Launch of Body,Movement & Dance in Psychotherapy

This article explores time-limited dance movement psychotherapy (DMP) with a female offender diagnosed with borderline personality disorder looking particularly at the development of the therapeutic relationship and attachment theory. DMP can help increase the ‘capacity to think’ and provide alternative approaches for managing emotions opposed to ‘acting out’ difficulties in relating. The therapeutic relationship in DMP can provide a containing, holding environment in the absence of healthy attachments, early experiences of deprivation and trauma. Laban Movement Analysis, psychodynamic and mentalisation approaches were used to underpin the assessment, formulation and therapeutic interventions.     

Dance movement psychotherapy with an adult with autistic spectrum disorder: An observational single-case study

Dance movement psychotherapy (DMP) is considered to be a relevant and appropriate intervention for people with autistic spectrum disorder (ASD). A number of studies have reported DMP techniques and approaches in therapeutic work with children. Wider therapeutic practice in special education and other settings for children with ASD includes the use of structured narrative approaches in treatment. To date there is limited literature reporting DMP practice with adults with ASD. The aim of the study was to introduce a structured narrative approach in the form of the six-part story within DMP with an adult with ASD. A practice-based research approach was used to generate therapist observations and collect in-therapy responses from one patient. The study results indicate that DMP practice can incorporate structured narrative approaches in work with adults with ASD.     

The acceptability and feasibility of the Baby Triple P Positive Parenting Programme on a mother and baby unit: Q-methodology with mothers with severe mental illness

New mothers with severe mental illness (SMI) frequently experience significant difficulties in caring for their babies. There are no structured, evidence-based interventions that guide health professionals to help these women improve early parenting. The extensively researched and effective Triple P Positive Parenting Programme has recently been expanded to families with children less than 1 year old, which provides an opportunity to develop the intervention for women with severe postnatal mental illness. This study explored the views of mothers with SMI about the acceptability and feasibility of Baby Triple P (Baby TP) in the setting of a psychiatric Mother and Baby Unit (MBU). An 88-item Q-sort was conducted with a purposive sample of 15 mothers using Q-methodology. Three main factors were identified: ‘what we need’, ‘what we want’ and ‘we can do it’. A consensus was noted with general agreement about the benefits of Baby TP, and suitability of the MBU environment to accommodate Baby TP. Baby TP was viewed as an acceptable and feasible parenting intervention and deemed positive and non-stigmatising. Mothers requested more staff awareness and knowledge about the programme so that they were supported in learning and generalising skills.     

Where one cannot speak,there one can dance: a comparative analysis of dance movement therapy and Processwork

The text aims to outline the basic comparison of the theoretical roots, concepts and frameworks, principles, attitudes, typical interventions, phases of development and scope of practical use of dance movement therapy (DMT) and process-oriented psychology (Processwork). The author proposes that mutual benefits and opportunities are at disposal for practitioners from both schools, including the primary and secondary process and ‘edge work’ in Processwork, as well as movement observing techniques, movement profile mapping and the ‘dance-not-done’ approach in DMT. The theme of communication channels and the theme of ‘essence level’ or spiritual experience as approached in both practices is discussed as well.     

Attachment and Trauma in Groups and Organizations

Attachment processes develop across the life cycle and also express themselves in group and organizational situations where they can be conceived as a ‘politics of affect’ through which identities are constructed. I use the concept of ‘reciprocating selves’ to draw attention to these attachment‐seeking and relational processes. I argue that trauma can ossify the reciprocal movement and responsiveness necessary to human relating, the back and forth between people through which differences are negotiated and resilience created. I draw on Volkan's concept of ‘time collapse’ to characterize situations in which the embodied experience of affect overwhelms. This can render the past unrevisable and undifferentiated in the present. An idea of reciprocating selves helps us to understand how formative attachment experience continues to develop through the life of groups and organizations and the difficulties which occur if this process becomes frozen or where an ersatz reciprocation in the form of a narcissistic defence may result.     

