He studied social sciences as well as medicine as an undergraduate, being particularly interested in critical theories of psychiatry. After working as a GP, he trained as psychiatrist, then as an NHS medical psychotherapist and group analyst – becoming a consultant in Berkshire in 1994, where he has been based since.

He received a mid-career award from the Health Foundation in 2002, and became Clinical Advisor to the English Personality Disorder Development Programme until it closed in 2011. At the Royal College of Psychiatrists, he was the founder of ‘Community of Communities’ quality network in 2002 and the ‘Enabling Environments’ award in 2008. He was a member of the 2009 NICE guideline development group for Borderline Personality Disorder, and is involved with several not-for-profit organisations in the field.

His particular clinical interests are modified therapeutic communities, ecotherapy, critical psychiatry, and co-creation with service users. The social enterprise he chairs, ‘Growing Better Lives’ won the 2014 sustainability award from the Royal College of Psychiatrists. He was appointed as Honorary Professor of Therapeutic Environments and Relational Health at Nottingham University’s School of Sociology and Social Policy in 2015.