bluuebunny/crossref_metadata_2025 huggingface dataset:
ADOLESCENT TRANSITION AND THE USE OF HALLUCINOGENS: A SUBCULTURAL ANALYSIS
Authors: MacDonald Shelley , Newrith Chris , Blyth Fiona , Winship Gary
Published: November 2006

ABSTRACT
A brief history of‘rave’ culture is presented. The creation of an ecstatic drug or dance induced euphoria is considered in terms of Freud's (1930) idea that drug intoxication is an inducement of a feeling of ‘oceanic oneness’. It is argued that there is tension in rave culture between pathological narcissism manifest in social withdrawal and the more normalizing process of an adolescent transitional phenomenon in the working through of self/peer identification and de‐identification from parents. A key witness account from a semi‐structured interview with a male rayer is contextualized with other accounts of rave drawing from popular culture. Based on the ideas of Herbert Rosenfeld, the authors propose a distinction between benign narcissism and its destructive counterpart, malignant narcissism. The context of rave as a subculture of narcissism is considered in terms of government leadership during the 1980s and the‘trickle up trickle down’ effect of social stratum reciprocity (Habermas 1989).
ENCOUNTERING SELF‐HARM IN PSYCHOTHERAPY AND COUNSELLING PRACTICE
Authors: Turp Maggie
Published: November 2006

ABSTRACT
This paper offers a perspective on self‐harm as encountered by psychotherapists and counsellors practising in non‐institutional settings. The author notes that the background of epidemiological information, which might inform clinical practice with these clients, is far from satisfactory. Difficulties in establishing an accurate epidemiology of self‐harm are considered. Some common responses to incidents of selfharm are then explored, with particular reference to countertransference issues and the lack of containment (Bion 1962) available to practitioners in some professions.

A brief overview of theoretical perspectives on self‐harm is followed by a more detailed account of the contributions of Welldon (1988), Bion (1962, 1967) and Winnicott (1949, 1962, 1967). The author describes and discusses her work with clients who harm themselves, drawing primarily upon the concepts of‘projective identification’ (Klein 1946),‘containment’ (Bion 1962) and‘psychosomatic indwelling’ (Winnicott 1967).
THE CASH NEXUS: OR HOW THE THERAPEUTIC FEE IS A FORM OF COMMUNICATION
Authors: Valentine Marguerite
Published: November 2006

ABSTRACT
Money is significant in many relationships, including that of psychotherapy. Yet within analytic writing it is often neglected. The early writings of Freud and Ferenczi are somewhat limited in identifying its potential importance, compared perhaps with Winnicott's exploration of its transactional significance within an object relations framework. Perhaps surprisingly, the early philosophical writings of Karl Marx, as he struggled to understand the symbolic importance of money in terms of its power to represent alienation and objectification, indicate a possible way of developing further understanding. The paper illustrates some of these points with two clinical case discussions.
THE THERAPIST AND THE FOOL: AN EXPLORATION OF WHY SOME PATIENTS ATTEND THERAPY IN ORDER TO NOT BE HELPED
Authors: Lamprell Michael
Published: November 2006

ABSTRACT
The writer considers why some patients present an apparent commitment to the work of therapy, through regular and reliable attendance at sessions, whilst seeming to disregard or attack anything of value in the therapy. He finds some answers in Shakespeare's King Lear. The therapist, whilst being abused, like the Fool in Lear, is providing an essential management of a split which enables the patient to feel neither narcissistic pain nor dependency anxiety.
OEDIPUS AND PSYCHE
Authors: Chasseguet‐Smirgel Janine
Published: November 2006

ABSTRACT
Rather than take up the habitual objections to Kleinian and object relations theorists’ conceptions of the Oedipus complex, a discussion is presented of two current ‘models’: the Anti‐Oedipus and the American relational perspective. Considered as Utopias (the Utopia of limitless, unconstrained pleasure and the egalitarian Utopia), these ‘models’, which apparently stand opposed, are shown to be sustained by a common underlying fantasy, that of a psyche without structure or organization. A relationship is established between the birth of the psychic apparatus and the oedipal configuration which can also be found in the classical analytic situation as well as in the biblical myth of Genesis.
THE THERAPIST AS OUTSIDER: THE TRUTH OF THE STRANGER
Authors: Williams Sherly
Published: November 2006

ABSTRACTThis paper considers the surprising fact that, despite all we know of how‘otherness’ causes psychic retreats of various kinds, therapy provides a remarkable instance of‘other‐ness’ being sought out. The patient in distress turns not to a familiar and trusted figure but to an outsider, a stranger. The unique nature of the therapist's perspective from this outsider's vertex is here explored within the context of current analytic debate about objectivity, subjectivity and intersubjectivity, and in the light of analytic tradition as well as historical and cultural antecedents. The aim is to illustrate how the exploration of personal truth is made possible by the therapist's willingness to locate, occupy thoughtfully, and suffer the position of‘outsider’ in relation to the patient.
THE ABSENT FATHER AND HIS RETURN: ECHOES OF WAR
Authors: Mander Gertrud
Published: November 2006

