Tavistock and Portman E-Prints Online
Not a member yet
2774 research outputs found
Sort by
Fears, reassurance, and milestones: A Twitter analysis around World Prematurity Day during the COVID-19 Pandemic
Get PDFPreterm birth (birth <37 completed weeks’ gestation) is common, affecting 10.6% of live births globally (nearly 15 million babies per year). Having a new baby admitted to a neonatal unit often triggers stress and anxiety for parents. This paper seeks to explore experiences of preterm birth via Twitter. The intermingling of COVID-19 restrictions and World Prematurity Day allows for an understanding of both the additional stresses incurred as a consequence of the pandemic and the more “everyday” experiences in the NICU and beyond. The content analysis of the data included 3161 tweets. Three themes were identified: 1. COVID-19 was not the only trauma; 2. Raising awareness, especially World Prematurity Day; and, 3. Baby milestones. These themes highlight the multi-level challenges faced by parents of premature babies and the healthcare professionals involved in their care. The COVID-19 pandemic and the consequent restrictions imposed on parents’ contact with their babies have resulted in immense emotional strain for families. The reported COVID-19 pandemic “baby blind spot” appears to particularly impact this group of babies. Improved understanding of the lived experiences of preterm babies and their families should inform greater awareness and improved support
Work and wellbeing: Organisations and systems
No full textBuilding on session one but also free-standing, this session will take an organisation and system focus and draw on the Trust’s education and training programmes as well knowledge generated from our development and consulting work in collaboration with others to reflect on what is required systemically and organisationally to create and sustain organisations in which individuals and groups can thrive. The sessions will be co-chaired by Brian Rock, Postgraduate Dean and Director of Education & Training and Chris Caldwell, Director of Nursing and System Workforce Development who will host a panel
Group cohesion in multifamily therapy with multilingual families
Get PDFThis study explores how Multifamily therapists create a context for group cohesion between
monolingual and multilingual family members and what they might inadvertently do to hinder it.
Group cohesion has been found to enable processes of change. I examine the intersection between
group cohesion and language which is underrepresented in psychotherapy, MFT process research.
Qualitative research methods were used to address the following research questions: 1) What do
Multifamily therapists do in dialogue to create a context for horizontal (between multilingual and
monolingual families) and vertical (between family members and therapist) group cohesion?; 2)
What do Multifamily therapists do in dialogue that inadvertently hinders the horizontal and vertical
group cohesion between monolingual and multilingual families?; 3) What is the intersection
between Multifamily therapy, group cohesion and language, including interpreters’ roles?
Participants included families with children between 6 and 14 years old, from different cultural
backgrounds, attending a Multifamily group in inner London for children who were at risk of being
permanently excluded from school. For some, English was their first language, and for others
English was their second language and some needed an interpreter. Therapists, students and
interpreters also participated.
Two types of analysis, Dialogical Investigations of Happenings of Change (Seikkula, Laitila and
Rober, 2012), and Thematic Analysis, were carried out on three data sources– 2 MFT sessions, a
focus group with group participants, and an interview with therapists. A significant finding was
that MFT therapists used a collaborative voice in dialogue, but also held an inherently powerful
position influenced by how group participants positioned them, their own positioning (such as
organising the room/activities, deciding topics and who talked, their work context) and by
contextual/external factors (e.g. reasons for families’ referral, societally constructed as experts),
and their therapeutic task. Dialogical language seemed to create a space for ‘withness’ interactions
between group members, and more group cohesion. I identified some factors which were likely to
have impacted negatively on group cohesion and placed participants in a powerless/non-agentic
position. Interpreters’ roles and children’s positioning as their ‘mother’s voice’ were also
considered.
Implications of the study are discussed as is its potential contribution to the practice, training and
supervision of MFT and individual FT with multilingual and monolingual families. The importance of creating a space where everyone’s voices can be heard and in particular those of
silenced/marginalised members is highlighted. Therapists’ relational reflexivity and self-reflexivity
play a crucial part in this in order to avoid unintentionally putting group members in shameful or
powerless/non-agentic positions. The significance of, and processes involved in, creating a
‘community of help’ are identified
Angels and devils: Sadism and violence in children
No full textThis chapter describes the features of violence and sadism in children seen at the Portman Clinic, using the related vertices of psychoanalysis and developmental science. Presentations of anti-social tendencies with the core complex issues at their core can arise when early experiences of emotional safety are lacking. Children who suffer violence and trauma often lack much empathy and mentalizing capacity, believing that life is not fair, safe or reliable. More reactive children and adults often seek justice but they misperceive the motivations of others and can very easily feel that they are ‘victims’. Many adult psychopaths were anti-social children, started fires, torturing pets and showing cruelty. The presence of callous-unemotional traits in children, alongside conduct disorders, hugely increases the likelihood of serious offending, violent crime and shorter periods between re-offending. In adolescence, when the dopaminergic circuitry is fast developing, risks of addictive behaviours are heightened, whether to drugs, computer games or sexual and other forms of cruelty and sadism
Group Relations and other meditations: Psychoanalytic explorations on the uncertainties of experiential learning
No full textThis book examines the Tavistock tradition of using group relations conferences as temporary training organizations for groups and institutions, and how those can inform and enrich the theory and practice of experiential learning more generally.
