Tom Main

Tom Main was born on 25 February 1911 in Johannesburg[1]. His father was a mine manager who had emigrated there from Tyneside[2]. In 1914 the three children and their mother returned to Tyneside, while Tom’s father joined the South African army at the outbreak of World War 1[3]. After the war his father, now disabled, also returned to Tyneside[4].

Tom won a scholarship to the Royal Grammar School, Newcastle-upon-Tyne, where he was taught by Michael Roberts, a recognized poet of the time[5]. At the age of 16 he won a scholarship to the Medical College of the University of Durham, where he met his future wife, Agnes Mary (Molly) McHaffie[6]. They married on 27 February 1937[7]. Tom graduated with Honours in 1932, obtaining his M.D. in 1934[8].

After graduating he specialised in psychiatry. Training as a psychoanalyst under Michael Balint, he was supervised by Anna Freud, Melanie Klein and Paula Heimann. After a period at Rainhill he obtained a consultant post at Gateshead Mental Hospital in Northumberland[9].

In 1939 at the outbreak of World War 2 Tom was called up, but then discharged as belonging to a reserved occupation[10]. But Tom was determined to be in touch with colleagues in the psychoanalytical world who were contributing to the war effort, so with the help and influence of JR Rees he had himself called up again[11] and found himself working on recruitment procedures with Ronald Hargreaves in Leeds[12].

This provided him with exposure to some of the brightest minds of the Tavistock Clinic, but also senior members of the military. It was in this niche that Tom Main was found to have the great gift of being able to explain psychology with great clarity in everyday language[13]. Because of this he became an important member of the Officer Selection Boards, which were formed to develop more efficient ways of selecting officers[14]. He also became an acknowledged expert on leadership and morale[15].

Following this he was posted to join Montgomery’s 8th Army in North Africa, but quarrelled with him[16]. After this falling-out with Monty, he was asked to study the morale of paratroopers and insisted on getting parachutist’s ‘wings’ himself[17], as he felt that in order to understand the anxieties of the men, he should share their experience[18]. He made several jumps with them and visited the front line in France, which he described as terrifying[19].

Then on 26 January 1944 JR Rees selected Tom Main to become psychiatric adviser to the 21st Army Group, planning for psychiatric services for the Normandy invasion[20]. The Normandy operation was put under the command of General Montgomery. Tom Main only met Monty once. A few weeks before D-Day he was summoned. He stood there at attention wondering what it was about, Montgomery simply looked at him and said, ‘You can go now. I just wanted to know what a psychiatrist looks like’[21]. Main never made it into Monty’s inner circle[22], was unable to exert a large influence and gradually faded from the picture, marginalised by the quiet competence of Donald Watterson who took over as psychiatrist to the 21 Army Group on 17 October 1944[23].

Tom Main returned to England to work at an Army psychiatric hospital in Birmingham, where he took over the Northfield experiment, which had originally been started by John Rickman and Wilfred Bion[24] as a response to the need for mass treatment of neurotic disorders among army personnel[25]. Bion’s approach had been to allow indiscipline to grow until it got so bad that a collective neurosis would be displayed and where the men would be driven by their own self-respect to organise ways of controlling it[26].

The original experiment only lasted six weeks, but was later re-initiated by JR Rees with Harold Bridger and Michael Foulkes (Siegfried Heinrich Fuchs, a German analyst who had migrated to England before the war and changed his name) in charge[27]. When Tom Main arrived to take command in early 1945 he inherited a situation where there was ‘much indiscipline’, the military hierarchy was very unhappy, and non-psychiatric staff at the hospital felt excluded[28].

Tom Main considered the aim of the hospital was to be ‘the resocialisation of the neurotic individual for life in ordinary society’[29] and rather than closing down the experiment, as the military might have liked, he chose to expand it to create a ‘therapeutic community’[30] in which a ‘total culture of enquiry’ involved everyone at the hospital[31]. Subsequently the Northfield experiments have gone down in psychoanalytic history as an important landmark in the evolution of theory and practice in group psychotherapy and in the therapeutic community movement. Tom Main contributed to the success of the second experiment through the greater attention paid to the wider community, by involving a larger staff group involved, and running it at a slower pace[32].

By the end of 1945 most of the analysts were keen to get back to civilian life. Tom Main briefly joined the ‘Tavistock Group’[33], then worked with the Civil Resettlement Units, before becoming Medical Director of the Cassel Hospital for Functional Nervous Disorders in 1946, where he worked at the Cassell for the next 30 years[34].

He became best known throughout the world as the creator of the therapeutic community at the Cassel Hospital[35], where he created a hospital setting for inpatient psychoanalytic psychotherapy where the total environment and all aspects of the running of the hospital were scrutinised for psychodynamic significance[36]. He also maintained a close relationship between the Tavistock Clinic and the Cassell.

Tom Main was also a keen teacher of psychiatrists and general practitioners through Balint seminars[37], and following an idea set out by Michael Balint in a 1958 article, established the Institute of Psychosexual Medicine[38]. He also served as vice-president of the Royal College of Psychiatrists, and was a co-editor of the British Journal of Medical Psychology. Tom Main was also a keen writer of papers, of which ‘The Ailment’ is considered to be a classic[39].

