From Pathological Merger to a Reflective,Triangular Space: Parent-Infant Psychotherapy with a Mother with Borderline Personality Disorder

This article looks at Parent-Infant Psychotherapy work with a mother with Borderline Personality Disorder and her infant son. Mother had suffered a traumatic childhood and, when her son was born, withdrew into a delusion of merger with him, avoiding what she experienced as a violent, threatening and confusing world. Drawing on psychoanalytic and attachment-mentalization theories and neuroscientific and developmental research, this article explores mother’s difficulties in acknowledging her baby as a separate being, and the impact this had on baby, who was slowly turning toward an autistic way of functioning. The article discusses the therapeutic challenges in creating a reflective, triangular space where both mother’s and baby’s experiences could be thought about and understood. Finally, the author considers an interpretative stance that includes both mother’s and baby’s shared and their separate experiences.     

The Gentleman Vanishes: Dementia,Caretaking and the Life of the Mind

This essay recounts the author’s journey with her father during his prolonged decline due to dementia. The experience pushed her to break out of the confines of conventional scholarly research in her academic field of architectural history to a multi-disciplinary consideration of nineteenth-century environmental, sensory and horticultural therapies for the mentally ill. During her father’s illness, she discovered the tangible therapeutic benefits of momentary engagements with his environment through his five senses and through the emotional filter of poetry. This reorientation to sensory and poetic experience had a beneficial impact on the caretaker as well.     

Being the Shadow: Witnessing Schizophrenia

This essay discusses Susan Smiley’s documentary film, Out of the Shadow (2004), and Tina Kotulski’s memoir, Saving Millie: A Daughter’s Story of Surviving Her Mother’s Schizophrenia, as filmic and narrative treatments of their mother’s schizophrenia. Mildred Smiley, and her diagnosis of and treatment for schizophrenia, is at the center of both her daughters’ treatments of mental illness, and in these texts, all three become witnesses to the multiple experiences of mental illness and the multiple events of psychiatric power. As I will argue, these two texts are treatments of schizophrenia that both see and don’t see Mildred Smiley’s experience of mental illness. Through these texts, we—viewer and reader—are asked to look again, or to look for the first time, at mental illness, and we are positioned as having the agency to look or look away. As we look and try to make sense of what we see (and don’t see), we too participate in the production of mental illness as a category of analysis.     

Jeri altneu sechzer (1926-2011)

Presents an obituary for Jeri Altneu Sechzer. Jeri studied at the University of Pennsylvania, where her mentor was the renowned physiological psychologist Elliot Stellar. She received her doctorate in 1962 with a specialty in physiological psychology. That same year she was elected to Sigma Xi, the scientific research society, and received the Creative Talent Award from the American Institute of Research for her doctoral dissertation. She completed a U.S. Public Health Service Postdoctoral Fellowship at the University of Pennsylvania School of Medicine, after which she accepted a position at Baylor University College, followed by a position at the New York Hospital-Cornell University Medical Center. She completed her career as a visiting professor in the Psychology Department at Pace University. Jeri's husband of 56 years, Philip, died in 2004. As a result of her experience looking after him during the long illness that preceded his death, she became interested in the psychological impact of the stresses that caregivers face. She was planning to organize a conference on this subject when she suffered her final illness, leading to her death on October 29, 2011, just before her 85th birthday. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

Countertransference enactments informed by cancer in an analyst's child

The author's son was diagnosed with Hodgkin's lymphoma in the spring of 1997. She traces the impact of this trauma on her practice, with specific emphasis on her experience as both analyst and mother, and on the related countertransference feelings and enactments. The paper discusses in detail the analyst's effort to determine for each patient whether or not to disclose the fact of her son's illness, the internal conflict she experienced over those decisions, and the effects of her decisions on her patients. An extensive case discussion focuses on a patient who appeared to intuit in a dramatic fashion the traumatic events in the analyst's private life.     

Dante’s Divine Comedy and modern depth therapy

The author discusses a connection between the modern analysand’s experience of depth therapy and the Christian pilgrim’s experience of confession, penitence and transformation as described by Dante in his Divine Comedy. She looks at structure and order in the context of psychotherapy. Taking Adriana Mazzarella’s ‘In Search of Beatrice’ as a guide, she examines a Jungian interpretation of the poem as an analogy of therapeutic initiation. She explores the idea of cultural complexes via the study of the medieval world view as one distinct from our own. She demonstrates the way in which study of the Comedy unexpectedly helped her survive an experience of long-term psychotherapeutic work.     

Survivor mission: Do those who survive have a drive to thrive at work?

Are helping professionals who have experienced the same types of struggles as their clients more engaged at work? In the current investigation, we examine this question in samples of police detectives (with and without a history of violent victimization) and mental health workers (with and without a history of mental illness). Our results indicate that police detectives who have experienced violent victimization and mental health professionals who have experienced the same mental illness as their clients do indeed exhibit greater work engagement than their colleagues who lack these parallel life experiences. The link between a professional’s firsthand experience of his/her client’s hardships and work engagement appears to be partially explained by higher levels of grit among police detectives and by a greater sense of life-narrative continuity among mental health professionals.     

