Pub Date : 2022-05-04DOI: 10.1080/0075417X.2022.2084560
Rachel Acheson
of Adolescent boys have the highest rates of disengagement and drop out from mental health services. Further, research suggests that when boys do enagage with services, they may value therapies that provide practical strategies rather than those that advocate the exploration of thoughts, feelings, and relationships. Research is therefore needed to gain a better understanding of teenage boys’ experiences of participating in such therapies. This qualitative study aimed to explore the therapeutic experiences of five male adolescents (aged 16 to 18 years) with moderate to severe depression, who engaged in Short-Term Psychoanalytic Psychotherapy (STPP) as part of a randomised controlled trial. Interpretative Phenomenological Analysis of semi-structured interviews was used for an in-depth and idiographic exploration of their experiences. Three themes were identified: ‘Pain in therapy for a worthwhile purpose’, ‘A relationship unlike others: creating a space for reflection’, and “Ending with ‘a little bit of relief and a little bit of hope’”. The findings offer insight into factors that made it possible for these adolescents to engage in and benefit from STPP – a positive therapeutic relationship and gaining self-understanding – and, aspects that hindered their engagement and led to premature endings. This knowledge could inform clinical practice with depressed adolescent boys. Background: Brief psychosocial intervention (BPI) is a treatment for adolescent depression that has recently demonstrated clinical effectiveness in a controlled trial. The aim of this study is to explore experiences of adolescents with major depression receiving BPI treatment in the context of good treatment outcomes. Method: A subsample of five interviews from a larger study of adolescents’ experiences of BPI was purposively selected, focusing on good-outcome cases. Interviews were analysed using interpretative phenomenological analysis to provide a richer understanding of participants’ experiences of overcoming depression in the BPI group. Results: Four central themes were identified: ‘Being heard and feeling safe’, ‘Collaborative working enhancing therapy’, ‘Gaining a different perspective on one’s self and relationships’ and ‘A positive therapeutic relationship’. Conclusion: BPI is a novel approach with promising clinical effectiveness. Utilising adolescents’ experiences has revealed potential psychological mechanisms of good treatment response to BPI. Overall implications for clinical practice with depressed adolescents are discussed. medication-use. Methods: The qualitative study reports data from semi-structured interviews conducted 12-months post-treatment with 12 adolescents who were clinically referred and treated for depression as part of the IMPACT trial. The interviews were analysed using Thematic Analysis. Results: Four themes were identified: ‘a perceived threat to autonomy’, ‘a sign of severity’, ‘a support, not a solution’, and ‘an ongoing process of trial and er
{"title":"Research digest: expectations and experiences of therapy","authors":"Rachel Acheson","doi":"10.1080/0075417X.2022.2084560","DOIUrl":"https://doi.org/10.1080/0075417X.2022.2084560","url":null,"abstract":"of Adolescent boys have the highest rates of disengagement and drop out from mental health services. Further, research suggests that when boys do enagage with services, they may value therapies that provide practical strategies rather than those that advocate the exploration of thoughts, feelings, and relationships. Research is therefore needed to gain a better understanding of teenage boys’ experiences of participating in such therapies. This qualitative study aimed to explore the therapeutic experiences of five male adolescents (aged 16 to 18 years) with moderate to severe depression, who engaged in Short-Term Psychoanalytic Psychotherapy (STPP) as part of a randomised controlled trial. Interpretative Phenomenological Analysis of semi-structured interviews was used for an in-depth and idiographic exploration of their experiences. Three themes were identified: ‘Pain in therapy for a worthwhile purpose’, ‘A relationship unlike