ABSTRACT
The trauma of the past, the echoes of war ‐ how do we become aware of these in our work with individuals who as children suffered the consequences of their parents’ war experiences, and how do we conceptualize the damaging effects of the parents’ emotional wounds inflicted on the second or third generation? Much work has been done with Holocaust victims and the second generation and there are revealing American studies of Vietnam War veterans. But it took 70 years and a work of fiction to remind us of the beginnings of therapeutic treatment for shell shock in World War I. On the basis of extensive clinical material this paper attempts to describe some pathogenic effects exerted by the transmission of war trauma from fathers to children, speculates about the legacy of this century's terrible war and wonders how we are dealing with this in our therapeutic work.
CLINICAL APPLICATION OF THE CONCEPT OF INTERNAL COHABITATION
Authors: Jenkins Martin
Published: November 2006

ABSTRACT
Across the spectrum of diagnostic categories, patients allude in various ways to states of mind and emotion in which their autonomy is taken over to the detriment of their own goals and ambitions. These‘take‐overs’ happen within the therapeutic space or outside in the daily life of the patient, but a characteristic common to all is that they are experienced as outside the patient's control. Indeed it is for the very reason that patients feel their lives to be out of their control that they seek help in the first place. This paper reviews the concepts available to understand such processes and shows the clinical application of the concept of Internal Cohabitation.
SYNERGY OF VERBAL AND NON‐VERBAL THERAPIES IN THE TREATMENT OF MOTHER‐INFANT RELATIONSHIPS
Authors: Coulter Helga , Loughlin Elizabeth
Published: November 2006

ABSTRACT
The patient in the treatment of troubled mother‐infant relationships is understood to be the lived relationship between mother and infant with the infant being an active participant in the relationship. As the infant is communicating in a non‐verbal mode, a treatment medium is used that allows for both the active non‐verbal contribution of the infant and the contribution of the mother, thus enabling both to work as their own therapists. Two different types of treatment modalities were combined: a psychoanalytically informed individual psychotherapy of mother and baby and a non‐verbal approach of mother‐infant dance therapy groups. An introductory overview of dance therapy specific to mother and infant is included as well as one case vignette and one case study. That it was the mother‐infant dyad's physically meaningful experiences in the dance therapy group which acted as a catalyst for change became evident. The verbal treatment modality, on the other hand, was the essential understanding, metabolizing and containing space that sustained and consolidated these changes.
AN EXAMINATION OF THE RELATIONSHIP BETWEEN THE CONCEPTS OF PROJECTIVE IDENTIFICATION AND INTERSUBJECTIVITY
Authors: Weaver Carol
Published: November 2006

ABSTRACT
Projective identification has been described as‘the most fruitful psychoanalytic concept since the discovery of the unconscious’ (Young 1994, p. 120). Many psychoanalysts, including Ogden, have also begun exploring the philosophical concept of intersubjectivity and how it may augment psychoanalytic understanding and practice. Existential psychotherapists include those who believe that intersubjectivity is the basic way in which humans relate. Diamond writes that‘Without a notion of intersubjectivity, psychoanalysis is in difficulty, for it is impossible to envisage how feelings belonging to one individual pass into another’ (Diamond 1998, p. 202).

After exploring the concept of projective identification and the claims from various contemporary psychoanalysts that this mechanism is interpersonal rather than purely intrapsychic, the paper explores the philosophical concept of intersubjectivity. The communication of emotion and the implications for therapy are then discussed, before conclusions are drawn about the relationship between the two concepts under examination.
THE FUTURE OF PSYCHOTHERAPY IN THE UK: DISCUSSING CLINICAL GOVERNANCE
Authors: Owen Ian R.
Published: November 2006

ABSTRACT
‘Clinical governance’ is a term coined to denote a requirement that all forms of clinical care should be governed by an attention to the quality of its delivery to the public. Clinical governance has been set as the future for the NHS by the NHS Executive. This paper draws together some of the themes of current discussions concerning clinical governance and other related issues for psychotherapy. Clinical governance has many facets but it can be defined as a commitment to evidence‐based quality assurance in relation to clear national standards for practice, the delivery of evidence‐based practice and the ongoing monitoring of standards. The paper provides a brief outline of clinical governance and indicates how it might be accomplished within primary and secondary care. A sketch is made concerning the possibility of there being local and national standards for various aspects of psychotherapy provision which is an additional requirement. The term‘psychotherapy’ is used to cover the full range of psychological interventions. Towards the end of the paper a critical overview of the standard paradigm of quantitative research is presented. This critical stance has been provided by two leading quantitative researchers who have called into question the applicability of the drug trial model for testing efficacy and finding the change‐active ingredients of psychotherapy.
ESTABLISHING PSYCHODYNAMIC PSYCHOTHERAPY WITHIN THE NHS: THE SOUTHERN COUNTIES MODEL
Authors: Maloney Chris , Haigh Rex , Knowles Jane , Rees Jean
Published: November 2006

ABSTRACT
Development of psychodynamic psychotherapy services has not been a priority in recent years, and existing services have a responsibility to provide impetus for growth and development of provision across the . Southern Counties Psychotherapy is a federation of psychodynamic psychotherapy services providing a Clinical Training in Psychodynamic Psychotherapy within the NHS, linked to an M.Sc. in Psychodynamic Psychotherapy in Health Service Settings. This is a rigorous analytic training, to the standards of the UKCP PPP Section, specifically addressing realities of practice within the NHS and the relationship to broader mental health services. The core philosophy is that good quality psychodynamic psychotherapies can only be available for populations if good quality psychodynamic psychotherapy training is also readily available.

