ABSTRACT
This chapter describes psychoanalytically informed work in the UK’s National Health Service with a family of three children and a father with a severe long-standing psychotic condition who had also made a number of suicidal attempts. The work took place, by necessity, in the family home. At the beginning, it was important to understand enough of the history of both parents in order to come to a formulation of interlocking psychopathologies between the mother and father that had maintained the regressive functioning of the father. As a result of this formulation a therapeutic alliance was developed that allowed for both parents to progressively stand up to the previous psychotic domination and undermining of both partners. Humiliation was a major dynamic, and a powerful countertransference enactment gave valuable insights. The children benefitted considerably from the father’s increased capacity to play and otherwise engage with them and to show concern for their own welfare.
