The experiences of transgender and non-binary children and young people and their parents in healthcare settings in England,UK: Interviews with members of a family support group

Abstract

Background: Transgender and non-binary children and young people and their parents in England, UK are poorly served across a range of healthcare settings. Whilst UK equalities legislation and international guidance on transgender healthcare pathways protects this group from discrimination and mandates an affirmative approach, services in England are not keeping pace.

Aims: This study aims to draw on the experiences of transgender and non-binary children, young people and their parents in a support group in England in order to investigate their experiences of healthcare provision, and to develop some ideas for improvement.

Method: Data was collected with participants in a family support group which offers a parent helpline service, social groups for children and parents, and training for schools and other organizations. 65 parents and children from 27 families from the family support group attended participatory workshops where they were given a range of briefs: “health,” “family,” “friends,” and “education.” Their participation involved being asked to define their own interview questions and collect data by interviewing each other. Their interview notes constituted the raw data. Data was coded inductively by the author with respondent checking as a second stage.

Results: Results constitute the views of a small group of people, so cannot be generalized. However, they do illustrate some of the issues which may arise. Participants’ experiences elicited five key themes: professionals’ perceived lack of clinical and therapeutic knowledge; mental distress caused by excessive waiting lists; professionals’ stereotyped gender assumptions; direct discrimination within healthcare settings; and a lack of attention to parent and child voice, especially in terms of school-based experiences and where a patient had a diagnosis of autism.     

When soothing succeeds: Simulating a risk for repeated shaking in abusive head trauma in infants

PurposeTo investigate the observation that perpetrators of abusive head trauma engage in repeated shakings because shaking “works” to quiet the infant.MethodsSixty first-time parent couples individually cared for a programmable model infant in two consecutive 7-min trials. After six minutes of consolable followed by inconsolable crying, parents selected one of three soothing techniques. For trial one, parents were randomized to a “Successful” or “Failed” Soothing Condition. Whether the soothing technique was repeated after trial two was determined by the study investigators. Parents rated their frustration after each trial.ResultsAs hypothesized, parents were more likely to repeat a soothing technique that “worked” in trial one. Compared to fathers, mothers reported more frustration when soothing failed.ConclusionsThat caregivers were more likely to repeat a successful soothing technique converges with perpetrator confessions that crying cessation after shaking may be a reason why shaking is used repeatedly in response to crying.     

Pathological nurturance: The root of marital discord

Abstract

During the process of Adlerian Family Education, a great deal of attention is given to understanding the dynamics of the family constellation, especially sibling ordinal position and family atmosphere. The first step in interviewing a “teaching-demonstration” family is to diagram the family constellation and make some tentative guesses regarding how the children in the family have “found their place,” gained a sense of belonging, and exhibited possible adjustment problems or misbehavior. Audience participants are encouraged to share in this stochastic process based upon knowledge gained in observing previous family education sessions. Then the parents being interviewed either confirm or revise the guesses presented. At this point the parents generally specify their primary concerns, which typically involve the “misbehavior” of their “problem child.” In helping parents understand children and their misbehavior, the family educators quickly point out that it is necessary for them to understand the whole context of the family and that the Family Education Center program is designed to improve not only the “identified problem” child but the relationships between all members of the family (Dreikurs, et al., 1959, p. 23).     

Modifications des relations intrafamiliales dans les familles françaises de jeunes enfants pendant le premier confinement lié à la COVID-19

IntroductionIn the context of the COVID-19 pandemic, the French state implemented containment measures requiring parents to stay at home with their children, while ensuring, in addition to daily tasks and work, their schooling.ObjectiveThe objective of this publication is to present the modifications of parent-child and spousal relationships during this period and their main sources according to the parents.MethodAn online questionnaire from 28 April 2020 to 29 May 2020 collected data from 490 French families with at least one child from birth to six years old. A content analysis of the discursive corpus was carried out with NVivo software (version 10). Quantitative statistical processing (using STATA software, version 16.1) tested the relationships between socio-demographic variables, as well as those relating to the parents’ experiences, and “strained” and “strengthened” intrafamily relationships.ResultsWhile for 33.3% of the respondents, family relationships did not change, they became stronger for 42.5% and tense for almost a quarter (24.3%).ConclusionUnderstanding the sources of tension experienced by families of young children during lockdown, as well as what enabled other families to better cope with this situation, may enable measures to be implemented to deal with the consequences of the discomfort generated by the lockdown and to avoid further psychological problems during possible future ones.     