When Tom knew he was terminally ill, he phoned his friends to say good-bye to them[40]. He died in Barnes, London on 29 May 1990, aged 79.

Author: Glenn Gossling 2019

Bibliography

The Ailment and other Psycho-Analytical Essays, Free Association Books, 1979


[1] TT Hayley, ‘Thomas Forrest Main (1911–1990)’, p719-722, International Journal of Psychoanalysis, 72, 1991

[2] TT Hayley, ‘Thomas Forrest Main (1911–1990)’, p719-722, International Journal of Psychoanalysis, 72, 1991

[3] TT Hayley, ‘Thomas Forrest Main (1911–1990)’, p719-722, International Journal of Psychoanalysis, 72, 1991

[4] TT Hayley, ‘Thomas Forrest Main (1911–1990)’, p719-722, International Journal of Psychoanalysis, 72, 1991

[5] TT Hayley, ‘Thomas Forrest Main (1911–1990)’, p719-722, International Journal of Psychoanalysis, 72, 1991

[6] TT Hayley, ‘Thomas Forrest Main (1911–1990)’, p719-722, International Journal of Psychoanalysis, 72, 1991

[7] TT Hayley, ‘Thomas Forrest Main (1911–1990)’, p719-722, International Journal of Psychoanalysis, 72, 1991

[8] TT Hayley, ‘Thomas Forrest Main (1911–1990)’, p719-722, International Journal of Psychoanalysis, 72, 1991

[9] TT Hayley, ‘Thomas Forrest Main (1911–1990)’, p719-722, International Journal of Psychoanalysis, 72, 1991

[10] TT Hayley, ‘Thomas Forrest Main (1911–1990)’, p719-722, International Journal of Psychoanalysis, 72, 1991

[11] TT Hayley, ‘Thomas Forrest Main (1911–1990)’, p719-722, International Journal of Psychoanalysis, 72, 1991

[12] B Shephard, War of Nerves, p247, Jonathan Cape, 2000

[13] B Shephard, War of Nerves, p247, Jonathan Cape, 2000

[14] TT Hayley, ‘Thomas Forrest Main (1911–1990)’, p719-722, International Journal of Psychoanalysis, 72, 1991

[15] B Shephard, War of Nerves, p247, Jonathan Cape, 2000

[16] ‘Obituary’, British Medical Journal, Volume 300, 30 June 1990

[17] HV Dicks, 50 Years of the Tavistock Clinic, p108, Routledge, 1970

[18] TT Hayley, ‘Thomas Forrest Main (1911–1990)’, p719-722, International Journal of Psychoanalysis, 72, 1991

[19] TT Hayley, ‘Thomas Forrest Main (1911–1990)’, p719-722, International Journal of Psychoanalysis, 72, 1991

[20] TT Hayley, ‘Thomas Forrest Main (1911–1990)’, p719-722, International Journal of Psychoanalysis, 72, 1991

[21] B Shephard, War of Nerves, p248, Jonathan Cape, 2000

[22] B Shephard, War of Nerves, p248, Jonathan Cape, 2000

[23] B Shephard, War of Nerves, p255, Jonathan Cape, 2000

[24] B Shephard, War of Nerves, p255, Jonathan Cape, 2000

[25] T Harrison and D Clarke, ‘The Northfield Experiments’, p698, British Journal of Psychiatry, 160. 1992

[26] B Shephard, War of Nerves, p259, Jonathan Cape, 2000

[27] B Shephard, War of Nerves, p262, Jonathan Cape, 2000

[28] B Shephard, War of Nerves, p267, Jonathan Cape, 2000

[29] TF Main, T. F. ‘The hospital as a therapeutic institution’. p66-70, Bulletin of the Menninger Clinic, 10, 1946

[30] ‘Obituary’, British Medical Journal, Volume 300, 30 June 1990

[31] B Shephard, War of Nerves, p267, Jonathan Cape, 2000

[32] T Harrison and D Clarke, ‘The Northfield Experiments’, p698, British Journal of Psychiatry, 160. 1992

[33] HV Dicks, 50 Years of the Tavistock Clinic, p139, Routledge, 1970

[34] TT Hayley, ‘Thomas Forrest Main (1911–1990)’, p719-722, International Journal of Psychoanalysis, 72, 1991

[35] TT Hayley, ‘Thomas Forrest Main (1911–1990)’, p719-722, International Journal of Psychoanalysis, 72, 1991

[36] ‘Obituary’, British Medical Journal, Volume 300, 30 June 1990

[37] ‘Obituary’, British Medical Journal, Volume 300, 30 June 1990

[38] TT Hayley, ‘Thomas Forrest Main (1911–1990)’, p719-722, International Journal of Psychoanalysis, 72, 1991

[39] ‘Obituary’, British Medical Journal, Volume 300, 30 June 1990

[40] TT Hayley, ‘Thomas Forrest Main (1911–1990)’, p719-722, International Journal of Psychoanalysis, 72, 1991