Psychiatric Bulletin (2000) 24: 398-399. doi: 10.1192/pb.24.10.398-a
© 2000 The Royal College of Psychiatrists
Psychiatric Bulletin (2000) 24: 398-399
© 2000 The Royal College of Psychiatrists
Tom Pitt-Aikens
Formerly Consultant Psychiatrist, Cassel Hospital, Surrey
John Denford
Dr Tom Pitt-Aikens died on 16 May 1999 after a long fight against cancer at
the early age of 59 years. He was a child and adolescent psychiatrist and
psychoanalyst who specialised in the causes and treatment of delinquency in
young people. He became a recognised authority in this field in London and the
Home Counties where he worked. He was also more widely known because of his
writings, especially two books he wrote in collaboration with the novelist
Alice Thomas Ellis, Secrets of Strangers and Loss of the Good
Authority. He graduated from Bristol in 1963 and entered psychiatry 4
years later. He was elected a Fellow of the Royal College of Psychiatrists in
1984 and Associate Member of the British Psychoanalytical Society in 1976. He
was a consultant at the Cassel Hospital, Finnart House, Stamford House and the
Feltham Borstal, as well as having a private psychoanalytic
practice.
He conceived of ‘the good authority’, a complex benign presence
in families, institutions and other organisations, whose understandings and
controls encompass the lives and awareness (both conscious and unconscious) of
their members. The good authority shields them from the tendency of historical
and contemporary family and other pressures to distort or limit
self-perception and behaviour. Its absence or loss, which is invariable in
delinquency, he believed to be the underlying cause of antisocial behaviour,
and his treatments attempted to re-establish this integrative presence in the
families and close associations of his patients. He used group methods, which
included the child's social worker as his primary client, and an agreed
‘focus’ rather than an individual as a reference point. He also
did individual and marital therapy with the child's parents, and individual
work with the child. With the same aim he worked with groups of young
offenders and in institutions of various kinds dealing with them. In this work
he was flexible, imaginative and effective.
His awareness of the possibility of losing this sense of an accompanying
good and saving presence may have arisen in part from the many moves he
experienced during his school years. In his own family though, he was clearly
experienced as the embodiment of his ideal, its mainstay after his father's
death, despite the very wide range of his personal and professional
activities.
Tom had rebellious, even mischievous characteristics mingled with his
seriousness. He was intolerant of what he saw as hypocrisy or inconsistency,
particularly in the workings of the institutions in which he found himself,
and impatient with anything he saw as pretentious. This made him sometimes an
uncomfortable, but always a challenging and refreshing, colleague. He was
probably happier working independently, in situations where he was
unrestricted by the demands to conformity that an organisation makes on its
members. And yet he was always the first to arrive for a meeting, the first to
point out a departure from the rules. He believed in order, when it was not
bearing down too harshly on himself! Away from work, where he was free to
express his exuberant nature, his best qualities showed most clearly. He was
adventurous and interested in almost everything, both physical and
intellectual, not sparing himself or his friends. He was restless and rarely
still, even when at work. This expressed itself in a more general way in that
he had never finally decided who or what he was, or wanted to be. He had won
the anatomy prize during his medical training, and hankered after a surgical
career for the rest of his life. But there were other possibilities: sailor,
athlete, builder and laird (at his house on Arran), collector, vintage car
expert.... It is a cruel irony that his own life proved shorter than most. He
will be missed by many.
References
PITT-AIKENS, T. & ELLIS, A. T. (1989)
Loss of the Good Authority: The Cause of Delinquency.
London: Viking.
ELLIS, A. T. & PITT-AIKENS, T. (1988)
Secrets of Strangers. Harmondsworth: Penguin
Books.
