ABSTRACT
The author have been thinking about what is central to psychodynamic work in general practice and what makes it so challenging to the medical conceptual framework that predominates there, along with the administrative/ financial conceptual framework. This chapter presents a psychodynamic perspective within the Jungian/Kleinian tradition. The basis of the work is what Fordham and others have called ‘the analytic attitude’, which consists of an attitude of mind that is impartial and ‘seeks to elucidate the patient’s conflicts with a view to helping him to resolve them’. The tolerance of great anger in the surgery matrix requires workers of all kinds to develop symbolic process, the capacity for interpretation and struggle for meaning. Even financial managers remaining in predominantly concrete mode disadvantage the patients. A clinical case where sadness rather than anger had to be tolerated by the matrix emerges strongly in this context.
