Pub Date : 2022-01-02DOI: 10.1080/02668734.2022.2049064
P. Cundy
In part 2 of this special issue we continue our series of papers from the celebration events for the centenary of the Tavistock Clinic. Exploring the theme of inequalities, the first paper in this issue is entitled ‘Pandemic: challenges in care and recovery’ by Dinesh Sinha. It has long been known that economic disadvantage is linked to higher rates of mortality and poorer access to healthcare (Black, 1982). More recent evidence has suggested that industrialised societies with the greatest income differentials (such as the UK and USA) have the poorest health and social development (Wilkinson & Pickett, 2009). The COVID-19 pandemic, which delayed the Tavistock centenary celebrations, has highlighted once again the inequalities in health within our society. Using the lens of everyday sadism, Sinha identifies corrosive and deliberate counter narratives to the themes of care and courage in this period. He describes how the pre-existing silos of separation between the privileged and dispossessed have prevented survival and wellbeing in the wider society. He cautions health and social care workers about the possible lapse into masochism and bravery as defences against exhaustion and the guilt of having survived when thousands of our colleagues have not. He highlights the need for awareness of our own feelings of guilt and aggression, so that they do not vitiate our capacity to care. Sinha suggests that the process of recovering from the pandemic is not just about the restoration of physical wellbeing but also the creation of healthier conditions in society that actively mitigate the scourge of everyday sadism. The next paper, ‘Under fire in the consulting room’ by Carine Minne, describes her work with patients at the Portman Clinic. The clinic traces its history back to 1933, when the ‘Psychopathic Clinic’ was founded by Edward Glover at the West End Hospital for Nervous Diseases. It was established as the clinical arm of the Institute for the Study and Treatment of Delinquency (ISTD), earlier founded in 1931 as the Institute for the Scientific Treatment of Delinquency. The Institute had been inspired by the work of Dr. Grace Pailthorpe, a psychiatrist and psychoanalyst, who worked in Birmingham and Holloway Prisons. There, she became interested in the personality of women prisoners and in 1932 published Studies in the Psychology of Delinquency. In her article Minne uses clinical vignettes with patients such as a woman who was convicted of infanticide. She illustrates situations when the therapist realised there was a sudden unexpected rise in the ‘temperature’ of a patient’s mind. She likens this to the ignition of a fuse and discusses why this may have Psychoanalytic Psychotherapy, 2022 Vol. 36, No. 1, 1–3, http://dx.doi.org/10.1080/02668734.2022.2049064
在本期特刊的第二部分中，我们将继续我们的系列论文，这些论文来自塔维斯托克诊所百年庆典活动。本期的第一篇论文探讨了不平等的主题，题为“流行病:护理和康复中的挑战”，作者是Dinesh Sinha。人们早就知道，经济劣势与较高的死亡率和较差的医疗保健机会有关(Black, 1982年)。最近的证据表明，收入差距最大的工业化社会(如英国和美国)的健康和社会发展最差(Wilkinson & Pickett, 2009)。2019冠状病毒病大流行推迟了塔维斯托克百年庆典，再次凸显了我们社会中健康方面的不平等。辛哈用日常虐待狂的镜头，识别出这一时期关心和勇气主题的腐蚀性和故意的反叙述。他描述了先前存在的特权阶层和被剥夺者之间的隔离如何阻碍了更广泛社会的生存和福祉。他告诫卫生和社会护理工作者，他们可能会陷入受虐和勇敢，以抵御疲劳和负罪感，因为我们的数千名同事都没有活下来。他强调，我们需要意识到自己的内疚和攻击性，这样它们才不会削弱我们关心他人的能力。辛哈认为，从大流行病中恢复的过程不仅是恢复身体健康，而且是在社会中创造更健康的条件，积极减轻日常虐待狂的祸害。下一篇文章是卡琳·明(Carine Minne)的《咨询室里的战火》(Under fire in The consultation room)，描述了她在波特曼诊所(Portman Clinic)治疗病人的工作。这家诊所的历史可以追溯到1933年，当时爱德华·格洛弗(Edward Glover)在伦敦西区神经疾病医院创立了“精神病诊所”。它是作为犯罪研究和治疗研究所(ISTD)的临床部门而成立的，ISTD成立于1931年，当时是犯罪科学治疗研究所。该研究所的灵感来自于在伯明翰和霍洛威监狱工作过的精神病学家和精神分析学家格蕾丝·佩尔索普博士的工作。在那里，她对女性囚犯的性格产生了兴趣，并于1932年出版了《犯罪心理学研究》。在她的文章中，Minne使用了病人的临床小插曲，比如一个被判杀婴罪的妇女。她举例说明了治疗师意识到病人的思想“温度”突然意外上升的情况。她把这比作导火索的点燃，并讨论了为什么这可能有精神分析心理治疗，2022年第36卷，第1期，1 - 3页，http://dx.doi.org/10.1080/02668734.2022.2049064
