Psychopathology: Theory and Practice

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Study the mind at CPD, certificate or diploma level in our new post-qualification programme

19 September 2019 to 4 June 2020
Thursday evenings 19.30-21.30

This newly created 30 week course will provide professional practitioners of psychotherapy, psychology, psychiatry, psychoanalysis, counselling, creative arts therapies, and related professions with an intensive, year-long study of the field of psychopathology in its many forms, introducing participants to psychological conditions ranging from severe manifestations of psychological illness to the more ordinary neuroses of everyday life.

The programme has been designed to survey not only basic psychiatric knowledge but also the century-long accumulation of psychological knowledge about psychopathology.

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COURSE STRUCTURE

The course will be divided into three terms which can be attended on different levels:

  • As CPD, attending the lectures and receiving a certificate of attendance OR
  • As a Certificate qualification, attending the lectures with a home study programme OR
  • At Diploma level, attending the lectures with a home study programme and submission of a 5000 word dissertation

Award

Certificate in Psychopathology or a Diploma in Psychopathology

Unit One

Basic Psychopathology

A study of the history and theory of psychopathology and some of the major psychoses and other forms of psychopathology that often require institutionalisation and psychiatric interventions

Unit Two

Sub-Clinical Psychopathology

An exploration of forms of psychopathology which are common in our society, and which often become culturally assimilated including personality disorders, addictions, eating problems, sexual issues and criminal behaviour.

Unit Three

Developmental and Applied Psychopathology

Different manifestations of psychological suffering across the life cycle, from infant, child and adolescent to old-age psychopathology, as well as psychological illness in many different relational contexts (eg couples, families, groups, organisations, and even among nations).

Senior Course Director

Professor Brett Kahr

Deputy Course Tutors

Raffaella Hilty, Dr Richard Sherry,

THE COURSE PHILOSOPHY

The newly constituted course will provide professional practitioners of psychotherapy, psychology, psychiatry, psychoanalysis, counselling and creative arts therapies with an intensive, year-long study introducing participants to psychological conditions ranging from severe manifestations of psychological illness (e.g., schizophrenia, affective disorders, and the forensic psychopathologies) to more common ordinary neuroses and character disturbances (e.g., anxiety disorders, hysteria, obsessive-compulsive disorders, addictions, psychosexual disorders).

The course will be divided into three units. During the first unit, participants will have an opportunity to study not only the history and theory of psychopathology but, also, some of the major psychoses and other conditions which often require institutionalisation. During the second unit, participants will have an opportunity to examine psychopathology in the community. And in the third and final unit, participants will engage with different manifestations of psychological suffering across the life cycle, by investigating infant psychopathology, child psychopathology, adolescent psychopathology, adult psychopathology, old age psychopathology, as well as psychological illness in many different relational contexts (e.g., couples, families, groups, organisations, and even among nations).

The core teaching team of the Certificate in Psychopathology and the Diploma in Psychopathology has designed this course to survey not only basic psychiatric knowledge but, also, the century-long accumulation of depth psychological knowledge about psychopathology. We hope that in offering broad coverage with a focus on the depth psychologies that practitioners will be able to embark upon a serious and carefully constructed examination of the field in all its multiple facets.

The course will offer a comprehensive study of each subject area, focusing on the clinical phenomenology of each state of psychopathology, upon its aetiology, and upon its treatment. Although the primary theoretical lens will be a psychodynamic one, broadly defined to include classical psychoanalytical, Jungian, and modern relational perspectives, participants will also be exposed to the more traditional theories from biologically orientated psychiatry and related disciplines in order to provide a wide coverage of the field.

The teaching team of the certificate and diploma course consists of some of the nation’s leading mental health experts. Collectively, we have designed this course to foreground the century-long accumulation of depth psychological knowledge about the various manifestations of psychopathology, so that this information can sit alongside, and even challenge, the shibboleths of the more traditional somatic models.

LEARNING OBJECTIVES

Although the formal study of psychopathology requires a lifetime of immersion in the profession, we intend that by the end of this year-long course, participants will be have acquired:

  1. A comprehensive knowledge of the traditional taxonomy of psychopathology (e.g., schizophrenia spectrum and other psychotic disorders; neurodevelopmental disorders; bipolar disorders; depressive disorders; personality disorders; paraphilic disorders; anxiety disorders; sexual dysfunctions; gender dysphoria; and many more).
  2. An understanding of the basic biomedical approach to the phenomenology, aetiology, and treatment of these aforementioned mental conditions.
  3. An engagement with the psychoanalytical and psychotherapeutic alternatives to the study of aetiology and treatment.
  4. A capacity to read the empirical and clinical research literatures in more critical depth.
  5. An ability to undertake a piece of clinical or academic research (for those pursuing the final qualification for the Diploma in Psychopathology).

