ABSTRACT
This chapter owes a deep debt to the work of Dr Tom Main during his years at the Cassel Hospital. One of his achievements was to transform a model of in-patient treatment of mental disturbance in which regressed patients were being attended to and passively nursed, into one in which the patient is actively involved in the psychotherapy and nursing processes (Main, 1989). I put forward here the simple idea that central to this new model is the notion of what I call the ‘work of the day’, around which is focused both psychotherapy and the psychosocial nursing work. I am limiting the concept of the work of the day so that it does not refer merely to everything that happens in the day, but only to those events that are significant in some way to the individual and their family or have precipitated some kind of thought process and/or action. Thus, the work of the day would include the processing of unsolved problems, major worries, overwhelming experiences, undigested thoughts, forbidden or unresolved thoughts, what has been rejected and suppressed, and what has been set in motion in the unconscious by the activity of the preconscious and consciousness. It involves attention to all the significant, and at times deceptively indifferent, thoughts, feelings and experiences that have occupied us during the day and provide the raw material for thinking and for dreaming.