others: creating a space for reflection’, and “Ending with ‘a little bit of relief and a little bit of hope’”. The findings offer insight into factors that made it possible for these adolescents to engage in and benefit from STPP – a positive therapeutic relationship and gaining self-understanding – and, aspects that hindered their engagement and led to premature endings. This knowledge could inform clinical practice with depressed adolescent boys. Background: Brief psychosocial intervention (BPI) is a treatment for adolescent depression that has recently demonstrated clinical effectiveness in a controlled trial. The aim of this study is to explore experiences of adolescents with major depression receiving BPI treatment in the context of good treatment outcomes. Method: A subsample of five interviews from a larger study of adolescents’ experiences of BPI was purposively selected, focusing on good-outcome cases. Interviews were analysed using interpretative phenomenological analysis to provide a richer understanding of participants’ experiences of overcoming depression in the BPI group. Results: Four central themes were identified: ‘Being heard and feeling safe’, ‘Collaborative working enhancing therapy’, ‘Gaining a different perspective on one’s self and relationships’ and ‘A positive therapeutic relationship’. Conclusion: BPI is a novel approach with promising clinical effectiveness. Utilising adolescents’ experiences has revealed potential psychological mechanisms of good treatment response to BPI. Overall implications for clinical practice with depressed adolescents are discussed. medication-use. Methods: The qualitative study reports data from semi-structured interviews conducted 12-months post-treatment with 12 adolescents who were clinically referred and treated for depression as part of the IMPACT trial. The interviews were analysed using Thematic Analysis. Results: Four themes were identified: ‘a perceived threat to autonomy’, ‘a sign of severity’, ‘a support, not a solution’, and ‘an ongoing process of trial and er","PeriodicalId":43581,"journal":{"name":"JOURNAL OF CHILD PSYCHOTHERAPY","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2022-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42812538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-04DOI: 10.1080/0075417x.2022.2086601
Alessandra Marsoni
{"title":"A psychotherapeutic understanding of eating disorders in children and young people: Ways to release the imprisoned self","authors":"Alessandra Marsoni","doi":"10.1080/0075417x.2022.2086601","DOIUrl":"https://doi.org/10.1080/0075417x.2022.2086601","url":null,"abstract":"","PeriodicalId":43581,"journal":{"name":"JOURNAL OF CHILD PSYCHOTHERAPY","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2022-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43711207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-04DOI: 10.1080/0075417X.2022.2096664
Yaakov Roitman
ABSTRACT For some time, Bion’s unique version of a theory of representation appears to have been overlooked. A close reading of his ideas, however, provides crucial insight into the existence of a concomitant relationship between recognition and representation. To elucidate this notion, I explore the problem of representation and recognition in autistic states, with the use of two clinical cases of child psychotherapy. In both examples, the child’s struggle to coordinate sensorial information was hampering their ability to create a sensorial engram, which if successfully formed would enable a matrix bearing the unique shape of the object to remain, in times of its absence. The process of object recognition is possible when the external object reappears before this matrix and there is a good enough resemblance between them. In contrast, if the child has difficulty coordinating perceptual information and the object fails to assist in this task, an amorphous engram is established in the psyche, to which any entity in external reality can fit. In this way, every inanimate object can become a substitute for a memorable alive object. As a result, a child cannot recognise their significant other and may remain in an undifferentiated state of merger and non-existence.