First, this book analyses the structures, rituals, and beliefs of group relations conferences, drawing on the author’s learned experience in the field, followed by meditations extending to broader areas, such as the social nature of corruption, martial arts, Western culture’s longing for creativity, and the use of drawing in social science research. It addresses the tension between psychoanalysis and systemic theory in group relations thinking, refining and re-defining key concepts of the practice, challenging notions of dependence and dependency, performative poetics, learning, the politics of power, nostalgia, and the unspoken reasons for the wish to join conference staff teams. It offers a critique of the polarity concerning terms such as spontaneity, the sense of mystery, openness to the unexpected, and trust in unconscious processes, as opposed to the desire for certainty and the confusion, anxiety, and aggression evoked when groups find themselves without familiar signposts. Drawing on his thinking developed over the course of a professional life as organizational consultant, artist, designer, teacher, researcher, and poet, the author invites the reader to challenge boundaries towards a less inflexible and defended engagement with the Other. The metaphor of bricolage, an activity that inspires creativity and originality, suggests possible ways of putting known things together to approach new meaning as provisional and shifting. The many strands thus gathered reveal new dimensions of group life that crucially affect our everyday living and surviving, both as individuals and as members of society.
This work will allow psychoanalysts, psychotherapists, group therapists, organizational consultants and trainers to put the lessons learned from group relations conferences into everyday practice
A Systems-Psychodynamic exploration into GP experiences of current changes in healthcare delivery
Get PDFMy research uses a psychosocial approach to undertake an exploration into
general practitioners’ (GPs) experiences of current changes in healthcare
delivery. Under the impact of the neoliberal paradigm and the challenges of
running a general practice, GPs appear to have been retiring early, and it has
been hard to recruit GPs for some years. At this time, when we are seeing an
ageing population, increasing incidence of chronic comorbidities, and the
development of clinical technologies, the biopsychosocial model of medicine has
to contend with much complexity. Moreover, the nature of primary care is such
that the business of general practice is also being challenged by the processes
of commissioning, bidding and contracting required to sustain income and
viability, with some practices joining together to form primary care networks in
order to survive. All of these varying elements beg the question: what defines
GPs’ primary tasks, roles and systems, and how might their motivation and
identity be affected by this situation of clinical complexity and financial challenge
in the healthcare context? Bringing in concepts from systems psychodynamics
and organisational consultancy, this thesis considers both the doctor- and
organisation-in-the-mind. Using a qualitative approach to explore these
dynamics, semi-structured interviews were undertaken with 12 GPs at different
stages of their career, with different interests and responsibilities. Ten themes
were identified as pertinent to the sample, to varying degrees: 1) the long-term
patient relationships – dependency and intimacy; 2) identification with the role,
and the GP surgery as a second home; 3) underpinning ethical value systems;
4) satisfaction in one’s role as a clinical GP; 5) the systemic leadership role; 6)
being overwhelmed by the context; 7) a business-minded approach to the
financial state of the surgery and context; 8) determining one’s own timetable; 9)
one’s own family or illness as a motivator; 10) family aspiration as a motivator.
Three major clusters of responses were identified, revealing three GP types with
varying social defences and valencies for individual and group functioning.
iii
The neoliberal paradigm, together with managerialism, changes in funding
methodology, the erosion of social support systems, an ageing population,
advanced medical technologies and other issues, appear to have disrupted GPs
status as the family-doctor-in-the-mind committed to caring for patients from
cradle to grave. An increasing ambivalence about meeting the demands of
patient dependency, and a turning away from the responsibilities of full-time
partnerships in general practice, is an identifiable trend. In addition, my research
identifies the alternative allure of entrepreneurial activity and engagement with
both organisational demands and novel clinical pathways in the wider system of
healthcare. Through the application of the metaphor of the periodic table, a
hypothetical model is tentatively offered comprising the three GP types in order
to consider not only the effect on individual GPs but also the possible impact on
general practice as an institution
The lived experiences of first-generation West African black parents whose children have been subject to statutory interventions
Get PDFThe primary aim of this research project is to gain a deeper understanding of
the lived experiences of a group of first-generation West African black parents
whose children have been subject to children’s services. This research focuses
on the experiences of parents, their personal stories of immigration to England
and their journey to local authority children’s services intervention. This is
because parents’ stories are not heard and talked about enough in relation to
the concerns around statutory intervention.
There are no literatures on the experiences of first-generation West African
black parents who have been subject to statutory intervention. However, there
are studies on the migration stories of black Africans and the overrepresentation of black children in the child protection systems.
