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It's Grim Up North? Reflections on Manchester's Psychoanalytic History
No full textThis isn't a definitive history of Manchester's psychoanalytic journey. It is more akin to a story which gives an account, partly personal, partly historical and partly professional. I will tell the story in two parts
Losing and regaining the thread: learning from the experience of moving from in-person to Zoom observations
No full textThe authors of this paper describe and share their experiences of moving from in-person infant observation to observing remotely on Zoom during the Covid-19 Pandemic. The story is told chronologically, firstly reflecting on their own response to the change, and then, through vignettes, looking at detailed aspects of the move for the babies and their families, as well as tracking the emergence of distinct and meaningful online observations. This is followed by a discussion of a particular feature of remote observations that came to be seen as a significant dimension of the material in both observations: that of the family’s agency in positioning the device, and thus the observer, during observations. The authors were members of the same Infant Observation seminar and were both in the second year of two-year observations when the UK government imposed a national lockdown
“What happens in the Frontline Unit Meeting and can this model be of use to Children and Families Social Work?”
Get PDFSocial work supervision is consistently described by professional bodies and academic literature as key to the quality of social work practice. Despite this consensus, there appears an incongruence between models of supervision espoused in the literature and the reality of practice. This incongruence is attributed to pervasive technical-rational approaches to social work practice, synonymous with neoliberalism, which permeate supervision, and leads to the rejection of the notions of uncertainty and complexity, stifling the reflective practice espoused in the literature. This incongruence is further complicated by the paucity of empirical data regarding what happens in supervision, and as such the supervision evidence base remains weak. This thesis is unique as it analyses the contribution of unconscious processes, detailing how anxiety implicit in the social work task impacts the nature of supervision, and contributes to this schism between the rhetoric and reality of supervision practice. Six systemic group sessions are researched with the researcher physically present in half of the sessions, and the remaining half accessed online due to the Covid19 pandemic. A psychoanalytically informed research methodology drawn from the work of Skogstad and Hinshelwood (2000) is employed to explore the emotional atmosphere of the supervision sessions, the anxiety present, and the collective strategies employed by supervision attendees to address this. The subsequent data is analysed through a thematic analysis (Braun and Clarke 2006). Bion’s (1962) K and -K models of thought are employed to demonstrate how each group evidences a unique capacity to ‘think’ in light of its ability to contain the anxieties and frustrations implicit in social work. This demonstrates that when anxiety is not contained, supervision attendees operate social defence systems against anxiety which stifle supervision practice, resulting in a denial of the reality of the social work task. However, this study also evidences how supervision characterised by negative capability, reflexive practice, a non-directive leadership style, and creation of containment can process anxiety, leading to more thoughtful and effective supervision discussions, and more purposeful practice. In doing so it demonstrates how attention to unconscious processes, and the creation of containment, have critical implications for the functioning of the Frontline Unit Meeting, wider supervision practice and the social work profession
Parenting a child with difficulties in learning caused by trauma
No full textChildren who are looked after or adopted may experience varieties of learning difficulties that are caused by the trauma and disruptive relationships that marked their early lives. These difficulties may exist not just in education, but also in social skills, in children’s ability to relate and attach to others, and to absorb new information. For parents and carers of these children who are seeking to help them manage or overcome these difficulties, it is imperative that the past informs the present – to relate this early trauma to the child’s difficulties now, and to use this knowledge to inform healing and development for the child.
This new title in the Parenting Matters series provides authoritative, clinical guidance for carers and adopters on why these learning difficulties can occur and what can be done about them. In straightforward language, it explains how children’s difficult early experiences can affect their learning; the importance of play to being able to learn; how to understand what the child is experiencing and why, and how carers and parents can help. In the second half of the book, an adopter who has been affected by this issue explores what it is like to live with affected children, and what did and did not work for them.
