British Journal of Psychotherapy最新文献

This paper examines epistemological plurality in contemporary relational psychoanalysis. I draw on clinical material with my own clients who have experienced environmental trauma in early life, such as experiences of incest, battery, abuse and molestation. In this paper, I put forward arguments for the positivist thinking within the development of psychoanalysis, as well as drawing on neuroepistemology, postmodernism and hermeneutic philosophy to consider the ways in which epistemological plurality may provide a more holistic way of conceptualising clients concerns. In this paper, I highlight the role that language, and the analysis of language, plays in meaning making within psychotherapy.

This paper takes issue with the way in which female sexuality and sexual repression has been limited by phallocentric position which has largely ignored the very real connection between sex and physical suffering, injury and death in childbirth which might have given women good cause to fear sex. It links the time at which Freud became interested in the subject, and various aspects occurring in the world around him in terms of history. The article suggests looking at hysteria as a phenomenon arising at a point where there is an extreme amalgamation of the life and death drives, and as a discourse that escalates at certain periods of history, when this fusion reaches, for whatever reason, a particularly high concentration. Vienna was such a point during the 19th and early 20th centuries, where the birth of psychoanalysis took place against the backdrop of a steep ‘inexplicable’ increase in female mortality in childbirth and neighboured with stunning discoveries in the field of quantum mechanics and revolution in art.

This study examined the relationships between adverse childhood experiences (ACEs) and personality organization with suicidal thoughts through the mediating role of psychache using structural equation modeling (SEM). A total of 200 adult outpatients with mental disorders were included in the descriptive cross-sectional study using the purposive sampling method based on self-referral. The data were collected using the Beck Scale for Suicidal Ideation (BSSI), Adverse Childhood Experience International Questionnaire (ACE-IQ), Inventory of Personality Organization (IPO) and Orbach and Mikulincer Mental Pain Scale (OMMP). The results indicated that ACEs, personality organization and psychache explained 72.3% of variations in suicidal thoughts. ACEs, personality organization and psychache have significant positive direct associations with suicidal thoughts. ACEs and personality organization have significantly positive indirect connections to suicidal thoughts through the mediating role of psychache. This study has shown a fitted SEM for the direct and indirect relationships of ACEs and personality organization with suicidal thoughts concerning the mediating role of psychache. These results have implications for the development of psychodynamic interventions and community-based initiatives for individuals dealing with suicidal thoughts.

In this article, I examine the work of the negative, in particular denial, through the case of a sick child and his family, and its transformations. A child's serious illness mobilizes the family group in particular to deny, in a collusive manner, breakdown and death anxieties. I hypothesize that Emile's serious illness shifted the family alliance from a narcissistic contract to a negative pact. However, according to several authors, the negative has a double significance and can be structuring. I will show how therapy and playing with this child encouraged the emergence of greater symbolization and the elaboration of the Oedipus complex, or how to move from a devastating, disorganising negative, a pure product of the death drive, to a structuring negative, where life drives and death drives become entangled. The analyst's investment in the child's psychic life allows the objectalising function to unfold, which, as this therapy shows, involves taking the sexual function into account. Narcissistic issues are also dealt with, in an intricate way.

The increasing prevalence of gender dysphoria or transgender identity in children and adolescents has raised clinical, ethical and psychological concerns, particularly regarding the efficacy and appropriateness of medical interventions. This paper explores the critical role of thorough psychological assessment in addressing gender dysphoria, with a focus on the closure of the Tavistock NHS Gender Identity Service (GIDS) and the findings of the Cass Review. The author draws on her clinical experience to argue for a comprehensive, individualized approach to the treatment of children and young adults with gender identity conflicts. Key issues discussed include the lack of a robust evidence base for early medical treatments, such as puberty blockers and cross-sex hormones, and the ethical implications of medicalising the bodies of children before psychological and physical maturity. The paper argues that many children presenting with gender confusion may be navigating complex psychological conflicts, including issues of identity, sexual orientation, anxiety and trauma, and that rushing into potentially harmful and life-changing medical treatments may remove opportunities for addressing these emotional struggles. The author critiques the affirmative model of treatment, advocating for a more cautious, holistic and empathetic framework that prioritises improved assessment, psychological support and the time required between early adolescent pubertal changes and full sexual, psychological maturation. The paper highlights the implications of the Bell v. Tavistock Judicial Review and questions the issue of informed consent to hormone treatments. The author calls for the restoration of ethical clinical practices aiming to reduce potential harm and improve long-term outcomes.