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Medium 9781782203988

Tale Eleven: Psychotic Episodes: A Musician Seeks Ecstasy and Ends in Chaos

Rainer Matthias Holm-Hadulla Karnac Books ePub

“How can I find my way between fascinating thrills and dreadful horrors?”

After a long plane flight followed by a “psychedelic” party with unlimited amounts of alcohol, Berthold, a twenty-five-year-old musician, “freaked out with a vengeance”. He had to undergo a five-month course of treatment at a psychiatric hospital far away from his home. Although this therapy helped him, he is determined never to experience another “horror trip” like this one. At the hospital, he was soon able to calm down, but his inner isolation scared him. The medication made him feel “woozy” and he found the diagnosis, “schizophrenia”, frightening in the extreme. He does not want to go through such horrors again. He had previously gone in search of psychotherapeutic treatment but terminated a brief course of therapy because his (female) therapist made sexual advances to him.

Berthold makes a timid and desperate impression. At the same time, he comes across as rather contemptuous and patronising. However, I have a good feeling about the connection between us, and we are soon operating in a trustful atmosphere. Initially, of course, the deeper roots from which this understanding relationship springs remain unconscious. Berthold is obviously looking for someone to stabilise and guide him. He expects me to help him get on top of his mood swings and avoid chaotic states. At the same time, he senses that it is up to him to change his behaviour. He also wants to understand his feelings better. While I naturally intend to honour my professional obligations, I know that this will only be possible with empathy and understanding. I also see it as a challenge to accompany him on his path to creative self-realisation.

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Medium 9781782205180

Chapter Three - Privacy, Telecommunications, and the Psychoanalytic Setting

Jill Savege Scharff Karnac Books ePub

John Churcher (UK)

What are the implications for privacy when telecommunications are introduced into the psychoanalytic setting? In the classical setting, shared tacit knowledge about buildings enables privacy to be maintained, but this is insufficient when telecommunications are involved. We find it hard to know where to turn for expert advice, but there are conspicuous examples of bad advice, for example, those concerning Skype. From revelations by Edward Snowden in 2013, we now know that interception of telecommunications, including telephone and video conversations, is occurring on a massive scale and indiscriminately. Our reaction may be to turn a blind eye, disavowing the danger to privacy that this interception entails. As Freud showed, this is a defense against a psychical trauma, the fear of something intolerable happening in the future, and involves a splitting of the ego. José Bleger's view of the setting as a depository for the psychotic part of the personality implies that this splitting will undermine our work in a particular way. It will also tend to happen differently in countries and communities with differing social and political norms. It is unclear whether “good enough” security of telecommunications is in principle available, or what it would cost, but even the best systems are compromised by our poor “endpoint security.” Our only option, if we wish to continue using telecommunications as part of the psychoanalytic setting, is to try to analyze these difficulties within the setting itself. This will mean being honest with patients and ourselves about the new situation, undoing the disavowal, and proceeding on the basis of an “acceptance” of the uncertainty.

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Medium 9781855751170

CHAPTER 7. Converting a teaching event into consultation

David Campbell Karnac Books ePub

Jan Fjordbak


This chapter is about learning the important skills that you have to develop before starting out to do consultation, about reorganizing your previous and on-going experiences to become part of a consultant's identity, and about creating small-scale opportunities to practice consultation.

In recent years, we have seen an increasing interest in consultation work in a broader sense. The number of consultants has increased, and professionals occupied in other functions are trying to work in a more consultative way. In Denmark, this tendency is very visible in areas like school counselling and public agencies supporting developmental activities in the social services, unemployment, the occupational health service, and so forth. It seems as though everybody wants to be a consultants nowadays. Nobody wants to do the real work any more: being a consultant to people doing real work carries more prestige—even better, being a consultant to consultants!

The people who are becoming interested in systemic consultation are mostly social workers with a background in family counselling and psychologists with a clinical background. Some are pressured by their employers, others are themselves eager to expand their held of working into consultation.

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Medium 9781855759985

CHAPTER ELEVEN: Infantile trauma and perversion

Franco De Masi Karnac Books ePub

Infantile trauma and perversion

A psychic trauma is an action, either sudden or repeated, that proves harmful because the defences required to protect the individual who undergoes it are not yet ready. It is typical of the traumatic situation that the subject is confronted by a crushing event that cannot be understood or coped with mentally.

Infancy, of course, is the time of greatest exposure. When the trauma is occasioned by the child’s care-givers—e.g. the parents— the harmful effect is greater.

Views differ on the significance of early infantile traumatic experiences in the development of the pathologies or forms of suffering that will later emerge in adulthood. The uncertainty begins with the type of experience to be seen as traumatic in any individual case. An appraisal perhaps may be possible only retrospectively.

The systematic administration of beatings or humiliations has lasting adverse effects on the victim’s personality. An ill-treated child may develop a state of evacuation or masochistic passivity or, conversely, may readily, by identification, turn into a sadistic aggressor. There is a great deal of evidence that abused children become violent parents when they grow up.

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Medium 9781855753082

CHAPTER FOUR: Bowlby and Winnicott: differences, ideas, influences

Bruce Hauptmann Karnac Books ePub

Judith Issroff

Few would disagree that Winnicott and Bowlby were perhaps the two most influential pioneering British child psychiatrists and psychoanalysts of the past century, although technically Winnicott was a community paediatrician, not a psychiatrist, and Bowlby had worked in a residential school and been a teacher who had read psychology prior to taking his medical degree. Without aspiring to comprehensive or in-depth considerations of the broad scope of their work and its developments, because its range was great, this chapter touches on a number of topics and looks in greater detail at their respective attitudes, styles, links to others, mutual provocations, differences, and influences.

Bowlby and Winnicott were among the first to recognize that human infants enter the world predisposed to participating in social interaction. Their work addressed both healthy “securely attached” development with its consequent reflection in the inner world and the ravages caused by neglect, deprivation, and insensitive parenting. They showed how these early experiences pave the way for understanding a developing dependent infant’s and child’s absolute need for continuity of “good-enough” care (Bowlby, 1940, 1953; Winnicott, 1945a, 1945b, 1945c, 1949d, 1967b, 1984, 1986b, 1987a, 1988a, 1988b). Accordingly, they traced the adverse developmental consequences of loss of appropriate personal environmental provision, trauma, and mourning.

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