Deliverance,demonic possession,and mental illness: some considerations for mental health professionals

This paper outlines an unconventional treatment for mental illness, the exorcism or deliverance ritual used by Pentecostals and some other charismatic Christians. Deliverance beliefs and practices are based on the assumption that both mental and physical ills result from possession of the sufferer by demons, and are to be treated by the expulsion of those demons. Deliverance practitioners claim to treat schizophrenia, ADHD, and Reactive Attachment Disorder, and believe that these problems are related to sins either of the person in treatment or of an ancestor. Clinicians and counsellors dealing with clients who partially or completely espouse deliverance beliefs may need to understand their worldviews and to discuss their belief system before managing to engage them in conventional mental health treatments. Unusual ethical problems may also be met in the course of such work.     

L’invention managériale : une compétence cardinale pour les situations organisationnelles complexes

This study models “the manager invention”, cardinal skill to face the complex, contradictory, unpredictable socio-organizational reality. The works of Morin (on 1986, 1999, 2001) on the processes of the complex thought and those of Detienne and Vernant (1974), of Frontisi-Ducroux (1975) and Dejours (1993) about the mètis or practice intelligence serve us as theoretical supports, the analysis of contents of managers' narratives of empirical supports. The principles of a complex cognition (dialogical of the contradictory, complementarity of opposite, logic of the inclusive third) support the creative strategies of the managers : guile rather than force, diversion, bypassing, double position, happy medium, oblique speeches.     

Catalysts for psychic change: Perspectives from contemporary psychoanalysis

This paper was given as the inaugural ‘Ellen Noonan Counselling Lecture’ on 3 July 2007, at Birkbeck College, University of London, and I have retained some of the spoken style of the original lecture. Since the 1960s, psychoanalytic models of change and growth have in themselves undergone radical changes. The aims of psychoanalytic and psychodynamic work are now less tied to a model of ‘health’ or ‘normality’ and more linked into processes that enable people to keep developing throughout life. The lecture examines some of the new theories of psychic change and growth from the contemporary Independent, Lacanian and post-Kleinian schools of psychoanalysis and, using clinical illustrations, explores the implications of these new theories for psychodynamic practice.     

Between Cultures

Abstract

A hospital is an institution established to pursue one principal primary task: the care and treatment of the sick. In some hospitals, other important tasks - for example, training and research - must also be undertaken. There may at times be conflict about the relative importance of these tasks. Within the hospital, a large number of heterogeneous groups must coexist, communicate and co-operate to achieve the primary task. Each group is composed of individuals. Each individual has his own motivation for belonging to that group and for working within the hospital. The individual's roles within his own group, his relationship with other subgroups and his place within the hospital as a whole are to a considerable degree determined and driven by his unconscious impulses and needs. Within a gynaecological unit the levels of anxiety and other primitive emotions may be particularly high. Here, issues of life, death and sexuality are constantly being confronted. A strong defence system is therefore likely to operate at both an individual and a social level. This may either enhance or hamper the work effort.     

Working with Psychosis

This is the first of four papers about working with psychosis in a newly established post of psycho-analytic psychotherapist in an acute psychiatric unit in Australia. In this paper the author gives an account of some early impressions and experiences with staff and patients, particularly connected with an unacknowledged grief in the aftermath of psychosis. The author next discusses some of the psycho-analytic theory about psychosis which he found containing and helped make some sense of his experiences. He then introduces a case study of an exploratory psycho-analytic psychotherapy with a 40-year-old man suffering from a bi-polar disorder. The beginning of the therapy is described when this man revealed feelings of grief and despair about his illness. Being able to face and bear these feelings enabled him to begin to mourn what was irretrievably lost because of his illness and to contemplate what might still be possible. The author describes some of the early themes and one session in detail, and discusses how fluctuations in contact with the client reflect his retreat to a pathological organization in the mind. This psychic retreat was dominated by a psychotic process, and the retreat offered refuge from a dread of fragmentation and the pain of mourning and loss.     

Working with psychosis: Part 3 – ‘Struggling to contain madness – losing and recovering a capacity to think’

This is the penultimate paper in a series about working with a patient suffering from a psychotic disorder. The paper describes the third year of the work in which ‘John’ had four breakdowns in a period of six months. Much of the time I was unable to think. I was sitting on the edge of my chair either worrying that John was breaking down again or trying to help him recover from a breakdown. My small office became a cramped prison cell in which I felt myself a witness to a disturbing dance into and out of madness. A turning point seemed to happen as I developed a way of thinking about John's breakdowns. I seemed then to become a less persecutory figure in John's mind and more someone to whom John could turn for help. We found a way of thinking and talking about an infant in John. John responded by finding a way of being in my office as though he was reclining in a hammock. His breakdowns ceased. He was able to share in common humanity's concerns following September 11. Finally, I discuss thoughts about containment particularly about the paternal role in containment, drawing on Robert Caper's elaboration of Bion's ideas about containing psychotic aspects of experience.     

Working with psychosis Part 4: Therapy online – ending by email

This is the fourth and concluding paper from a series about psychotherapy with a man suffering from a psychotic illness. The paper describes the ending of the therapy which was precipitated by my decision to leave the country. News of ending was extremely disturbing for my client and stirred fears that he would again break down and need re-admission to hospital. Six weeks before the ending he stopped attending but continued to stay in contact by email. I decided to reply to his emails during the session times, and we developed what he came to call his ‘email therapy’. This online technology provided a means for my client and me to separate, to find a third perspective and to begin to mourn this ending without him losing his mind and breaking down. Following James Fisher's ideas about ‘mourning in the presence of the loved object’ I understand aspects of this email ending as enabling a relinquishing of projective identification used to possess and control, a recognition of the freedom of the other and of the need to mourn omnipotence. I discuss some of the problems presented by premature ending with a vulnerable client – problems which can be seen in my difficulty of mourning and working through the ending reflected in the long time it has taken to finish writing this paper.     

To let hair be,or to not let hair be? Gender and body hair removal practices in Aotearoa/New Zealand

Research and anecdotal evidence suggest women continue to remove body hair, and there is some evidence for cultural changes in men's hair removal practices. This paper reports on data collected using an online mix-methods survey from 584 New Zealanders between the ages of 18–35 (mean age 26, 48.9% male, 50.6% female). The data demonstrated that substantial proportions of both women and men in Aotearoa/New Zealand remove body hair from many sites. However, gendered differences remain, and a key dimension of gendered difference appears in the concept of flexible choice around body hair removal or retention. This was seen in the difference between perceived acceptability of having body hair (81% for men, 11% for women). These findings suggest that although men, like women, are now coming under some pressure to remove body hair, there is still a great difference in men and women's capacity to choose whether to bow to it.