My psychiatry training in the 1980s was in Cork and in the UK so I never had the opportunity to work directly for, or with, Ivor Browne in Dublin as part of my education. However, even from a distance, he was an inspiration. I was impressed by the independence of his thought and his courage in always standing up for the underdog. He was one of the few senior psychiatrists in this part of the world who was able to see through, and reject, the great push towards a very reductionist form of psychiatry in the era of DSM III and its successors. While he has always acknowledged the role of biological factors in mental health, he never bought into the Big Pharma-funded quest to make psychiatry a form of ‘applied neuroscience’. And, while not dismissing the use of psychotropic drugs, he stood well back from the simplistic idea that any of these drugs could fix some sort of ‘chemical imbalance’. His appearances in the media were (and continue to be) master classes in how to be outspoken without being strident, challenging without being arrogant. In my opinion, he has been, as Fintan O. Toole says in the introduction to this volume of his papers, one of Ireland's most important public intellectuals in the second half of the 20th century ‘not merely for what he says but for the way he says it’. In recent years, I have been privileged to get to know Ivor Browne and I have learned that not only is he a great intellectual but, more importantly, he is a man with a big heart.

While this is a collection of papers from an emeritus professor of psychiatry, it is far from a dry collection of academic publications. In fact, most of the contents of this volume have not been published before. It is an eclectic mixture of letters to newspapers, lecture notes, and academic and non-academic publications that reflect the wide-ranging nature of Ivor's many interests and passions. From a letter to the Irish Times about ECT, to a commentary on the architectural book Redrawing Dublin, to a speech to agricultural inspectors after the introduction of the Common Agricultural Policy in 1974, these papers reveal a great mind contemplating and responding to the social and psychological issues that have faced Irish society in recent decades. His style is always personal, reflective and engaged. The language used is always accessible and non-technical. He avoids any retreat into jargon or cliché. These papers date from 1959 (a short article from the Lancet on the treatment of withdrawal symptoms in patients with alcohol dependence) to 2011. While we may not agree with everything he writes, and I am sure that there are many statements from some of the older papers that he, himself, would question, in this book we are, in turn, challenged, educated and moved.

While wide in scope, there are a few issues that Ivor returns to again and again. Several chapters explore the nature of psychotherapy and indeed the book ends with a chapter entitled simply ‘Psychotherapy: what is it?’. Ivor has always been concerned to emphasise the role of traumatic events in the genesis of mental problems, even in situations where the individual does not seek help for the usual post-traumatic symptoms. He argues that such events can become ‘unassimilated happenings’ in the psychology of an individual and give rise to problems if they are not fully experienced, both cognitively and emotionally, in a psychotherapeutic context. He writes about the importance of trying to access the traumatic material as soon as possible in therapy, and how he achieved this, often through ‘an altered state of consciousness’. In the past, he has used LSD to help patients achieve this ‘altered state’. One of the early papers included in this volume is from a 1959 edition of the Proceedings of the Royal Society of Medicine. Written with Joshua Bierer, this is a fascinating account of a ‘psychiatric night hospital’, where the patients stayed in by night but went out to work during the day. The authors used LSD in the context of individual and group psychotherapy and reported positively on their experiences. The use of LSD was not an end in itself but a way to help patients gain access to ‘unexperienced experiences’. Later, Ivor started to use a non-drug technique to produce ‘altered states’: ‘holotropic therapy’, which he learned from Stanislav Grof in the 1980s.

In general, he writes that he is wary of the dependency that can emerge in the context of more transference-centred forms of psychotherapy. In his work he aims to avoid, as far as possible, the idea that solutions come from the doctor/therapist. He wants a psychotherapy, and a psychiatry, that is less ‘doctor centred’; one in which the professional person acts as a ‘guide and support to provide a context, where the person feels held in a trusting relationship, that enables them to do the work they have to do’.

In the end, most of the papers in this volume are about relationships of different sorts: therapeutic, familial, communal, spiritual. Ivor Browne has always advocated for a psychiatry that is primarily about relationships: as the cause of the problems we encounter in our patients and as the frequent path along which recovery and growth can occur. This is a message that fits very well with what we now call the ‘recovery approach’. Indeed, this book provides a rich resource for anyone seeking to embrace this.