Divorce Therapy in Context

Abstract

Partners trying to decide whether to continue or end their marriage rely on the expertise of therapists to help them evaluate their alternatives. Research on what predicts divorce and what consequences divorce has for parents and children is reviewed so therapists are informed in the guidance they give clients. Attention is given to the environmental context of marriage as well as its interior quality. Implications for therapists doing divorce therapy in the context of a “pro-marriage” climate are also discussed.     

Deconstructing the “Covered Bridge” - Couples Therapy with Sexual Abuse Survivors and Their Partners

SUMMARY

In accepting the editor's invitation to submit an article for this volume, I have taken the subject matter, Building Bridges, quite literally: that is, to talk about bridges as a rather compelling metaphor for couple relationships. I have chosen to focus on the covered bridge, in particular, as it informs me most graphically of the structure and therapeutic challenge presented by couples in which one partner is a child sexual abuse survivor. In my clinical work with such couples, I invariably find myself in the role of surveyor/engi-neer/builder, deconstructing the “covered bridge” and engaged in building a stronger, more open and enduring structure. The steps toward rebuilding and transforming the “covered bridge” structure for these couples are outlined and illustrated.     

Enhancing the Creative Process in Couple Therapy

ABSTRACT

This paper reviews the literature as it relates to psychotherapy and creativity. The focus is on the creative process and the role of the therapist as “artist” in the practice of couple therapy. The theory on which the paper is based in problem-centered with influences from the writing of Satir, humanistic psychology and psychodynamic psychotherapy. The paper attempts to offer suggestions as to how therapists might enhance their innate creative ability when working with couples.     

The Mating Game

SUMMARY

Mate selection processes of couples have been of interest to a multitude of disciplines ranging from biology to psychology to social psychology. Debates usually center around “like marries like” or “opposites attract.” While generally the research indicates, at least with regard to social variables, that similarities among couples is the norm, little systematic empirical research exists which examined this basic belief. Family therapists, also adhering to this basic assumption in their notions of couple selection, collusion, and reciprocal patterns of interaction, have not empirically tested this assumption either. The present paper examines the literature from the biological, psychological, and social psychological disciplines and discusses these assumptions in family therapy theory. A discussion of the implications for couple therapy is then presented.     

Fetal Homicide

Summary

Under common law, a crime resulting in the death of a fetus that was viable but not “born alive” was viewed as a transgression less serious than murder. Accordingly, courts did not allow parents to bring wrongful death suits for the death of a fetus. In the past decade, however, several states have amended their criminal or civil statutes to include the specific crime of “feticide” or “fetal homicide,” and the Federal government is considering similar legislation. This paper examines the history and current status of criminal and civil law regarding the third-party killing of a fetus.     

An Ethos of Affirmative Laughter in Nietzsche’s Zarathustra

In Thus Spoke Zarathustra (2006), Nietzsche presents Zarathustra as a sage and parodic prophet, who acquires and offers insight over the narrated journey of his spiritual development. Nietzsche’s conception of Zarathustra as a gift (to “all and none”) endorses learning as the kind of emulation condensed into Zarathustra’s complex formulation: rather than “corpses that I carry with me wherever I want . . . I need living companions who follow me because they want to follow themselves—wherever I want.” Thus I aim, firstly, to follow the text closely to see what is given. However, noting that Zarathustra is deeply imbued with figures of laughter, I also impose an interpretation. “Repeating differently,” as demanded by Zarathustra, I outline a practicable, spiral-shaped “learning curve” of traversal and return to various “shades of laughter,” advancing from the worst laughters to “golden laughter,” which embraces complexity. This represents what it means to laugh well. In so doing, I hope to demonstrate that the complex ethos of affirmative laughter in Zarathustra remains strikingly pertinent for a contemporary era urgently tasked with embracing complexity.     

Who Has the Power?

SUMMARY

“Who Has the Power” describes the impact of a wife's change in role on her husband. Despite the seemingly harmonious nature of traditional gender behavior, uni-dimensional roles cannot sustain a dynamic marriage. In order for a lively marriage to be sustained, both partners must alter their style of relating when either one changes. When this is achieved, the couple moves from an illusion of themselves and the coupling and can begin to deal with the reality of who they are.     

