THE LETTER 55 & 56 Spring/Summer 2014, pages 81-91.

This paper is an account of an entrée by psychoanalytic methodology and practice into the public psychiatric service in what is now HSE Dublin North at St. Francis Day Hospital Raheny, chiefly by referrring to a seminal case of intractable paranoia, the analysis of which lasted over three years leading to the acceptance of what has become a valuable contributor to psychiatric treatment within the Kilbarrack catchment area.

Keywords: observe; adapt; assimilate; accommodate; challenge; methodology; confidence

‘…If the doctor ‘says what there is’, if the doctor gives his diagnosis, it is indeed to give an adequate response.  He is the right person in the right place at the right moment (‘is there a doctor on the plane?’).  And that can work as long as the process of the illness is not understood as a signifying process im-plying the subject….” Medical science functions by setting aside the subject of stating….’

Case Study:    ‘HIM’   October 1997 – April 2001

In November 1996 I telephoned St. Ita’s Hospital (SIH) to see if I could speak to someone about gaining experience working with patients who were men-tally ill.  I was referred to a Dr Mullaney (now deceased) for contact. He was the man I needed to see – the main man – the Clinical Director as it turned out.  So some days later when I phoned him he listened to my request and asked if I would forward a CV which I did.