PROGRAMME

UNIT ONE: BASIC PSYCHOPATHOLOGY

19 September 2019 – Professor Brett Kahr

Introducing Psychopathology: Historical and Contemporary Perspectives
In this introductory lecture, Professor Brett Kahr will provide an historical overview of the concept of psychopathology, exploring the ways in which our predecessors conceptualised the treatment of insanity from ancient Greece to the present day. Drawing upon the extensive research on the history of psychiatry, Kahr will consider the century-long tension between the conceptualisation of madness as either a spiritual curse or as a brain disease, unrelated to one’s personal biography, or as a consequence of early childhood experiences, especially those of a traumatic nature. After reviewing medieval models of mental illness and its treatment, Kahr will focus on the landmark year of 1856 – the date of birth of both Emil Kraepelin (who would become the father of biological psychiatry) and Sigmund Freud (who would, of course, become the father of psychoanalysis). We shall conclude with a study of the anti-psychiatry movement of the 1960s and the critical psychiatry movement of the 1970s and beyond, exploring the tension between the biomedical model, the psychoanalytical model, and the deconstructive model which has questioned whether psychological distress should be conceptualised as a condition requiring treatment at all.

Venue: The October Gallery, 24 Old Gloucester Street, London WC1N 3AL


26 September 2019 – Professor Brett Kahr

Schizophrenia
No topic within the mental health field has generated as much controversy as that of schizophrenia. Since the publication of Professor Eugen Bleuler’s ground-breaking monograph on schizophrenia in 1911, members of the medical and psychological professions have engaged in heated debate as to the origin and treatment of this severe form of mental distress. Professor Brett Kahr will introduce course participants to the different ways in which colleagues have conceptualised the signs and symptoms of schizophrenia, and he will help students to understand such aspects of schizophrenia as positive and negative symptoms; so-called “thought disorder”; catatonic retreats; and so forth. He will provide an overview of the theories of aetiology, ranging from genetic, biochemical, and neuroanatomical approaches, to those derived from social psychiatry and psychoanalysis and traumatology, prior to considering the psychoanalytical alternatives to traditional psychiatric treatment. Kahr will examine the pioneering contributions of both Sigmund Freud and Carl Gustav Jung, as well as those of more modern contributors such as Harry Stack Sullivan, Harold Searles, Herbert Rosenfeld, Bertram Karon, and many others, and will also discuss his own work on the role of early parental death threats in the aetiology of psychotic states, which he has come to understand as the “infanticidal attachment”.

Venue: The October Gallery, 24 Old Gloucester Street, London WC1N 3AL


3 October 2019 – Raffaella Hilty

Depression: A Psychoanalytical Approach
In view of the widespread use of antidepressant medication and time-limited cognitive-behavioural therapy as so-called treatments of choice for depression, many practising mental health professionals have lost sight of the landmark contribution of the early psychoanalysts who made great strides in the understanding of severe melancholia, more than one hundred years ago. Raffaella Hilty will provide a detailed overview of some of the most seminal psychodynamic contributions to the study of depressive illness, beginning with the pioneering work of Sigmund Freud, who, in his classic essay, “Mourning and Melancholia”, formulated a profound theory of the impact of loss and bereavement. We shall also consider the contributions of other major psychoanalytical thinkers including Melanie Klein, René Spitz, Edward Bibring, Donald Winnicott, John Bowlby, and Edith Jacobson.

Venue: The October Gallery, 24 Old Gloucester Street, London WC1N 3AL


10 October 2019 – Elizabeth Wilde McCormick

Affective Disorders
The evening will look at the contribution of Cognitive Analytic Therapy (CAT) to disorders of mood such as anxiety, depression and bipolar disorder. CAT was pioneered by Dr Anthony Ryle in the 1980’s at Guy’s and Thomas’ hospitals in London and is a therapy offered throughout the UK and in eight other countries. The model offers patients presenting with a wide range of difficulty a way of making sense of their learned responses. The emphasis is on a collaborative approach to change and to learning ways to manage shifts in mood. There will be an overview of the model and research, and an invitation for some live supervision and mapmaking. Please bring someone you would like to discuss.

Elizabeth Wilde McCormick has worked as a psychotherapist, supervisor, trainer and writer for nearly 40 years. Her professional background is in Transpersonal and Humanistic psychology; Mindfulness based stress reduction; Sensorimotor psychotherapy and Cognitive Analytic Therapy. She is the author of a number of books including Surviving Breakdown, Living on the edge, Your Heart and You and Change For The better, the CAT self help book now in its fifth edition.

Venue: The October Gallery, 24 Old Gloucester Street, London WC1N 3AL


17 October 2019 – Michael Knight

Suicidality
First, some thoughts and discussion about how we respond as therapists to a client at serious risk of suicide, a situation that tests the limits of the underlying robustness of our theory and practice and our relational resilience.

