Northfield Hospital

The Northfield Hospital is a psychiatric hospital located near Birmingham and is famous primarily for the work on group psychotherapy that took place there in the years of the Second World War.

Background
Therapeutic communities, as we know them today, developed from two visionary experiments between 1942 and 1948, known as the Northfield experiments ( Harrison, 2000 ). In 1942, Wilfred Bion from the Tavistock Clinic was placed in charge of the military training and rehabilitation wing of Northfield Hospital where he had to rehabilitate and return up to 200 men to the army. He used "group dynamics" to encourage the men to learn a way of coping and adapting to inter-group tensions. Although Bion and his colleague Rickman were successful in rehabilitating many patients, their approach was not appreciated in the prevailing military-oriented system and they were transferred.

The "first Northfield experiment", then, was led by Bion and was unsuccessful, in the sense that it had to close after 6 weeks. The ideas were, however, taken up and developed by others such as S. H. Foulkes, Rickman, Bridger, Main and Patrick De Mare. Army psychiatric services were faced with hundreds of psychologically traumatised soldiers and the expectation that they were to help as many as possible recover to a state where they could return to the front line. The psychiatrists at Northfield Hospital in Birmingham decided to focus on the unit as a whole rather than on individual problems; they structured the wards as communities, encouraging mutual support and cooperation in living (in some ways similar to life in the army), with non-directive group discussions to examine and understand the process. They saw the whole community as both the patient and the instrument of treatment, and the aim was the education and training of the community in the problems of neurotic defences and interpersonal relationships.

Foulkes went to Northfield in 1943 where he joined Harold Bridger, Joshua Bierer and Tom Main. They too made use of group psychotherapy but took care to integrate their approach into the overall treatment philosophy and hence were able to stay on, with much success. The "second Northfield experiment", led primarily by S. H. Foulkes, was therefore more successful and was based around the use of small psychotherapy groups on the hospital wards.