David Taylor (born 1946) has had a distinguished career as a Training Analyst and as a psychiatrist and psychotherapist in the public sector. He is a visiting professor at University College London, a trustee of the Melanie Klein Trust and an ordinary member of the British Psychoanalytical Society’s Board with responsibility for research.
Known for his capacity for articulating ideas, Taylor has a talent for re-examining prevailing notions and for recognising when analysts’ adherence to these may interfere with their freedom to make observations. This quality also accounts for his capacity to engage in searching psychoanalytic research.
Taylor studied medicine at University College London Hospitals. From the outset, he intended to specialise in psychiatry and psychoanalysis. During psychiatric training at the Maudsley Hospital, his exposure to psychoanalysis included such exceptional Kleinian analysts as Henri Rey, John Steiner, Michael Feldman and Leslie Sohn. Taylor saw how, in the right hands, Kleinian forms of understanding can have a profound impact on people who are very ill. After beginning training analysis with Ruth Riesenberg-Malcolm, Taylor was greatly influenced by his training supervisors, Betty Joseph and Herbert Rosenfeld. He was appointed a consultant at the Tavistock Clinic in 1981. He held prominent positions including chair of the Tavistock’s Adult Services and medical director of the Tavistock and Portman NHS Foundation Trust.
Confidence in Kleinian psychoanalysis and research into the outcomes of psychoanalytic psychotherapy
When most senior analysts were disdainful of research into the outcomes of psychoanalytic treatments, Taylor was aware of the trend towards evidence-based medicine and of the threat that it posed to the provision of psychoanalytic therapies in mental health services. Although recognising that demonstrating the therapeutic effects of psychoanalytic therapies might be challenging, Taylor thought that there was nothing to make it impossible in principle. He links his ability to direct the Tavistock Adult Depression Study (TADS) to his experience of research at the Maudsley, when, with Michael Feldman, he devised ‘Object Attribute Scales’ aiming to capture along Kleinian dimensions some of the changes psychoanalytic therapies seek to bring about.
Taylor undertook TADS first in partnership with Phil Richardson and later Peter Fonagy. It required him to combine the technical procedures of outcome research with Kleinian clinical insights. Taylor’s treatment manual sets out a psychoanalytic approach to patients with chronic, treatment-resistant kinds of depression. It has been adopted by a German trial. It will be used in a planned replication of TADS in Switzerland.
Taylor says modestly that the positive nature of the TADS findings “cause a certain hesitation amongst those sceptics who formerly dismissed the benefits of psychoanalytic therapies”. Many analysts working in the public sector feel a huge debt of gratitude to him for his perseverance, and for results which validate the application of a Kleinian analytic model to refractory depression.
Taylor’s writing attests to his interest in developing Bion’s ideas. Like Bion, his thinking is characterised by a freedom to look again at supposedly familiar phenomena and to try to understand them anew. He is interested in observations that are accessible to experience and is critical of our tendency to treat what are hypothetical ideas (such as those Bion proposed) as real entities whose existence has been established. We need to recover from this. He says:
“It is only when psychoanalysts can restore provisionality to psychoanalytic ideas that we may further develop our theories about how the mind works.”
He suggests that ‘experience-near’ observations (and ways of working that privilege them) can lead to new theories about the basis of patients’ difficulties, and more generally about how the mind operates. For example, rather than thinking about an ‘unconscious’ we might sometimes need to think about aspects of our functioning in terms of different perceptual modalities, and of embodied actions, including not only speech, but language and thought. These may reside just outside of our customary view of conscious experience rather than operating in some sense beneath it.
Taylor’s paper ‘Anticipation and interpretation’ explores the analyst’s orientation to what is incipient in the patient rather than what is already evident. He suggests the manner of this incipience varies from one patient to another. He examines the way in which the analyst may be alerted to what is emerging through qualities of the patient’s speech (what he refers to as the ‘prosody’ of speech). Subsequent papers expand these lines of thought. For instance, he examines what in detail is required if “the absoluteness of our personal moral systems” is to be modified.
Taylor’s papers and ideas will eventually form a book provisionally to be titled Psychoanalytical Investigations. In this, he will further direct attention to how our capacity to develop certain currently nascent ideas about how the mind works is hampered by our resorting to old models to explain them. He will give detailed phenomenological examples of the operation of different ‘ego’ functions to show how we all struggle to bring perception, emotion, language and action together. Problems in arriving at forms of interpretation that permit change in analysis often express some element of these difficulties. Another book in preparation, Understanding Depression, will bring together what the psychoanalysts on the TADS study learned and place it on a par with its formal research findings.
Francesca Hume, 2017