I Am,a Central Concept of Winnicott

The attainment of unit status or I AM is a crucial stage in Winnicott's theory of development and arguably ranks amongst Winnicott's more well known ideas, such as transitional object, true and false self, and primary maternal preoccupation. Using Winnicott's 1968 paper ‘Sum, I am’, the author traces the dangers inherent in attaining I AM and what might hamper this achievement, the personal significance of numbers and divisibility, and how this links with his subsequent ideas on monotheism and a radical revision of Freud's dual drive theory. Returning to the ‘Sum, I am’ paper, the author briefly explores the importance Winnicott places on play in pedagogy and the significance of an intermediate space followed by Winnicott's thoughts about death, dissociation, and the importance of a mouse! Four clinical examples are used to illustrate difficulties in achieving I AM. Finally, the author suggests the spatula game in ‘Observation of infants in a set situation’ published over a quarter of a century earlier is a prime example of an I AM experience, with a beginning, middle and end.     

CAN WE BE BRIEF?

The author explores the subjective and objective nature of time in relation to brief psychotherapy, the contemporary contexts for this work and the impact of research on the changing culture of provision of counselling/psychotherapy. She describes clinical treatment using a brief Dynamic Relational approach with a traumatized patient in primary care who presents with panic and depression. Through this case she illustrates the most significant points of technique in her interpretation of this approach: assessment through interactional aspects of the first and second meetings, further assessment through history-taking and the development of narrative, forming a collaborative focus based on a maladaptive relational pattern, selective inattention and benign neglect, interpretative ‘action’, termination and the collaborative therapeutic summary and use of other attachment figures available in the primary care team setting, particularly during the termination phase. The patient's unconscious and conscious internalization processes enable brief treatment to be durable, and it is argued that depth can be achieved. The author contends that brief therapy requires specific techniques but also makes connections with long-term analytic work, for example, the parallel between Bion's concept of the ‘selected fact’ and the ‘focus’ in brief therapy.     

Educational outcomes in extremely preterm children: neuropsychological correlates and predictors of attainment

This study assessed the impact of extremely preterm birth on academic attainment at 11 years of age, investigated neuropsychological antecedents of attainment in reading and mathematics, and examined early predictors of educational outcomes. Children born extremely preterm had significantly poorer academic attainment and a higher prevalence of learning difficulties than their term peers. General cognitive ability and specific deficits in visuospatial skills or phoneme deletion at 6 years were predictive of mathematics and reading attainment at 11 years in both extremely preterm and term children. Phonological processing, attention, and executive functions at 6 years were also associated with academic attainment in children born extremely preterm. Furthermore, social factors, neonatal factors (necrotizing enterocolitis, breech delivery, abnormal cerebral ultrasound, early breast milk provision), and developmental factors at 30 months (head circumference, cognitive development), were independent predictors of educational outcomes at 11 years. Neonatal complications combined with assessments of early cognitive function provide moderate prediction for educational outcomes in children born extremely preterm.     

‘You Can Take it With You’: Transitions and Transitional Objects in Psychotherapy with Children Who have Learning Disabilities

This paper will consider what impact a learning disability may have on development and transition in a child's life. With reference to Hollins and Sinason's ‘Three secrets’ (2000), Alvarez's ‘Levels of psychoanalytic work’ (2012), and attachment theory, I will reflect on the development of the self when there is learning disability. The paper will go on to relate Winnicott's paper, ‘Transitional objects and transitional phenomena’ (1953) to the theory and practice of integrative arts child psychotherapy (IACP). In IACP, objects, play and creativity form a central part of the treatment. Drawing on clinical material from my long‐term treatment of two young people in particular, I will link the therapeutic effect of objects with Winnicott's ideas about creativity, aggression, motivation and the expression of self. In the paper I set out how, through the therapeutic use of objects and what I call, ‘object games’ we were able to address the children's experiences of trauma as well as the impact of their disabilities. I will describe the changes I saw in the internal worlds of my patients which in turn led to significant and positive changes in their relationships with self and with others. These changes came, over time, to allow them greater independence and self‐determination in everyday life.     

A psychoanalytic perspective of endings in therapy: A dance movement psychotherapy case study

This paper is an account of time-limited dance movement psychotherapy in an inner-city London school during my final year of training for an MA in Dance Movement Psychotherapy. I describe the treatment of a traumatised 9-year-old boy using psychoanalytic theories, in particular Winnicott's ideas. This patient suffered at an early age from the drastic separation of his father and, when he was 6 years of age, various dramatic events led to the hospitalisation of his mother due to psychiatric problems. The impending ending of the therapy and the trainee's repetition of a ‘neglectful transference’ triggered powerful memories of traumatic past separations, which aroused deep-seated anxieties in the patient and trainee alike. The work towards a ‘good enough’ ending in the new therapeutic relationship was of great value to the patient's recovery. Parallels are drawn with the trainee's feelings of ending her dance movement psychotherapy course.     