Nine parents participated in interviews using the Biographical Narrative
Interview Method and preparatory focus group, while 21 social care
professionals participated in two focus group sessions. The key questions
include what the psychosocial accounts of the lives of immigrant parents are,
and this is deployed to learn from parents about their experiences of statutory
intervention and the responsiveness of children’s services to the needs of the
children and their families. The research will learn about the difficulties of
working with this community using carefully facilitated focus groups comprising
social work and social care practitioners.
Findings from the research include professionals’ unconscious/conscious bias
towards parents formed from childhood experiences of discipline; the toxic mix
of professional’s’ unresolved anger towards (own mothers) with punishment and
racism to mothers of West African origin, complicated systems dynamics;
biographical and cultural tensions in the experiences of parents and
professionals; parents’ experiences of discrimination and racism; parents’
mistrust towards agencies; professionals’ inability to think about culture and the
convergence of participants’ experiences; and professionals’ defensiveness.
Implications for policy, practice, research and education include social work
training to explore cultural knowledge of black parents’ parenting values; the
need for social work students to have spaces to address their own histories of
childhood abuse and experiences of being parented; reflective case
ii
discussions; sound knowledge of legislation and policies; and the recruitment of
social workers who share similar cultural backgrounds to the parents described
in this research
The experience of illuminating organisational culture from a Systems Psychodynamic perspective
No full textHaving encountered significant resistance in both leaders and myself as a consultant when providing systems-psychodynamic cultural feedback, I set out to investigate the experience of illuminating the unconscious elements of organisational culture, both for organisational leaders, and for the researcher. Taking a single case study approach, within the Royal College of Surgeons, I applied psychoanalytic observation alongside a systems-psychodynamic supervision group to gather both conscious and unconscious data around organisational culture. I also incorporated organisational members’ experience of culture through focus groups and captured my own experience in a research log. Characterising organisational culture as ‘ways of being’, thematic analysis generated twelve cultural themes which I then illuminated with organisational leaders in a feedback loop. I captured leaders’ experiences of cultural illumination in subsequent interviews and recorded my own experiences in narrative form. Interpretative phenomenological analysis (IPA) of leader experience yielded four master themes – Positive Awakening; Stimulating or Stuck?; Group Therapy; Painful or Painless? Applying a systems-psychodynamic perspective, I hypothesised that leaders dealt with these positive, negative and nearly unbearable experiences of cultural illumination by splitting good/bad elements between themselves and utilising myself as a metabolising container of organisational anxieties. Conducting IPA on my researcher narrative generated three master themes – professionally engaged, hopeful & relieved; defensive, wary & impeded; useless & guilty. Discerning countertransference, I interpreted ‘useless and guilty’ as a 13th cultural theme and unconscious way of being. In a systems-psychodynamic frame, this could be understood as the organisation unconsciously processing the uselessness and guilt which arises for their surgeon members around death in surgery so they can continue to operate. This research has innovatively applied IPA to researcher narrative as a means to access and interpret researcher countertransference in psycho-social research. It has also offered a practical methodology to illuminate organisational culture at both conscious and unconscious levels
"Securing the disaster zone. Assessing the damage. Sifting through the rubble": The early stages of psychotherapy with a traumatised boy
No full textSean, a young boy in foster care, was referred to the clinic by his social worker when he was eight years old. He had recently been excluded from school for sexually propositioning a female teacher, simulating sex whilst lying on top of a female classmate and hitting a male classmate over the head with a plank of wood when Sean was beaten by him in a game. Sean came from an Irish Traveller background. At the time of his birth, Sean’s mother was a class ‘A’ drugs user with mental and physical health issues. Sean was mother’s sixth child. At the time of Sean’s referral, the network around him was not joined up or robust enough to make therapy a safe option. Sean was out of school, his foster carers were not being given enough support in managing him and were losing confidence in their ability to do so
Ordinary emotional development in the primary school years
No full textIn this chapter, we draw on psychoanalytic concepts in order to explore emotional development across the primary school years. We begin with some thoughts about the impact of early experience and relationships on starting school, before moving on to consider some of the factors at play in school transitions and relationships, and in the formation of individual and group identities. In particular we focus on the importance of individual and group identity formation as key aspects of developing the capacity to contain oneself, which, in turn, is intrinsic to learning and emotional life. Although the complexity of the emotional task of development in the primary school years can look less tumultuous than that in the child’s early years and adolescence, it is of paramount importance in terms of social identity and relationships. The mastery of conflicting senses of self as an individual, and as a group member is a fine balancing act, and we present the maze of issues for children in negotiating this challenge for the first time, in preparation for secondary school. With these themes in mind, we draw together an overview of the emotional development context for primary school children’s thinking and learning, including the supportive function of the imagination and reflectiveness of teachers in relation to children’s social development and academic achievement