{"title":"Bion’s unique contribution to the theory of representation: autistic states, unrepresentability and the problem of recognition","authors":"Yaakov Roitman","doi":"10.1080/0075417X.2022.2096664","DOIUrl":"https://doi.org/10.1080/0075417X.2022.2096664","url":null,"abstract":"ABSTRACT For some time, Bion’s unique version of a theory of representation appears to have been overlooked. A close reading of his ideas, however, provides crucial insight into the existence of a concomitant relationship between recognition and representation. To elucidate this notion, I explore the problem of representation and recognition in autistic states, with the use of two clinical cases of child psychotherapy. In both examples, the child’s struggle to coordinate sensorial information was hampering their ability to create a sensorial engram, which if successfully formed would enable a matrix bearing the unique shape of the object to remain, in times of its absence. The process of object recognition is possible when the external object reappears before this matrix and there is a good enough resemblance between them. In contrast, if the child has difficulty coordinating perceptual information and the object fails to assist in this task, an amorphous engram is established in the psyche, to which any entity in external reality can fit. In this way, every inanimate object can become a substitute for a memorable alive object. As a result, a child cannot recognise their significant other and may remain in an undifferentiated state of merger and non-existence.","PeriodicalId":43581,"journal":{"name":"JOURNAL OF CHILD PSYCHOTHERAPY","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2022-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44732442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-04DOI: 10.1080/0075417X.2022.2092644
Idit Dori
ABSTRACT This paper explores the use of a smartphone within a therapy. It describes its use as a screen object in the service of survival-oriented infantile omnipotence, towards its use as a bridge that facilitated the structuring of internal space and the emergence of nascent capacities for relatedness and introspection. Clinical material from a ten year-long therapy with an adopted girl illustrates the presence of the smartphone on three layers of the therapeutic relationship. First, on a sensory level, the smartphone was used as an almost autistic screening object, but also as an auditory-visual envelope where therapist and patient could be immersed together. Second, on the level of patient-therapist communication and transference relations, the use of the smartphone revived infantile trauma involving the internalisation of a parental gaze that established a distorted internal and external gaze experience, which I termed ‘psychic cross-eyes’. Third, the smartphone served as a ‘third’ object that helped establish our shared observation of reality, and of the patient’s own psyche. By dwelling together, and developing a private language of ‘being-with’ ‘inside’ the phone, while gradually interpreting primitive anxieties and defences in terms of withdrawal from relatedness, we were able to add greater flexibility to the patient’s notion of relatedness, establish her binocular vision, and promote the development of the inner witness function. The paper thus explores the smartphone’s transition from a sterile, screening object, to a communicative, ‘object-seeking’ presence.
{"title":"One smart object – three layers of smartphone use in discovering an encapsulated patient’s inner world*","authors":"Idit Dori","doi":"10.1080/0075417X.2022.2092644","DOIUrl":"https://doi.org/10.1080/0075417X.2022.2092644","url":null,"abstract":"ABSTRACT This paper explores the use of a smartphone within a therapy. It describes its use as a screen object in the service of survival-oriented infantile omnipotence, towards its use as a bridge that facilitated the structuring of internal space and the emergence of nascent capacities for relatedness and introspection. Clinical material from a ten year-long therapy with an adopted girl illustrates the presence of the smartphone on three layers of the therapeutic relationship. First, on a sensory level, the smartphone was used as an almost autistic screening object, but also as an auditory-visual envelope where therapist and patient could be immersed together. Second, on the level of patient-therapist communication and transference relations, the use of the smartphone revived infantile trauma involving the internalisation of a parental gaze that established a distorted internal and external gaze experience, which I termed ‘psychic cross-eyes’. Third, the smartphone served as a ‘third’ object that helped establish our shared observation of reality, and of the patient’s own psyche. By dwelling together, and developing a private language of ‘being-with’ ‘inside’ the phone, while gradually interpreting primitive anxieties and defences in terms of withdrawal from relatedness, we were able to add greater flexibility to the patient’s notion of relatedness, establish her binocular vision, and promote the development of the inner witness function. The paper thus explores the smartphone’s transition from a sterile, screening object, to a communicative, ‘object-seeking’ presence.","PeriodicalId":43581,"journal":{"name":"JOURNAL OF CHILD PSYCHOTHERAPY","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2022-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49219883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-04DOI: 10.1080/0075417X.2022.2092643
Hillel Mirvis
ABSTRACT This paper discusses my work with Sunaya, an adopted adolescent girl who asked to return for a second phase of therapy. This happened several months after her first phase of treatment had abruptly been brought to an end, due to unsolicited organisational changes. Sunaya’s search for identity was severely compromised by her having been abandoned at birth by her biological parents to a foreign orphanage, and subsequently being adopted at five months of age. In this second phase of therapy, I was struck by the extent to which Sunaya was now so suddenly driven to make sense of her origins in open discussion, managing to process and integrate the biological and adopted parts of herself in a way which had not seemed possible in our earlier work. This enabled her to make considered decisions about the next stages of her life post 18. I suggest that the original ending of Sunaya’s therapy, followed by our therapeutic reunion, represented in her mind a reunion with her biological parents; within the therapy Sunaya’s curiosity and ambivalence about such a reunion could be safely worked through. I link Sunaya’s request for ‘something more’ than one phase of treatment with Stern’s ideas about offering ‘something more’ to some of the most deprived patients in therapy. I further suggest that Henry’s ideas about some fostered and adopted children being ‘doubly deprived’ helped me understand Sunaya’s need for a ‘double dose’ of therapy, in order to redress how she had internalised multiple experiences of deprivation. This further helps us understand the need for looked after children to develop stronger attachments in multiple contexts.
