Communicating with Vulnerable Patients explores ways to improve the communication process between highly vulnerable patients and the therapist, based on the assumption of the permanent presence of an ‘outsider’ or potential space in the communication field between them. In this space, the therapist and highly vulnerable patients can undergo transitional states of mind established between and within their relationship.
Leticia Castrechini-Franieck, also known as Maria Leticia Castrechini Fernandes Franieck, presents practical methods to overcome communication issues and engage therapeutically with highly vulnerable patients suffering from personality disorders, addiction, and trauma, as well as with deprived
Communicating with Vulnerable Patients is presented in five parts, with Part one focused on building communication through a Transient Interactive Communication Approach (TICA) and Part two applying TICA in forensic settings with five case studies illustrating the approach in a range of contexts. Part three considers TICA in intercultural settings, including work with refugees, and Part four outlines adaptations of the approach, including T-WAS (Together We Are Strong), which aims to avoid an increase of antisocial behavior in deprived children, and the use of TICA in the COVID-19 pandemic. The book concludes in Part five with reflections on outcomes and limitations of both TICA and T-WAS.
Communicating with Vulnerable Patients will be invaluable reading for professionals, psychotherapists, group therapists, and group analysts working with at-risk populations.
Published by Routledge, 2023
What does one do when a dangerous paedophile, nearly six feet seven inches in height, threatens to kill you? How does one manage when a brain-damaged, psychotic patient spits on the office floor two hundred times during the first consultation? And what does one say when one member of a warring couple reveals the most horrific acts of sexual cruelty?
In perhaps his most gripping book to date, Professor Brett Kahr offers colleagues a detailed glimpse into the challenge of working with highly distressed and disturbing individuals in long-term psychotherapy. Kahr explains the ways in which such deeply troubled people hurl "bombs" into the consulting room, leaving considerable "psychological shrapnel" in their wake.
The book contains five sensitively and compellingly written clinical chapters, followed by several historical chapters which explore the ways in which Donald Winnicott attempted to manage the bombs in his consulting room, often of his own making. Kahr then examines the pioneering contribution of Enid Eichholz (later Enid Balint) who, during the Second World War, created marital psychoanalysis as a means of dealing with couples ravaged by actual wartime bombs. The book concludes with an historico-clinical chapter on how thoughtful and sophisticated classical interpretation can reduce the impact of clinical bombs. Kahr even provides us with an examination of his favourite "top ten" interpretations in the history of psychoanalysis!
A unique and helpful volume, written by a practitioner steeped equally in psychoanalysis and history, Bombs in the Consulting Room: Surviving Psychological Shrapnel will be essential reading for anyone who has ever felt frightened while treating patients.
By Prof. Brett Kahr
Published by Routledge
Mothers Accused and Abused: Addressing Complex Psychological Needs brings together stories about mothers who are accused of harming, and in some cases killing, their children, children who subsequently harm or kill others and the challenges to professionals who work with them.
Contributors consider the deeply rooted cycles of neglect and abuse manifested in the childhoods of mothers, who only come to our attention when their extreme distress is expressed through their actions. By recognising the long-standing, unmet dependency needs of abused and neglected women, the book argues that longer term engagement can prevent a seemingly endless repetition of court hearings and imprisonment, and thereby address cycles of neglect.
With sections on mothers in prison and interventions following child care proceedings, Mothers Accused and Abused will be a valuable resource to those working in the criminal and civil justice systems, social work and mental health as well as others who, in a professional or personal capacity, encounter troubled mothers and their children.
Edited by Angela Foster
HMP Holloway was the largest women's prison in Europe, historically holding numerous infamous female criminals and eliciting intrigue and fascination from the public. The End of the Sentence: Psychotherapy with Female Offenders documents the rich and varied psychotherapeutic work undertaken by dedicated specialists in this intense and often difficult environment, where attempts to provide psychological security were often undermined by conflicting ideas of physical security. Women commit crime most often in the context of poverty, addiction and transgenerational violence or trauma, familial cycles of offending and imprisonment which are often overlooked. Using personal testimony and case studies, and screened through the lens of psychoanalytic theory, the book examines the enduring therapeutic and relational endeavour to find connection, closure and to experience a "good enough" ending with prisoners when the possibility of a positive new beginning often seemed remote. It also considers how the cultural and political discourse remains hostile towards women who are incarcerated, and how this may have culminated in the closure of the only female prison in London. Through insightful real-life accounts, this insightful book also emphasizes the importance of professionals finding ways of supporting one another to offer women who have entered the criminal justice system a way to leave it. It will prove fascinating reading for forensic psychotherapists, forensic psychologists and criminologists, as well as anything interested in the criminal justice system.
There is an expectation that women will be nurturers and carers. Women who have been judged violent, destructive and criminal and who are detained in the criminal justice system can find themselves perceived through a distorted lens as unwomanly. This book explains how they become hypervisible in their difference, while the histories of trauma and suffering that are communicated through their offending and other risk behaviour remain hidden, and so are unseen.
