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Medium 9781608680733

Chapter 6: Cultivate Healthy Relationships (and Stay Sexy!)

Michael J. Gelb New World Library ePub

Beautiful music, aesthetically pleasing sights, enlivening aromas, and inspiring illumination all serve to create the human equivalent of a stimulus-rich environment. But there’s another aspect of a brain-enhancing environment that is so important it deserves its own chapter. Cultivating healthy relationships is one of the most important elements of improving your mind as you age.

Those who love
deeply never grow old;
they may die of old age,
but they die young


Aristotle believed that human beings were, by nature, social animals. He noted, “Whosoever is delighted in solitude is either a wild beast or a god.” Despite Aristotle’s observation, solitude can be delightful when it’s chosen; but when it’s the only option, as it often is for older people, it can lead to loneliness, alienation, and a sense of disconnection.

In many traditional societies, older people were at the center of their community’s social life. They were consulted for their wisdom on a range of matters, and they often presided at rituals and ceremonies. In our current culture, we tend to treat older people as obsolete and rarely make them the center of social gatherings.

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Medium 9781782203049

Chapter Ten - Medea, Almighty Mother

Arlene K Richards Karnac Books ePub

Elina Reenkola

Women have often been defined as mere objects and victims of oppression, deprived of power and subject to violence. Mother is often conceptualised as a subjugated victim or slave of the patriarchal society.

I want to challenge this view by arguing that a woman's potential for bearing new life inside her and giving birth to a baby represents formidable maternal power. This has several consequences. Female generativity may lead to intense envy of the female reproductive body by both males and females. The female body may excite horror and fear of monsters. The mother who gave birth to us may even take our life or be a terrifying castrator of men.

I use the myth of Medea to describe a woman who exerts maternal power, is aggressive, and acts as a subject. Medea uses her children as weapons of her violent revenge. Medea is not an idealised and good Madonna-like woman, but, rather, an abhorrent monster mother. The myth describes the dark side of motherhood. It also deals with the mother's unconscious phantasies of power and aggression. I describe the feelings aroused in both men and women by maternal power, and the psychic mechanisms they use for dealing with them, such as envy, fear, and devaluation of motherhood.

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Medium 9781855758483

CHAPTER TWELVE: Valuing the splits and preventing violence

David Reiss Karnac Books ePub

Valuing the splits and preventing

Oliver Dale, David Reiss, and Gabriel Kirtchuk


Managing the risk of violence, be it directed toward others or the self, is a central function of an adult psychiatric service. Vital to this process is the risk assessment, which can be a difficult and lengthy process, requiring a methodical approach and space for reflection. It can be resource intensive and needs to be pitched sensitively to the individual situation.

It is clear that only through completing an appropriate risk assessment can a fitting management plan be developed. What we would like to focus on in this chapter is how the patient’s relationship with clinicians can be used to provide important information which helps produce a more therapeutic, informed service, appropriate to the patient’s needs.

The struggle to find meaning in violence

Those who commit the most serious violent acts often demonstrate a recurring pattern of incidents; as such, it is often a truism that a very good predictor of future behaviour is past behaviour. Actuarial and structured assessments place great importance on historical data and have provided much needed objectivity in identifying risky individuals. They are, however, very poor at helping us understand incidents, and often lead to a dry and rather wooden account of events. Limited time is spent on the now “taboo” activity of making sense of, and giving meaning to, violent acts, but not only is this a vital part of risk management, but also a key therapeutic goal, central to recovery.

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Medium 9781780490779

Chapter Four: The Importance of having an “Agency” on the Other

Franco Borgogno Karnac Books ePub


The importance of having an “agency” on the other


The repair of agency and the analyst's personal influence 1

Jonathan H. Slavin 2

One of the most vexing, enduring, and controversial issues in the history of psychoanalysis has been the question of the role of the analyst's personal self, personal agency, and personal influence as an individual—as a specific subject, as opposed to what I will call an analytic subject—on the treatment process, and on the evolution and shaping of the patient's post-analytic self. Indeed, beginning with Freud, the history of psychoanalysis is replete with theoretical and clinical efforts to describe and theorize how the analyst's unique individuality and personal influence might be controlled, diminished, and even excised from the process and prevented from influencing or imprinting the patient.

At the same time, well before Winnicott had formulated the concept of the “true self” (1960), psychoanalysis had already developed a view that something “true” and authentic about the patient needed to emerge in the process of psychoanalytic treatment. Freud's early discussion of the adolescent process contains an eloquent statement of this sensibility. In discussing the process of overcoming incestuous fantasies during adolescence, Freud (1905) suggested that:

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Medium 9781780490816

CHAPTER EIGHTEEN From the cushion to the couch

Maria Pozzi Monzo Karnac Books PDF


From the cushion to the couch

Dialogue with Nicholas Carroll

Wisdom tells me I am nothing,

Love tells me I am everything.

