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A psychotherapeutic understanding of eating disorders in children and young people: Ways to release the imprisoned self
No full textThis important book shows how psychotherapy can address severe eating disorders in children and young people, illustrating the ways an imprisoned self can be released from suffering.
The book features a range of case studies while addressing core issues such as self-harm, hallucinations and the threat of suicide, as well as related topics such as depression and psychosis. Illustrating the psychological roots to eating disorders, it places therapy within hospital, clinical and multi-disciplinary contexts, as well as displaying how psychoanalytic theory can be applied across various settings and in different teams.
Written by an eminent author in the field, this will be a key text for anyone wishing to understand eating disorders in children from a psychotherapeutic and psychoanalytic dimension
A single-center, observational study of 607 children & young people presenting with Differences in Sex Development (DSD)
No full textContext: Differences in sex development (DSD) represent a wide range of conditions presenting at different ages to various health professionals. Establishing a diagnosis, supporting the family and developing a management plan are important.
Objective: We aimed to better understand the presentation and prevalence of pediatric DSD.
Design: A retrospective, observational cohort study was undertaken of all children and young people (CYP) referred to a DSD multi-disciplinary team over 25 years (1995-2019).
Setting: A single tertiary paediatric center.
Participants: In total, 607 CYP (520 regional referrals) were included.
Main Outcome Measures: Data were analyzed for diagnosis, sex-assignment, age and mode of presentation, additional phenotypic features, mortality, and approximate point prevalence.
Results: Amongst the three major DSD categories, sex chromosome DSD was diagnosed in 11.2% (68/607) (most commonly 45, X/46, XY mosaicism), 46, XY DSD in 61.1% (371/607) (multiple diagnoses often with associated features), while 46, XX DSD occurred in 27.7% (168/607) (often 21-hydroxylase deficiency). Most children (80.1%) presented as neonates, usually with atypical genitalia, adrenal insufficiency, undescended testes or herniae. Those presenting later had diverse features. Rarely, the diagnosis was made antenatally (3.8%, n = 23) or following incidental karyotyping/family history (n = 14). Mortality was surprisingly high in 46, XY children, usually due to complex associated features (46, XY girls, 8.3%; 46, XY boys, 2.7%). The approximate point prevalence of neonatal referrals for investigation of DSD was 1 in 6,347 births, and 1 in 5,101 overall throughout childhood.
Conclusions: DSD represent a diverse range of conditions that can present at different ages. Pathways for expert diagnosis and management are important to optimize care
How can we reduce racial discrimination in schools? An Interpretative Phenomenological Analysis exploring how Educational Psychologists enact change
Get PDFIn Britain pupils who are Black or of dual heritage (Black Caribbean and White) are three times more likely to be excluded from education than white pupils. Alongside this there is a well-documented attainment gap which has been evident for decades. These academic inequalities highlight the systemic nature of racial discrimination within educational settings in Britain. There is some research around addressing racial discrimination in schools, however there is limited research on how educational psychologists work to reduce racial discrimination in schools. Educational psychologists work to enact change in various ways, including systemic, group and individual levels. They appear to be well-placed to challenge practice within an educational setting and so how they do this in relation to racial discrimination is the focus of this study. This research aims to explore the factors that enable educational psychologists to enact change within these systems. Interpretative Phenomenological Analysis (IPA) was used in this study to analyse information gathered through semi-structured interviews. This focused on how educational psychologists have responded to enact change when working in a school environment in which they felt there was racial discrimination and the factors that they felt enabled positive change. The findings for this study unearthed six overarching themes on the ‘context of the racial discrimination’, ‘individual EPs and the role’, ‘noticing racial discrimination’, ‘forming relationships’, ‘use of structure and tools to support change’, and ‘acknowledging different responses to racial discrimination’. The findings are discussed in relation to psychological theory and existing literature, with implications for the practice of individual educational psychologists, educational psychology services, training providers and national bodies
Examining our own relationships to racism as the foundation of decolonising systemic practices. ‘No time like the present’
No full textRacist discourses embedded in our social structures can have a profoundly negative impact on people's emotional well-being. This paper calls for a re-focusing within systemic therapy on anti-colonial and social justice approaches specifically on addressing racism. We propose that if we are to make this shift in our practice, we need to first engage in processes of self-reflexivity about the impact of racism on ourselves and our personal relationships. We draw on Paolo Freire's idea of ‘conscientisation’, or consciousness raising – a form of self-reflexivity through the lens of power, and on the work of McKenzie-Mavinga, who highlights the importance of therapists developing their awareness and understanding of how racism operates in their lives. We illustrate these ideas through an exploration of how we have approached this work within a long-standing peer supervision group
Psychoanalytic perspectives on psychopathy
No full textThe neuroscientific understanding of the brain of the psychopath is gathering apace. But to guide empirical research, a theory of the psychopath’s mind is also important. One such theory of mind is the psychoanalytic. Contemporary psychoanalytic theorists offer an explanatory model of the psychopath’s personality, which encompasses the dynamic nature of his mind and its developmental origins. Such a model needs to take into account attitudes and behaviours that may appear to be antithetical to human nature – the lack of empathy and emotional attachment, the inversion of moral values, the addiction to violence, cruelty and extreme states of excitement, the triumphant manipulation and deception of others, and the stance of arrogance, grandiosity and omnipotence. It also specifies the motivation and meaning of the psychopath’s behaviour, understand his subjective experience of the world, and informs our realistic perception of the risks he poses to himself and others (Meloy & Yakeley, 2021
Quietly subversive: The selected works of Dilys Daws
No full textThis book gathers together selected papers and book chapters by Dilys Daws, covering her 50 years of pioneering work as a child psychotherapist.
