mittee for permission to carry out the research. Basic demographic information aside, the interview questions centred on patients' own views of their problems and strengths, their experiences of support or lack of it, and what improvements they would like to see in the way treatment is offered.
The account of the efforts the researchers went to, despite in some cases having to cope with hospital admissions during the conduct of study, is impressive, and the testimony of those they interviewed is moving. There is little doubt that a humane approach to services and increased availability of psychological treatments are called for. However, a passage the author quotes from Hinshelwood (1998) reminds us that 'bridging the gulf' is no simple matter of a change in attitudes: 'they offer a relationship too intensely infused with human feelings -usually very unpleasant ones . . . [through which] they directly and deliberately, although unconsciously, interfere with our own'. Mental health professionals need not only training to understand why abused patients can become so abusive but also their own support in the face of the emotional impact of working with them.
References
Hinselwood R (1998) The difficult patient: the role of 'scientific psychiatry' in understanding patients with chronic schizophrenia or severe personality disorder.