Attachment, Family, and Social Systems: London's “Cradle to Grave” Contributions as a Model for Social Psychiatry

This article explores the parallels among postwar Britain's “cradle to grave” welfare state with its “social safety net,” especially the National Health Service, the consequent social realism and social upheaval in every sphere of the society, and the birth of the Social Psychiatry (SP) movement in London. From Bowlby's attachment theory, to the pivot from individual to relational therapies, and from research on the social origins of depression in women and Expressed Emotion in family relationships, to the hospice movement, London has uniquely served as a model for SP. There is an organic relationship among these social phenomena in a collectivist society that values “the commons” that created a social safety net, manifested by social realism in the arts reflecting a social upheaval that challenged tradition, notably the class structure of British society. The hallmark of SP is to discern governing patterns across social domains. Anthropologist Gregory Bateson sought “the pattern that connects” while sociologists and systems theorists found patterns in the structures, scripts, and systems of a society. What distinguishes SP is in perceiving these patterns, taking them seriously to re-vision how we think about determinants and influences of mental and social health, and to construct new approaches in psychiatry from research to pedagogy and clinical practice to policy-making.