Jihad, McWorld and enactment in the postmodern mental health world.

Most clinicians have strong reactions to managed care. This article suggests that managed care, despite its imperfections, shares the same moral imperative as the environmental movement. In a rapidly changing world, skilled clinicians' intense reactions to managed care may lead them unwittingly to participate in enactments involving failure to attend to the emerging meaning of resource limitation in analytic work. A case example is offered as an illustration.