Bringing together authors uniquely placed as experts in their fields, Invisible Trauma argues that it is essential to trace the traumatic roots of women’s violence and criminality. Powerful intergenerational factors perpetuate the cycles of offending and trauma re-enactment that current sentencing practice overlooks. The authors present a psychoanalytically informed account of the development of violence and other offending, identifying pathways for change to address trauma within the lives of these women and their children, and also to create a responsive, effective and sensitive workforce.
Invisible Trauma highlights the role of emotional, social and cultural forces in traumatising women who come into contact with the criminal justice system and uncovers areas of their lives that are all too often hidden from view. It will be invaluable to those working in clinical and forensic psychology, mental health nursing, psychotherapy, social work, medical practice and women’s health, as well as frontline practitioners in the criminal justice system, the health service and third sector organisations and for anyone with an interest in racism, equality and social justice.
By Anna Motz, Maxine Dennis, Anne Aiyegbusi
Published by Routledge, 2020
Series: The New Library of Psychoanalysis
In his new book, Considering the Nature of Psychoanalysis: The Persistence of a Paradoxical Discourse, Gregorio Kohon describes the complexity of the psychoanalytic encounter, questioning the misguided attempts to simplify and/or reduce it to either art or science.
Kohon disputes the contemporary use of parameters offered by evidence-based medicine as a research model to study psychoanalysis. Instead, he proposes to reconsider the relevance of the psychoanalytic single case study, its importance and pre-eminence.
The present book will be of great interest to all psychotherapists, councillors, psychiatrists, mental health workers and students and academics of the social sciences.
By Gregorio Kohon
Published in association with the Institute of Psychoanalysis
This is a provocative collection exploring the different types of violence and how they relate to one another, examined through the integration of several disciplines, including forensic psychotherapy, psychiatry, sociology, psychosocial studies and political science. By examining the 'violent states' of mind behind specific forms of violence and the social and societal contexts in which an individual act of human violence takes place, the contributors reveal the dynamic forces and reasoning behind specific forms of violence including structural violence, and conceptualise the societal structures themselves as 'violent states'.
Other research often stops short at examining the causes and risk factors for violence, without considering the opposite states that may not only mitigate, but allow for a different unfolding of individual and societal evolution. As a potential antidote to violence, the authors prescribe an understanding of these 'creative states' with their psychological origins, and their importance in human behaviour and meaning-seeking. Making a call to move beyond merely mitigating violence to the opposite direction of fostering creative potential, this book is foundational in its capacity to cultivate social consciousness and effect positive change in areas of governance, policy-making, and collective responsibility.
This two-volume set includes:
Volume 1: Structural Violence and Creative Structures ISBN 9781785925641
Volume 2: Human Violence and Creative Humanity ISBN 9781785925658
by Tilman Kluttig and Bandy X. Lee. Prologue by Estela Welldon. Epilogue by James Gilligan. John Adlam (Editor)
In the pre-modern era, those who committed serious crimes would invariably be treated with extreme cruelty - often punished, tortured, eviscerated, and executed in the most grisly, sadistic fashion. Over time, the treatment of offenders has become more enlightened and more benign. But have we really progressed sufficiently in our approach to the rehabilitation and cure of vicious perpetrators of savage acts?
This book considers the intersection between madness and violence across the ages, and investigates how Sigmund Freud and the early generation of psychoanalysts and psychotherapists challenged the more primitive, punitive models. Professor Kahr also discusses some landmark projects, which help to humanise serious criminal offenders and further our understanding of the ways in which severe early childhood trauma plays an important role in the genesis of extreme criminality.
By Prof. Brett Kahr
Published by Confer Books
The UK Government's Offender Personality Disorder (OPD) Strategy is one of the most significant developments in mental health and criminal justice in recent years. The challenges presented by personality disorder offenders are not unique to the UK and this book also provides a useful overview of developments in the UK for those working with this population in countries where health service provision and legal frameworks pose different challenges.
Managing Personality Disordered Offenders: A Pathways Approach describes how the OPD Strategy has been implemented by a consortium of mental health trusts in the UK, in collaboration with the National Probation Service and the Prison Service. This volume covers the broad range of key tasks in developing and delivering an OPD service. This includes reviewing the political and clinical context and how it aims to address some of the criticisms levelled at previous initiatives developed to
meet the needs of this population. In each chapter, the authors review the existing literature and discuss the various options that were considered during the development of each of the services. Through this lens, the reader gains a better understanding of the direction taken, followed by a detailed,
practical "how to do it" guide.
Edited by Colin Campbell and Jackie Craissati
New Horizons in Forensic Psychotherapy: Exploring the Work of Estela V. Welldon, edited by the author, contains many rich contributions by some of Welldon's most distinguished former students and proteges. The book consists of important chapters on the creative ways in which colleagues have utilised and expanded upon Welldon's work in the field of forensic psychotherapy in a variety of settings, including in hospitals, prisons, community mental health clinics, and, also, in private practice.
Edited by Brett Kahr