{"title":"‘Something more than one phase of treatment’: Sunaya, an adopted adolescent patient who asked to return to therapy","authors":"Hillel Mirvis","doi":"10.1080/0075417X.2022.2092643","DOIUrl":"https://doi.org/10.1080/0075417X.2022.2092643","url":null,"abstract":"ABSTRACT This paper discusses my work with Sunaya, an adopted adolescent girl who asked to return for a second phase of therapy. This happened several months after her first phase of treatment had abruptly been brought to an end, due to unsolicited organisational changes. Sunaya’s search for identity was severely compromised by her having been abandoned at birth by her biological parents to a foreign orphanage, and subsequently being adopted at five months of age. In this second phase of therapy, I was struck by the extent to which Sunaya was now so suddenly driven to make sense of her origins in open discussion, managing to process and integrate the biological and adopted parts of herself in a way which had not seemed possible in our earlier work. This enabled her to make considered decisions about the next stages of her life post 18. I suggest that the original ending of Sunaya’s therapy, followed by our therapeutic reunion, represented in her mind a reunion with her biological parents; within the therapy Sunaya’s curiosity and ambivalence about such a reunion could be safely worked through. I link Sunaya’s request for ‘something more’ than one phase of treatment with Stern’s ideas about offering ‘something more’ to some of the most deprived patients in therapy. I further suggest that Henry’s ideas about some fostered and adopted children being ‘doubly deprived’ helped me understand Sunaya’s need for a ‘double dose’ of therapy, in order to redress how she had internalised multiple experiences of deprivation. This further helps us understand the need for looked after children to develop stronger attachments in multiple contexts.","PeriodicalId":43581,"journal":{"name":"JOURNAL OF CHILD PSYCHOTHERAPY","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2022-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46138637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-04DOI: 10.1080/0075417x.2022.2090020
Maria Papadima
describing the experience at that moment, in the room. This is the work in what Jeanne calls ‘the dark world of not-thinking’ (p. 189), where her existence is not even acknowledged. Gradually there are the first signs that there is a person out there who understands how frightened the patient might feel. Fear begins to be registered; this is an opening, compared to the withdrawal into the shell of not-feeling. During the course of the treatment, Yufang, with Jeanne’s help, gives words to this fear: there is a voice in her head, like ‘a dictator’, ordering her to starve and die. Nine months into the treatment, Yufang is able to talk about the beginning of her illness, how the ‘dictator’ first took hold of her, whereby the cocoon of not living was preferable to facing longstanding inner conflicts and psychic pain. Slowly Yufang lets go of her regression to near death, having acquired, with Jeanne’s help, the internal psychic structure to face life and growth. In the last chapter of the book (chapter eight), Jeanne asks the question with which I started this review: . . . ‘why expose myself to so much lack of love for the self and for me? . . . why have I chosen to work with so much rejection of all that is me?’ (p. 204). In answering this question in the conclusion of the book, Jeanne poignantly refers to her own primitive omnipotence, which keeps infantile feelings at bay. Through her work with these young people, Jeanne achieves a ‘different kind of taming’ (p. 222), not through denial but through an emotional understanding that fosters development and change, in herself and in her patients.