{"title":"Editorial","authors":"P. Cundy","doi":"10.1080/02668734.2022.2049064","DOIUrl":"https://doi.org/10.1080/02668734.2022.2049064","url":null,"abstract":"In part 2 of this special issue we continue our series of papers from the celebration events for the centenary of the Tavistock Clinic. Exploring the theme of inequalities, the first paper in this issue is entitled ‘Pandemic: challenges in care and recovery’ by Dinesh Sinha. It has long been known that economic disadvantage is linked to higher rates of mortality and poorer access to healthcare (Black, 1982). More recent evidence has suggested that industrialised societies with the greatest income differentials (such as the UK and USA) have the poorest health and social development (Wilkinson & Pickett, 2009). The COVID-19 pandemic, which delayed the Tavistock centenary celebrations, has highlighted once again the inequalities in health within our society. Using the lens of everyday sadism, Sinha identifies corrosive and deliberate counter narratives to the themes of care and courage in this period. He describes how the pre-existing silos of separation between the privileged and dispossessed have prevented survival and wellbeing in the wider society. He cautions health and social care workers about the possible lapse into masochism and bravery as defences against exhaustion and the guilt of having survived when thousands of our colleagues have not. He highlights the need for awareness of our own feelings of guilt and aggression, so that they do not vitiate our capacity to care. Sinha suggests that the process of recovering from the pandemic is not just about the restoration of physical wellbeing but also the creation of healthier conditions in society that actively mitigate the scourge of everyday sadism. The next paper, ‘Under fire in the consulting room’ by Carine Minne, describes her work with patients at the Portman Clinic. The clinic traces its history back to 1933, when the ‘Psychopathic Clinic’ was founded by Edward Glover at the West End Hospital for Nervous Diseases. It was established as the clinical arm of the Institute for the Study and Treatment of Delinquency (ISTD), earlier founded in 1931 as the Institute for the Scientific Treatment of Delinquency. The Institute had been inspired by the work of Dr. Grace Pailthorpe, a psychiatrist and psychoanalyst, who worked in Birmingham and Holloway Prisons. There, she became interested in the personality of women prisoners and in 1932 published Studies in the Psychology of Delinquency. In her article Minne uses clinical vignettes with patients such as a woman who was convicted of infanticide. She illustrates situations when the therapist realised there was a sudden unexpected rise in the ‘temperature’ of a patient’s mind. She likens this to the ignition of a fuse and discusses why this may have Psychoanalytic Psychotherapy, 2022 Vol. 36, No. 1, 1–3, http://dx.doi.org/10.1080/02668734.2022.2049064","PeriodicalId":54122,"journal":{"name":"Psychoanalytic Psychotherapy","volume":"36 1","pages":"1 - 3"},"PeriodicalIF":0.8,"publicationDate":"2022-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43611147","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 : 2021-12-06DOI: 10.1080/02668734.2021.2005671
C. Minne
A slow match is a very slow-burning fuse presenting only a small glowing tip whereas a quick match is one, which once ignited, burns at top speed. In this paper, I will present a number of clinical vignettes to illustrate situations when the therapist realised there was a sudden unexpected rise in ‘temperature’ of a patient’s mind and why this may have occurred. A fuse was lit but was it a slow or a quick one? I will relate this ignition to the possibility of premature interpretations, or a failure to notice how anxious the patient was in the presence of the terrifying object-therapist and also, patients’ unexpected responses to external interferences during a session. Descriptions of how these situations unfolded during sessions are given, and how, upon reflection, these could have been diffused differently. The emphasis will be on how best to maintain a psychoanalytic stance but also how to clinically judge when a session must be terminated in order to protect patient and therapist from exploding ‘bombs’ inadvertently ignited by patient or therapist. The importance of supervision and consultation with colleagues will be stressed.