‘Journeys’ in the Life-Writing of Adult-Child Dementia Caregivers

This article explores how Alzheimer’s disease caregivers struggle under the impact of a parent’s memory loss on their own personality. In particular, it analyses how caregivers perceive and, thus, present their experiences of the ever intensifying caregiving activity in terms of a ‘journey’. In doing so, this work takes into account both the patient’s continuing bodily as well as cognitive decline and its intricately linked influence on the caregiver’s physical and emotional stability. Equally, this study investigates how caregivers portray memory loss, and how their portrayal fits into our conceptualisation of illness narratives and the culture of autobiographical writing.     

A Narrative Inquiry into a Female Athlete’s Experiences with Protracted Concussion Symptoms

This article explores a female university volleyball student-athlete’s experience with protracted concussion symptoms. Through the methodology of narrative inquiry, four salient themes became apparent related to Daphnée’s experiences: (a) “I felt so alone,” (b) “I had to make one of the hardest decisions of my life,” (c) “I feel like I’m in prison,” and (d) “There’s no light at the end of the tunnel.” Overall, this study offers a rare look into the impact of concussion on an individual’s athletic and academic identities, career progression, and in turn, her imagined stories of who she was and who she was becoming.     

Euthanasia in psychiatry can never be justified. A reply to Wijsbek

In a recent article, Henri Wijsbek discusses the 1991 Chabot “psychiatric euthanasia” case in the Netherlands, and argues that Chabot was justified in helping his patient to die. Dutch legislation at the time permitted physician assisted suicide when the patient’s condition is severe, hopeless, and unbearable. The Dutch Supreme Court agreed with Chabot that the patient met these criteria because of her justified depression, even though she was somatically healthy. Wijsbek argues that in this case, the patient’s integrity had been undermined by recent events, and that this is the basis for taking her request seriously; it was unreasonable to expect that she could start again. In this paper, I do not challenge the Dutch euthanasia criteria in the case of somatic illness, but I argue that both Chabot and Wijsbek are wrong because we can never be sufficiently confident in cases of severe exogenous depression to assist the patient in her irreversible act. This is partly because of the essential difference between somatic and mental illness, and because of the possibility of therapy and other help. In addition, I argue that Wijsbek’s concept of integrity cannot do the work that he expects of it. Finally, I consider a 2011 position paper from the Royal Dutch Medical Association on euthanasia, and the implications it might have for Chabot-style cases in the future.     

Chronic Illness and Child Behavior Problems in Low-SES Families: The Mediation of Caregivers’ Mental Health

Journal of Child and Family Studies - Childhood chronic illness is associated with deleterious effects on caregivers’ mental health and children’s socio-emotional development. This...     

Race-Related Differences in the Experiences of Family Members of Persons with Mental Illness Participating in the NAMI Family to Family Education Program

Families play an important role in the lives of individuals with mental illness. Coping with the strain of shifting roles and multiple challenges of caregiving can have a huge impact. Limited information exists regarding race-related differences in families’ caregiving experiences, their abilities to cope with the mental illness of a loved one, or their interactions with mental health service systems. This study examined race-related differences in the experiences of adults seeking to participate in the National Alliance on Mental Illness Family-to-Family Education Program due to mental illness of a loved one. Participants were 293 White and 107 African American family members who completed measures of problem- and emotion-focused coping, knowledge about mental illness, subjective illness burden, psychological distress, and family functioning. Multiple regression analyses were used to determine race-related differences. African American caregivers reported higher levels of negative caregiving experiences, less knowledge of mental illness, and higher levels of both problem-solving coping and emotion-focused coping, than White caregivers. Mental health programs serving African American families should consider targeting specific strategies to address caregiving challenges, support their use of existing coping mechanisms and support networks, and increase their knowledge of mental illness.     

‘Making Room for the Other(s)’: A consideration of psychodynamic counselling with women with Asperger’s Syndrome

This paper explores psychodynamic therapy with young women with Aspergers Syndrome through the use of a composite case study. It seeks to make sense of a female patient’s obsession with a figure from celebrity culture – ‘Tom’ from ‘Britain’s Got Talent’. The potential use of ‘Tom’ by the patient as an idealised object, an autistic object, a transitional object and a transformative object is considered. Drawing on Rosenfeld’s concept of pathological narcissism and Meltzer’s concept of ‘aesthetic reciprocity’, the paper seeks to make sense of both the defences that the patient utilises and the impact of the deficits she has experienced. Attention is given to the development of the therapy through the use of play and work in the transference. Gradually, the patient becomes more able to tolerate separateness and in doing so becomes more connected to her own internal world and the feelings of others. In so doing, she becomes more aware of her actual social marginalisation and gains a greater sense of awareness of her diagnosis.     

