Paper short abstract:

In this co-authored theoretical paper, we take up psychoanalytic understandings of time and mental life in order to try to understand the temporal trope of waiting and its role in mental health treatment in the current NHS.

Paper long abstract:

This paper explores the relationship between psychoanalytic understandings of time and mental life and the waiting that is a core experience for those seeking mental health treatment in the NHS. Despite government interventions around waiting, it is clear that both mental healthcare professionals and service users experience the current system as demanding an excessive and sometimes intolerable wait for non-pharmacological forms of care. Alongside the ways that waiting becomes a synonym for service failure and abandonment, we explore how the durational time of care at the centre of psychoanalytic therapy remains a key component in effective treatment. We first track the chronic temporalities of psychic life - its repetitions, suspensions, and forms of binding and unbinding that resist linear temporality. This underpins psychoanalytic modes of care that function not through a 'flash' of insight, nor the future-orientated focus of CBT, but through practices of waiting, suspension of the everyday, the repetitions of the transference, and working through. In the context of social and historical conditions that increasingly demand waiting, while rendering it intolerable through instrumentalised accounts of service provision and cost-benefit notions of time, we suggest that the importance of the recent Tavistock Adult Depression Study is not so much the finding that long-term psychotherapy is an effective treatment for chronic depression, but that its impacts are felt long after the cessation of the treatment. Elongated practices of waiting, in other words, give rise to new psychic temporalities of endurance as the NHS is caught between acute crisis and chronic decline.