The main content of the presentation will then be on Maytree, a unique short stay (100 hours) respite (and therapy) centre for those in suicidal crisis, of which I was a co-founder, and the principal architect of its model. In expounding its genesis and vision, and the gap in services it fills, I will focus on its ethos and the core values of its practice, namely containment and compassion – the essence surely of all our work. Finally, we’ll look at outcomes, successes, failures, inviting discussion on its merits and potential.

Venue: The October Gallery, 24 Old Gloucester Street, London WC1N 3AL


HALF-UNIT BREAK

7 November 2019 – Marcus West

Borderline Personality Disorder
The term – Borderline Personality Disorder – has a long history, dating back to 1938 and Adolf Stern’s definitive paper (although it has recently been supplanted in the psychiatric field by the term Emotionally Unstable Personality Disorder). In this lecture, Marcus West will be tracing some of the ways the concept has been understood in both psychiatric and analytic fields, particularly focusing on Kernberg’s and Fonagy’s conceptualisations and contemporary attachment and trauma theories, which have afforded us further, and now widely accepted, ways of looking at the phenomena. West will explore the overlap between borderline and narcissistic organisations and ways of functioning, before focusing on the powerful and profoundly distressing clinical phenomena as they occur in the consulting room, understood primarily as sometimes near-unbearable (for both patient and analyst) co-constructions in the analytic relationship of early relational trauma. The clinical challenges, as well as the opportunities, opened up by these co-constructions will be explored using, amongst other things, a developed understanding of Jung’s concept of the traumatic complex.

Venue: The October Gallery, 24 Old Gloucester Street, London WC1N 3AL


14 November 2019 – Dr Carine Minne

Forensic Psychopathology
In this talk there will be a brief introduction to forensic psychiatry settings, the Criminal Justice System and how these can interact. Some individuals suffering from mental disorders can end up involved in both systems. This talk will focus on the most prevalent disorders seen within these settings and suffered by the individuals. There is often a division and indeed, segregation, made between those suffering from psychoses and those suffering from personality disorders with dual and indeed triple diagnoses being made. Carine will describe the helpfulness of using a single entity diagnostic approach, illustrating the psychopathological presence of several features, some times more manifestly psychotic and at other times more manifestly personality disordered. An emphasis on the aetiological factors, particularly early environmental traumas, will be made. Many of the presenting features can evoke strong responses in others, which can influence the management and treatment of the patients and these will be referred to. There will be descriptions of the multi-disciplinary treatment approaches with special focus on the role of psychoanalytical psychotherapy.

Venue: The October Gallery, 24 Old Gloucester Street, London WC1N 3AL


21 November 2019 – Dr Richard Sherry

PTSD: The Past and Potential Future
In his lecture on PTSD Dr Sherry will take 20 years plus of expertise within the field of psychological traumatology that has literally taken him around the world and across multiple fields of training.

His psychological traumatology work has evolved from his seven years treating traumatized soldiers when he headed the Clinical Psychology section for US Military inpatients for Europe. As a Consultant Clinical Psychologist with neuropsychology training, he is a specialist in traumatology (ESTSS Cert and an EMDR Consultant), a licensed Psychoanalytic Psychotherapist (BPC Reg.); he will take these expert insights to shed light on this diagnosable condition from the assessment and treatment across modalities. Much of his work has looked at extreme environments including gender based violence (GBV) and genocide as well as this he did his ethics training focused on re-examining the core ethical approaches within a disaster.

In this lecture Dr Sherry will cover some of the history of what PTSD is, the assessment and diagnostic issues, including from a psychoanalytic vantage point, and the treatment issues including some of the innovations with very low resource environments. Much of his focus on PTSD will examine the question of identity and how can we transform issues of instability through expert leadership to create profound well-being.

Venue: The October Gallery, 24 Old Gloucester Street, London WC1N 3AL


28 November 2019 – Dr Maggie Turp

Making Sense of Self-Harm
Drawing on infant observation extracts, clinical practice and service user testimony, we will consider both the history and intentionality of acts of self-harm. With regard to history, a well-functioning capacity for self-care is identified as a protective factor in relation to the destructive and self-destructive tendencies that are part of our human make-up. We will endeavour to identify the building blocks of such a capacity within parental care and consider how psychotherapy practice can best address early damage or deficit in this area of development. With regard to intentionality – and bearing in mind that the most common reason given for self-harm is a desire to ‘cope’ – we will consider self-harm as an extreme attempt at self-regulation. Bick’s theory of psychic skin functioning offers a perspective that links self-harm of various kinds to difficulties in the management of the psychic skin boundary between self and others, a perspective that will be explored with the help of clinical examples. We will also consider possible reasons for the gender imbalance in acts of self-harm and the recent increase in incidence among teenage girls.

