychoanalytic/psychodynamic concepts to complex topics in mental health care and psychiatry. The aim is to encourage open, honest dialogue....I am currently thinking about the nature of self-harm, prejudice and discrimination in those diagnosed with a personality disorder, assisted dying/suicide and the defensive processes we use as clinicians to deny our own vulnerability. I am a psychiatrist, psychoanalyst, and group analyst.

Recent Papers

Scapegoating in healthcare: a primitive response to tragedy 
In recent years, a pattern has emerged in healthcare systems where clinicians and organisations are publicly blamed and punished following tragic events such as suicides or homicides. These responses often reflect more than institutional accountability, they reveal unconscious cultural mechanisms of scapegoating rooted in collective anxiety, grief, and the intolerability of uncertainty.
International Journal of Social Psychiatry, December 2025
Working with psychosis: the unconscious impact on clinicians, teams and organisations
Clinical work with people who are seriously unwell and overwhelmed by psychotic functioning can be profoundly rewarding yet uniquely demanding. Beyond visible symptoms lie powerful unconscious forces that affect all involved. Drawing on psychoanalytic theory from Bion, Money-Kyrle, Menzies Lyth and Lucas, this article explores how psychotic processes such as splitting, projection, denial and rationalisation are transmitted to those providing care. 
BJPsych January 2026
The impossibility of working in the current NHS: sacrifice to a primitive god 
This paper explores the current crisis in the NHS, focusing on the ‘impossible’ demands faced by staff and the underlying psychodynamic factors that perpetuate these challenges. It examines how idealisation of the NHS has fostered an unconscious dependency on a fantasy of omnipotent care, akin to an idealised love. Rising demand, workforce shortages, and financial pressures have exacerbated these unrealistic expectations, contributing to systemic dysfunction.
​The most downloaded downloaded paper ever from the Journal Psychoanalytic Psychotherapy May 2025
The psychodynamics of self harm
An examination of the complex phenomenon of self-harm, exploring its motivations, theoretical underpinnings and the intricate transference and countertransference reactions that arise in clinical settings. This paper won the Editors Choice Award BJPsych Advances 2025. 
BJPsych November 2024
The menopause transition: a call for a holistic approach 
This paper advocates for a holistic approach to the menopause transition and challenges the current dominant narrative that frames this transition primarily in biological terms. It examines the psychological, social and cultural dimensions, addresses the stigma faced by older women and advocates for the vital role psychiatrists have to play in supporting postmenopausal women.
BJPsych March 2025

Suicide 

Mourning and mental illness
The mourning process and its importance in mental illness: a psychoanalytic understanding of psychiatric diagnosis and classification
BJPsych article of the month March 2024
Clinicians' experiences 
Effects of patient suicide on psychiatrists: survey of experiences and support required
BJPsych April 2019
​Rethinking suicide prevention
This paper critically examines key assumptions in suicide prevention, including the predictability of suicide, the role of suicidal ideation, and the conflation of self-harm and suicide 
​BJPsych International
The nature of suicide and the impact on the bereaved
The 8 'truths' about suicide

​
Understanding the psychodynamics of the pathway to suicide
​The impact of suicide on
​the mind of the bereaved
​
Supporting mental health staff following the death of a patient by suicide
​

Book

Seminars in the Psychotherapies (Second Edition)
'It is a full and wide-ranging book that can be used for reference or quiet study... it also includes throughout its pages a rich seam of personal reflection, literary quotations, on-the-hoof clinical anecdotes and case studies that help bring things to life.'
The book 'provides refreshing views of modern-day psychotherapy that are firmly rooted in principles psychoanalysis.'

Other Articles, videos and podcasts

Discussion about assisted dying with locked up living
​The locked up living podcast
Experiences and support needs of psychiatrists under investigation
BJPsych
​Experiences and support needs of consultant psychiatrists following a patient-perpetrated homicide
BJPsych
​Psychiatrists’ Experience of a Peer Support Group for Reflecting on Patient Suicide and Homicide: A Qualitative Study
Int. J. Environ. Res. Public Health 2022
The 'impossibility' of working in the current NHS Podcast
The Tavistock Institute 
Valdo Calocane: Navigating the complexities of blame in the wake of tragedy: a call for realistic expectations of mental healthcare
BMJ
Parity of esteem within the biopsychosocial model: is psychiatry still a psychological profession?
BJPsych
​The Psychodynamics of Self Harm 
BJPsyche Advances

Current Reccomendations

You don't have to be mad to work here by Dr Benji Waterhouse
Humane, hilarious, and heart-breaking, You Don’t Have to Be Mad to Work Here is an enlightening and darkly comic window into the world of psychiatry.
​
Unlocking the doors to the psych ward, NHS psychiatrist Dr Benji Waterhouse provides a fly-on-the-padded-wall account of medicine’s most mysterious and controversial speciality.
Working in the Dark by Donald Campbell and Rob Hale
Working in the Dark focuses on the authors’ understanding of an individual’s pre-suicide state of mind, based on their work with many suicidal individuals, with special attention to those who attempted suicide while in treatment.

The book explores how to listen to a suicidal individual’s history, the nature of their primary relationships and their conscious and unconscious communications.
Dr Rachel Gibbons