It provides those working with parents, infants, and children with a means of learning from Daws’s decades of experience as a psychotherapist and therapeutic consultant, with plentiful case material illustrating her method of working in action. The first two sections of the book focus on her work as consultant psychotherapist in the baby clinic of a GP practice and her parent-infant work in this context as well as at the Tavistock and Portman Clinic. The third section explores her work with young children, focusing on questions around the therapeutic frame and setting. The fourth section features extended excerpts from her writings for the general public, most particularly aimed at new parents and parents with infants. Finally, the book also contains several short reflective pieces addressing themes to do with parent-infant work, the experience of the therapist, and the social role of psychoanalytic thinking.
This book will be of interest to all those working with parents and children, including doctors, health visitors, and social workers, as well as child psychotherapists and child psychoanalysts
‘The ticking clock thing’: A systems-psychodynamic exploration of leadership in UK organisations that engage the public on climate change
Get PDFSystems-psychodynamic scholars have paid limited attention to organisational
dynamics in organisations whose task includes addressing climate change, but the
experience of working in such organisations is increasingly significant as the climate
crisis intensifies. This phenomenological study convened a group of leaders in
organisations that engage the UK public on climate change (climate change
communication), for seven meetings over eleven months. The results are analysed
and the experience explored using an innovative combination of Co-operative
Inquiry, Interpretative Phenomenological Analysis and a systems-psychodynamic
lens. Methodologically the study contributes new links between these three fields
and proposals for how Co-operative Inquiry can be appropriately managed.
The study identifies seven themes: exclusion, shame, sexualised excitement and
threat, splitting, a sense of fragility, an uncertain relationship with authority, and
difficulties with grieving. These themes represent social defences that can be seen
as characterising the experience of participants’ work. The emotional flavour of these
social defences resonates with the climate emotions proposed by the existing body
of climate psychology literature.
A tentative proposal is made that working in this field constitutes a traumatic
epistemological, social, and emotional experience; and that the fact of the traumatic
experience, and the fear of annihilation that its elements carry, is the ‘unthought
known’ in this work. Organisations that engage the public on climate change, it is
proposed, may unconsciously activate a version of the ‘internal establishment’ that
exists to defend against the unthought known, with the establishment unleashing
perverse dynamics and other defensive mechanisms such as shame, with a
particular focus on maintaining the split polarities and thereby preventing genuine
connection with others who are different.
New connections are made between climate trauma theory and organisational social
defences. Psychoanalytically-informed and ecopsychological trauma scholarship are
explored to identify steps that could be taken to support people working in climate
change communication and related fields. Further research is proposed, including
organisational observation and biographical exploration
Erosion of good intent: Professional perspectives of child protection conferences
Get PDFChild protection conferences (CPCs) sit within a legislative and procedural framework responding to
the most vulnerable in our society. The onus of which is not held by society due to the intolerable
feelings evoked by child abuse and maltreatment instead, this sits with a specialist group of
professionals. MacAlister’s (2022) review of the children social care system has cited CPCs’ as
questionable spaces.
Within this study eight episodic interviews (EI’s) were conducted with professionals’ integral to the
child protection system and associated conference. The nature of EI’s seeks to capture professionals’
perspectives through narratives, creating an experiential approach to understanding the reality of the
CPC.
Findings suggest professionals enter the CPC with good intentions seeking to respond to the task of
protecting and supporting children to ensure effective family systems. This small-scale study
concluded suggests that anxiety runs like a vein through professional representations of the CPC
resulting in a cluster of social defences manifesting and obstructing the task and good intentions
within the CPC.
Findings within this study suggest that although anxiety cannot be eliminated it can be reduced if the
CPC is refocused. This small-scale study provides evidence that the process of the CPC is intertwined
with anxiety resulting in social defences eroding good intentions and diverting professionals from the
intended procedural, and legislative task. Recommendations propose how, refocusing the task,
clarifying professional responsibilities, and re-establishing the power and independence of the
conference chair could ensure the CPC remains a place to ensure the effective working of family
networks and the protection of childre