Asian American Intermarriage

SUMMARY

This paper describes the therapeutic process of an interracial couple: an Asian American woman and a White American man. The intent of this therapy was to broaden the conversational space and encourage the couple to explore the effects of cultural beliefs and practices on their relationship. The therapist introduced two approaches for evoking the couple's interest in sharing narratives about their individual and couple racial identity. One approach was to have the couple interview their partner's “internalized other.” The other approach used two research studies to stimulate conversation about outmarriage with Asian Americans. This case study offers an account of two different ways individual narratives and shared conversational space can be expanded.     

A Cross-Cultural Perspective on Couple Differences

SUMMARY

This paper challenges the idea that differences between partners in couple relationships are inherently problematic. A “cross-cultural” perspective on differences in couples that considers partners' reactions to difference as the problem is presented. Couples therapy from a cross-cultural perspective begins with a detailed' assessment of perceived differences, reactions to differences, the context in which the differences have developed, and the purposes they serve. Therapeutic tasks involve managing maladaptive reactions to differences, learning to accept differences, and co-designing a common couple culture.     

Hospitable Kinship in Theological Education: Cross‐Cultural Perspectives on Teaching and Learning as Gift Exchange

Abstract. Using an autobiographical approach for pedagogical reflection, the author raises questions about how to include “hospitable kinship” and “gift exchange” in teaching and learning. Her experience with a Zimbabwean community circle of hospitable kinship has prompted her to consider how this method of community formation might be employed in classroom situations. Definitions for hospitable kinship and gift exchange are woven throughout the narrative. Attention to the role of the teacher as host is provided as well. The essay prompts readers to turn their attention toward specific strategies that will aid in the formation of classroom community.     

Separateness/Togetherness

SUMMARY

Within the framework of the developmental stages of marriage, this article focuses on the paradox of separateness/togeth-emess in the marital relationship and how this issue is manifested in the first four stages of marriage. The author also examines the intervention of a “structured trial separation” as a method for ensuring the growth of the individuals and for enhancing the growth of the couple during one of the most critical stages of marriage.     

The Differential Validity of Items in a Liberalism-Conservatism Test

Summary

The purpose of this study was to provide a large sample validation of the Family Attitude Measure (FAM) developed by Delhees et al. (7). The FAM was given to the parents of 250 junior high school children, and the items factored. The results of the analyses on two of the subtests were found to be interpretable and are described in detail. Few of the factors identified were as interpretable in the sense of the Delhees et al. factors, but this could be due to the fact that this study involved the factoring of items rather than the “packages” which served as variables in the Delhees article.     

Children of Nazi Germany 60 years on

Abstract

Defence against shock, feelings of guilt, and shame about German atrocities during National Socialism (NS) have dominated the public discourse in Germany for decades. Mitscherlich and Mitscherlich have talked about the inability to mourn due to the involvement of most German families in Nazi terror. The research projects “Childhood in War” at the University of Munich and “War Children and their Flight” at the Hamburg DPG Institute are studying the long-term implications of a childhood during World War II and the Nazi period. In most cases, the personal development of the “war children” was affected – in the case of psychoanalysts, their psychoanalytic socialisation and current professional practice as well. The transgenerational transmission forms an NS introject in the personality. Due to their parents’ lack of empathy, war children are unconsciously looking for a containment of their unbearable feelings in their childhood. Psychoanalysis (including training analysis) becomes a stage where the analysee's childhood loneliness, the taboo-forming, the inhibition to ask and the protection of the parents, as well as feelings of guilt and embarrassment in the family, not talking about matters, and silence, occur once more in transference.     

Research & clinical exchange

Abstract

Question: I once heard Carl Whitaker say at a workshop that one of the greatest myths about marriage is the idea that “I didn't marry your family, I married you.” This makes me wonder when it would be appropriate to involve the families of the two people planning to get married, when the couple goes for premarital counseling.     

Saving Them From Yourself: AnInquiry into the South Asian Gift of Fearlessness

This article considers the importance of indigenous classifications in the study of comparative ethics. Specifically, it explores medieval South Asian gift discourses from Jain, Theravada, and Hindu Dharmasastra sources, which list and discuss a variety of prescribed gifts. Such lists generally include a category of gift known as the “gift of fearlessness”(abhayadana), wherein refraining from harming others is considered a species of gift giving. This type of gift and the discussions concerning it unite generosity and nonviolence in a way that is suggestive for understanding how some medieval South Asian theorists conceived of the gift, human nature, and altruism.