Tavistock and Portman E-Prints Online
Not a member yet
2774 research outputs found
Sort by
The Tavistock trauma service centenary lecture
No full textIn celebration of its centenary, The Tavistock and Portman NHS Trust hosted a series of lectures. This paper has evolved from a lecture on trauma work within the Trust shared with Graham Music. The history and theoretical developments of clinical work with adult patients in the Tavistock Trauma Service are outlined
Oedipal aspirations and phallic fears: On fetishistic presentation in childhood and young adulthood
No full textThis chapter explores work with a young man who cross-dressed, wore nappies in bed and was preoccupied with pregnant women. When people engage with young people seemingly in route to what once was termed a perverse resolution people encounter early insult, primitive defences and real fear of the oedipal constellation. In ‘Three essays on the theory of sexuality’, Sigmund Freud outlined his view of fetishism: What is substituted for the sexual object is some part of the body which is generally very inappropriate for sexual purposes, or some inanimate object which bears an assignable relation to the person whom it replaces and preferably to that person’s sexuality. The fetishistic position for Stanley, with its early, polymorphous presentation, has helped hold the abandoned fragile self with a solution that could contain the inexpressible rage with the object, conceal the growing sexual self, but which inhibited development and genuine potency
Mental health, mental illness and migration
No full textThis book unravels the mental health challenges of the migrants and the socio economic and cultural conditions that bear on the mental well being. In addition, it covers the measures of intervention that can help the migrants maintain or restore their mental well being. Research included in the book is timely given that there is ever increasing mobility of people which on one hand has led to better livelihoods, but on the other has created conditions of stress for the migrants and their families. As migrants are often found to be hesitant of using the health care facilities in the new place which may be due to the lack of awareness, this book elaborates on the health care facilities, cost issues, stigma, and several other factors
Trauma and abuse
No full textIn this paper I reflect on my work with adult patients and the Tavistock based sexually abused girls study. I discuss two young women who came for help with their relationships, but subsequently disclosed having been sexually abused as children. I was particularly interested since contrary to what one might expect, the young woman who seemed to enjoy better relationship with her mother did less well in treatment. These two patients are contrasting and this underlines the importance of focussing on specific aspects of the primary maternal object relationship that are unique to each individual in understanding the ability to benefit from therapy. Important features shared across the two patients such as PTSD, the distortion of time, and the role of the father are considered. The timing of the disclosure is also an issue. Both patients elicit strong countertransference responses that were difficult to manage and the value of supervision was stressed. The author tries to address two questions, why the patient who had a better maternal relationship did not benefit as much, secondly the point in treatment when the disclosure occurred
A feasibility study and pilot RCT of a modified video-feedback parenting intervention for children in foster care with reactive attachment disorder: Brief study protocol
Get PDFIntroduction: Looked after children are at significantly greater risk of experiencing attachment difficulties. There is an urgent need to develop and make available effective and cost-effective interventions for this group of highly vulnerable children. Video-Feedback Intervention to Promote Positive Parenting and Sensitive Discipline (VIPP-SD) is an extensively evaluated and effective
treatment that is a promising intervention for children in care with attachment difficulties.
Methods and analysis: This is a mixed-methods study. Firstly, with the guidance of experts in the field we will adapt the VIPP–Foster Care intervention for use in the context of children in foster care in the UK with symptoms of reactive attachment disorder. The identification of eligible participants will be supported by a screening mechanism run by the local authorities in collaboration
with the university. Through a pilot randomised controlled trial we will test the screening process and the acceptability of the intervention and research assessments. Qualitative interviews will be conducted with key stakeholders and with carers who receive the new intervention.
Ethics and dissemination: The complex consent process was designed based on consultation with experts and local authorities. This feasibility study and pilot trial will determine a range of key feasibility parameters in preparation for a future full-scale trial of the effectiveness and costeffectiveness of VIPP-FC. Findings of the pilot RCT and interviews will be published in peer-reviewed journals and presented to various audiences.