Clinical Practice With Cases of Extreme Traumatization 40 Years After the Military Coup in Chile (1973–1990): The Impact on the Therapists

This paper presents our clinical experience with patients who were severely traumatized by the systematic violation of human rights during the military dictatorship in Chile (1973–1990). The lack of recognition of trauma of sociopolitical origin encapsulates the traumatic experience and forces it to remain as part of the present. Clinical vignettes of two therapeutic processes—mother and son—are presented: The mother was detained; sexually tortured; and, as a result of this, gave birth to the torturer’s son. Her therapeutic process is an account of her ambivalence towards her son, of how his origins were kept a family secret, and of how this secret was unconsciously transmitted. The young man’s therapeutic process centers on the transgenerational transmission of trauma and how the torturer–tortured dynamic seeps into the relationship with the analyst. The impact on the analysts’ subjectivity in working with extreme trauma is described.     

Sexuality,Normality, and Social Terror: XXY by Lucía Puenzo

Lucía Puenzo’s (2007b) subtle and observant coming of age film, XXY, is the starting point for a discussion of gender, families, and unspoken anxieties. This article explores the world of Alex, an intersex teenager, who is navigating a relationship with the visiting son of family friends. Alex has reached the age when she wants to make her own choices about both gender and desire, setting off a family and social chain reaction about who decides that there are only certain ways to be human. XXY is first considered as a narrative of a common developmental crisis, then as a narrative case study.     

Moments Out of Time: A family canoes the north woods

This nature essay recounts the author's 10-day canoe trip with her blended family through Algonquin Provincial Park in Canada. Within the narrative, she explores the ways in which a young child's spirituality ('relational consciousness') influence her own adult consciousness. Conversations with her 6-year-old son lead to her to develop the metaphor of radio frequencies to reflect upon the differences between children's and adults' attitudes toward time: solar time; here-and-now time; the human life cycle; historical time; memory time; industrial time; infinity time. In addition to these conversations, the author draws upon several social critics, nature writers, and others. Other themes touched upon include contemplation, the sense of wonder, bodily knowing, the deep self, and time management. The essay closes with the author reflecting on the need to reclaim time in ways that nurture the natural spirituality of childhood.     

Reflections for Clinical Pastoral Education Students in Psychiatric Settings

This article focuses on Donald Capps’s books on mental illness. In doing so I highlight three key insights from Capps that I have applied in my own ministry with persons with mental illness in various psychiatric hospitals. These insights, together with my own experience as a chaplain, lead to three practical lessons for clinical pastoral education students in psychiatric settings. I provide some context for my interest in mental illness and my friendship with Capps, as well as some background regarding how Capps’s writings on mental illness fit with certain broader themes in his own work as a pastoral theologian. This essay is personal throughout.     

‘It’s silly these doors don’t open’: a six-year-old girl emerges from a chronic state of emotional withdrawal

This clinical paper explores the way in which the first two years of a long-term psychotherapy helped six-year-old Anna to lessen her retreat into a chronic withdrawn emotional state. Over the course of the first year she would occasionally pick up the fridge from the doll’s house and try to open the doors, but because the fridge was actually a block of wood the doors could not open. In treatment, this inquiry came to represent the difficulties of engaging and making contact with a baby who found it very hard to feed. The author describes how, as Anna entered into a therapeutic relationship, it slowly became clear that there was an inner world jam-packed with persecutory anxieties and a family history of unmourned loss and trauma. Through fear Anna slammed the doors to her mind – to knowing herself – and by not feeding, Anna starved herself of opportunities for mental growth. It took some time for her to state, “it’s silly these doors don’t open, they should”. In the discussion of this clinical material the author draws on the work of Francis Tustin, Alessandra Piontelli and Marguerite Reid to consider the link between intergenerational and prenatal trauma and subsequent emotional disturbance in the child.     

THE <Emphasis Type="Italic">DEAD-LIVING-MOTHER</Emphasis>: MARIE BONAPARTE’S INTERPRETATION OF EDGAR ALLAN POE’S SHORT STORIES

Princess Marie Bonaparte is an important figure in the history of psychoanalysis, remembered for her crucial role in arranging Freud’s escape to safety in London from Nazi Vienna, in 1938. This paper connects us to Bonaparte’s work on Poe’s short stories. Founded on concepts of Freudian theory and an exhaustive review of the biographical facts, Marie Bonaparte concluded that the works of Edgar Allan Poe drew their most powerful inspirational force from the psychological consequences of the early death of the poet’s mother. In Bonaparte’s approach, which was powerfully influenced by her recognition of the impact of the death of her own mother when she was born—an understanding she gained in her analysis with Freud—the thesis of the dead-living-mother achieved the status of a paradigmatic key to analyze and understand Poe’s literary legacy. This paper explores the background and support of this hypothesis and reviews Bonaparte’s interpretation of Poe’s most notable short stories, in which extraordinary female figures feature in the narrative.