{"title":"A practical psychoanalytic guide to reflexive research: the reverie research method","authors":"Maria Papadima","doi":"10.1080/0075417x.2022.2090020","DOIUrl":"https://doi.org/10.1080/0075417x.2022.2090020","url":null,"abstract":"describing the experience at that moment, in the room. This is the work in what Jeanne calls ‘the dark world of not-thinking’ (p. 189), where her existence is not even acknowledged. Gradually there are the first signs that there is a person out there who understands how frightened the patient might feel. Fear begins to be registered; this is an opening, compared to the withdrawal into the shell of not-feeling. During the course of the treatment, Yufang, with Jeanne’s help, gives words to this fear: there is a voice in her head, like ‘a dictator’, ordering her to starve and die. Nine months into the treatment, Yufang is able to talk about the beginning of her illness, how the ‘dictator’ first took hold of her, whereby the cocoon of not living was preferable to facing longstanding inner conflicts and psychic pain. Slowly Yufang lets go of her regression to near death, having acquired, with Jeanne’s help, the internal psychic structure to face life and growth. In the last chapter of the book (chapter eight), Jeanne asks the question with which I started this review: . . . ‘why expose myself to so much lack of love for the self and for me? . . . why have I chosen to work with so much rejection of all that is me?’ (p. 204). In answering this question in the conclusion of the book, Jeanne poignantly refers to her own primitive omnipotence, which keeps infantile feelings at bay. Through her work with these young people, Jeanne achieves a ‘different kind of taming’ (p. 222), not through denial but through an emotional understanding that fosters development and change, in herself and in her patients.","PeriodicalId":43581,"journal":{"name":"JOURNAL OF CHILD PSYCHOTHERAPY","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2022-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43951762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-04DOI: 10.1080/0075417X.2022.2086283
Ruth S Weinberg
ABSTRACT This article discusses a unique form of withdrawal observed in children with ASD, using a detailed case study. This withdrawal can be understood as linked to a psychotic organisation, in addition to the autistic aspects and early developmental difficulties in the sense of self. A child on the spectrum with psychosis makes for a unique case, because the psychosis rests on an early developmental impairment. In such cases, a fragile self uses disintegration of the mind as a mechanism that enables blurring of the self. This defence mechanism is different from Tustin’s ideas about the autistic sensory blurring of the self through autistic objects and shapes. If this psychotic mechanism becomes fixed, it creates unique anxieties regarding the lack of self-nuclei. The constant projection of large parts of the self into outside figures creates a fear of rapid form transformation and poses unique challenges in analysis. A clinical example is given to illustrate these momentary states.
