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The warm blooded infant beneath the salamander’s skin: The complexity of challenging bullies while reaching out to the hidden vulnerable child
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Autistic functioning and language development
No full textThis thesis is a retrospective qualitative study based on psychotherapy sessions with children presenting autistic features who use language in atypical ways. The aim was to understand, through the transferential relationship, what psychological context in terms of anxieties and defences prevents the child from using language efficiently. Hypotheses concerning children‘s use of language in the context of their emotional oscillation and evolution during the course of treatment were noted and checked against subsequent developments. They were also triangulated with the outcome of a grounded theory analysis. The grounded theory analysis led to the emergence of higher-level themes that were compared within and across cases and allowed factors surrounding the children‘s use of language to be conceptualized. The grounded theory method was used in parallel with the usual process of evaluation of the dynamics of each session and patient used by psychoanalysts a posteriori and which is part of the researcher‘s background. This procedure was enhanced by the use of Bion‘s Grid, here in a version adapted to the aims of the research. This approach is discussed in detail in the Methodology chapter. The psychoanalytic theoretical background that supported the research was mainly based on the tradition of Object-Relations Theory, particularly the evolution of Kleinian thinking represented by Bion‘s works, and as far as autism is concerned, by Frances Tustin and Donald Meltzer‘s formulations. Concerning the subject of language development, Meltzer‘s explorations on the necessary conditions for its development and the philosopher Wittgenstein‘s investigations on the social function of language were the main influences of this work. The evolution of the children‘s use of language in parallel with their emotional development in the context of their psychotherapies was analyzed and some hypotheses about the oscillations in their emotional and mental functioning were made.
The oscillation in the children‘s emotional state, language use and thinking processes was also studied in terms of a general fluctuation between different mental states that was considered to be present in different degrees and quality in mental life and more strongly when there are limitations in communication skills and social interaction. A few excerpts from notes on adolescent and adult cases with autistic features were included in the Discussion Chapters to briefly illustrate this aspect
Nurture groups: Well-being and the physical environment
No full textPhysical environments speak to us. In this article Batul Al-Khatib explores how the physical location and design of the nurture room can be used to communicate the nurture principles and improve outcomes for children
Challenges facing long-term foster carers: An exploration of the nature of psychoanalytic parent/carer support
No full textThis research study investigates the role and impact of psychoanalytically-informed
short-term parent work with long-term foster carers of looked-after children, in
support of the foster placement.
The study reflects on the data gathered from four child assessments and five foster
families seen by a psychoanalytic child psychotherapist for four sessions each. It
draws on psychoanalytic ideas from a range of theoretical traditions, exploring such
concepts as trauma, defences, compulsion to repeat, psychological-mindedness,
‘container/contained’ (Bion) and ‘holding environment’ (Winnicott).
One distinctive contribution of this research is what it adds to our already existing
understanding of the defences (or responses) aroused in the carer when faced with
the intense and distressing affect associated with the child’s early trauma; and the
impact of this legacy of trauma on the child, on the carer and on the wider Social
Services system.
Applying Grounded Theory and psychoanalytically-informed clinical case study
methodology to the research material, the study breaks down the data analysis into
seven stages of coding, from the initial reading of the data to the eventual
development of two key hypotheses. One of the predominant themes that emerged
from the analysis was the carer’s capacity to remain focused on the child’s emotional
needs and how this in turn was linked to the direction of the therapist’s focus. The
successive analyses of the data culminated in the hypothesis that the more the
therapist focused on the carer and the carer’s emotional states in the course of the
parent work, the more the carer was enabled to focus on the child’s emotional
needs.
As the system of categories emerged according to the themes exemplified in the
sessions, a particular focus of analysis became the concept of psychologicalmindedness,
considered under several sub-categories: displaying insightful
comments; awareness of the child’s bodily states; awareness of the child’s affect; the
carer’s ability to recognize the child’s defences; and the carer’s ability to make links
between the child’s current difficulties and the child’s past experiences. Through this
analysis it became apparent that degree of psychological-mindedness was closely
linked to the individual carer’s capacity to metabolize the child’s distressed and
distressing communication. This in turn led to a deeper exploration of the situations
that were particularly challenging for the carers: i.e., instances when the child was
compelled to repeat past traumatic emotional states and as a result was
communicating intense distress. This exploration eventually generated the second
hypothesis: that in reaction to the child’s distress, the response of each carer could
be plotted somewhere along a spectrum, from either distancing themselves from the
child’s emotional state to seeking excessive closeness with the child (merging). The
next stage of the analysis developed four new categories of carer responses to the
distressed child: identification and distancing from the child; identification and
merging with the child; the category that describes the carer’s psychologicalmindedness
as being ‘impaired’; and ‘good enough’ caring. This then led to an
exploration of the carer’s own defences at these most challenging times.
This research demonstrates clearly that even within the short space of four sessions
of weekly psychoanalytic parent work, it is possible to achieve significant
improvement in a carer’s capacity to bear the child’s compulsion to repeat early
traumas, and to help the carers become more emotionally available to provide the
child with effective psychological parenting at such difficult and challenging times
Psychotherapeutic work with families with life-threatening maternal illness
No full textThis exploratory research study describes a child and adolescent psychotherapeutic clinical service offered to children/adolescents and their families with mothers with a life-threatening illness. The clinical service itself was also exploratory in nature. The research objectives of the study were (i) to explore whether this form of clinical work could be beneficial for such families in relieving distress and supporting their development; (ii) to discover the factors at play within and between the family members using an adaptation of Grounded Theory research methodology; and (iii) to add to the knowledge base for adults – family members and professionals – relating to, and dealing with, such children and adolescents. Descriptions and discussion of the therapeutic input and research study are given. Symptoms, which included emotional, behavioural, psychological, learning, and interpersonal difficulties, decreased in all the children/adolescents who were offered clinical treatment within an outpatient multidisciplinary Tier 3 Child and Adolescent Service (CAMHS). Six themes were identified across the cases and these were named: Engagement, Parental Concern, Impact of Mother’s Illness, Defences, Sustaining Factors and Feeling Different. These Themes are discussed in the light of relevant published research. A literature review was undertaken and focuses on: epidemiological context; children’s understanding of death; impact of parental bereavement in childhood; the mourning process; anticipatory grief; psychoanalysis: mourning and trauma; children’s play and drawings as communication; and psychosocial therapeutic services. The thesis has particular relevance for child and adolescent psychotherapists and other mental health professionals who work within hospital and hospice settings
Colaborando, conteniendo e inspirando confianza: Fisioterapia con un niño que no habla, no camina y no come
No full textEl niño en silencio: Comunicación más allá de las palabras
No full textEl Niño en silencio: Comunicación más allá de las palabras, editado por Jeanne Magagna y Marie Saba Veile, es un libro indispensable para todo aquel que reconozca la importancia y esté dispuesto a relacionarse con esos silencios, aparentemente inaccesibles, que llevamos dentro. En sus capítulos, encontramos el testimonio de profesionales de diversas disciplinas y nacionalidades, incluyendo el de la madre de un niño con sindrome de retiro generalizado. Se muestra el uso de la observación, la empatía y la creatividad para promover la comprensión de la persona que siente que ya no puede comunicar pero, sin embargo, está esperando ayuda. Vemos trabajos donde el setting, si bien indispensable, lejos de ser rígido, es un setting biológico, vivo, como es siempre la comunicación entre personas que logran conectarse. Si bien se habla sobre el silencio, el énfasis está puesto en la comunicación, en el uso de la contratransferencia como guia principal para vivir el proceso de ir descifrando un idioma, de comenzar a conectarse, a sentir y ser sentidos