Sir: In his editorial, ‘Managers' hearings: dialectic and maternalism’ (Psychiatric Bulletin, October 2000, 24, 361-362), Kennedy appears to equate maternalism with a strategy of weakly avoiding confrontation.
I feel obliged to challenge this stereotype, not on behalf of strong authoritarian female parents, who are more than able to come to their own defence, but on behalf of Milne's quoted maternal archetype (Reference MilneMilne, 1928), Kanga, who cannot.
In order to deal with Tigger, “a young person of impulsive and energetic temperament who does not know what he wants but has strong opinions about his dislikes”, Kanga does not, as is suggested by Kennedy, avoid confrontation. Rather, Milne's maternal archetype encourages her charge to explore the therapeutic possibilities of her food cupboard. In the context of a long-term relationship, Tigger has a role in planning his own breakfast. Kanga asserts her own view by insisting that when she “thought he wanted strengthening, he had a spoonful or two of Roosbreakfast after meals as medicine”.
Kanga does not, like Kennedy's avoidant maternalistic psychiatrist, conceal the fact that she has her own opinions as to what is best for Tiggers.
In using the terms paternalism and maternalism Kennedy is confounding the real issue. Both stereotypical ‘authoritarian psychiatry’ and stereotypical ‘avoidant psychiatry’ are unhelpful attempts to sidestep the reality that, mentally ill or not, our patients have minds of their own. It cannot be left up to psychiatrists to decide in which contexts our opinions should prevail.
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