{"title":"Psychosis in autism","authors":"Ruth S Weinberg","doi":"10.1080/0075417X.2022.2086283","DOIUrl":"https://doi.org/10.1080/0075417X.2022.2086283","url":null,"abstract":"ABSTRACT This article discusses a unique form of withdrawal observed in children with ASD, using a detailed case study. This withdrawal can be understood as linked to a psychotic organisation, in addition to the autistic aspects and early developmental difficulties in the sense of self. A child on the spectrum with psychosis makes for a unique case, because the psychosis rests on an early developmental impairment. In such cases, a fragile self uses disintegration of the mind as a mechanism that enables blurring of the self. This defence mechanism is different from Tustin’s ideas about the autistic sensory blurring of the self through autistic objects and shapes. If this psychotic mechanism becomes fixed, it creates unique anxieties regarding the lack of self-nuclei. The constant projection of large parts of the self into outside figures creates a fear of rapid form transformation and poses unique challenges in analysis. A clinical example is given to illustrate these momentary states.","PeriodicalId":43581,"journal":{"name":"JOURNAL OF CHILD PSYCHOTHERAPY","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2022-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49202791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-02DOI: 10.1080/0075417X.2022.2044371
Alexandra de Rementeria
The papers in this issue represent a range of approaches we, as therapists, adopt when writing about our work within the constraints of publishing ethically in the digital age. As I write this, we at the Journal of Child Psychotherapy are organising a symposium on the contemporary challenges of publishing clinical material, and I want to highlight some of the issues we will explore at the symposium, by commenting on that aspect of each paper, as I introduce them here. In this issue there are a number of papers about work with children with autism. We have the final part of Robin Holloway's triptych, and Sheila Levi's two-part narrative of the intensive treatment of a young boy diagnosed with autism at two years of age. These papers demonstrate how richly repaid we are when we engage closely with the details of clinical phenomena. These papers celebrate child psychotherapists’ deep curiosity and commitment to our cases, and what we learn from our patients. We are not able to publish as many of these sorts of case studies as we did in the past because of the need to seek informed consent, which isn't always appropriate or possible to obtain. However, in these three papers, informed consent was given. In Sheila Levi's paper, the patient was a young man when he read about his treatment all those years before. His mother reported that he appreciated reading it a great deal, but one wonders what, more specifically, he appreciated and what motivated him to allow his story to be shared in print. Holloway's patient was still in treatment at the time consent was sought. The complexities of this situation were touched upon in the first of the three papers, but you sense when reading these papers that the treatment, including the discussions around consent, was a collaborative endeavour. We will find out more when Holloway expands on the vicissitudes of this experience in his presentation at the symposium. What we do know is that this paper is alive with his patient ‘Sam’, who leaps out of the pages through the many drawings he consented to share. However, I think this also has something to do with the way Holloway manages to present his patient as a whole person, rather than a collection of pathological organisations. The way he uses subheadings to signal that he is interrupting ‘Sam's’ story with what he terms ‘theoretical interludes’ is part of this honouring of the patient's experience. Holloway ends his triptych with a review of the various attempts psychoanalytic theory has made to formulate autism and its aetiology. I find it a particularly lively and engaging exposition. The first of Sheila Levi's papers focuses on the use young ‘Tao’ made of intensive psychotherapy to help him relinquish his autistic defences. Her second paper explores her work with the family and network to support them in loosening their investment in his autism diagnosis. Levi’s argument about what it was in the parental couple’s relationship that supported development is likely
{"title":"Editorial","authors":"Alexandra de Rementeria","doi":"10.1080/0075417X.2022.2044371","DOIUrl":"https://doi.org/10.1080/0075417X.2022.2044371","url":null,"abstract":"The papers in this issue represent a range of approaches we, as therapists, adopt when writing about our work within the constraints of publishing ethically in the digital age. As I write this, we at the Journal of Child Psychotherapy are organising a symposium on the contemporary challenges of publishing clinical material, and I want to highlight some of the issues we will explore at the symposium, by commenting on that aspect of each paper, as I introduce them here. In this issue there are a number of papers about work with children with autism. We have the final part of Robin Holloway's triptych, and Sheila Levi's two-part narrative of the intensive treatment of a young boy diagnosed with autism at two years of age. These papers demonstrate how richly repaid we are when we engage closely with the details of clinical phenomena. These papers celebrate child psychotherapists’ deep curiosity and commitment to our cases, and what we learn from our patients. We