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CHAPTER THREE: Violence to body and mind: treating patients who have killed

Paul Williams Karnac Books ePub

Carine Minne

The nature and function of aggression, described so elegantly by Don Campbell in his chapter, and the theme of the conference, “Aggression: from fantasy to action”, are subjects that have intrigued me for many years and caused so much suffering to the patients I have seen, and to those around them, particularly their victims. In particular, I have wondered what is it that makes a mind that entertains an aggressive fantasy, a common occurrence, transform into a violent muscular action, a much less common occurrence. When violent patients have psychoanalytic psychotherapy as part of their treatment plan, and the prospect of understanding develops, what does one need to indicate has changed in the patient and, indeed, how can one demonstrate any changes that may have arisen which would mean the patient is now less at risk of being violent again? Generally, clinical risk assessments on patients who have been violent tend to focus on the patients’ behaviour, combined with a psychiatric mental state examination. This often neglects what, if any, changes may have arisen in the patients’ internal worlds, and it is here that a psychoanalytic approach can contribute to clinical risk management, one that emphasizes the fluidity of risk as opposed to presenting a snap-shot.

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Medium 9781855752412

CHAPTER ONE Dialogues with parents

Siv Boalt Boethious Karnac Books ePub

Margaret Rustin

This chapter is intended as an overview of current practice at the Tavistock Clinic. The approach described also represents a significant strand within child, adolescent, and family mental health services of the British National Health Service. I shall sketch a map of some varieties of approach, provide clinical examples, raise some ethical concerns, and explore how work with parents is encompassed within the identity of the child psychotherapist.

History of work with parents within child guidance

Perhaps it would be useful to start with some historical background. The early generations of child psychotherapists could rely on close working partnerships with experienced social workers (Harris, 1968). The postwar child guidance clinics were fortunate in their genuine multidisciplinary ethos and particularly in their social workers, who usually had a commitment to a psychoanalyti-cally based understanding of human development and family relationships. Much of Winnicott’s writing about his hospital work is imbued with his sense of the multidisciplinary teams within which his creative potential developed and standards of good practice were established. This was a very particular culture of care.

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Medium 9781780491615

Chapter Three: To Mend the World—Trauma, Mourning, and Containment

Lene Auestad Karnac Books ePub

He wrote me that in the suburbs of Tokyo there is a temple consecrated to cats. I wish I could convey to you the simplicity—the lack of affectation—of this couple who had come to place an inscribed wooden slat in the cat cemetery so their cat Tora would be protected. No she wasn't dead, only ran away. But on the day of her death no one would know how to pray for her, how to intercede with death so that he would call her by her right name. So they had to come there, both of them, under the rain, to perform the rite that would repair the web of time where it had been broken.

Marker, 1983

The main objective of Emil Fackenheim's 1982 work To Mend the World is to lay the foundations of a post-Holocaust Jewish thought. This work's urgency is to confront the possibility of collapse of Jewish, Christian, and secular philosophies that results from the reality of Auschwitz and what was lost therein (Morgan et al; 2008). Fackenheim takes seriously Adorno's claim of the metaphysical capacity being arrested in Auschwitz and takes it to its last consequences.

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Medium 9781782202912

Chapter Eight - On the Psychology of Love

Esa Roos Karnac Books ePub

Esa Roos


Can anyone say one what makes love happy or unhappy? In spite of the essentially subjective nature of the question, it is important to examine what factors lead to disappointment and failure of love and what factors lead to the hoped-for results, that is, to a happy union of individuals as well as a cohesive society. Why is love so central to our existence? Because it is a strong motivational force in life and a central interest for humanity. It is an extremely communicative state, a force for development, and a motivating and creative drive of human nature and culture. Love and happiness are not simply psychoanalytic terms. Both are well-known mental states, as well as hate and dream. Certain things are indispensable to happiness, such as food, health, work, parenthood, respect, and love. In being in love, we hope to find our happiness. Pascal Bruckner (2012) says that the modern family is centred on the happiness of its members (p. 130). According to him, “we love as much as human beings can love, that is, imperfectly” (p. 219).

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Medium 9781855750463

2. Learning from divorce

Christopher Clulow Karnac Books ePub

Martin Richards


All is not well in the state of marriage—or, at least, that seems to be a widespread view. There is much discussion of our “high” divorce rate, the rise of cohabitation, and the number of children born outside marriage, which now approaches a third of all births. It is suggested that marriage is not providing the satisfaction and support it once did. Society seems to have lost its way—that, at least, is the claim. The causes of these changes are usually perceived as a shift in marital behaviour and attitudes and not, for example, as the result of changing economic and social pressures on couples. So it is more likely that the so-called “sexual revolution” of the 1960s will be cited as a cause rather than the present economic recession, with its accompanying housing crisis and high rates of unemployment.

In this chapter I want to stand aside a little from these current debates and draw on the work of social scientists, including historians, to see how far these perspectives may illuminate the current debate. But before doing this, it is worth commenting on what is seen as “the problem”.

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