This book is part of CoramBAAF’s Parenting Matters series which explores many of the health conditions commonly diagnosed in looked after children
NHS staff burnout, stress and resilience
No full textCOVID-19 and the experiences and pressures brought about by lockdown have been devastating for the mental health of people throughout the country and the pandemic has brought an urgent focus on the impending impact of mental illness on the NHS
Considering perversion from a Portman Clinic perspective
No full textPsychoanalytic thinking about perversion has aroused condemnation from the right of the intellectual and political spectrum, and criticism that we have got it all wrong from gay rights activists and feminist writers. Freud reminds us that none of us can stand in a superior judgemental position in relation to those who suffer from perversions. In this chapter, the author addresses the subject of sadism because the desire to inflict pain upon the sexual object and to have it inflicted upon oneself is, as Freud maintained in the Three Essays, ‘the most common and the most significant of all the perversions’. He focuses particularly on sadism as a solution to primitive anxieties about survival. The author begins with recent and graphic illustrations of violence, which is motivated by a self-preservative instinct, to illustrate its destructiveness and the complex nature of the psychological ingredients that humans depend upon for their survival
A grounded theory of successful Educational Psychology practice in Key Stage 4 Pupil Referral Units: A jointly constructed perspective
Get PDFSchool exclusion rates in England have risen consistently in recent years, and Pupil Referral Units (PRUs) and other alternative provisions (APs) are often destinations for those excluded. Many of these young people have identified special educational needs and disabilities (SEND). Whilst there is a large body of research around school exclusion, and some specifically looking at ‘good practice’ in PRUs, very little research has looked at Educational Psychology (EP) practice in these provisions, and how Educational Psychologists (EPs) can be utilised most effectively. This is particularly relevant for Key Stage 4 (KS4), given the high levels of exclusion in this age group and consequently, the poor life outcomes associated with this cohort as they transition to adulthood. This study aimed to explore ‘successful’ EP practice in KS4 PRUs and to identify and explain the mechanisms and factors that can facilitate this. Taking a grounded theory approach (Charmaz, 2014) from a social constructionist perspective, five joint interviews were conducted with EPs and commissioners of EPs working in KS4 PRU settings. 12 participants (six EPs and six commissioners) from five London boroughs were included. Findings frame the EP-commissioner relationship as ‘parents’ who play a ‘parental’ role and function, impacting all other aspects of the system or ‘family’. Relationships across the ‘family’ were fundamental for facilitating change through joint working, reflection and learning. The importance of shared values, goals, approaches and language were highlighted, such as strengths-based approaches, prioritising young people’s involvement and agency, flexibly supporting needs, going above and beyond, taking a systemic approach and planning for positive futures. Literature relating to ‘containment’ (Bion, 1962b) in APs and ideas related to systems psychodynamics (Neumann, 1999) are discussed in relation to EP practice in PRUs
Embracing darkness: Clinical work with adolescents and young adults addicted to sexual enactments
No full textThis chapter describes common themes and transitions in the treatment of adolescents and young adults presenting as addicted to sexual enactments. It follows the therapeutic process with patients seen in either group or individual long-term psychotherapy. The chapter follows a pathway of change and transformation, which when successful enables patients to reduce or cease addictive behaviours by coming in contact with a good object, enabling both emotional pain and the experience of potency and hope. Becoming mindful of the button increases patients’ awareness of other ritualistic aspects in their relationships to themselves and others. When patients become less addicted to the activities that symbolically and concretely maintain the mystical union with the bad object, they start to develop a sense of separateness
Working together better for mental health in children and young people during a pandemic: experiences from North Central London during the first wave of COVID-19
Get PDFDirect risk from infection from COVID-19 for children and young people (CYP) is low, but impact on services, education and mental health (so-called collateral damage) appears to have been more significant. In North Central London (NCL) during the first wave of the pandemic, in response to the needs and demands for adults with COVID-19, general paediatric wards in acute hospitals and some paediatric emergency departments were closed. Paediatric mental health services in NCL mental health services were reconfigured. Here we describe process and lessons learnt from a collaboration between physical and mental health services to provide care for CYP presenting in mental health crisis. Two new ‘hubs’ were created to coordinate crisis presentations in the region and to link community mental health teams with emergency departments. All CYP requiring a paediatric admission in the first wave were diverted to Great Ormond Street Hospital, a specialist children’s hospital in NCL, and a new ward for CYP mental health crisis admissions was created. This brought together a multidisciplinary team of mental health and physical health professionals. The most common reason for admission to the ward was following a suicide attempt (n=17, 43%). Patients were of higher acute mental health complexity than usually admitted to the hospital, with some CYP needing an extended period of assessment. In this review, we describe the challenges and key lessons learnt for the development of this new ward setting that involved such factors as leadership, training and also new governance processes. We also report some personal perspectives from the professionals involved. Our review provides perspective and experience that can inform how CYP with mental health admissions can be managed in paediatric medical settings