are not able to publish as many of these sorts of case studies as we did in the past because of the need to seek informed consent, which isn't always appropriate or possible to obtain. However, in these three papers, informed consent was given. In Sheila Levi's paper, the patient was a young man when he read about his treatment all those years before. His mother reported that he appreciated reading it a great deal, but one wonders what, more specifically, he appreciated and what motivated him to allow his story to be shared in print. Holloway's patient was still in treatment at the time consent was sought. The complexities of this situation were touched upon in the first of the three papers, but you sense when reading these papers that the treatment, including the discussions around consent, was a collaborative endeavour. We will find out more when Holloway expands on the vicissitudes of this experience in his presentation at the symposium. What we do know is that this paper is alive with his patient ‘Sam’, who leaps out of the pages through the many drawings he consented to share. However, I think this also has something to do with the way Holloway manages to present his patient as a whole person, rather than a collection of pathological organisations. The way he uses subheadings to signal that he is interrupting ‘Sam's’ story with what he terms ‘theoretical interludes’ is part of this honouring of the patient's experience. Holloway ends his triptych with a review of the various attempts psychoanalytic theory has made to formulate autism and its aetiology. I find it a particularly lively and engaging exposition. The first of Sheila Levi's papers focuses on the use young ‘Tao’ made of intensive psychotherapy to help him relinquish his autistic defences. Her second paper explores her work with the family and network to support them in loosening their investment in his autism diagnosis. Levi’s argument about what it was in the parental couple’s relationship that supported development is likely ","PeriodicalId":43581,"journal":{"name":"JOURNAL OF CHILD PSYCHOTHERAPY","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2022-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48787907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-02DOI: 10.1080/0075417X.2022.2037105
S. Kegerreis
ABSTRACT In this paper, the 1998 film The Truman Show is considered as a parable about parenting, adolescence, and patients’ struggle to break free of defensive structures. The central conceit of the film is that Truman lives in a world entirely created by, and under the control of the show's director, Christof, with all the other characters in his life being actors playing semi-scripted parts. The paper explores how this resonates with the problems faced by all parents when it comes to allowing their children freedom to develop independently and to face the realities of life; the difficulties faced by all adolescents leaving latency behind to encounter themselves more fully; and the therapeutic task with all patients of relinquishing the relative safety created by symptoms and projective mechanisms.
{"title":"Life lessons from The Truman Show: parenting, adolescence and the therapeutic process","authors":"S. Kegerreis","doi":"10.1080/0075417X.2022.2037105","DOIUrl":"https://doi.org/10.1080/0075417X.2022.2037105","url":null,"abstract":"ABSTRACT In this paper, the 1998 film The Truman Show is considered as a parable about parenting, adolescence, and patients’ struggle to break free of defensive structures. The central conceit of the film is that Truman lives in a world entirely created by, and under the control of the show's director, Christof, with all the other characters in his life being actors playing semi-scripted parts. The paper explores how this resonates with the problems faced by all parents when it comes to allowing their children freedom to develop independently and to face the realities of life; the difficulties faced by all adolescents leaving latency behind to encounter themselves more fully; and the therapeutic task with all patients of relinquishing the relative safety created by symptoms and projective mechanisms.","PeriodicalId":43581,"journal":{"name":"JOURNAL OF CHILD PSYCHOTHERAPY","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2022-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43014216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-02DOI: 10.1080/0075417X.2022.2037104
S. Levi
ABSTRACT This paper, the first of two parts, aims to highlight the unique contribution that intensive psychoanalytic psychotherapy can make with complex cases where, in the absence of an engagement with another mind, self and ego development have been severely arrested. Intensive therapy with a boy aged four who was diagnosed with autism at the age of two is examined, to illustrate how the mind is both internally driven and relationally responsive. This work illustrates how the experience of analytic mutuality enables the development of the child's mental capacity for representation and symbolic thought, as well as relationality. Autistic encapsulation is understood as a psycho-physical protective reaction, rather than a psychodynamic defence mechanism. Clinical vignettes demonstrate how the therapist gradually emerges in the child's mind as an object to relate to and be made use of, alleviating arrested development and enabling the child to evolve from an almost mute, ‘undrawn’, confused and confusing child, into a latency boy with social, academic and behavioural skills.
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