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Pub Date : 2021-11-30DOI: 10.1080/02668734.2021.2001685
Julie Folkes-Skinner, Letitia Collins
Dynamic interpersonal therapy (DIT) was developed for individual clients. This pilot project set out to evaluate if DIT could be adapted to group psychotherapy. Three consecutive groups were run in an NHS IAPT service over two years. Twenty-seven clients (10 men and 17 women, median age 34) were offered treatment. Groups were facilitated by accredited DIT therapists. Clients completed the PHQ9 and the GAD7 at assessment and then weekly. Scores were used to evaluate the impact of GDIT on client symptoms. Data collected during routine treatment was later analysed. The delivery of key aspects of the model that included the formulation of the IPAF and the Goodbye Letter were changed. Results suggest that DIT can be adapted to a group setting and that this way of working may have significant benefits for clients. 74% of patients (n = 19) who completed treatment were above Caseness on the PHQ9 (p = < .00001, d = 1.82) and 58% on the GAD7 (p = < .000001, d = 1.63). Only one client (5%) dropped out of treatment. Given the small size of the sample and no control, the reduction in client symptoms cannot be reliably attributed to GDIT. More research is needed.
动态人际治疗(DIT)是针对个人客户开发的。这个试点项目旨在评估DIT是否可以适用于团体心理治疗。连续三组在NHS IAPT服务中运行超过两年。27名患者(10名男性，17名女性，中位年龄34岁)接受治疗。小组由认可的DIT治疗师协助。患者在评估时完成PHQ9和GAD7，然后每周完成。评分用于评估GDIT对患者症状的影响。随后对常规治疗期间收集的数据进行分析。该模式的关键方面，包括IPAF的制定和告别信的交付都发生了变化。结果表明，DIT可以适应于群体环境，这种工作方式可能对客户有显著的好处。完成治疗的患者中，74% (n = 19)的PHQ9评分高于Caseness (p = < 0.00001, d = 1.82)， 58%的GAD7评分高于Caseness (p = < 0.000001, d = 1.63)。只有一名患者(5%)退出治疗。由于样本量小且无对照，病人症状的减轻不能可靠地归因于GDIT。需要更多的研究。
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Pub Date : 2021-11-25DOI: 10.1080/02668734.2021.1978527
C.A. Lemeshko, S. M. Babin, N. Semenova, Y.O. Fedorov, E.A. Kalinina, A.M. Koryoukin, D.V. Sevryougin
The article provides an overview of the current state of psychoanalytic psychotherapy in the NHS of the Russian Federation (RNHS). The authors discuss successful examples of the implementation of psychoanalytic methodology in psychiatry during the Soviet Union and the Russian Federation. Psychodynamically oriented professionals of the RNHS and outside of RNHS are mainly concentrated in large cities. Despite a long tradition and a growing body of evidence for efficacy, the medical community is hostile to psychoanalytic ideas in psychiatry. However, psychoanalytic psychotherapy is in great demand in a society.
{"title":"Psychoanalytic psychotherapy in the Russian Federation","authors":"C.A. Lemeshko, S. M. Babin, N. Semenova, Y.O. Fedorov, E.A. Kalinina, A.M. Koryoukin, D.V. Sevryougin","doi":"10.1080/02668734.2021.1978527","DOIUrl":"https://doi.org/10.1080/02668734.2021.1978527","url":null,"abstract":"The article provides an overview of the current state of psychoanalytic psychotherapy in the NHS of the Russian Federation (RNHS). The authors discuss successful examples of the implementation of psychoanalytic methodology in psychiatry during the Soviet Union and the Russian Federation. Psychodynamically oriented professionals of the RNHS and outside of RNHS are mainly concentrated in large cities. Despite a long tradition and a growing body of evidence for efficacy, the medical community is hostile to psychoanalytic ideas in psychiatry. However, psychoanalytic psychotherapy is in great demand in a society.","PeriodicalId":54122,"journal":{"name":"Psychoanalytic Psychotherapy","volume":"36 1","pages":"331 - 346"},"PeriodicalIF":0.8,"publicationDate":"2021-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42148266","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 : 2021-11-08DOI: 10.1080/02668734.2021.1988683
E. Seidl, D. Schwerthöffer, O. Seidl
Tinnitus aurium is the conscious perception of an acoustic sensation in the absence of a corresponding external stimulus. Besides other psychological factors, psychodynamic factors play an important role in the disease. This study evaluated patients with tinnitus who attended the tinnitus outpatient clinic at the ENT Department of LMU Munich. In addition to a physical examination, in a psychodynamic interview the trigger situations, parents’ parenting style, relation to hearing personality, and individual conflict dynamics associated with the onset and course of tinnitus were examined. We included 99 patients diagnosed with tinnitus. Besides organ-related triggers, we identified conflict-laden stresses as trigger situations. 53% of the patients described themselves as sensitive to noise before the start of the tinnitus. Compared with the general population, patients with tinnitus showed less overt aggressiveness (P < .001) and more social orientation (P < .001) and state and trait anxiety (P < .001). Inhibition of aggression was a major psychodynamic factor in the development of tinnitus. A conflict of autonomy was found in the majority of cases. The results underline the importance of psychodynamic factors in tinnitus. We were able to put the individual psychological factors into a meaningful overall context.
