On psychic elements in a case of autistoid perversion

The paper explores the formation of psychic elements from an epistemological point of view, drawing on the work of Bion to examine a clinical case of autistoid perversion. Distinguishing the qualification of psychic elements from the realization of pre‐conceptions, the paper argues that psychical elements are constituted through a mutually shared experience of presence, and so they should be understood in a paradoxical way – through being‐O and transformations into K. These ideas are explored via a clinical case concerning a patient with an autistoid–perverse organization. The patient had been denied any bodily contact with her parents during her first year of life due to an infection; in later life she exhibited an autistoid coprophilic perversion. During the course of her treatment, as it became possible to break down the autistoid organization, the nameless contents surfaced in a mutually shared experience of presence. The analyst was able to hold on to their meaning, which was unavailable to the patient. The absent analyst, however, turned into the mother who ‘put the child down’ and was experienced by the patient as a suicidal threat. In being‐O, the analyst was able to endure the paradox of being the one who ‘put her down’ in order not to put her down; the paradox of being‐O functioned as a container for the destructive objectal dimension of the state of ‘being put down’.     

Risk and resilience: The moderating role of social coping for maternal mental health in a setting of political conflict

Violence can threaten individual wellbeing and tear at the social fabric of communities. At the same time, suffering can mobilize social coping and mutual support. Thus, the backdrop of political violence increases risk factors and stimulates resilience. The current study examined the moderating role of social coping as reflective of risk and resiliency in Northern Ireland, a setting of protracted conflict. Specifically, structural equation modeling was used to investigate whether social coping protects from or exacerbates the negative impact of sectarian crime and nonsectarian crime on maternal mental health (N = 631). Nonsectarian crime predicted greater psychological distress for mothers in Belfast. Mixed support was found for the buffering and depletion moderation hypotheses; social coping functioned differently for nonsectarian crime and sectarian crime. Greater social coping buffered mothers’ psychological distress from the negative effects of nonsectarian crime, but exacerbated maternal mental health problems when facing sectarian crime. Results suggest that social coping is a complex phenomenon, particularly in settings of protracted political violence. Implications for interventions aimed at alleviating psychological distress by enhancing mothers’ social coping in contexts of intergroup conflict are discussed.     

The Evidence Base for Occupational Therapy in Mental Health: More Systematic Reviews Are Needed

To shape its work, the Research Centre for Occupation & Mental Health is interested in research priorities. Systematic reviews develop an overview of the research available about an intervention, which can provide evidence to underpin practice. They also however, identify gaps in the knowledge base and so are useful for research-prioritization exercises. A rigorous literature search identified only four systematic reviews about occupational therapy in mental health, which suggests that more are needed to underpin practice. This article also explains a six-stage process for conducting a systematic review that can be used by occupational therapists in mental health.     

Transformative Experience of Master of Occupational Therapy Students in a Non-traditional Fieldwork Setting

The purpose of this qualitative pilot study is to further understand the transformative experiences of Master of Occupational Therapy students who engaged in a role emerging fieldwork. Five students were interviewed and their reflective journals were analyzed following a fieldwork experience at an at-risk youth shelter. Four themes emerged through the coding process: fear and anxiety of the unknown, clinical reasoning and self-reflection, personal and professional growth, and further understanding of occupational therapy. Results indicate the powerful impact of role emerging fieldwork on the development of the student and provide a framework for meeting the standards of psychosocial fieldwork experiences.     

Relational trauma in infancy. Psychoanalytic,attachment and neuropsychological contributions to parent–infant psychotherapy

Abstract

The paper argues that residential projects working mainly with those diagnosed schizophrenic are specialized work groups, in Bion's terms, operating upon the assumption of pairing, and illustrates this with reference to a period of organizational change at one such project. The reasons why this might be so are discussed, and are related to the central issue of hope and despair in work with those who are unlikely to recover.     

Soul pain and the therapeutic use of ritual

Abstract

This paper will explore the relationship between ritual and transformation. It will show how a therapist and a monk work together to create sacred spaces in which individuals can experience transformation of and through their personal histories, linking their past, present and future to address their soul pain through ritual.

It is illustrated with case studies which will demonstrate the phases of ritual work which are collectively important as part of the psycho-dynamic therapeutic process.     

Chapter 7 The Gay Therapist's Response to a Gay Client Practicing Unsafe Sex

Abstract

The significance of psychoanalytic perspectives for brief psychotherapy is discussed in the report of a gay man practicing unsafe sex (known colloquially as “barebacking.”). The paper focuses both on understanding transference and counter-transference issues in work with this man.     

Couple Therapy in the Presence of Mental Disorders

Abstract

Mental disorders and relationship discord commonly occur together and couples where one or both parties suffer from a mental disorder are commonly seen in couple therapy. Symptoms of mental disorders can usefully be conceptualized cybernetically and viewed as part of negative feedback loops that couples become trapped in without denying the potential contribution of biological or other types of knowledge. Most of the existing research focuses on couples and depression and couple therapy has been found to have efficaciousness as a treatment of depression especially when depression occurs along with relationship discord. There is less research on couple therapy and other mental disorders but general guidelines are offered that couple therapists can use with any of the mental disorders.     

Evaluating School Readiness to Implement Positive Behavioral Supports

ABSTRACT

One state's efforts to assess school readiness to implement a comprehensive mental health innovation are described. To determine the likelihood of achieving success with positive behavioral supports (PBS), a process to identify school buildings ready for planned organizational change was designed and implemented within a large-scale system of care initiative in southeastern Kentucky. The salient features of the innovation are discussed, the process used to design and implement the approach is delineated, and limitations and implications of this method are considered. This multi-systemic intervention can serve as an example of the practice of organizational school psychology.