Displacement as trauma and trauma as displacement in the experience of refugees

This paper investigates the relations between displacement, home, trauma and the self in the experience of refugees, which has become an issue of unexpected and far-reaching proportions in recent times. It questions to what extent and under what conditions displacement in the world may be traumatic and how trauma may be considered the effect of an inner displacement. Refugees’ lives are marked by forced migration that is related to a certain suffering due to the changes in their family, relational, social and cultural lives. The paper explores the extent to which these changes can represent a break so significant as to be traumatic. It outlines the way in which traumatic experiences can produce an inner displacement and reorganization of one’s mental life that leads to a focus on traumatic complexes. Under the most severe traumatic conditions, this can be understood as a displacement of the central axis of Self, in which the ego complex yields its position to other complexes, with a deep change in the organization and functioning of self. The experience of refugees highlights the way in which we live in a matrix of conscious and unconscious links between inner and outer worlds that need deeper and simultaneous consideration to understand their implications and mutual resonances for the psyche. Clinical cases of refugees will illustrate some aspects of these interconnections.     

The analyst in action: An individual account of what Jungians do and why they do it1

This paper describes some similarities and differences between contemporary approaches to analysis as practised by ‘Freudians’ and ‘Jungians’ in London today. It aims to contribute to mutual understanding between different schools of analysis by showing how the analyst’s interventions can only be understood in terms of the theoretical context from which they arise (cf. ‘the analyst’s preconscious’, as discussed by Hamilton [1996] ). A discussion of five key themes of Jungian theory is followed by an account of clinical work with a patient who enacted her inner world through the use of material objects brought to the consulting room, presenting difficult technical dilemmas concerning boundaries and enactment. The paper aims to shows how these Jungian themes influenced the analyst’s response, particularly in relation to ideas of symbolic transformation, the unknowable nature of unconscious processes and the purposive orientation of the self towards wholeness and integration.     

A School Psychologist's Self-Study Guide to Sport Psychology

SUMMARY

School psychologists may find the field of sport psychology beneficial to them in extending their skills and effectiveness. As trained psychologists, they are likely to already have some of the knowledge and skills necessary for working in the area of sport psychology. However, without additional training, this may not be sufficient for ethical and effective practice. This article enumerates the necessary knowledge and skills for working in sport psychology according to APA's recent proficiency standards. It then details a plethora of available resources and methods for entering into the domain of sport psychology. The article emphasizes self-study while continuing to practice ethically within the ‘boundaries of one's competence.’     

Countering Cultural Metaphors of Aging

SUMMARY

This article examines three clusters of metaphors or cultural images of aging which function to marginalize older adults: metaphors which focus on aging as physical decline, on aging as aesthetic distance from youth, and on aging as failure of productivity. It then sketches out two ways to counter the marginalizing power of these cultural images of aging, to shape new metaphors or images of aging within a community of meaning, and to help make new sense of growing old, namely the formation of face-to-face groups of older adults and the creation of rituals in worship which name publicly the realities and experiences of aging.     

Assessing Professional Boundaries in Clinical Settings: The Development of the Boundaries in Practice Scale

This article reports on the Boundaries in Practice (BIP) Scale developed to measure knowledge, comfort, ethical decision making, and experience. Few instruments used in studies conducted on professional/?client boundaries have been validated. The BIP demonstrated sound face, content and construct validity, and adequate internal consistency reliability. The BIP Scale provides the first reliable and valid means of investigating multiple boundary domains across health disciplines and teams. The sensitivity and complexity of boundary issues and the serious consequences of breaches highlight the importance of a valid and reliable measure in building empirical knowledge in this field.     

Sexual Abuse Litigation

Summary

Practicing psychologist Janet Sonne and attorney Julian Hubbard illuminate how the different aims and languages of psychotherapy and law can be either an asset or a liability in the emotionally-charged environment of sexual abuse litigation. Properly understood, these differences can optimize the ability of each professional to assist their common client, the sexual abuse survivor, in the litigation process and beyond. Dr. Sonne reviews the psychological and behavioral sequelae of childhood sexual abuse and identifies six elements of the client's psychological functioning key to the litigation process, as well as posing questions for the attorney's self-evaluation for the unique demands of sexual abuse litigation. Mr. Hubbard then addresses what survivors and therapists need to know about the litigation process, exploring dynamics of legal strategy that can exacerbate the client's psychological problems. In the final section, both offer tips to enhance professionals' focus on education and communication as a means to better serving the sexually abused client.     

Say hello to the scream extractor: working with an autistic child with psychotic mechanisms

This paper describes the first two years of intensive psychotherapy with a six-year-old boy diagnosed with autism. I explore the many ways in which he retreated from reality, most frequently by taking refuge inside the maternal body or flying off into an imaginary space world. He fragmented his identity and that of his objects by using the discourse of fictional characters. Everything was externalised; there was little transmutation of material available for thought. I consider his dilemma – the wish to fuse with the object and the fear of being engulfed; the omnipotent denial of the need for an object and of the parental relationship, leading to an inability to make links. The paper discusses working with a child who experienced any ‘paternal’ firmness as persecuting and destructive. The softer, receptive maternal mind of the therapist was more easily tolerated. He gradually began to internalise a more benign combined object, as he became more able to bear separateness from the other.     

Negotiating time: the significance of timing in ending inpatient work

This paper discusses work with young people during their stay on an NHS psychiatric inpatient unit, especially focusing on the end of treatment and the appropriate timing of discharge into the community. When approaching the end of an admission, various factors are considered that seem particularly relevant to the decision of when a young person may be ready to leave and cope with the transition back to life outside the unit. Indications of medical stability, in patients where this has been an issue, is a factor of prime importance. Other important factors include family functioning; the availability of adequate ongoing local CAMHS support for the child and family; suitable school provision; and the identity of the child within a peer group. The reality of NHS resources and the demand for inpatient beds is another pressing consideration. The young person's own motivation emerges as crucial at this stage – towards the end of treatment – not only in terms of what is said, and therefore evident verbally, but also through signs of internal shifts in the child that indicate a capacity to re-engage with life outside in a lasting way. Decisions about when to stop are taken with all this in mind and when the decision does not seem straightforward, it can provoke considerable anxiety in the multi-disciplinary team. Clinical material from psychotherapy with a young adolescent boy with anorexia nervosa is used to illustrate some of the dilemmas.     

Journeys in the labyrinth: Some difficulties in the psychotherapy of a severely traumatized adolescent

This paper explores the long-term sequelae of chronic early trauma as expressed by an adolescent in intensive psychotherapy. In particular, attention is given to the ways in which intolerable early experience may block subsequent identificatory ego growth by means of a radical defensive detachment from any potential source of help. Healthy maturation is replaced by an elaborate structure of defences aimed at obliterating awareness of unfulfilled attachment needs and providing a constantly available inner sanctum filled with exciting but profoundly unsatisfying sadomasochistic distractions. The technical importance of careful attention to the therapist's countertransference experiences is underlined. It is suggested that the presence of hatred in this area may represent one of the few undistorted communications from the patient, implying hatred of torture and cruelty. As such, when carefully metabolized by the psychotherapist, it may herald the recovery of hope and serve to protect hidden, bullied aspects of the patient's self which are still on the side of life and development.