Ongoing Work in Primary Care
All counsellors who work in a primary health care environment hold a body of knowledge, the content of which is likely to have been influenced by their training and personal therapy, and will in turn influence their beliefs about their work, theoretically, clinically and morally. The models of the mind that affect the ways in which we work and think are also affected and modified by new experiences in life in general as well as through clinical practice. Both authors, albeit trained in institutions with a different orientation (Freudian and Jungian), subscribe to what might be called a psychodynamic approach when working in primary care. We support Bateman and Holmes’ (1995) three central moral tenets of psychoanalysis, which have become incorporated into present-day social and political debate. These have clear relevance to relationships within primary care. They are (1) the high value placed upon truth, with all the personal pain this may involve; (2) the link between good nurturing experiences in childhood and a well-functioning society; and (3) the value of autonomy in its own right, which may develop out of sensitive parenting. Whether or not readers are sympathetic to these beliefs, an important question that must be raised here is whether we are practising psychoanalysis in our work in primary care.
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