Venue: The October Gallery, 24 Old Gloucester Street, London WC1N 3AL


5 December 2019 – Dr Adah Sachs

Dissociative Identity Disorder
There is a famous tale about a young Dutch boy who noticed a hole in the dike which protected his village from the sea. There was no one to call for help, and the rising waves of an approaching storm were threatening to flood the village. The boy pressed both his hands against the hole as hard as he could, and stood there all night in the storm, holding back the sea.

In Dissociative Identity Disorder (DID), a young part of the person is often in the role of the Dutch boy. Faced with collapsing boundaries and no help, he or she must put their own body in danger, sustaining injuries to body and psyche, to save others.

Does this role promote the persons sense of altruism, strength and purpose, or does it only entrench a reality of perpetual enslavement? Why does the hero part have to be a young one? And how can therapy support the growth of the young part, and the development of safety which does not depend on such sacrifices?

Venue: The October Gallery, 24 Old Gloucester Street, London WC1N 3AL


UNIT TWO: SUB-CLINICAL PSYCHOPATHOLOGY

12 December 2019 – Professor Brett Kahr

Hysterical Neuroses and Obsessive-Compulsive Neuroses
Although Sigmund Freud pioneered the theory and practice of depth psychology, based predominantly on his work with neurotic patients, especially those struggling with hysteria and with obsessive-compulsive disorders, the concept of neurosis has become increasingly marginalised within the fields of psychiatry, psychopathology and, even psychoanalysis itself. In this seminar, Professor Brett Kahr will review the classical foundations of the theories of hysteria and obsessive-compulsive illness and will argue for the importance of a detailed understanding of these ongoingly important characterological states. We shall begin by exploring Freud’s original work on the Studien uber Hysterie – the Studies on Hysteria – co-authored by Dr. Josef Breuer, as well as his exploration of the famous case of the obsessional “Rat Man”. We shall then consider more recent psychodynamic investigations of these foundational mental states.

Venue: The October Gallery, 24 Old Gloucester Street, London WC1N 3AL


19 December 2019 – Sian Morgan

Phobias
Sian will draw on her research into phobias. She will mainly be focusing on claustrophobia and agoraphobia.

Claustraphobia as pathological fullness and agoraphobia as pathological emptiness, both defences against painful traumatic and unmourned losses, leading to a constriction of both internal and external space. She will explore the notion of transitional space within which loss and emptiness can be borne and transformed through the expression of creativity.

Venue: The October Gallery, 24 Old Gloucester Street, London WC1N 3AL


HALF-UNIT BREAK

9 January 2020 – Dr Gwen Adshead

Attachment and Forensic Psychopathology
In this talk, Gwen will discuss the implications of attachment theory for the understanding of those mental states which are involved in the commission of violent offending. There is growing evidence that early childhood adversity is a potent risk factor for persistent and severe violent crime. Gwen will explore how childhood adversity leads to disorganised attachment systems; and the parallel disorganisation of how relationships and the people in those relationships are represented in the mind. Specifically, Gwen will discuss the importance of attachment narratives; and the language that offenders use to describe themselves, their offences and their victims. Gwen will conclude with what these findings might imply for interventions for offenders and the services in which they are provided; and discuss recent relevant research.

Venue: The October Gallery, 24 Old Gloucester Street, London WC1N 3AL


16 January 2020 – Dr Phil Mollon

Narcissistic Personality Disorder
Freud provided many interesting observations and perspectives in his classic 1914 paper On Narcissism. These were developed further in Kohut’s 1966 paper Forms and Transformations of Narcissism, in which he proposed a separate line of development of narcissism, from primitive to mature. The concept of narcissistic personality disorder did not emerge until the writings of Kernberg and Kohut in the 1970s. These authors presented contrasting, and seemingly incompatible views, a confusion compounded by their use of the same term (grandiose self) to mean quite different things – for Kohut a natural feature of childhood, for Kernberg a pathological structure consisting of a fusion of images of actual self, ideal self, and ideal other. These contrasting visions of narcissism were later mirrored in Rosenfeld’s concepts of “thin-skinned” and “thick-skinned” narcissists. Rosenfeld observed that treating the “thin-skinned” narcissist as if they were “thick-skinned” could be very damaging. During the 1980s and 1990s, cognitive therapists, and schema therapists, began to develop concepts of narcissistic personality disorder, and the term became increasingly widely used – sometimes pejoratively and simplistically. This teaching will outline some of the core narcissistic dilemmas we all must navigate during childhood – and how these can become particularly pronounced in certain conditions, including ADHD. The realm of narcissism also interfaces with problems of human identity – and the ubiquitous tendency to become falsely identified with culturally and familiarly presented images.