We offer this description of the course and its background as encouragement for others who may want to set up similar projects, and to invite collaborators.
‘WHATEVER MIGHT SURVIVE, FOR MEMORY, OF THE FRIENDS LITTLE CHILDREN HAD LOST‥:: DEFENCES AGAINST MOURNING IN THE TURN OF THE SCREW
Authors: Brookes Sasha
Published: November 2006

ABSTRACT
This article offers a psychoanalytic reading of Henry James's well‐known ghost story, The Turn of the Screw, an ambiguous and fascinating tale narrated by a young governess put in sole charge of two orphan children. Henry James was an early modernist in the sense that he required his readers to think about his text and interpret it for themselves. In this tale he engages the reader's interest in haunting in the story and in general, and raises the question of where ghosts are to be found: in inner or in outer reality? The ghosts of the tale have intense relationships and interchanges with some of the living characters, and the article suggests that the‘ghosts’ may be understood as the characters’ split‐off and projected experiences of loss. These return to haunt them, in spite of their strenuous efforts to defend themselves against the pain of bereavement and loss of omnipotence. As James says, the presence of the children in the story makes more poignant the return of the uncontained projections in the form of nameless dread.
THE SEDUCTION OF THERAPY
Authors: Weatherill Rob
Published: November 2006

ABSTRACT
This paper claims that the psychotherapeutic situation is haunted by the erotic transference which arises from the artificial setting of the analysis itself, which, with its care, attention and listening, reinvokes the primal seduction (Laplanche) or transformation (Bollas) of the infant by the mother. Freud wanted to distance himself from seduction, coming to prefer instead the productive work of analysis in a state of deprivation. I argue that modern practitioners and trainings (ironically, seductive in themselves!), responding to consumer demand and fearful of litigation, attempt to remove all risk from the‘professional’ setting of the therapy. Here, the great danger is the loss of the radical anarchic otherness of the unconscious, indeed the endless play of seduction itself, which alone animates the heart of the analytic process. Finally, psychosis is equated with the loss of seduction, as is our current cultural fascination with IT ‐ cool seduction (Baudrillard).
A PSYCHODYNAMIC PROFILE OF THERAPISTS WHO SEXUALLY EXPLOIT THEIR CLIENTS
Authors: Hetherington Angela
Published: November 2006

ABSTRACTThis paper reviews recent literature pertaining to therapists who sexually exploit their clients. It examines some of the common characteristics that have been identified in therapists who abuse, and the psychosexual factors in their background. It goes on to discuss the dynamics which may prevail in the event of therapist abuse. Research suggests that therapists who exploit their role will only do so if they are in some way dysfunctional (Russell 1993). Similarly, therapists who abuse are found to have severe problems with their own sexual identities and experience a considerable amount of sexual anxiety and guilt in their personal relationships (Strean 1993b). It is suggested that their own unresolved conflicts take precedence over those of their clients and unconsciously they harbour a deep antipathy towards the practice of psychotherapy (Strean 1993a).
PSYCHOTIC PROCESSES IN SIX CHARACTERS IN SEARCH OF AN AUTHOR BY PIRANDELLO
Authors: Domenico  , Di Ceglie Giovanna Rita
Published: November 2006

ABSTRACT
The play Six Characters in Search of an Author is about madness, its seductiveness, its at times apparent plausibility, its language and its infectiousness. It makes the spectator participate in a psychotic experience. A great deal of disturbance in the audience followed its first performance in 1920 at the Teatro la Valle in Rome. By representing what is ultimately the failure of mental and theatrical representation Pirandello has created a work of art which is a most interesting anticipation and validation of the work on psychotic states of mind of the last few decades. In this paper we explore aspects of the play which are relevant to the work in the consulting room with a group of psychotic or borderline patients whose functioning is evocative of the Six Characters in Search of an Author.
THE STATUTORY REGISTRATION OF PSYCHOTHERAPISTS
Authors: Balfour F.H.G.
Published: November 2006

ABSTRACT
In order to begin the process that might lead eventually to the statutory regulation of psychotherapists, agreement will have to be reached between the mentalhealth disciplines and the psychotherapy institutions on a structure that can contain and govern the profession. To establish whether statutory registration is possible for the profession, talks should be held between the appropriate representatives of the Royal College of Psychiatrists, the British Psychological Society, the Central Council for Education and Training in Social Work, the Royal College of Nursing, the Tavistock Clinic, the Association of Child Psychotherapists, the British Confederation of Psychotherapists, the United Kingdom Council for Psychotherapy and the British Association for Counselling among others. If the nature of the profession is found to be such that a single containing structure cannot be created for it, then the protection of the public will have to be provided, as it is at the moment, by well‐governed voluntary registers.
THE STATUTORY REGULATORY BODY PERSPECTIVE
Authors: Burley Peter
Published: November 2006

ABSTRACT
This paper surveys the legislative context for the statutory regulation of psychotherapy as in summer 1999. It looks at the public policy of regulation. The Parliamentary progress of the Health Bill (Health Act, as of 30 June 1999) is examined and its successful outcome for professions. The experience of State Registration for a profession is explored and benefits elaborated. The options for how the profession might take up the new opportunities are presented and a timescale indicated.