—Nisargardatta Maharaj


I understand that you are an adult counsellor and psychosexual psychotherapist and I’d like to ask about the impact your long-standing Buddhist meditation practice has had on your work with the adults you see, and in particular with reference to the child part inside your patients. Before that, I’d like to ask you if you come from a religious background and when you first became acquainted with Buddhism.


I was bought up nominally as a Catholic. My father was an agnostic and my mother a non-practising Catholic who used to take me to church on Sundays because she felt it was the right thing to do. When my parents separated—I was about ten— my mother sent me to boarding school as she wanted me to be exposed to a male environment. This was very thoughtful and kind of her, but she didn’t really quite know where she was sending me. It was a school run by Christian brothers, before the


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Medium 9781855757790

CHAPTER TEN: Leaders and groups in traumatized and traumatizing organizations: a matter of everyday survival

Earl Hopper Karnac Books ePub

Gerhard Wilke


Current organizational structures and behaviour patterns are marked by a high degree of disturbance and signify that leaders, their teams, and institutions are caught in a cycle of endless transition. The effect of the repeated reconfiguration of teams, departmental structures, and leadership arrangements has produced symptoms of failed dependency and cumulative trauma. The absence of reliable structures, the piercing of holding environments, and the regular removal of authority figures causes organizations and their members to regress to more primitive forms of defence against their increasing sense of existential insecurity. The pressure to globalize, modernize, and change in order to prevent extinction has produced organizations where the fear of redundancy and marginalization, rather than the primary task, are uppermost in the minds of leaders and employees. It is not surprising that the attendant defences against the fear of not surviving are also visible in most teams. On stage and in role, leaders present a “false self”, and off stage, in a coaching session, for example, reveal their “true self” (Winnicott, 1986). Groups work in dependency or compliant mode in a public forum, and reveal their true feelings when they meet over coffee or have a gossip in the corridors. What has become obvious is that the tension between the private self in what social anthropologists call a “sacred” and private space, and the public self in a “profane” and unsafe place, has become unbearable. The role conflict causes increasing numbers of high performing leaders and team members to take refuge in the sick role. I want to explore the traumatizing effects on organizations and groups of the frequent change of leader, the transitional nature of organizational structures and the deconstruction of hierarchies. I draw on the evidence gathered in an ethnographic and group analytic research project on leadership transitions. The full results were published in Living Leadership: A Practical Guide for Ordinary Heroes (Binney, Wilke, & Williams, 2009). As one of the tasks of an analytic consultant is to explore new ways in which to sustain hope, I will also try to show a way out of the current dilemma of groups and their leaders paralysing each other, lest more authentic and truthful dialogue in public should threaten their job security, their sense of identification, their need for belonging, and the future of the whole organization.

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Medium 9781855757134

CHAPTER FOUR: Working with question frameworks

Sunny Stout-Rostron Karnac Books ePub

•  Structure—working with question frameworks

•  Two-stage frameworks

-  Understanding intrinsic drivers or motivators

-  Functional analysis: the ABC of behaviour management

-  Functional analysis

-  Action learning approach

•  Three-stage frameworks

-  Contracting

-  What needs work?

•  Four-stage frameworks

-  Whitmore's GROW model

-  O’Neill's “executive coaching with backbone and heart”

•  Five-stage frameworks

-  Framework for change

-  Working with the CLEAR model

•  Six-stage frameworks

-  Nancy Kline's Thinking Partnership®

-  Six-stage Thinking Environment® coaching process

•  Eight-stage frameworks

-  Well-formed outcomes (NLP)

•  Ten-stage frameworks

-  Business Best Year Yet®

•  Developing your own question frameworks

•  Coach's library

At its core the coaching relationship is a strong personal connection between two individuals that typically occurs out of public view and whose workings may even appear mysterious to outsiders. Coaching is fundamentally a process for facilitating learning and change which is another way to describe development (Ting and Scisco, 2006:36).

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Medium 9781782201342

CHAPTER ONE Introduction

Xenia Bowlby Karnac Books PDF



Pat Frankish


his book aims to bring together the threads that make up the campaign for people with Dissociative Identity Disorder (DID).

The many threads reflect the multiplicity of the condition and this will become apparent as you read on. Weaving the threads together should be healing and that is one of the aims of the campaign. The multiplicity is both rich and confusing. Supporting people with DID can be exhausting. Living with it is both confusing and exhausting. DID is a survival mechanism and reflects the strength of the basic psyche to survive experiences that would drive some to psychosis.