Venue: The October Gallery, 24 Old Gloucester Street, London WC1N 3AL


23 January 2020 – Martin Weegmann

Substance Use Disorders
Martin’s illustrated talk is an accessible introduction to the psychodynamics of addiction, considering questions like: What relationships do people make with drugs? What consequences does (mis-)attachment to substances have? What if alcohol seems more reliable than people? How does addiction install itself at the centre, progressively displacing all other needs? How do extreme internal worlds, centred on inanimate substances, come about? He will also sketch pathways into, and phases of treatment, illustrated with brief examples, to which he will invite responses. Martin concludes with observations on the many, varied ways in which people can overcome addiction and find productive routes from the problematic identities and chemical careers that have trapped their lives. He has the pleasure of inviting Angie, an ex-patient, to talk about her (on-going) journey of recovery from substance misuse.

Venue: The October Gallery, 24 Old Gloucester Street, London WC1N 3AL


30 January 2020 – Dr Valerie Sinason

Intellectual Disabilities
Children and adults with an intellectual disability are more vulnerable to external trauma. In addition, the disability itself is difficult to emotionally process. This seminar reveals the key seminal themes that emerge from talking therapy with children and adults with mild, severe and profound multi-disability.

Venue: The October Gallery, 24 Old Gloucester Street, London WC1N 3AL


6 February 2020 – Richard Curen

Asperger’s Syndrome and Autism Spectrum Disorders
The world appears to be split into those that can be classed as neurotypicals and those that are neurodivergents. People with Autism Spectrum Disorder (ASD) are a part of the neurodivergent group and people with Asperger’s Syndrome are part of the spectrum of people with ASD. There is a long history of misunderstandings and mistreatment of people with ASD across the medical profession and often in the consulting room. This seminar will present current thinking about ASD from a psychoanalytic perspective and suggest applications of that thinking in the treatment of individuals.

Venue: The October Gallery, 24 Old Gloucester Street, London WC1N 3AL


13 February 2020 – Marian O’Connor

Psychosexual Disorders
Clients in psychotherapy may be happy to talk about relationship problems, but may find it difficult to talk about psychosexual concerns. Should psychotherapists encourage clients to open up about sexual difficulties? Is there a danger that talking about sex might stimulate erotic transference or voyeurism or expose the therapist’s ignorance about sexual functioning. This lecture will look at some of the blocks that might prevent the client or therapist talking about sex and will also provide information about sexual anatomy and common psychosexual dysfunctions.

Venue: The October Gallery, 24 Old Gloucester Street, London WC1N 3AL


HALF-UNIT BREAK

27 February 2020 – Professor Julia Buckroyd

The Food Fix: working with people who manage their lives via the manipulation of food.
Different presentations of disordered eating seem to have more in common than what differentiates them. That has led me to think of them collectively as an addictive/compulsive defence or coping mechanism against feelings, memories, thoughts, realisations etc. Current understanding of brain chemistry attests to their power in changing mood while rumination on food/weight/shape/size can fill many hours to the point of destroying ordinary functioning. The implication is that the eating behaviour is a symptom, not a cause and that in order for it to be surrendered its purposes will have to be met by other means. Secure attachment enables difficulties to be transacted by self soothing and with help from others.Those with eating disorders seem very often to have attachment deficits which leave them struggling to cope with their lives. The problem for the therapist is that their solution is cheap and legal and very readily available – a formidable competitor to therapy. As a group these are people with poor emotional language or awareness, often distant from the experience of their own bodies – classic psychoanalytic (or person centred) strategies of the minimally active therapist are unlikely to provide the ‘alternative emotional experience’ that these clients so desperately need. This seminar will therefore present a model of therapy which is more active and more psychoeducational than conventionally practised in order to facilitate internalisation of the therapist’s soothing and supportive voice.

Venue: The October Gallery, 24 Old Gloucester Street, London WC1N 3AL


5 March 2020 – Professor Brett Kahr

Sub-Clinical Psychopathy
Men and women diagnosed as suffering from personality disorders or those described as psychopathic or sociopathic commit the vast majority of serious offences, whether murder, arson, rape, paedophilia, or theft. But many individuals who do not function as formally identified forensic patients will, nevertheless, often perpetrate “unconscious crimes”, expressing violence – often deadly violence – through so-called “accidents”, whether by pushing loved ones down staircases, by transmitting infectious diseases, by killing family members through neglect, and so forth. In this seminar, Professor Brett Kahr will introduce the notion of “sub-clinical psychopathy”, exploring the unconscious motives and the manifestations of those who struggle with profound death wishes and who, in spite of a lack of a formally diagnosable mental illness, will, nevertheless, cause great harm.

Venue: The October Gallery, 24 Old Gloucester Street, London WC1N 3AL


UNIT THREE: DEVELOPMENTAL AND APPLIED PSYCHOPATHOLOGY

12 March 2020 – Maria Pozzi Monzo

Neurodevelopmental psychotherapy and mindfulness with parents and babies
Neurodevelopmental psychotherapy studies the birth, the developing and the maturing brain and nervous system of the infant. It explores both the links with the environment, i.e. with the carer’s capacity to attune with the infant as from utero and the containing and transforming bonding relationship with her after birth. Parents and babies are seen together to explore their relationships and where things have become stuck.