This is an overview of the topic and cannot attempt to do it justice in detail. Areas such as the history of regulated professions, how educational approvals are conducted, devolution, complaints and conduct procedures and many others will have to be dealt with elsewhere.
OCNOPHILIA AND THE INTERPRETATION OF TRANSFERENCE
Authors: Gerrard Jackie
Published: November 2006

ABSTRACT
This paper examines Balint's statements regarding ocnophilia and transference interpretations; namely his proposition that making transference inter pretations the over‐riding focus of psychoanalytic technique encourages an ocnophilic way of being and relating in the patient. The author is not convinced that this is so and presents her argument, which is later illustrated with four clinical vignettes.
OBSESSIONAL THINKING ‐ A DEFENCE AGAINST LOSS
Authors: Cooper Sara
Published: November 2006

ABSTRACT
In this paper I describe my theoretical thinking and clinical work with a patient suffering from obsessional thought disorder and differentiate this from obsessive compulsive disorder, by its absence of ritualized behaviour patterns. I base much of my thinking on Freud, but suggest that the constellation on which this pathology is based consists of a physically and/or emotionally absent father coupled with inadequate mothering. This precludes identification with and emulation of father as the bearer of the ego ideal so that patient attempts to regress to narcissistic blissful union with an idealized mother. If the primary loss, separation from mother, cannot be negotiated successfully then any loss is felt to be intolerable. Thus obsessional thinking is developed as a defence against loss, an attempt within the psyche to create a situation where nothing is given up, symbolized by the alternating opposing thoughts which never get resolved.
NHS PSYCHOTHERAPY ‐ PAST, FUTURE AND PRESENT
Authors: Holmes Jeremy
Published: November 2006

ABSTRACT
The paper considers whether the ideal of a‘national psychotherapy service'is a realistic or desirable possibility. In its origins community psychiatry was inextricably linked with psychoanalysis and group psychotherapy. Today the links between community psychiatry and psychotherapy are much more tenuous, despite the evidence for the effectiveness of many psychological interventions in psychiatric disorders. Future psychotherapies will explore the links between brain and mind, integrate the different psychotherapeutic modalities, consider the wider costs of not providing psychotherapy, and be more client responsive. How will this come about? Authority in the field depends partly on seniority, partly on evidence, partly on popular appeal, and partly on psychotherapeutic narratives which accurately reflect the needs of society and those who suffer from psychological distress.
TRANSFORMATIONAL, CONSERVATIVE AND TERMINAL OBJECTS: THE APPLICATION OF BOLLAS'S CONCEPTS TO PRACTICE
Authors: Mann Gabriela
Published: November 2006

ABSTRACT
This paper focuses on Christopher Bollas's contributions to the understanding of transformations in object usage. Bollas has delineated numerous kinds of object usage but has not described the possible transformations that could occur as a result of psychotherapy. The author examines conservative and terminal objects, on the one hand, and transformational objects, on the other hand, as signifiers for the kinds of transformation that are likely to occur in psychotherapy. Two vignettes informed by Bollas's ideas will illustrate how the therapist can facilitate the patient’ s use of the therapeutic environment that‘transforms’ rather than‘conserves’ or‘terminates’ psychic evolution. The author describes how Bollas draws from diverse theoretical sources, particularly from Freud, Winnicott and Bion. The author also suggests that unrestricted use of different theoretical frameworks is consistent with Bollas's favoring free movement between different modes of interpretation. It is argued that this flexibility of moving between modalities is indeed the chief distinguishing characteristic of Bollas's therapeutic style.
MODES OF THERAPEUTIC RELATIONSHIP IN KLEINIAN PSYCHOTHERAPY
Authors: Nuttall John
Published: November 2006

ABSTRACT‘Klein seems to take us to the limits of what is imaginable about psychic life’(Stonebridge & Phillips 1998, p. 3) and brought new techniques to child psychoanalysis. She probably brought very little new to the technique of adult psychoanalysis. It was left to her followers to develop a distinctly Kleinian approach to psychotherapy, which today emphasizes the emotional immediacy of the patient‐therapist relationship. This paper explores the multi‐faceted nature of the therapeutic relationship in contemporary Kleinian practice by using as a template the five modes of psychotherapeutic relationship Clarkson identified from her researches, and published in this journal in 1990. Following a review of Kleinian metapsychology, the five modes are discussed individually to show in what way each is manifested in the Kleinian approach. The conclusion is that Kleinian psychotherapy contains, as part of its ontology, the five modes of therapeutic relationship elaborated by Clarkson, and as a corollary offers a postmodern perspective on psychoanalytic psychotherapy.
FUTURE CHOICES FOR PSYCHOANALYTIC PSYCHOTHERAPY
Authors: Johns Jennifer
Published: November 2006

