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Commentary (GW) on Chapter Four: Fear of dependence in therapeutic relationships

ByJonathan Pedder

In this chapter, Pedder argues the case that all professionals ought to have some theoretical underpinning to the task of understanding patient needs and dependencies. This chapter gives some scope to reflect on the urge in the National Health Service (NHS) to prevent patients from becoming dependent and institutionalized. Pedder’s argument is something of a riposte to the dominant opinion during the last decades of the twentieth century, when dependency somehow came to be seen as a bad thing. Especially in psychiatry, care in the community was put into practice with the closure of hospitals and decantation of patients. Part of the rationale for these hospital closures was that mentally ill patients were thought to become unnecessarily institutionalized by the psychiatric system, that somehow the system caused patients to become dependent. Pedder tells us that it is all well and good trying to make patients independent, but what about the process of getting there?