Mindfulness consists in “paying attention in a purposeful way in the present moment and no-judgementally” (J Kabat-Zinn, Full Catastrophe Living 1990). It is a popular, highly researched intervention with many applications that are demonstrated to have clear effects on the immune system and brain functioning. It can reduce stress and depression and is used also to treat addictions and reduce criminality. Mindfulness, as I use it in my work, guides parents to tune in finely with their own feelings, sensations and thoughts as well as with their babies, held in arms or observed on a cushion on a mat, where we usually position ourselves during sessions. This mindful, observing stance helps to foster better bonding and healthy separateness, freeing the baby from parental anxieties and projections.

This approach combined with more traditional parent-infant psychotherapy, is unique and innovative as it is also informed by neurodevelopmental studies and discoveries.

Venue: The October Gallery, 24 Old Gloucester Street, London WC1N 3AL


19 March 2020 – Dr Arnon Bentovim

Family Psychopathology
The language of family psychopathology was established by the pioneering group of professionals working with Gregory Bateson in the 1950s who used the perspective of General Systems Theory as the basis of their observations to establish the ‘Double Bind Theory’ of schizophrenia. Concepts such as boundaries, homeostasis, reciprocal transactions, symmetrical and complementary communication, feedback loops, alliances, triangulation have entered shared language. The Family Therapy Movement differentiated from the pervasive psychodynamic orientation in the US, but as practitioners trained in psychodynamic approaches we attempted to link psychodynamic and systemic thinking.

Based on our research on family functioning we introduced the Family Assessment model which provides the tools for practitioners to work with families. It describes the Family System as being made up of parts or sub-systems such as the parental partnership, and the parent-child subsystem which all contribute to the working or functioning of the system as a whole. Properties include how family members communicate, the nature of family alliances including attachments, and the management of boundaries and feeling states affect how the family system operates. The family system is more than the sum of its parts and there are characteristic patterns and core ways of relating and being – not so much cause and effect, but patterns of interaction. Families are located within the wider social system of extended family, local community and cultural norms and expectations.

Conflict is inherent in family life as a result of significant differences in gender, age, and developmental stage of family members. The basic structure of the family needs to work optionally to manage differences. The experiences of the parents as children – inter-generational effects – have a profound impact on the way the family functions. Parents with a history of trauma, abuse and dysfunction may have distorted, complex relationships with partners – and children, with mutual dependence and high levels of conflict. Traumatic events ‘organise’ relationships justifying harsh, abusive or neglectful responses. Children may be organised into caring roles for parents with mental health and substance abuse, children with special needs can organise the lives of the family around their needs.

A variety of therapeutic approaches have been developed to work with families including the SAAF Assessment approaches to determine whether the family is via-ble as an organisation or whether there is a potential for positive outcome, strengths which can be built on, goals which can be met. It is essential that practitioners develop skills to engage with children, young people and family members, joining, managing conflict in the here and now, using a variety of tasks to promote communication, allowing all family members to have a voice. “Structural approaches’ aim to intervene to change dysfunctional patterns, block dominating controlling voices, and promote and reinforce alternate patterns. Solution Focused approaches look for instances of appropriate responses – care rather than criticism, and helps the family to build on the positive – the solution. Attachment based approaches promote positive responsive, reflective key relationships to develop security and organisation of relationships. Mentalisation based approaches aims to help family members to begin to put themselves in each other’s shoes, and develop relationships based on understanding rather than beliefs.

The Hope for Children and Families approach takes the key practice elements therapeutic procedures across the field to provide the practitioner with a step by step approach to working with families. The seminar will use video examples to explore the concepts of family psychopathology and introduce approaches to intervention.

Venue: The October Gallery, 24 Old Gloucester Street, London WC1N 3AL


26 March 2020 – Tamsin Cottis

Introduction to Child Psychopathology
This lecture will outline the structure of provision of current UK child mental health services

A number of the most frequently diagnosed child mental health disorders (eg ADHD, ASC, Conduct Disorder, Eating Disorders, Childhood Depression,) will be identified and briefly described, drawing on the most up-to-date diagnostic criteria of DSM 5 and the ICD 10/11 (ICD 11 due to be adopted in May 2019).

Information will be critically considered with reference to ordinary child development and in the light of up to date research regarding the development of the brain in infancy and childhood. Close consideration will be given to what is known about how trauma and adverse childhood experiences may impact on a child’s emotional, relational, cognitive, behavioural and relational development. Bessell van der Kolk’s Model of Developmental Trauma Model (2005) will be considered.