ABSTRACT
This paper was given as the second Annual BCP Lecture in November 1999. It addresses the paradoxical position of psychoanalytical psychotherapy at present, pointing out that Freud's ideas are frequently attacked while at the same time being common currency, and the situation in which our ideas are quoted but our referrals drop. The paper questions the extent to which we ourselves are responsible for this and the ways in which our profession itself has become rigidified, clinging to old patterns of behaviour, especially in relation to training, without understanding either the reasons for the outdated patterns or the need to adapt and change them. It is suggested that unconscious disappointment in our work may contribute. Regretting the fact that in this we are an ageing profession, solutions from other countries are discussed. Finally it is suggested that we can, if the profession so wishes, make appropriate changes here.
GROUP‐ANALYTIC PSYCHOTHERAPY WITH THE ELDERLY
Authors: Canete Maria , Stormont Fiona , Ezquerro Arturo
Published: November 2006

ABSTRACT
Orthodox psychoanalysis offered the view that mental processes in the elderly are too rigidly established for favourable treatment results. Group psychotherapy with the elderly in general has received little attention, mostly concentrating on inpatient groups. The main focus has been on supportive techniques, often in institutional settings.

Two of the authors (Maria Canete and Fiona Stormont) co‐conducted a weekly slow‐open analytic group for elderly people, in a London outpatient NHS clinic. This paper presents clinical material that illustrates some age‐specific issues, as they appear in the group process. For example, issues of competitiveness, rivalry and aggression, which are generally present in the beginning of groups with younger people, tend to be absent, or manifest themselves differently, in the elderly group. Denial of age becomes impossible, which helps these patients to accept approaching death and the process of dying itself. Psychoanalytic group psychotherapy can be especially indicated for this age population.
INTEGRATION IN PSYCHOTHERAPY: AN EVOLVING REALITY IN PERSONALITY DISORDER
Authors: Bateman Anthony W
Published: November 2006

ABSTRACT
Psychotherapy continues to be bedevilled by ideological schisms with practitioners apparently ignoring alternative conceptualizations and potentially superior interventions. However, I argue here that there is evidence of a rapprochement, both in theory and in practice, between cognitive therapy and psychoanalytic therapy, especially within the domain of personality disorder, which may lead to the development of integrative psychotherapy. Cognitive therapy has begun to encompass an interpersonal approach within its theoretical base. Similarly, psychoanalytic therapy increasingly uses an interpersonal formulation of the process of therapy. The therapeutic alliance is emphasized equally and process research suggests that interventions, when given by experienced practitioners, are not as dissimilar as‘brand‐named’ therapies imply. Continued refinement of process psychotherapy research could lead to true integration of efficacious therapeutic interventions. But translating research findings into practice will necessitate psychotherapists opening themselves up to each others’ ideas.
REGRESSION, DEPENDENCY AND THE EVOLUTION OF THE SELF
Authors: Valentine Marguerite
Published: November 2006

ABSTRACT
This paper is about the difficulties in working with the regressed or borderline patient. Drawing on clinical material, and recent empirical research on mother–infant interaction, theoretical explanations are considered. It is noted that these theories contain, by implication, guidance for psychotherapeutic practice. For patients functioning at this level of emotional development, techniques of traditional psychoanalysis are eschewed in favour of a ‘relational’ model, which draws on the therapist's capacity to be empathically engaged with the patient's internal and external world. Working in this way, it is argued, regressive periods can be seen as containing a potential for the patient's evolution of self.
USE OF FAREWELL LETTERS IN THE CONTEXT OF BRIEF PSYCHODYNAMIC‐INTERPERSONAL THERAPY WITH IRRITABLE BOWEL SYNDROME PATIENTS
Authors: Howlett Stephanie , Guthrie Else
Published: November 2006

ABSTRACT
Irritable bowel syndrome patients being treated by brief psychodynamic‐interpersonal therapy were given a farewell letter written by the therapist in the final session. The context was a randomized controlled trial to assess the cost‐effectiveness of psychotherapy and antidepressant treatment for painful functional bowel disorders. A year after the end of treatment patients completed a questionnaire to evaluate their perceptions of the usefulness of farewell letters. Five case vignettes illustrate different ways in which patients reacted to the farewell letters during and after treatment. Patients who benefited from therapy found the letter helpful as a means of sharing their experiences with others, continuing the work of therapy and dealing with the ending. The letter seemed to act as an embodiment of the therapist or transitional object, facilitating the continued assimilation of problematic experiences. Where therapeutic outcome was poor there was less evidence of helpfulness. Preliminary impressions suggest that farewell letters may be a helpful tool enhancing the benefits of brief therapy.
HOLDING AND TREATING SEVERE DISTURBANCE IN THE NHS: THE CONTAINMENT OF BORDERLINE PERSONALITY DISORDERS IN A THERAPEUTIC ENVIRONMENT
Authors: White Jean , Berry Denise , Dalton Joy , Napthine Geoff , Prendeville Bill , Roberts Judith
Published: November 2006

