Psychoanalysis at Work in the Community
Easing the Pain of the Most Vulnerable
Vincent Panetta, Ph.D., decided early in his career that if his patients would not come to him, he would
go to them.
Now Director of Outreach Services for South Shore Mental Health in Plymouth, Massachusetts, he
reports that he and his staff have stopped that “revolving door that is so typical of mental health
services,” working with a very challenging population of children, adolescents, and families, mostly in
their homes and other community settings. “Eventually, you want your patients to come to the office, of
course,” Dr. Panetta says, “but I immediately observed when I first worked as a psychotherapist in an
outpatient clinic in Boston how much need there was for home visits.”
Dr. Panetta developed an outreach program at a counseling service south of Boston. It was so
successful that when he moved the whole staff to South Shore Mental Health in 1999, all of the
patients followed. They now see around 300 people a week, including referrals from the state
Department of Mental Health, the Department of Children and Families, and the Department of
Developmental Services. Their patients include many children from foster homes, developmentally
disabled adults, and patients from group homes and workshops.
Dr. Panetta and several of his clinicians have studied at the Boston Graduate School of Psychoanalysis
(BGSP), where he is now on the faculty. He considers his training at the school essential in his work with
difficult cases. “We see young children who have already lived two lifetimes, in terms of abuse, loss,
and emotional damage,” he explains. “Some of our patients are flagrantly psychotic, paranoid, or
bipolar. We have kids who have been in and out of DYS (Department of Youth Services) and suffer from
oppositional defiant disorders and explosive disorder."
“Without my psychoanalytic knowledge, this would be like operating in the dark, knee-deep in the mud,"
he continues." What I got from BGSP provides that guiding light and the tools I need to work with these kids.
Psychoanalysis teaches you that human emotions are very contagious. When you are working with kids
who have a good reason to feel angry, self-destructive, and aggressive; you quickly become infected with
those feelings. My training at BGSP helps me navigate those feelings, to study them until I have enough
information to make an intervention. It’s like a puzzle. I intervene based on what I feel, know, study,
“Without this kind of training, clinicians often get burned out,” he adds. “They get tangled in their own
emotions and the emotions of the patient.”
The proof is in the results, Dr. Panetta points out. “We hold onto our patients," he says. “Before working
with us, some had been to several therapists, were periodically hospitalized, medicated, living in group
homes without jobs. They weren’t making any progress. Today some of our kids have graduated from
college, hold jobs, are living independently, and are off medication. Thanks to my BGSP training and our
outreach program, we have really been able to help our patients.”