Body and movement in dynamic psychotherapy: reflections on talking and movement therapies

In recent decades, somatic experiencing has taken a major place in psychoanalytic thinking. Different theories relate to the meaning of the mother’s attunement towards her baby’s body and to the importance of the therapist’s attentiveness to his own somatic sensations, awakened in the encounter with the patient. With the patient in the armchair, psychodynamic therapists think, imagine, feel and wonder about what the patient’s body may wish to express. This article concerns the patient leaving the armchair in order to actively express himself in the space of the room. It includes examples from the work of Winnicott, Balint and Ogden, and describes the use of analytic work in conjunction with the body and movement. It suggests that the patient’s need to ‘dance the soul stories’ during treatment may bring about actual changes in treatment technique, even prior to systematic theoretical conceptualisation that addresses intervention methods incorporating somatic movement.     

Fortpflanzung zwischen Natürlichkeit und Künstlichkeit

There are now many ways in which reproduction can be influenced. When natural boundaries are exceeded this means taking responsibility. The author reflects on what sort of action reproduction is meant to be and what kind of risks are associated with seeing reproduction as a manufacturing process. The nature of reproduction as a ‘good’ is then analysed. Against this backdrop the impact of individual starting points on the way persons see themselves and on the relationship between parents and their children is then considered, and some thought is devoted to the extent of reproductive freedom that might be seen as a right. Being natural has no inherent moral weight; it just has a normative function insofar as it can protect such ethically important ‘goods’ as freedom and equality.     

Mentalization within Intensive Analysis with a Borderline Patient

The author discusses whether the concepts of mentalization are helpful within intensive, individual analytic work with a personality disordered patient. Child and adult technique within the widening scope of psychopathology can be thought of as building on developmental help, studied at the Anna Freud Centre from the sixties to reach ‘atypical’ children who could not use classical analysis. The first two years of work with Jenny, a young borderline woman, were anchored by developmental research on attachment and early parent–infant relating. Later, when her capacity to symbolize, tolerate and communicate affect had greatly improved, she could accept and use interpretations, and working in the transference was gradually able to be accepted as thinking and not only as action. The infantile modes of experiencing psychic reality hypothesized in mentalization theory are illustrated from the material, and the status of attachment within psychoanalytic theory is reconsidered. In the last section, how each psychotherapist specifically shapes the process of change will be discussed, building on the concept of ‘marked mirroring’.     

Vitamin D in pregnancy and early life: the right target for prevention of allergic disease?

Evaluation of: Weisse et al. Maternal and newborn vitamin D status and its impact on food allergy development in the German LINA cohort study. Allergy 68, 220–228 (2013).

Allergic diseases are the most common chronic disorders of childhood. The alarming trend is that these diseases are expressed early in life and are no longer outgrown in childhood. Over the last 10 years, the rates of food allergy and eczema have continued to increase dramatically in children as part of what appears to be a ‘second wave’ of the allergy epidemic. Although the risk factors for allergic disease are multifactorial, the early onset has implicated lifestyle and environmental factors as significant contributors to this escalating trend. Weisse et al. present supporting evidence for vitamin D being positively associated with children’s risk for food allergy or sensitization against food allergens during their first 2 years of life and argue against the use of vitamin D supplements to protect against allergy. Here, the authors provide a mechanistic insight into how high cord blood vitamin D levels can result in increased food allergy risk in children.     

Matriarchy,Matricide and Mourning

Matricide is suggested as an important counterpart to the traditional oedipal manifestations of patricide. This paper turns to The Oresteia to examine its murderous protagonists and the meaning of the drive to eliminate mothers. A daughter may enact unconscious matricidal wishes in order to separate from an ambivalent tie to her mother, by excising femininity and femaleness in herself. The author explores early bisexual pulls that can emanate from primal scene identifications. The capacity to relinquish the option to have all options is brought in as a ubiquitous and painful developmental move away from having and being all sexes. Father's role as crucial in the sexual development of daughters, including Freud's role in relation to his daughter Anna, is considered and mourning is linked to Klein's Depressive Position. The author includes clinical material of two children from the literature and draws on interviews conducted with trans men to reflect on these struggles. The paper explores early awareness of the difference between the sexes and argues that this can fuel a protest for daughters, sometimes manifesting as a ‘no-mother’ or matricidal state of mind. If these wishes or phantasies remain unmourned, they can at times lead to a concrete flight from femininity.     