ABSTRACT
People who have been assessed as suffering from borderline personality disorder are notoriously difficult to treat or to help either within individual psychoanalysis or psychotherapy or within a hospital or day centre. The treatment milieu is most commonly that of a psychiatric day hospital. The purpose of this paper is to explore some of the therapeutic challenges in working with this client group, and then to look at what has been and is being achieved at Belle Ridley Day Hospital, a psychiatric day hospital run on psychodynamic lines which is based in the Waterlow Unit in North London.
BRIEF PSYCHOANALYTIC PSYCHOTHERAPY: THE IMPACT OF ITS FUNDAMENTALS ON THE THERAPEUTIC PROCESS
Authors: Laor Ilana
Published: November 2006

ABSTRACT
By identifying the three fundamentals of brief psychoanalytic psychotherapy – (1) time limit, (2) therapeutic focus, (3) therapist's activity – this type of therapy is established as a distinct therapeutic modality with distinct ‘active containing’. The way this ‘custom‐tailored structure’ may be adapted to the patient and used to reflect and intensify dynamic aspects of the treatment's focus is demonstrated through clinical material.
THE MYTH OF SELF‐CREATION
Authors: Gerhardt Sue
Published: November 2006

ABSTRACT
This paper situates a case history in the context of an emerging theoretical perspective, influenced by attachment research, that gives increasing weight to early real interactions. It suggests that the developing individual often has little choice in the kind of relational strategies that their early interactions unconsciously set up. The case history explores how this might have been the case for Marian, and asks to what extent such a patient can subsequently choose to modify her way of relating to others, as an act of selfcreation. It suggests that to a large extent this is determined by her current social context and the vicissitudes of a jointly created therapeutic relationship.
THE INNER WORLD AND SYMBOL FORMATION: SOME DEVELOPMENTAL ASPECTS
Authors: Rita Di Ceglie Giovanna
Published: November 2006

ABSTRACT
This lecture is about psychoanalytic hypotheses and theories about a mental function called symbol formation. Disturbances in the development of this function lead to disturbances of the capacity to communicate. Clinical vignettes will show different degrees of impairment of this function and also how its development goes hand in hand with the acquisition of the sense of inner and external reality.
SELF IMAGES AND GOD IMAGES
Authors: MacKenna Christopher
Published: November 2006

ABSTRACT
The paper suggests reasons for thinking that there can be a new dialogue between psychotherapy and Judaeo‐Christian religion. An evolving and reciprocal series of self images and God images is traced through the pages of the Bible. Case material is advanced to illustrate the power of God images to maintain a rigid defensive system, and the way these images can develop in more benign ways – with corresponding change to our self image – as the defensive structure is modified. The paper concludes by suggesting that a God image may be the only safe container for our longing for perfection, so long as our attitude towards it is one of worship rather than identification.
GOD AND THE UNCONSCIOUS
Authors: Bomford Rodney
Published: November 2006

ABSTRACT
This paper summarizes the author's recent book, The Symmetry of God. It proposes that the concepts of God in the Christian tradition and of the Unconscious in Freudian theory have much in common. In particular, the mystics may be seen as explorers of the Unconscious and religious narrative as revelation of the Unconscious into Consciousness. Matte Blanco's theory about the logic of the Unconscious is used to support this. Theology has often turned to philosophy for ‘models’ of God and using the Unconscious as such opens discussion between spiritual and psychological understandings of humanity. While the traditional Christian language is retained, it is given a less objective feel than is customary, and religious truth is sharply distinguished from factual or empirical truth. This may make the language of faith more accessible to those who find literal interpretations incredible.
THERAPY AS MEMORY‐WORK: DILEMMAS OF DISCOVERY, RECOVERY AND CONSTRUCTION
Authors: Burman Erica
Published: November 2006

ABSTRACT
In this paper I have sought to shift the focus on the construction of memory within psychotherapeutic practice in a number of different directions to draw some more general lessons for the process and status of therapeutic accounts. The precipitating context for the current scrutiny of memory‐making within therapy may have limited its scope and fruitfulness. The fact that this issue was largely prompted by debates about the status of (usually) adult women's recovery of memories of early abuse within therapy is a relevant factor that has been compounded by issues of professional credibility and hierarchy. Clearly, at a cultural level, women's memories of childhood abuse function politically as well as personally, as reflected by the social and legal responses to this challenge.

However, guidelines for professional practice cannot legislate for the indeterminacies surrounding the subjectivity of memory, while assumptions underlying the empirical psychological resources drawn upon to inform debates in psychotherapy require critical scrutiny. Clinical and interpretive dilemmas extend beyond the status accorded client memorial reports to therapists’ memory‐making practices as textualized via both supervision and clinical notetaking. Drawing on more recent (including feminist) discussions of memory that identify different political possibilities within third and first person accounts it was suggested that, rather than eschewing the subjectivity of memory, therapists can instead analyse this as a key interpretive and reflexive resource to inform their own practice.
NEW ‘NORMALITIES’, NEW ‘MADNESSES’
Authors: Starace Giovanni
Published: November 2006