The Clinic for Dissociative Studies (CDS) has taken a lead in the diagnosis and treatment of people with DID. Valerie Sinason has been a major contributor to the sharing of knowledge and raising the profile of this disabling condition. She has also been influential in highlighting ritual abuse as one of the main causes. This situation has led to many attacks from people who try to conceal their identity and role in the horrific abuse that people with DID report. Valerie, in particular, who has been willing to be named and to speak out, has been attacked in the press and on the internet. She continues to be brave and withstand these attacks, and is well supported by her colleagues to do this. The Bowlby Centre, looking at attachment and how this has been


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Medium 9781855758193


Michael Eigen Karnac Books ePub


Day 1

Madness in psychoanalysis: Freud and Klein

First let me get the feel of the microphone. Is the sound OK? I was told that there are some twenty art therapists here. My wife is an art therapist in addition to being a more general child and adult therapist. So I’m happy to welcome art therapists and everyone else.

I was saying earlier today that I’m happy if in a meeting one sentence or one phrase that I manage to utter is significant to one person. If that happens I will be happy and if more than that happens even better. Meaning is very hard to transmit. Meaning is very hard to communicate and there is so much noise in our psychic systems, in our heads, in our souls, that it is very hard to understand each other, certainly even to understand ourselves, but we’ll give it a try. I welcome the chance to communicate with you, or try to, and for you to communicate with me.

I’m going to speak about madness in psychoanalysis. There will be time for questions, for responses, for your thoughts and feelings. I like interruptions so feel free to interrupt me anytime about anything as the spirit moves you. Nothing I’m saying is so important that it can’t be interrupted. Maybe the interruption will be much more important. We don’t know. So I will talk but if you don’t interrupt me, I’ll just keep on talking.

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Medium 9781855759367

CHAPTER FIVE: Unselfish love—some theories

Josephine Klein Karnac Books ePub

A story from the days of sail. Voyages took years. One ship’s voyage is uneventful except that an albatross has adopted it and followed it for days. This powerful and beautiful bird lightens the unvarying burdensome routine of the crew’s days. They make a pet of it and apprehend, without thinking much about it, that it stands for something important and good. Then, says the mariner who is telling the story, without explanation or warning,

With my cross-bow, I shot the albatross.

[The Rime of the Ancient Mariner, Coleridge, & T., 1772-1843]

It is as though a hate for something good and beautiful came unexpectedly from the unconscious depths of the mariner’s mind and expressed itself in action. The crew is shocked and angry, and they hang the inert symbol of play and promise round the guilty man’s neck. All the crew die one by one, even the wind dies. The sea dies.

The very deep did rot: O Christ!
That ever this should be!
Yea, slimy things did crawl with legs
Upon the slimy sea.
About, about, in reel and rout
The death fire danced at night;
The water, like a witch’s oils
Burnt green, and blue, and white.

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Medium 9781855758865

CHAPTER TEN: Psychoanalysis of a cityscape: a case of post-traumatic stress disorder—the city of Warsaw

Halina Brunning Karnac Books ePub

Andrzej Leder

Before a psychoanalytical case study is presented, it is necessary to provide a brief description of the physical aspects of the patient and the most salient facts in their history. In particular, this applies to the character portrait that remains hidden to the majority of readers. Let me then share a brief history of our patient—the city of Warsaw—with the readers who might not be so familiar with its dramatic past.

In the sixteenth century, Warsaw became a “royal” city, the capital of the Polish Lithuanian Commonwealth that stretched from the Baltic to the Black Sea. This royal heritage was decisive in dictating the constructs of the urban grid, stretched along a north–south axis along the Wisla River dissecting the Mazowiecka Lowland, between the Royal Castle as the seat of political power and the king’s summer residence in Wilanów.

At the close of the eighteenth century, Poland lost its independence. Three empires—Prussian, Austrian, and Russian—grabbed the opportunity to divide the territory of Poland at a moment of political crisis. Warsaw suffered a fall from the status of a royal city to that of a provincial capital of a region in the Russian empire—and afterwards, after unsuccessful uprisings, lost even that status. In the nineteenth century when capital cities of independent states were modernizing at a dramatic pace, Warsaw was mired in apathy and any development that occurred was ad hoc and chaotic. The eastern and western boundaries were areas of dire poverty, and there, especially in the west, most of Warsaw’s heavy industry was concentrated. At that time, about twenty-five per cent of the city’s population was Jewish.

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Medium 9781782202912

Chapter One - On the Medea Fantasy

Esa Roos Karnac Books ePub

Marianne Leuzinger-Bohleber


As Freud often stressed, unconscious fantasies are shaped in myths, art, and literary works in such a way that people of different cultures and historical epochs can relate to them, probably one reason why the organisers of this fascinating conference have chosen the myth of Medea as one approach to helping us understand in depth some aspects of female destructiveness.