Trial registration: This study was registered in the ISRCTN registry, with number ISRCTN18374094, on 05-22-2017 and the Central Portfolio Management System, CPMS ID: 34889
What’s yours and what’s theirs? Understanding projection, transference and countertransference in educational psychology practice
No full textThe contribution of child psychotherapists within a specialist CAMHS and autism assessment service
No full textObjective: This qualitative research is the first exploration of what psychotherapists have to offer children under 5 and their families where the child has or is identified at-risk of an autism diagnosis. Method: Semi-structured interviews were conducted with six psychotherapists working within a specialist CAMHS and autism assessment service. The interviews were transcribed verbatim and the transcripts were analysed using thematic analysis. Results: The qualitative analysis of these narrative accounts generated 4 themes containing a total of 11 subthemes. The four themes were: temporal aspects of child psychotherapy interventions, elements of child psychotherapy interventions that promote understanding, distinctive aspects of understanding informed by unconscious processes and managing uncertainty. Conclusions: Child psychotherapists significantly contribute to the assessment and treatment of children under 5 with or at-risk of an autism diagnosis. The presence of the child psychotherapy profession was shown to have an impact both within the clinical context and through enriching the formulations within the multi-disciplinary team. The results indicate that child psychotherapy uniquely provides an understanding of unconscious processes which is highly valuable when working within a specialist autism service
A State of Inbetweenness: The Challenges of Working with Disavowal
No full textA presentation of emotional detachment is sometimes encountered in working with challenging patients. The term ‘disavowal’ describes a particular kind of splitting of consciousness in which the person repudiates awareness of disturbing realities or their meanings. Disavowal involves a distortion of emotional significance, rather than a distortion of perception, as in the case of a dissociative split in consciousness. Detachment protects the individual from emotional contact, which is experienced as potentially overwhelming. Safety is achieved, but at the cost of denuding mental life of meaning. With the help of detailed clinical material, the challenges of working with a person who has established a psychic retreat based upon disavowal are outlined. I describe the clinical challenges of working with someone who places themselves out of reach of emotional engagement. A state of inbetweenness protects the person from knowing about their aggressive impulses, their need for care and the passing of time. This forestalls experiencing the dangerous, shameful feelings of dependence. The clinician needs to recognize the necessity for the defensive retreat, whilst being patiently ready to enter engagement when the patient becomes available
Interview with the world's oldest living child psychotherapist: 98 years old Isca Wittenberg
No full textFor over fifty years Isca worked at the Tavistock Clinic in London, where she eventually rose to be its Vice Chair. Her colleagues were some of the greatest names in psychotherapy such as Donald Meltzer and Neville Symington.
Isca was in analysis with Dr Sonny Davidson for four years when he tragically died. Hear her reflections on why she decided she wanted Wilfred Bion as her analyst.
Having taught infant observation for over 50 years, Isca explains her passion for it and why it is an essential part of understanding babies and their parents. She also reveals the challenges of working with one of the key creators of Infant Observation, Esther Bick.
Isca discloses how her own experience growing up led her to gravitate towards helping adolescents experiencing mental health difficulties. She developed a young peoples counselling service at the Tavistock where for the first time they could refer themselves.
Hear too why a deep interest in spirituality alongside psychoanalysis runs through Isca’s life and work and why at 98 she’s learning to play the piano!
A generation of Holocaust survivors has helped to shape the course of child psychotherapy and mental health services in the UK. You can also watch a clip of our upcoming interview with Lydia Tischler who survived the Terezin and Auschwitz concentration camps to go on to transform therapy services for mothers and babies and establish child psychotherapy trainings all over the world. Go to www.mindinmind.org.u
How do the narratives of depressed adolescents and their parents compare?
Get PDFThis qualitative study used psychoanalytically informed narrative analysis to explore the narratives of two clinically-depressed adolescents alongside their parents’ narratives. The study also aimed to explore the co-construction of narrative as observed in psychoanalytic psychotherapy sessions. Two cases were transcribed and analysed. For each case, two adolescent therapy sessions were compared with one parent session. From this analysis, several overlapping themes were seen to arise between the adolescent’s and their parent’s narratives. These themes included a sense of persecution and anxiety related to expressing distressing emotion. It is suggested that the way in which the adolescents’ narratives often mirrored their parents’ narratives indicates a close link between how the adolescents and their parents understood and experienced the world around them. Significantly, it is argued that the difficulties faced by the parents – as seen principally in their narratives revealing a sense of persecution and difficulty expressing distressing emotion – combine to leave the adolescent feeling isolated, fearful and lacking capacity to manage the tumultuous period of adolescence. These factors are considered to be key to the adolescent’s difficulties and, as such, contributing to their depression. Several comparable themes were also seen to arise between the two depressed adolescents . These themes included an idea that talking about emotions might be dangerous, the difficulty of being in between quarrelling family members, lack of belief-in-self and a wish for robust containment. It is hoped that this small study supports the ongoing need for parent work within resource-pressurised times and adds to an understanding of contributary factors in adolescent depression