British Journal of Psychotherapy最新文献

This qualitative study explores the subjectivity of UK-based psychoanalytically oriented psychotherapists regarding money matters and their impact on the analytic process. Reflexive thematic analysis was used to analyse data from interviews of 19 psychotherapists, generating three overarching themes; the first, ‘the concrete-symbolic continuum’ includes themes titled ‘money-matters located in the external-setting’ and ‘money-matters located in the external and internal settings’. The second, ‘feelings associated with money’ includes themes titled ‘shame’, ‘greed’, ‘envy’ and ‘guilt’. The third, ‘cultural differences and money’ includes themes titled ‘culture, monetary needs and desires’ and ‘culture and money discussions’. Applying the theory of mentalisation to discuss the findings, it is suggested that money matters are often experienced in the ‘psychic-equivalence’ mode, whereby internal states are perceived as concrete reality. Rather than flexibly oscillating between the concrete and the symbolic, money matters become fixed at the concrete end of the continuum. Consequently, difficult feelings about money matters cannot be reflected upon, leading to defensive monetary arrangements that do not serve the analytic process. The study concludes that money remains a taboo subject in the British psychoanalytic community, hindering the analytic process. The study suggests reflective spaces on money matters are incorporated into psychoanalytic trainings and institutions.

Following a piece of qualitative research into the effects of being observed in infant observation, some conclusions are drawn about why it might be a valuable experience and what psychoanalytic theories could be relevant. A condensed narrative of the research chronology and methodology, which involved the use and integration of Interpretative Phenomenological Analysis (IPA), with some aspects of Conversation Analysis (CA), is presented. The two main themes which were extrapolated — being judged and put at ease, and lovely and calm space — are examined. There follows a discussion of why it might be expected there would be effects of being observed in this way. Some relevant psychoanalytic theories — holding and containment, projective identification and narcissism — are explored, and how they might underpin the themes and conclusions discussed. There are conclusions and three recommendations about ways of setting up and conducting such observations.

In this piece, we consider the practice of psychoanalysis ‘otherwise’ through the legacies and lessons of free clinics. Here, we challenge the ‘straight line’ of an institutionalised, exclusive historiography, arguing that prohibitive fees have enclosed psychoanalysis within bourgeois quarters – yet, this is not the whole story. Against a backdrop of biomedical dominance, we assert the renewed relevance of psychotherapeutic approaches that work with singularity, and the dynamic unconscious as a guarantor of creativity and liveable future. Our research collective, FREEPSY, investigates free clinics as fundamental experiments of political implication. We identify an ‘infrastructural turn’ in psy-practice, where clinics operate as micro-economies that reinvent rules on value, setting and the social bond. Through radical listening and a creative relationship to the institution, these collectives de-individualise care. We conceptualise this as a ‘mental health commons’, positioning mental health under a biopsychosocial matrix that is not individualising, but is a micropolitical matter of social (re)production. The ‘free’ in free clinic becomes an exclamation—a call to action and a collective interpellation for practising otherwise. We argue for a new relevance of psychoanalysis in catastrophic times by opening space for that which does not fit, and honouring the unconscious.

This paper explores the role of psychodynamic psychotherapy in the treatment of patients with cancer, a therapeutic approach that has faced criticism for various unexamined reasons. Given the limited literature on this subject, we aim to contribute by examining (i) the specificity of the cancer experience, particularly its five main existential dimensions and dialectics, (ii) the psychological challenges patients with cancer encounter from a psychodynamic perspective and (iii) the relationship between these psychological dimensions and the existential dialectics experienced by patients, which we consider central to psychodynamic psychotherapy. Notably, this last aspect has not been addressed in the literature. To illustrate our perspective, we present a case vignette of a patient who underwent 2 years of weekly psychotherapy before ultimately succumbing to the disease. Through this discussion, we aim to demonstrate that psychodynamic psychotherapy is particularly well suited for patients experiencing existential threat who wish to benefit from psychological support. Additionally, we hope to contribute to clinician training and to the destigmatisation of psychodynamic psychotherapy within somatic care settings.

The growing prevalence of children's mental health difficulties has gained increased attention, particularly since the pandemic. This has led to various UK government initiatives and strategies, including improving mental health support in schools, colleges, and community-based services and increasing mental health services available through private practices for children and young people. However, in an era of evidence-based practice, there is an absence of data from these services that contribute to the evidence base to understand what works for whom under specific circumstances, contexts, and therapeutic approaches. Drawing on theoretical and research foundations, this paper discusses the art and science of integrative child psychotherapy as evidence-based clinical practice. While a framework and assessment process which considers problems, processes, and mechanisms related to the internal world of a young person helps identify a treatment plan, integrative child psychotherapists must also recognise and take account of the child's wider world: their socio-cultural environment, family, parent(s) or carer(s), impact of other professionals, and the political context in which they live. Central to integrative child psychotherapy is the underlying premise that therapeutic work with young clients is fundamentally different from that with adults and requires specific training and appropriately experienced and skilled supervision.

In this article, the author explores how the symbolic absence and the failure to internalize a good or transformational object leave a lasting imprint on the psyche and the therapeutic process. Contemporary trauma theory privileges event-based accounts of trauma and can overlook the intrapsychic experience of absence and its symbolic consequences. Two case studies show how early abandonment can foster persecutory anxiety, dissociation and a persistent inability to symbolize experience or relate to others, leaving patients fixed in paranoid, schizoid functioning. In analysis, real or imagined absences evoke narcissistic withdrawal, annihilation fears and attacks on linking. When the therapist contains these enactments through countertransference awareness and survival, absence can be symbolized. Through such lived moments, a transitional space opens in which the patient gradually develops the capacity to be alone, to think and to use the therapist as a usable object within an evolving analytic space.