ABSTRACT
A few decades ago a great deal of attention was given to the narcissistic syndromes, as well as to the culture of narcissism. Basic difficulties and deficits in the subjects were emphasized, more so than the drive to selfsufficiency. These pathological manifestations are certainly still alive today, but other manifestations tend to characterize this ‘culture of narcissism’ even more. The drive to consumerism, the fast use and obsolescence of things, difficulties of expectation, the over‐estimation of material goods in definition of the self, an inclination to risk‐taking, and a compulsiveness of action are examples of them. Such manifestations find expression in drug addiction, the ‘consumption’ of sex, gambling, compulsive shopping, abuse of alcohol, and pathological behaviour toward food. These expressions of discomfort are apparently distinct, but they are also very ‘close to the culture’ and they express the environment from which they emerge. The article includes clinical material from private praxis, and institutional work with drug addicts.
IS EMPIRICAL RESEARCH COMPATIBLE WITH CLINICAL PRACTICE?
Authors: Clulow Christopher , Shmueli Avi , Vincent Christopher , Evans Christopher
Published: November 2006

ABSTRACT
This paper explores the provocative question in the title through the authors’experiences of working within a couple psychotherapy service. In it we hope to chart how it became possible to undertake empirical research in a clinical setting. Underlying the question we found a number of others. For example, when and how does empirical research threaten or enhance couples’therapies? Is empirical research a toxic introject, an idealized object and/or a real cultural, developmental experience for a clinical service? The process of change described in this paper involved conflict and took time to develop. We hope to demonstrate that what was achieved was done without detriment to the quality of the service offered and was not at the expense of those who used it. Our view is that the careful engagement we describe is most likely to have had a beneficial impact on both.
WORKING IN THE MOTHER‐TONGUE: FIRST LANGUAGE PROVISION AND CULTURAL MATCHING IN INTER‐CULTURAL THERAPY
Authors: Gowrisunkur Jaya , Burman Erica , Walker Kanta
Published: November 2006

ABSTRACT
This paper describes an individual psychotherapy conducted in Urdu by a psychoanalytic psychotherapist in training, using Hobson's Conversational Model of therapy. This integrational approach draws upon an eclectic range of thought including psychoanalysis, philosophy, cognitive therapy, systems theory, particular schools of philosophy and the Romantic Movement. An outline of the background issues leading to this particular case‐study is followed by a case description emphasizing particular aspects of the therapeutic endeavour that allowed creative change and conflict resolution to occur, including the flexibility and openness of the therapist's stance. A discussion of wider issues posed by this clinical experience, including cultural matching, the provision of therapy for ethnic minorities conducted in the client's first language and the appropriateness of Westernized schools of psychotherapy in the context of inter‐cultural therapy is offered.
EVALUATION OF OUTCOME IN A DYNAMICALLY ORIENTATED GROUP FOR ADULT MALES WHO HAVE BEEN SEXUALLY ABUSED IN CHILDHOOD
Authors: Morrison Audrey , Treliving Linda
Published: November 2006

ABSTRACT
At a time when males abused in childhood are coming increasingly to attention of clinical services, we review the literature, describe the process and report on clinical outcomes of a slow open long‐term dynamically orientated group for abused adult males. Twenty‐nine men referred to the local psychotherapy service for consideration for inclusion in the group are discussed along with some of the most prevailing themes, namely identification with the aggressor, self‐esteem, guilt and sexuality. Symptoms were measured using the SCL 90‐R and demonstrate relatively high levels of psychological distress in this group at initial assessment. There is significant improvement in global scores, interpersonal sensitivity, depression and psychoticism in the group of 13 men who engaged in therapy for at least six months compared with those who did not.

The authors conclude that symptom measurement provides evidence that group psychotherapy is a useful therapeutic approach in a group of men who might otherwise be considered unsuitable for psychotherapeutic interventions due to symptom severity and personality difficulties.
GROUP SUPERVISION OF INDIVIDUAL CASES IN THE TRAINING OF COUNSELLORS AND PSYCHOTHERAPISTS: TOWARDS A GROUP‐ANALYTIC MODEL?
Authors: Scanlon Christopher
Published: November 2006

ABSTRACT
The process through which individual psychodynamic practitioners learn how to learn from practice is central to their future professional development and second only to having had a ‘good enough’ experience of personal therapy. To facilitate this learning process many trainees, particularly those working within organizations, might be offered the opportunity to join a supervision group. The aim of this article is to explore some group dynamic issues that might enable greater understanding of this learning opportunity. Literature from the general field of professional education will be integrated with more specific psychodynamic and group‐analytic psychotherapy sources. Implications for the place of analytically informed cooperative inquiry groups in continuing professional development will also be briefly discussed.
CONNECTION AND CATASTROPHE, HOPE AND DESPAIR IN OUR BORDERLINE WORLD
Authors: Campling Penelope
Published: November 2006

ABSTRACT
Despair is the absence of connections or the severance of connections and the consequent sense of emptiness and impotence. Hope is about connecting, relating, being part of a healthy matrix and the consequent sense of agency that can come from this.

This talk explores the particular quality of disconnectedness in our more disturbed patients where hope and despair move in cycles without any sense of a functioning centre that can keep hold of the pieces and understand how they fit together. Parallels are drawn between our patients' internal worlds and the external world in which we are located and work.

