ABSTRACT
In this chapter, the authors enquire about the unconscious “hospital in the mind” that staff and patients carry with them. They describe the ways in which this intrapsychic object informs their thoughts, behaviour, actions, and feelings, as this object becomes externalized through the roles they take up and the relationships they form. The authors present a form of practice that takes the form of a set of cycles, moving from actions, to reflection and understanding, and then back to actions—a form of psycho dynamically informed action learning. Each of these three steps may involve the use of words in various ways to carry information, to keep relationships going, and to assist in the provision of support. Together with the nurses at the Cassel, he sought to institute within the hospital a culture that prevented the de socialization and removal of adult responsibility.