As well as talking about medication-based treatments, we will explore how child psychotherapy, informed by Attachment Theory and Object Relations Theory, may be an effective response to childhood disorders which have their roots in traumatic experiences.

Venue: The October Gallery, 24 Old Gloucester Street, London WC1N 3AL


2 April 2020 – Dr Matthew Hagger

Geriatric Psychopathology
My talk will initially cover the common signs and symptoms of mental disorder in older people within the traditional psychiatric framework, including approaches to treatment and management within the biomedical model. A large part of working in old age psychiatry is working with the 3Ds as conditions ie depression, delirium and dementia. However I will also discuss and explore the wider backdrop of ageing and older people and how these factors and many others can affect someones individual mental health. This will lead into discussion about ways to understand and approach mental health in older age. I have a long term interest in psychodynamic approaches in working with patients, families and staff and will also discuss this in relation to older adults.

Venue: The October Gallery, 24 Old Gloucester Street, London WC1N 3AL


HALF-UNIT BREAK

23 April 2020 – Jenny Riddell

You’re driving me mad, I can’t get through to you!
The subject of this paper is emotional and psychological violence in couple relationships. “Emotional and psychological violence” is defined as the interaction between a couple which causes distress to one or both in the couple, to an extent that the impact is at the level of trauma.

The clinical setting of working psychoanalytically with couples will be described.

The hypothesis that is offered is that the unconscious motivation for such violence can either be developmentally or pathologically driven. These drives will be illustrated and explored through clinical material. The ideas explored in the paper of Harold Searles’ (1959) on “The Effort to Drive The Other Person Crazy”, written from the perspective of individual therapy, will be applied to the couple in couple therapy and illustrated using disguised material from several clinical cases.

It is hoped to stimulate thinking rather than offer didactic ideas and questions will be welcomed as will the experience and thoughts of other clinical work.

Venue: The October Gallery, 24 Old Gloucester Street, London WC1N 3AL


30 April 2020 – Professor Stephen Briggs

Introduction to Adolescent Psychopathology: disturbance, defence or development?
Mental health problems in adolescence cause concern worldwide; adolescence is notable for the emergence of distinctive difficulties of varying severity and uncertain duration, including; self-destructive relatedness; depression; eating disorders. Diagnoses and prognoses are volatile and unreliable. Most adult disorders begin in adolescence, up to 75% by the age of 24; yet most mental health difficulties are resolved during adolescence. Diagnostic approaches therefore need to be supplemented by other ways of formulating understanding of adolescent mental health issues.

Unprecedented social changes have transformed the social and cultural worlds young people live in and created new contexts for development. The momentous and radical developmental process in adolescence makes demands on young people to bear loss and re-evaluate relatedness, to adapt to the emerging adult sexual body and become more separate from parental figures. It forms a necessary turbulence; mental health difficulties arise through disturbances to the developmental process and internal relatedness. The seminar will focus on understanding different aspects of the developmental process for individuals, distinguishing between developmental breakdown, communications of states of mind, including through acting and projecting; defences against the pains and turbulence of change; and processes of making developmental changes and gains.

Venue: The October Gallery, 24 Old Gloucester Street, London WC1N 3AL


7 May 2020 – Gabrielle Rifkind

Global Psychopathology
“Global psychopathology – how war monsters people” – why empathy fails in the conditions of war and how a theory of managing radical differences has more to offer.

War creates the conditions for human regression. The conflict parties have often done terrible things to each other. These are not the conditions for self-awareness. Instead, it is far more likely to find the parties in a deep state of denial, particularly as to the horrors they have committed on the enemy, and the suffering they have caused their own people by not finding a solution earlier. This kind of denial often creates a rigid mindset where the leadership needs to believe in the rightness of their cause. Within this state of mind there are a number of psychological states and interests which will be obstructive to peace making. What can be done?

Venue:
The October Gallery, 24 Old Gloucester Street, London WC1N 3AL


14 May 2020 – Raffaella Hilty

Enactment in Borderline and Narcissistic Disorders: “The Smelly Patient”
In this seminar Raffaella will deliver on the topic of enactment in borderline and narcissistic disorders, meaning any mutual acting out that arises in the therapeutic relationship in the context of the challenges faced in counter-transference work.

In order to address this topic, a clinical case will be presented where meaningful aspects of the difficulties faced in receiving and making sense of the patient’s use of primitive defences, to communicate preverbal and un-symbolised experiences of early physical and emotional neglect, will be described, especially highlighting their expression through a very uncomfortable symptom: the client’s bodily odour.

The link between disorganised-attachment, characterised by a mix of avoidant and ambivalent states of mind, and the development of adult psychopathology, characterised by a fragmentation of the self, will be explored in the context of contemporary research evidence, whilst specific elements of therapeutic technique, providing containment and facilitating understanding, will also be highlighted for the discussion.

