‘The Tavistock and Portman is a tremendous organisation with an important role to play in the contemporary NHS.’
Matthew Patrick joined the Tavistock Clinic in 1990 as a senior registrar and spent a significant portion of his career as a consultant psychiatrist in the Adult Department, spending 24 years in all at the Tavistock. He was the Chief Executive of the Tavistock and Portman NHS Foundation Trust from 2007 to 2013 overseeing a significant expansion of the Trust with important developments across both its clinical, training and education portfolios. Over his working life he effectively had three overlapping careers: the first as a clinical academic contributing to the emerging research and literature on mother-infant relationships and attachment; the second as a psychiatrist, psychoanalyst and clinical and educational leader in psychological therapies; and thirdly as a board level executive for two internationally famous mental health trusts, the Tavistock and Portman NHS Foundation Trust and the South London and Maudsley NHS Foundation Trust.
Matthew Patrick was born in London. His mother was Australian and his father half Scottish and half Russian, with his paternal grandfather having fled Odessa in the early part of the twentieth century. Both of his parents were journalists who had met in Fleet Street just after World War 2.
Matthew Patrick grew up in London, living in Fulham, Hampstead and Wandsworth. He went to Westminster School, at the time a progressive public school led by Dr John Rae. He went to medical school at the London Hospital Medical College in 1979 and lived on the Isle of Dogs while he was a student and has subsequently remained a resident of east London.
In the earlier part of his medical training Matthew struggled to see a career for himself as a physician. For his elective, however, he arranged to study psychiatry in Sydney, Australia. The main focus of this work was on child and family psychiatry, including eating disorders. It was this experience of practical work that made Matthew realise what he wanted to do. He found a sense of fit and connectedness in psychiatry that he had never had with general medicine.
When he came back to the UK he completed his Undergraduate Medical Training at London Hospital Medical College, receiving a 1st Class Honours BSc in Physiology in 1982 and his MBBS in 1985. Then, after his house jobs, Matthew went straight to the Maudsley to train in psychiatry.
He joined the Maudsley and Bethlem Royal Hospitals in 1987 as a Registrar in psychiatry. Quite early on in his psychiatric training he realised that the branch of psychiatry that he was most interested in was psychological therapies. At that time the Maudsley had a very strong psychotherapy department that a number of eminent psychoanalysts including John Steiner, Michael Feldman, Caroline Garland and Nick Temple. At the same time as working through his registrar period at the Maudsley, Matthew went into analysis, which then became a training analysis at the British Institute of Psychoanalysis.
When he qualified as a psychiatrist, receiving his MRCPsych in 1990, Matthew was awarded an MRC Training Fellowship to pursue developmental research with Peter Hobson as his professor. Three years later he was awarded a Welcome Trust Advanced Fellowship to continue this work at the Tavistock and University College London. Matthew and Peter’s work together focused on mental representation and the development of mother-infant relations. Peter Hobson was the Chair of Developmental Psychology at the Tavistock Clinic
Matthew Patrick completed his higher psychiatric training and his analytic training during this period at the Tavistock.
Reflecting on these earlier years he still feels hugely privileged to have had the opportunity to work with staff of such high quality, and to have worked in an environment that managed to hold passion, intellectual rigour, tensions and debate together in such a hugely productive manner. He believes very much that part of the strength and richness of the organisation is the way that different disciplines and modalities were contained within one organisation, enabling such constructive and creative dialogue.
In 1993 Matthew was awarded an honorary consultant contract. After his Wellcome Trust Fellowship ended he returned to full time clinical work. He had finished his analytic training and was able to accept full-time consultant responsibilities at the Tavi, taking on David Taylor’s clinical unit, one of the three clinical units of the Adult Department.
Over time Matthew took on more management responsibilities. Although he never became head of the Adult Department, in 2004 he took on the role of Trust Director, which was then the Chair of the Professional Committee with oversight over all the clinical services and responsibility for financial and operational performance. This was his first Board level role and he found that he enjoyed the challenge of working with the Board. He also found that he had great support from the two Chief Executives that he worked with – Anton Obholzer and then Nick Temple, both of whom were key mentors for him.
While Nick Temple was Chief Executive he and Matthew worked together closely on the Trust’s application for Foundation Trust status, attending the national interviews and then, when successful, managing the Tavistock and Portman’s transition process from Trust to Foundation Trust.
When Nick Temple came up to retirement Matthew applied for the role and was successful.
Matthew Patrick was Chief Executive of the Tavistock and Portman from 2007 to 2013. During his tenure Matthew aimed to position the Trust as a contemporary and relevant organisation within the health service. He feels that he was able during that time to demonstrate how a small specialist organisation could be completely viable in a challenging and changing NHS landscape, marked by a purchaser/provider split.
Under Matthew the Tavistock and Portman grew, successfully winning contracts and tenders, delivering more training and more clinical services. Matthew feels that while organisations have to re-invent themselves as they grow and adapt to a changing environment, what is important about both the Tavistock and the Portman is that they have deep roots. After a number of years as Chief Executive at the Tavistock and Portman Matthew was approached about becoming the Chief Executive of the Maudsley, which he says was the only other job in the NHS that he would have considered. So after considerable reflection he decided to return to the Maudsley and finish his career where he started it. He formally retired from the NHS in July 2019.
Quotes
‘The Tavistock and Portman is a tremendous organisation with an important role to play in the contemporary NHS.’
