The practice of medicine does not occur in a vacuum. We work within a culture and a society, and we owe it to the society that our services are of a standard that will ensure their use by patients and one in which carers will have confidence in our abilities to look after their loved ones. Society expects certain standards of care and skills from its clinicians and as in any contract we, in turn, expect things from society. However, as such a contract is not specifically written down but is instead a virtual and an implicit one, some factors become crucial in understanding the relationship between society and the psychiatrist. Here, I propose to highlight some of the components of such a contract and how we renew this in the 21st century.

Since the 1960s, Western society has adopted a more liberal attitude to sexuality. Choice of sexual partners, sexual preferences, attitudes and practices are increasingly a matter of individual choice and freedom. These changes, however, have had little impact on the lives of psychiatric in-patients (Eiguer et al, 1974; Akhtar et al, 1977; Taylor & Swan, 1999). ‘Mental illness,’ it has been suggested, ‘is one of the few disabilities where people run the risk of losing their freedom in order to receive in-patient treatment’ (Cook, 2000). This loss of liberty and rights becomes more pronounced in secure settings where mentally disordered offenders can spend a substantial part of their adult (sexual/reproductive) lives. Prisoners in some US state prisons (of medium and low security) are afforded conjugal visits from their married partners, in view of the rights of the latter. Paradoxically, detention in secure units, which we consider a therapeutic and not a punitive measure, places constraints on the formation of new relationships and the maintenance of previously existing ones. New relationships are, in our experience, viewed with more concern than previously existing ones.

Some believe that Cartesian dualism of mind and body in the 19th century and the rise of psychoanalysis by the turn of the 20th century was what led to the separation of neurology and psychiatry. More recently, conceptualisations of the mind/brain paradigm have helped rediscover the relationship between the mind and the brain, bringing renewed synergy between neurology and psychiatry (Cunningham et al, 2006). However, division is still apparent in current service planning and provision in the UK for individuals whose presentation lies in the no-man's-land between these two historical domains.

In 2000, an article published in this journal described a method of reviewing serious incidents based on peer group discussion, a model then in its sixth year (Rose, 2000). This paper describes how the model has changed in response to the National Health Service (NHS) developments since then.

Bereavement following suicide is traumatic. Guilt, shame, stigma and feelings of rejection and isolation set it apart from the sadness following other kinds of death and may make it difficult for the bereaved person to obtain help (Harwood et al, 2002; Hawton & Simkin, 2003; Beautrais, 2004). the necessary official processes surrounding death by suicide, like the police and coroner's investigations, can add to the trauma (Biddle, 2003). This may be compounded by inaccurate or insensitive media reporting. Bereaved individuals are at risk of increased morbidity from abnormal grief reactions (Mitchell et al, 2005) and suicide (Qin et al, 2002), and they often need considerable support (de Groot et al, 2006; 2007).

The Foundation Programme is a 2-year programme in the UK which forms the bridge between medical school and specialist/general practice training. It provides trainees with a broad range of experiences enabling them to apply for specialty training at an earlier stage. J.K., consultant psychiatrist in old age psychiatry, tells us about the experiences of hosting a Foundation Year 1 (FY1) doctor for the first time and the first incumbent G.T. (FY1) adds his views.

The new Modernising Medical Careers agenda in the UK raises concerns about maintaining the standard of psychotherapy training (Mizen, 2007). In 1993 the Royal College of Psychiatrists made psychotherapy a mandatory rather than recommended work experience and there is now a competency portfolio outlining requirements for trainees. However, startling data have been revealed recently, showing that 91% of senior house officers did not meet the requirements of the Member of the Royal College of Psychiatrists (MRCPsych) exam regarding psychotherapy training and 23% were not even aware of them (Agarwal et al, 2007). the quality and variability of psychotherapy experience in training have been surveyed in several papers (Podlesjka & Stern 2003; Carley & Mitchison 2006; Pretorius & Goldbeck 2006), and some solutions to practical problems with its provision have been proposed, for example, consultation from a consultant psychotherapist, utilising feedback from trainees, and focusing on practicalities and logistics at a local level (Wildgoose et al, 2002; Mitchison 2007). However, little has been said about trainees' own experiences of undertaking supervised practice in psychodynamic psychotherapy. This paper discusses trainees' outlook on psychotherapy training schemes.

Silvio Benaim died on 10 January 2008 at Highgate Nursing Home, London, after a long illness. He was a senior consultant psychiatrist at the Royal Free Hospital since 1968, having been a consultant at Halliwick Hospital from 1959. He retired from the National Health Service (NHS) in 1983 but continued his private practice at the Charter Nightingale Clinic until 2004.

Brian was born in 1922 into a religious family who lived near Liverpool where his father was a jobber at the Liverpool Stock Exchange. He was the youngest of three brothers of whom the eldest, Frank, like Brian, studied medicine with a view to becoming a missionary in India. Brian began his studies in Edinburgh in 1940 and qualified with the ‘Scottish Triple’ in 1945. After house jobs at the Edinburgh Royal Infirmary and a period as Senior R.M.O. at the Royal Liverpool Children's Hospital. He was rejected for military service on medical grounds, so he decided to go to sea; he served with the Cunard White Star Line for the greater part of the 1950s. However, it was his contact with the crew and his involvement in negotiations to settle conflicts between them which most interested him and led to him to develop an interest in psychiatry. In the late 1950s he joined the junior staff at Warlingham Park Hospital in Surrey where he found himself among a stimulating group of trainees, many of whom later became distinguished in the psychiatric world. He obtained the DPM in 1961.