Obituary: Dr Robert Hobson

ROBERT HOBSON was a creative and talented psychiatrist and psychotherapist whose work has had an enormous impact on clinical practice, training and research. He had a particular gift for bringing together diverse strands of his personal experience, wide reading, and a challenging professional life. Much of his personal biography was directly reflected in his work, via anecdotes, identifications, and enthusiasms.

He grew up in Rossendale, Lancashire, and was educated at Bacup and Rawtenstall Grammar School, Selwyn College, Cambridge, and Manchester University Medical School. In 1944/46 he served as surgeon lieutenant, RNVR, on the Arctic convoys. During the late 1940s and early 1950s, based in the London area, he gained qualifications and experience in both psychiatry and psychotherapy. Among formative influences he was proud to name Wordsworth, Coleridge, Jung, Rogers, Popper, Harry Stack Sullivan's interpersonal psychiatry, Aubrey Lewis's rigorously scientific psychiatry, his fellow-stammerer Nye Bevan, and the American learning theorists.

Hobson's MD thesis (1951, receiving journal publication in 1953) was on prognostic factors in electroconvulsive therapy (ECT). In later years, colleagues who knew him as a psychotherapist were amazed to learn that this seminal ECT study was by the same Hobson. He was widely trained in administrative and community therapy, child and adolescent psychiatry, and forensic psychiatry. As a psychotherapist, he qualified with the Jungian Society of Analytical Psychology (SAP) in 1954, and was profoundly influenced by meetings with Carl Jung.

He was equally a psychiatrist and a psychotherapist, resisting on well- argued intellectual grounds (which might today be described as a "whole person approach" or "biopsychosocial theory") the pressure to choose between these roles. He thus relished the historical resonance of being styled, on appointment as a consultant at the Bethlem Royal Hospital in 1954, as Physician.

At the Bethlem, he directed for some 20 years an in-patient unit, run on therapeutic community lines, for the treatment of patients with long- standing personality disorders, whilst also supervising and teaching widely as well as carrying his own caseload. Whilst an energetic contributor to the therapeutic community movement, he was keenly aware of the hazards of self-servingly charismatic leadership and of overstated rejection of other psychiatric approaches, aptly captured in the title of an article on the "therapeutic community disease". This paper, together with another written with his longstanding collaborator Russell Meares on the "persecutory therapist", illustrates Hobson's distinctive clinical wisdom.

A succession of psychiatric registrars who later became leaders in psychiatry in the UK, received first-rate training and supervision on the Bethlem unit, alongside nurses, occupational therapists and others. In the Sixties, Hobson pioneered the use of audio (and later video) recordings in clinical supervision, arguing that therapists' recollections of their own work are a poor guide to the minute particulars of the encounter to which they are party.

In a supervision group, he would stop the tape after a therapist statement and ask each member to predict how the patient would respond. This was scientific method in action, as each exposed their predictions (and accompanying rationales) to the risk of Popperian disconfirmation. His tape-based supervision was a direct precursor of subsequent research on strains and ruptures in the therapeutic alliance.

Hobson's key contribution to psychotherapy was his articulation of the Conversational Model. This views psychotherapy as a special sort of conversation. It is a formulation of fundamental principles, specified procedures and methods of learning, that aims to state unambiguously what is done in psychotherapy and for what reasons. It is designed to be readily teachable to a wide range of professionals and non-professionals. It draws upon fundamental psychological principles such as personal problem-solving, reciprocal engagement, experiencing, attention to cues, use of imaginative imagery, and metaphor. For research trials, the method has been further codified and renamed Psychodynamic- Interpersonal (PI) therapy, but the central ideas are all Hobson's.

From the mid-1970s, Hobson devoted himself to the development of psychotherapy in the North-west, establishing at Gaskell House in Manchester a specialist service that was ahead of its time in its effective blend of leadership, research, training and clinical excellence, with a practical and pragmatic approach to the sharing of psychotherapy skills across many disciplines and beyond the elite confines of north London.

Hobson did not publish prodigiously, setting himself ferociously high standards, and sometimes needing to be convinced that he had something worth saying. His fullest memorial will be his 1985 book Forms of Feeling: the heart of psychotherapy. Every therapist and counsellor can learn from it. It is intensely personal, immediate, wise, theoretically rich, disarmingly direct and free of jargon. It reflects a unique ability to blend personal, literary, scientific, psychodynamic, spiritual and philosophical themes and ideas, together with finely drawn and succinct stories of therapeutic encounters.

It draws freely upon diverse "schools" of psychotherapy, seeking a dynamic synthesis rather than a mere eclectic compromise. The writing is poetic: every word feels chosen for its textured meanings, resonances, and associations, every phrase crafted with intensely applied skill. Unusually for a psychotherapy book, it attracted a positive review by the eminent American cognitive psychologist George A. Miller.

Alongside his direct influence on the psychotherapy research carried out in Britain, which earned him a Lifetime Achievement Award from the UK Chapter of the Society for Psychotherapy Research, Hobson's long-held central ideas and beliefs about how psychotherapy helps people change - through interpersonal learning grounded in a secure, open, responsive, interdependent therapeutic relationship - have proved prescient, as they continue to gain support in the wider research literature. His approach also prefigured the trend toward integration across the different approaches to psychotherapy.

Bob Hobson found time for involvement in numerous professional groups and committees in psychiatry and psychotherapy, as well as giving practical expression to his interest in psychology and religion through work with groups such as the Guild of Pastoral Psychology and Westminster Pastoral Foundation. As well as his work and his reading, Hobson enjoyed his family and friends, the Lakeland fells, and the game and ethos of cricket. In late middle age he took up golf.

David A. Shapiro

Robert Frederick Hobson, psychiatrist and psychotherapist: born Rawtenstall, Lancashire 18 May 1920; Physician, Bethlem Royal Hospital 1954-74; Consultant Psychotherapist, Manchester Royal Infirmary 1974-85; Reader in Psychotherapy, Manchester University 1974-85, Honorary Emeritus Reader 1985-99; married 1946 Marjorie Brett (two sons, one daughter); died Stockport, Cheshire 13 November 1999.