‘Holding on to the Tavi’s quality of thoughtfulness and reflectiveness is absolutely essential – holding open a space for thinking at times when the pressure to collapse such spaces can be tremendously powerful’
Selected Bibliogaphy
Parnham, A., Patrick, M., Raiman, A., Valori, R. and Wingate, D. (1982). The inhibition of the human fasting motor complex by prolonged but intermittent mental stress. Journal of Physiology, 332, 100.
Patrick, M., Higgitt, A., Holloway, F. and Silverman, M. (1989). Changes in an inner city psychiatric in-patient service following bed losses. Health Trends, 21, no. 4, 121-123.
Patrick, M. and Howells, R. (1990). Editorial: Barbiturate-assisted interviews in modern clinical practice. Psychological Medicine, 20, 763-765.
Patrick, M. and Holloway, F. (1990). Two year follow-up of new long-stay psychiatric patients in a district general hospital. International Journal of Social Psychiatry, 36, no. 3, 207-215.
Patrick, M., Hobson, R.P., Castle, D., Howard, R. and Maughan, M. (1994). Personality disorder and the mental representation of early social experience. Development and Psychopathology, 6, 375-388.
Hobson, R.P. and Patrick, M. (1994). Emotion, cognition, and representation: the interpersonal domain. In D. Cicchetti and S. Toth (Eds.), Rochester Symposium on Developmental Psychopathology, Volume VI: Emotion, Cognition, and Representation. Rochester, NY: University of Rochester Press.
Temple, N., Patrick, M., Evans, M., Holloway, F. and Squire, C. (1996). Interpretive group psychotherapy and dependent day hospital patients – an exploratory study. International Journal of Social Psychiatry, 43, 116-128.
Davenhill, R. and Patrick, M. (Eds.; 1998). Rethinking Clinical Audit. London: Routledge Press.
Cape, J., Hartley, J., Durrant, K., Patrick, M. and Graham, J. (1998). Development of local clinical practice guideline for counselling and psychological therapies. Journal of Clinical Effectiveness, 3, 116-121.
Hobson, R.P., Patrick, M. and Valentine, J. (1998). Are psychoanalytic judgements merely subjective – the case of the Personal Relatedness Profile. British Journal of Psychiatry, 173, 172-177.
Patrick, M. (1999). Kleinian Psychoanalysis. In R. Haigh, J. Pearce and S. Stein (Eds.), Essentials of Psychotherapy. London: Routledge Press.
Weiner, A., Withers, K., Patrick, M., and Bradley, E. (1999). What changes represent a good outcome for severely disturbed children in day treatment? Journal of Clinical Child Psychology and Psychiatry, 4(2), 201-213.
Crandell, L., Patrick, M. and Hobson, R.P. (2003). ‘Still-face’ interactions between mothers with borderline personality disorder and their two-month-old infants. British Journal of Psychiatry, 183, 239-247.
Hobson, R.P., Patrick, M., Crandell, L., Garcia Perez, R., and Lee, A. (2004). Maternal Sensitivity and Infant triadic communication. Journal of Child Psychology and Psychiatry, 45(3), 470-480.
Hobson, R.P., Patrick, M., Crandell, L., Garcia-Perez, R. and Lee, A. (2005). Personal relatedness and attachments of mothers with borderline personality disorder. Development and Psychopathology, 17, 329-347.
Melnick, S., Lyons-Ruth, K., Patrick, M., and Hobson, R.P. (2007). A controlled study of hostile-helpless states of mind among borderline and dysthymic women. Attachment and Human Development, 9(1), 1-16.
Patrick, M., Melnick, S., Finger, H., Lyons-Ruth, K. (2008). ‘Hostile–Helpless States of Mind in the AAI’. Chapter 16 in Clinical Applications of the Adult Attachment Interview. Eds. H Steele, M Steele. Guilford Publications.
Hobson, R.P., Patrick, M., Meyer, J., Crandell, L., Bronfman, E. and Lyons-Ruth, K. (2009). ‘How mothers with borderline personality disorder relate to their year-old infants’. The British Journal of Psychiatry, 195, 325-330.
Patrick, M. (2010). ‘Psychoanalytic Psychotherapy Now’. Psychoanalytic Psychotherapy, Vol 24 Issue 1, 8-13.
Lemma, A. and Patrick, M. (Eds.; 2010). Off the Couch: Contemporary Psychoanalytic Applications. London: Routledge Press.
Hobson, R.P., Patrick, M., Kapur, R. and Lyons-Ruth, K. (2013). ‘Research reflections’. Chapter 10 in Consultations in Psychoanalytic Psychotherapy. Ed. R.P.Hobson. London: Karnac Books.
Cotton, R., Hyatt, J. and Patrick, M. (2013). ‘Emental Health; what’s all the fuss about’. Mental Health Network briefing paper.
Lyons-Ruth, K., Riley, C., Patrick, M. and Hobson, R.P. (2019). ‘Disinhibited attachment behaviour among infants of mothers with borderline personality disorder, depression and no diagnosis’. Personality Disorders: Theory, Research and Treatment, 10(2), 163-172.
Hobson, R.P., Patrick, M., Maughan, B., Shine, J., MacKeith, J., Main, M. and Hesse, E. ‘Is the mind of the psychopath so distinctive? Is violence related to derogation? Evidence from Adult Attachment Interviews in a prison setting’. Development and Psychopathology, submitted for publication.