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Pub Date : 2021-10-02DOI: 10.1080/02668734.2021.1992490
Graham Music
This paper outlines ways in which more traditional psychoanalytic technique has been challenged by new findings about trauma and the optimal ways in which it can be worked with. In particular it outlines how therapists need to become much more knowledgeable about the risks of retriggering PTSD symptoms, and about dissociative symptomatology. In addition, in some cases it is suggested that psychoanalytic therapists might become braver in helping victims of trauma to feel anger about what happened to them, and that often for optimal recovery anger and rage needs to precede remorse, reparation and a bearing of depressive anxieties
{"title":"Being safe and being brave: new thoughts on trauma, and adaptations to technique","authors":"Graham Music","doi":"10.1080/02668734.2021.1992490","DOIUrl":"https://doi.org/10.1080/02668734.2021.1992490","url":null,"abstract":"This paper outlines ways in which more traditional psychoanalytic technique has been challenged by new findings about trauma and the optimal ways in which it can be worked with. In particular it outlines how therapists need to become much more knowledgeable about the risks of retriggering PTSD symptoms, and about dissociative symptomatology. In addition, in some cases it is suggested that psychoanalytic therapists might become braver in helping victims of trauma to feel anger about what happened to them, and that often for optimal recovery anger and rage needs to precede remorse, reparation and a bearing of depressive anxieties","PeriodicalId":54122,"journal":{"name":"Psychoanalytic Psychotherapy","volume":"35 1","pages":"318 - 334"},"PeriodicalIF":0.8,"publicationDate":"2021-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43041494","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 : 2021-10-02DOI: 10.1080/02668734.2021.1986741
D. Daws, Alexandra de Rementeria
The authors, both child psychotherapists but from different generations, describe the legacy of Esther Bick in their learning, teaching and clinical practice. In telling two very personal stories about the importance of infant observation in their work, they span 60 years and trace the arc of Bick’s legacy over that period.
{"title":"In the footsteps of Bick: continuing the legacy of infant observation","authors":"D. Daws, Alexandra de Rementeria","doi":"10.1080/02668734.2021.1986741","DOIUrl":"https://doi.org/10.1080/02668734.2021.1986741","url":null,"abstract":"The authors, both child psychotherapists but from different generations, describe the legacy of Esther Bick in their learning, teaching and clinical practice. In telling two very personal stories about the importance of infant observation in their work, they span 60 years and trace the arc of Bick’s legacy over that period.","PeriodicalId":54122,"journal":{"name":"Psychoanalytic Psychotherapy","volume":"35 1","pages":"353 - 367"},"PeriodicalIF":0.8,"publicationDate":"2021-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48928159","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 : 2021-10-02DOI: 10.1080/02668734.2021.1992491
S. Reid, A. Alvarez, Nechama Polak, Myooran Canagaratnam
An event held in December 2020 explored the rich clinical work and innovative thinking around Autism Spectrum Condition at the Tavistock over the past four decades. Consultant Child and Adolescent Psychotherapists Sue Reid and Anne Alvarez describe their early groundbreaking work within the Tavistock Autism Team and Workshop. This work yielded the fascinating clinical observations that there were some children with the condition who made significant gains in therapy, leading to major developments in psychoanalytic techniques for this group. Since then, there has been a continuing influence of psychoanalytical, systemic perspectives on the Tavistock approach to Autism. It is an approach which at the same time is firmly rooted in the research around Autism’s neurodevelopmental basis. Nechama Polak, Clinical Psychologist, provides an account of how the current work of the team has increasingly focused on supporting young adults with the condition, and their parents, whilst Myooran Canagaratnam, Consultant Psychiatrist, describes the Tavistock approach to diagnostic assessment.