Assessment of motor control using kinematics analysis in preschool children born very preterm

The aim of this study was to better understand the mechanisms underlying the motor difficulties encountered by children born very preterm (VPT) without major sequelae from preterm birth. We compared the organization of visuo-manual aiming in preterm and full term (FT) preschool aged children based on performance and kinematics data. Twenty preterm (4 females, 16 males) and 20 sex- and age-matched FT children were divided into two age groups (mean age: 3 years-4 months, and 5 years). Comparison of the performance data showed differences between the older preterm and FT children. Kinematics data revealed differences in movement control between the younger preterm and FT children. The younger FT children did not differ from the older children. In addition, there was an effect of age on both performance and kinematics data for the preterm children only. The pattern of results suggests difficulties in integrating sensory information for movement control in the preterm groups, leading to a delay in the development of visuo-manual coordination. Kinematics analyses may help identify children at risk for poor school performance.     

Confidentiality and Consent Issues in Psychotherapy Case Reports: The Wolf Man,Gloria and Jeremy

In this article I explore the issues surrounding confidentiality and consent in the writing of psychotherapy case reports. An important theme is the challenge of protecting a patient's privacy while furthering knowledge in the field through publication. I discuss some of the complexities as well as the relevance of present day requirements for informed consent, including a consideration of the provisions within the Declaration of Helsinki (1964, last revised 2013). To illustrate the difficulties inherent in writing about our work I give examples of three cases: Freud's patient Sergei Pankejeff (the ‘Wolf Man’), Gloria (the patient in the ‘Gloria Films’), and a contemporary patient, ‘Jeremy’, whose therapist published an account of her work with him. The writing of case material is complex and resists easy solutions; there can be no ‘one‐size‐fits‐all’ approach but instead the therapist writer's careful consideration on a case by case basis of his or her motivations for writing, what the patient is really consenting to, whether patient consent can ever be truly informed, and how writing and publishing a case might impact on the safety and well‐being of the patient (including others connected to the patient), as well as on the therapeutic relationship itself.     

Some Reflections on the ‘Teaching Attitude’ and Its Application to Teaching About the Use of the Transference: A British View

In this paper the author argues that psychoanalytic education is enhanced when (a) it attends seriously to the affective, relational and social processes that frame the experience of teaching and of learning, fostering a critical engagement with both, and (b) it engages candidates in exploring what they do (technique) in the context of the articulation of their model of working (theory). The features of the ‘teaching attitude’ that are relevant to psychoanalytic education are illustrated though a ‘teaching case study’ detailing the rationale, process and content for a curriculum on the concept of transference.     

Dual adaptation to opposing visuomotor rotations with similar hand movement trajectories

This research explored specific contextual cues that might facilitate human motor learning. Using a dual adaptation task, humans performed manual reaches to visual targets while experiencing a 30° clockwise or counterclockwise rotation, which randomly alternated between trials, of a seen cursor representing their unseen hand. Groups had different cues to distinguish between rotations: ‘Cue’ (colours and shapes), ‘Workspace’ (target locations) and ‘Workspace with Cue’ (combination of cues). Importantly, the workspace groups required similar hand movement trajectories to accurately acquire pairs of targets. Our data show that only the ‘Workspace’ and ‘Workspace with Cue’ groups, but not ‘Cue’ group, adapted to both rotations concurrently (dual adaption). These findings suggest that colour and shape cues, even when integrated with the end-effector and targets, do not facilitate dual adaptation. However, target separation is sufficient to facilitate dual adaptation, even when hand movement trajectories are similar. Interestingly, adaptation was less complete when required hand trajectories were completely overlapping for pairs of targets (versus being similar), suggesting an important role for the motor system as well. Nonetheless, the location of targets and consequent differences in motor planning may play a larger role in facilitating adaptation than previously thought.