From perversion to policy: Knowing and not-knowing in the emergence and management of critical incidents

Deacon, Jude (2010) From perversion to policy: Knowing and not-knowing in the emergence and management of critical incidents. Professional Doctorate thesis, Tavistock and Portman NHS Foundation Trust.

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Abstract

Through studying the report of a public enquiry - the Report of the committee of the inquiry into the Personality Disorder Unit, Ashworth Special Hospital (DoH 1999a) - and a detailed analysis of interpersonal processes in professional consultations with forensic practitioners through the ‘lens’ of a psycho-analytically-informed paradigm, a critical link is demonstrated between clinical interpersonal processes with patients in perverse, antisocial states of mind and professional performance. The study shows unconscious processes attacking reality and thinking, ‘nudging’ professionals into acting out of role in ways known to contribute to the emergence of critical incidents. It is grounded in an enquiry that effected changes in legislation, policy, clinical practice and the delivery of social care in secure psychiatric settings. Social work is conducted within a social arena of contemporary concerns about risk and its prediction and management. When things go tragically wrong, events are scrutinised in the form of internal and public formal enquiries with emotive media commentary. Recent examples – Victoria Climbie, Baby Peter – demonstrate the way the public imagination can focus on perceptions of professional failings. The explosion of private events such as these into the public domain results in changes to structures, processes and political understandings in relation to risk, danger and fear. Such enquiries illuminate professional conduct with hindsight, foregrounding decisions that may appear misguided and are popularly held as evidence of incompetence. However, rarely do they ask why apparently ‘ordinary decent’ professionals appear to have acted in extraordinary ways and usually sensible people sometimes do foolish things. This forensic study suggests that a psychoanalytic paradigm is a useful means of achieving a depth of insight in this context. It proposes widely applicable understandings of the types of personal qualities and management structures necessary to delivering high risk, high profile, anxiety-driven services in a social climate of fear.

Item Type: Thesis (Professional Doctorate)
Additional Information: Thesis submitted in partial fulfilment of the Professional Doctorate in Social Work awarded by the University of East London in collaboration with the Tavistock and Portman NHS Foundation Trust
Uncontrolled Keywords: Professional Doctorate in Social Work, D60, Paedophilia
Subjects: Children, Young People and Developmental Pyschology > Child Protection
Children, Young People and Developmental Pyschology > Child Sexual Abuse - Social Work
Criminology > Forensic Psychotherapy
Social Welfare > Social Work
Department/People: Children, Young Adult and Family Services
Research
URI: http://repository.tavistockandportman.ac.uk/id/eprint/2265

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