{"title":"Tavistock Centenary: the Tavistock Autism service over four decades","authors":"S. Reid, A. Alvarez, Nechama Polak, Myooran Canagaratnam","doi":"10.1080/02668734.2021.1992491","DOIUrl":"https://doi.org/10.1080/02668734.2021.1992491","url":null,"abstract":"An event held in December 2020 explored the rich clinical work and innovative thinking around Autism Spectrum Condition at the Tavistock over the past four decades. Consultant Child and Adolescent Psychotherapists Sue Reid and Anne Alvarez describe their early groundbreaking work within the Tavistock Autism Team and Workshop. This work yielded the fascinating clinical observations that there were some children with the condition who made significant gains in therapy, leading to major developments in psychoanalytic techniques for this group. Since then, there has been a continuing influence of psychoanalytical, systemic perspectives on the Tavistock approach to Autism. It is an approach which at the same time is firmly rooted in the research around Autism’s neurodevelopmental basis. Nechama Polak, Clinical Psychologist, provides an account of how the current work of the team has increasingly focused on supporting young adults with the condition, and their parents, whilst Myooran Canagaratnam, Consultant Psychiatrist, describes the Tavistock approach to diagnostic assessment.","PeriodicalId":54122,"journal":{"name":"Psychoanalytic Psychotherapy","volume":"35 1","pages":"368 - 382"},"PeriodicalIF":0.8,"publicationDate":"2021-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42044671","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 : 2021-10-02DOI: 10.1080/02668734.2021.1990114
Helen Morgan
From time-to-time concern is expressed within the psychoanalytic community that so few individuals from the black and minority ethnic communities want to train with us and join our organisations. I have come to believe that these discussions many will be familiar with are not only futile but a part of the defensive structures that serve to act against the radical change that is needed. I know individuals change. However, apart from some tinkering, our institutions do not. This paper considers the defensive structures of disavowal within ourselves and our organisations as well as the features of psychoanalytic training that produce a disabling complacency. These work against the radical changes that are required if the profession is to become one to which people of colour can feel they belong and that reflects twenty first century multicultural Britain. I offer some suggestions for ways of working against the racist assumptions behind some of our theories and our structures. The underlying conviction of the presentation is that this is a white problem which white people need to address – not only for the benefit of black colleagues but because it also does us all harm.
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Pub Date : 2021-10-02DOI: 10.1080/02668734.2021.1991990
A. Balfour
This paper explores the link between parenting difficulties and couple relationship issues in psychotherapeutic work with parental couples. Initially, the discussion focusses on the social policy context of couple psychotherapy and the resistances it can evoke, which has led to an emphasis on ‘parenting’ rather than ‘couple’ interventions in the historic development of family service provision in the UK. Some developmental challenges facing couples who are parents are then discussed, focussing on a clinical case and drawing on the concepts of shared unconscious phantasy and enactment in the analytic session, to elucidate defensive and developmental possibilities of working at the interface between ‘parenting’ and ‘partnering’.
{"title":"Between partnering and parenting: psychoanalytic approaches to working with parental couples","authors":"A. Balfour","doi":"10.1080/02668734.2021.1991990","DOIUrl":"https://doi.org/10.1080/02668734.2021.1991990","url":null,"abstract":"This paper explores the link between parenting difficulties and couple relationship issues in psychotherapeutic work with parental couples. Initially, the discussion focusses on the social policy context of couple psychotherapy and the resistances it can evoke, which has led to an emphasis on ‘parenting’ rather than ‘couple’ interventions in the historic development of family service provision in the UK. Some developmental challenges facing couples who are parents are then discussed, focussing on a clinical case and drawing on the concepts of shared unconscious phantasy and enactment in the analytic session, to elucidate defensive and developmental possibilities of working at the interface between ‘parenting’ and ‘partnering’.","PeriodicalId":54122,"journal":{"name":"Psychoanalytic Psychotherapy","volume":"35 1","pages":"396 - 411"},"PeriodicalIF":0.8,"publicationDate":"2021-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46703449","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}
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