British Journal of Psychotherapy最新文献

Domestic violence is a prevalent public health concern, affecting millions worldwide. The presence of domestic violence affecting women and couples experiencing homelessness both continue to be underreported areas of clinical work and commissioning within the sector. This paper explores the difficulties of trying to house and contain unhoused couples with reference to the psychoanalytic ideas of attachment and the claustro-agoraphobic dilemma. The paper argues that more wrap-around support, such as temporary alternative housing options, are required to manage instances of domestic abuse and instances of attachment anxiety. Flexible options are also required to account for the likelihood that a couple may return to the streets when perpetrators are evicted based upon the implementation of blanket policies. The paper also attempts to offer some nuance into the complexities of relational dynamics, which are amplified by two unhoused minds coming into intimate contact with one another in front of a professional audience. The paper concludes with drawing attention to the lack of therapeutic support and lack of appetite to commission this to enable couples to explore the roles each partner can play when enmeshed in destructive forms of relating.

Developing psychotherapeutic competencies is an essential part of psychiatric training. All Core Trainees at Leeds and York Partnership NHS Foundation Trust (LYPFT) saw a patient for psychodynamic psychotherapy until 2020. Due to the pandemic, all face-to-face appointments at the LYPFT Medical Psychotherapy Service were paused from March 2020. Patients could choose whether to continue therapy remotely or defer therapy. Supervision was also moved to a remote format. Face-to-face therapy sessions resumed from August 2020, with new infection control procedures. This project aimed to establish doctors’ experience of training in delivering psychodynamic psychotherapy at LYPFT during the pandemic. A two-step methodology was used: an online survey including qualitative and quantitative analysis of the impact of the pandemic; and semi-structured interviews with thematic analysis. The online survey had a response rate of 68%. Four patients deferred therapy; the mean deferral length was two months. Ten respondents had sessions cancelled due to infection/self-isolation. Thirteen respondents (commencing therapy pre-pandemic) delivered therapy face-to-face (without personal protective equipment [PPE]). During the pandemic five respondents delivered therapy via phone, six face-to-face with PPE. Thirteen were concerned about attaining psychotherapy competencies. Thematic analysis of the interviews identified three main themes (with subthemes). Challenges of delivering therapy during the pandemic were identified, as well as areas of good practice and opportunities.

This paper explores how the process of learning to harness one's creativity in analytic listening can be analogous to the process of learning to do so in painting. It draws on clinical work with one client divided into two vignettes. The first describes the author's attempts to listen analytically by paying attention to form and content; narrative structure and use of language; and by paying attention to transference and countertransference communications. The second vignette explores what happened between therapist and client as the author had grown sufficiently confident to respond more intuitively to her client's communications. It describes how the process of becoming sufficiently familiar with theory was, paradoxically, what enabled her to respond to unconscious communications more loosely and creatively in the analytic encounter. It then explores what happened when she communicated this back to the client. The paper also describes how, as a result of the training and personal therapy, a parallel process of learning to let go and play was unfolding in the author's experience of painting. It concludes that learning to harness creativity in the therapeutic encounter can have an unexpected and welcome impact on the therapist's own artistic endeavours.