Developing a sense of personal agency within a meaningful social matrix in a therapeutic community is contrasted to the state where the organization is always on the edge of unpredictable catastrophe and patients remain in a condition of despairing helplessness.
LOSING, FINDING AND FAILURE: A GROUP ANALYTIC PERSPECTIVE ON THE TREATMENT OF DEPRESSION
Authors: Montgomery Charles
Published: November 2006

ABSTRACT
Group analytic psychotherapy is one of the principle forms of psychotherapy offered within the NHS. One of the main reasons for referral for psychotherapy is for the treatment of depression. There is growing evidence that for certain depressed patients group analytic treatment is effective and capable of producing lasting beneficial change although the mechanisms by which this occurs are not fully understood. In this paper I examine factors which I propose are of particular benefit to the depressed patient. I suggest that within the highly supportive set of relationships that the group comprises, themes of loss and failure can paradoxically lead to integration and increased coherence leading group members to a new perspective on the intersubjective nature of their lives.
ASSESSMENT FOR COUPLE PSYCHOANALYTIC PSYCHOTHERAPY
Authors: Lanman Monica
Published: November 2006

ABSTRACT
A therapist assessing with a view to couple psychoanalytic psychotherapy needs to hold several potentially conflicting points of view in mind simultaneously. Firstly the therapist attends to the experience of the session as an interaction with the ‘shared internal world’ of the couple, in the present, seeking to understand the dynamic meaning of whatever happens in the course of the meeting. At the same time the assessor needs to explore the question of appropriateness of different possible treatments, which may necessitate explicitly seeking certain kinds of information, relating, for example, to early experience or to risk assessment.

The various points of view can be felt to be in conflict with each other, and I suggest that different parts of this complex enterprise are unfamiliar to, and may be neglected by different professional groups.
ON BEING THERE, ON STRUGGLING TO BE THERE AND ON BEING ORDINARY
Authors: Ashley Jill
Published: November 2006

ABSTRACT
It is my view that healing takes place in a situation of intimacy around a vulnerable and damaged area and that, in order to have access to that area, the therapist must conduct himself as an ordinary and decent human being. He must have the capacity to ‘be there’. This paper discusses what it means to ‘be there’ and examines why it is of such central importance in bringing about change. Included in this is the struggle to ‘be there’, that is, the intimate struggle between the therapist and patient, as well as the separate and private struggle that both therapist and patient have intrapersonally. A clinical example is given in illustration.
TALKING MAN TO MAN: TRANSFERENCE–COUNTERTRANSFERENCE DIFFICULTIES IN THE MALE SAME‐GENDER ANALYTIC DYAD
Authors: Thomas Simon D.R.
Published: November 2006

ABSTRACT
The traditional psychoanalytic focus on the father's primary role in assisting separation from mother in the pre‐oedipal phase, and in disidentifying from mother in the oedipal stage of development, is criticized in this paper as being too narrow to comprehensively explain difficulties in male–male relating. It is argued instead that the father has a role to play in his own right as an object of identificatory love for his son, and the process of ‘mutual recognition’ (Benjamin 1995) is introduced from intersubjective theory as an explanatory framework for this. Failure or breakdown in the process of mutual recognition between father and son is seen as contributing to difficulties in intimacy between men, which are then re‐enacted in the male same‐gender analytic dyad. Three case vignettes describing transference and countertransference difficulties in a male–male therapy couple are used to clinically illustrate the different theoretical issues discussed.
THE USE OF LETTERS IN NHS PSYCHOTHERAPY:A TOOL TO HELP WITH ENGAGEMENT, MISSED SESSIONS AND ENDINGS
Authors: Ingrassia Antonina
Published: November 2006

ABSTRACT
Individual psychodynamic psychotherapy in the NHS has very specific characteristics: the absence of self‐referrals, time and resource limitations, a client group very often presenting with complex issues. Engaging the patient initially, maintaining the therapeutic alliance through the process and preparing to ‘let go’ without leaving the patient with the feeling of being ‘let down’ can be a difficult task. The use of letters, when carefully thought through, can be an invaluable aid to creatively resolving the problem of impasse at various stages of the therapeutic process.
PSYCHODYNAMIC INTERPERSONAL THERAPY FOR EARLY ALZHEIMER'S DISEASE
Authors: Brierley Eileen , Guthrie Else , Busby Charlotte , Marino‐Francis Fredrica , Byrne Jayne , Burns Alistair
Published: November 2006

ABSTRACT
Recent advances in the pharmacological treatment of Alzheimer's Disease has meant that the cognitive decline for patients in the early stages of the disorder can be delayed. The improved prognosis means that patients may have considerable insight into their illness for a much longer period, which may be emotionally distressing for themselves and their families. This paper describes the development of a brief psychological intervention, based upon psychodynamic‐interpersonal therapy, for patients in the early stages of Alzheimer's Disease. The key components of the model include: picking up cues; staying with feelings; working in the ‘here and now’; negotiation; understanding, linking and explanatory hypotheses; metaphor; sequencing of interventions (i.e. picking up cues → staying with feelings → linking to interpersonal problems); and the development of a shared interpersonal formulation. The cases discussed in this paper are drawn from a pilot study of psychodynamic interpersonal therapy plus usual care versus usual care alone.