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Finding your way with your baby: The emotional life of parents and babies
No full textFinding Your Way with Your Baby explores the emotional experience of the baby in the first year, and that of the mother, father and other significant adults. It does so in a way that is deeply informed by psychoanalytic understandings, infant observation, developmental science and decades of clinical experience.Combining the wisdom of many years' work with the freshness of up-to-date knowledge, Dilys Daws and Alexandra de Rementeria engage with the most difficult emotional experiences that are often glossed over in parenting books - such as pregnancy, through birth into bonding, ambivalence about the baby, depression, and the emotional turmoil so often brought to the surface by being a new parent. Acknowledgement and understanding about this darker side of family life offers a sense of relief that can allow parents to harness the power of knowing, owning and sharing feelings to transform situations and break negative cycles and old ways of relating. With real-life examples, references to current thinking and a calm and simple writing style they also provide new insights into the more commonly covered issues such as weaning, sleeping and crying. Finding Your Way with Your Baby is primarily aimed at parents but it will be a helpful resource for all those working with parents and babies including health visitors, midwives, social workers, GPs, paediatricians and childcare workers. It will appeal to parents and professionals who are interested in ideas from psychoanalytic clinical practice and the latest research in developmental psychology and neuroscience
Clinical management of gender dysphoria in adolescents
No full textThe chapter describes the clinical management of gender dysphoria in adolescents as offered by the Gender Identity Development Service at the Tavistock Centre in London. It provides a description of the presentations of gender dysphoria in adolescents, the associated psychosocial difficulties and a brief summary of the current explanatory models. It introduces the concept of ‘atypical gender identity organisation’ and its relevance to management.
The clinical management and therapy described are based on a staged approach in line with the Standards of Care by the World Professional Association for Transgender Health. The chapter highlights an approach which integrates psychological, social and physical interventions within a multidisciplinary and well-integrated team. The current eligibility criteria for early pubertal suppression adopted by the service are described. The chapter concludes that the management of gender dysphoria is in continuous evolution and that new models of care will be developed as clinical and research evidence progresses. Clinical vignettes are used to illustrate the approach to management described
'There is no room in Child and Adolescent Mental Health Services (CAMHS) for providing intervention without an evidence base’: The case against
No full text
An exploration of a patient's use of her body within the transference relationship in intensive psychotherapy - towards allowing thoughts to become thinkable
No full textThe thesis is an exploration of a patient’s use of her body in intensive psychoanalytic psychotherapy. The therapeutic encounter studied is between myself, a child and adolescent psychotherapist working in an NHS Child and Adolescent Mental Health Team,and a fifteen-year-old female diagnosed with depression. Pivotal sessions were examined: where significant shifts in the therapy were identified. These consisted of sessions where there was a transformation in anxiety; and the patient was able to verbalise what was otherwise being communicated in a bodily way. The analysis of the data using grounded theory highlighted the importance of visual communication in the therapeutic encounter.The analysis indicated that vision is the receptive point for the beginning of the containment process. The analysis of the data also highlighted that when the patient is communicating intense primitive anxieties, the therapist needs to receive and process the anxieties at a bodily level, when the patient is, perhaps for the first time, coming into contact with the feelings from which they have dissociated. The analysis of the data indicated that mirroring back emotional states that are congruent with those projected by the patient, makes thepatient aware of themselves in terms of the effect they have on others. This suggests the importance of the therapist’s non-verbal responses, which can be observed and
introjected by the patient. The study contributes to
the understanding of bodily communication in the therapeutic exchange. It raises interesting technical issues about when the
therapist should receive and hold the patient’s projective identification at a bodily level and reflect back non-
verbally that their communication has been received,
and when to make a verbal interpretation. It also highligh
ts the use of observation to gauge if the patient has been able to receive the therapist’s communication at a bodily level
Crossing the threshold: An inquiry into the lived experience of Bangladeshi parents with young children; their worries and sources of support
No full textParents with young children often have concerns about some aspect of their parenting or about a feature of their child’s behaviour, and may seek support from family or local support services about this. Bangladeshi parents with young children living in the borough of Tower Hamlets, East London, were considered a vulnerable group that did not readily take up health services, such as services for under 5’s. This began to change with the advent of Sure Start and locally based Children’s Centres. As a result of clinical work in one Centre, the author was keen to explore what kinds of concerns might lead Bangladeshi parents to seek help and to whom or where they turned for such help. A purposive sample of Bangladeshi parents, mostly mothers, took part in one or more focus groups and unstructured interviews. The study took an Interpretative Phenomenological Analysis (IPA) approach, coupled with a psychoanalytic perspective, to illuminate and make sense of the respondents’ understanding of their lived experience, in relation to the phenomena in question. The use of Focus Groups in IPA research is a subject of current debate and some of the strengths and limitations of this approach are discussed. The study highlights the importance of allowing opportunities for parents from this community to have informal contexts to articulate the complexities of their lived experience, rather than simply their views. Children’s Centres are seen to play a key role in providing psychosocial support for parents, with particular significance for first time parents and immigrants. The author suggests that Children’s Centres function as an alternative ‘village’ for parents, especially mothers, who are trying to find ways of bringing together their experience of being raised in Bangladesh with their role as parents of a new generation in another country
Connecting events in time to identify a hidden population: Birth mothers and their children in recurrent care proceedings in England
No full textThere is international concern about the population of birth mothers who experience repeat court-ordered removal of children. This article reports the findings from a population profiling study that provides the first picture of the scale of women's repeat involvement in public law proceedings in England. Based on national records from the Children and Family Court Advisory and Support Service (Cafcass) (n = 43,541 birth mothers, 2007–14), two subsets of mother, child and legal proceedings data were created. The aims of the study were to:(i) produce a descriptive profile of recurrent cases, (ii) estimate the probability and timing of recurrence and (iii) examine the relationship between maternal age and recurrence. Quantitative analysis comprised descriptive statistics for profiling purposes and methods of survival analysis to estimate probabilities. Findings indicate that the family justice system recycles a sizeable percentage of women (24 per cent) through repeat episodes of care proceedings, with young women aged sixteen to nineteen years most at risk of recurrence. Implications for social workers and the family courts are outlined with reference to new innovations in England