For me, Medea, as an impressing, powerful, and passionate mystical female figure, turned out to be an unexpectedly helpful heuristic when I was confronted with the unconscious fantasy world of ten psychogenic sterile female patients in extremely intensive and difficult transference situations in their long and challenging psychoanalyses (Leuzinger-Bohleber, 2001). Briefly summarised, with all of these patients, the experience of their femininity seemed to be determined by the unconscious “Medea fantasy”, which formed an unrecognised part of their own female self-representation. It was responsible both for the profound splits in their perception and experiences of their own identity as women and for their anxiety about their own unintegrated destructive impulses. Pivotal to the Medea fantasy was the unconscious conviction that sexual passion carried the risk of existential dependence on their love partner, like Medea on Jason in Euripides’ version of the myth. When she first meets the Greek hero in the palace of her father, Eros shoots his arrow of passion right into her heart; Medea has a presentiment of mortal danger and struggles with all her might against the overwhelming passion, curses the stranger and his appearance, but in vain. Having fallen in love with Jason, she fuses with him, helps him to tame the dragon and, thus, to steal the Golden Fleece. She then helps to kill her brother, who persecutes the fleeing couple. Her father, overwhelmed with narcissistic rage, tears himself to pieces. In the myth, the tragic fate of Medea that now ensues is the revenge for this double murder. All my analysands unconsciously were convinced that their love partners, in analogy to Jason, would deceive and abandon them and that they would not be able to endure such an abandonment and narcissistic injury. They were terrified by the unconscious belief that they would react to such a catastrophe with lethally destructive impulses constituting an existential danger to the self and the love object as well as to their children. As Medea had done, they would then kill their own offspring in order to take revenge. For this reason, it seemed to them psychically imperative to forgo any creative unfolding of their femininity and symbolically to “deaden” themselves and their bodies.

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Medium 9781855757905

8 - Trauma

Peter Hobson Karnac Books ePub



Joanne Stubley

My aims in this chapter are twofold. First, I consider how a brief series of consultations might be of value for individuals who present with trauma. Second, I discuss how the psychological effects of trauma yield insights into the workings of the mind. Such insights are relevant for therapeutic work beyond that with traumatized patients.

I begin with a clinical description, but not of someone who came for consultation.

A person's story of trauma

A young college student, walking through a park on the way home from a party, is brutally raped. In the following weeks two other women are attacked in a similar manner, but they lose their lives at the hands of their attacker. The college student experiences post-traumatic stress reactions in the form of nightmares, flashbacks, difficulty sleeping, feelings of isolation and distance from friends and family, emotional numbness, and withdrawal.

Unable to return to classes, the student leaves college and returns home. There she finds it difficult to speak about her experiences. She finds herself embroiled in pointless arguments and disputes within the family. She breaks up with her former boyfriend and sees many of her old friends drift away. Eventually she begins to pick up the pieces of her life, restarting college in another town.

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Medium 9781782201014

Appendix I - Therapy Worksheets

Birgit Gurr Karnac Books ePub


Abdominal breathing is achieved by expanding the abdomen rather than the chest when breathing in and releasing the abdomen when breathing out.

This type of breathing slows down your breathing rhythm, which helps when you are stressed or worried about your headaches.

Slowing down your breathing consciously can intensify your relaxation experience.

Begin by placing your hands on your abdomen.

Notice how your abdomen expands when you breathe in and how it is released when you breathe out.

If this is difficult, try it lying down.


Take a deep breath. Notice your abdomen expanding.

Let the air out slowly. Count aloud for as long as possible.

Empty your lungs.

Hold the breath for a couple of seconds.

Take in a new deep breath, expanding your abdomen.

The pain gate responds according to the extent of an injury and the readiness of the nervous system to send and process pain signals.

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Medium 9781855751750

3. Interrelationships between internal and external factors in early development: current Kleinian thinking and implications for technique

Sue Johnson Karnac Books ePub

Jessica Sacret

In this chapter I want to explore, in a necessarily somewhat schematic way, some of the issues implicit in current theoretical developments in the Kleinian literature and to elaborate some of their implications. More specifically, I want to focus on the relationship between internal and external influences in psychic development, insofar as these are highlighted in the discussion of issues underlying the understanding and treatment of patients whose therapy seems to present particular difficulties by virtue of the predominance in the personality of what has come to be known widely in the literature as a “pathological organization” of the personality (Spillius, 1988). For example, Joseph (1975) has described “patients who are difficult to reach”; Steiner (1993) uses the notion of the “psychic retreat”; and Rosenfeld (1971) has elaborated the concept of “destructive narcissism”. Others in the Kleinian tradition have also written on the subject of this now well-documented albeit diverse phenomenon.

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