Venue: The October Gallery, 24 Old Gloucester Street, London WC1N 3AL


21 May 2020 – Dr Joel Oberstar

Psychopharmacology
In this presentation, Dr. Oberstar will review the current understanding of the biological basis for certain psychopathology. Consideration will be given to the role of neurotransmitters in the expression of psychiatric symptoms. Commonly used psychiatric medications will be reviewed with a particular emphasis on “class” mechanisms of action and common effects and side effects.

Venue: The October Gallery, 24 Old Gloucester Street, London WC1N 3AL


HALF-UNIT BREAK

4 June 2020 – Professor Brett Kahr

Final Plenary Session
During the final meeting of this thirty-week training in psychopathology, participants will have an opportunity to review the course in detail with the members of the core teaching team. Professor Brett Kahr and his colleagues will review some of the principal findings of the course, and participants will have an opportunity to assess and reassess their current views and understandings of the concept of psychopathology and begin to examine how each of us might develop our education in this field more extensively in the months and years to come.

Venue: The October Gallery, 24 Old Gloucester Street, London WC1N 3AL

HOME STUDY VIDEOS

remy-aquarone
Rémy Aquarone
The assessment of dissociative disorders

In this presentation, Remy Aquarone, director of the Pottergate Centre, Norwich, UK, explains the value of the Structured Clinical Interview (SCID-D). This assessment instrument was created for the diagnosis of DSM-IV Axis 1 disorders, a list that includes Dissociative Disorders. Remy Aquarone takes us through the criteria for the assessment and diagnosis of dissociation disorders, giving detailed explanation of key symptoms. These include the five dissociative disorders outlined in DSM-IV: Dissociative amnesia, dissociative fugue, depersonalisation disorder, dissociative disorders (not otherwise specified) and dissociative identity disorders (DID).

Video lecture with captions – 1 hr 3 mins

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Lucy Biven
Treating Anxiety: a neuroscientific perspective

This talk offers an understanding of anxiety disorders that rests on research into the emotional systems that we share with all other mammals. Beginning with a brief discussion of Panksepp’s emotional taxonomy, with special emphasis on the GRIEF, FEAR & SEEKING SYSTEMS, Lucy Biven will explain how one type of anxiety is generated by issues in the FEAR system, while another separate pattern of anxiety is generated by GRIEF. The emotional, behavioural and biochemical aspects of each will be explained. The merits of both psychotherapeutic and psychotropic interventions will be discussed, including the interesting evidence that anxiety rooted in the FEAR system responds to tricyclite antidepressants, while GRIEF-based anxiety is addressed by benzodiazepines.

Video lecture with captions – 25 mins

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Dr David Celani
Fairbairn's Model of Borderline Psychic Structure as a Foundation and Guide for Work with Borderline Patients

In these talks Dr David Celani outlines Fairbairn’s pioneering model which describes how object relations influence personality development. He has found this particularly useful in the treatment of borderline patients who are generally considered difficult and unrewarding to work with.

Fairbairn’s Ideas
Video lecture with slides – 35 mins

Fairbairn’s Structural Model and Examples
Video lecture with slides – 45 mins

Treating the Hysteric, Obsessive and Narcissist
Video lecture with slides – 45 mins

Case Study: Clumsy Guy
Video lecture – 10 mins

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Dr Ronald Doctor
The Psychodynamics of Personality Disorder, Sadism and Destructiveness in the Countertransference

This presentation describes some concepts underpinning forensic psychotherapy, including a theory of a triangular dynamic between patient, psychotherapist and society that was developed by Dr Estela Welldon. The talk explores the countertransference in relation to personality disorder, and how challenging this can be for the clinician, arousing such responses as collusion, disbelief and condemnation and also stirring our own sadism via projective identification. He considers how even the most apparently insane violence has meaning inside the mind of the person who commits it. This is explored in relation to two cases in which the violence erupted through a fragile narcissistic structure that had been attempting to hold the self together. This concept of a narcissistic organisation of the mind, which arises when there is a failure of containment in infancy, is discussed as a means of understanding this fracturing of psychic defenses.

Video lecture with captions – 28 mins

The History of Murder – and the Murder of History

In this detailed theoretical and case-based presentation, Dr Ronald Doctor considers the many-faceted but mostly concealed psychological states and experiences underlying the act of murder. In most cases, killing occurs concretely only after it has been committed many times previously in dreams, nightmares and unconscious fantasies that have never become conscious. Before the deed, conscious efforts – sometimes unconscious too – are designed and devoted to keeping the impulse to murder encapsulated to prevent action. Commonly a sudden reversal takes place internally that breaks the murderousness loose from its cordoned-off status. Ronald Doctor proposes that there is always an underlying psychically traumatic and indigestible experience of loss and death. Using clinical material from two patients who suffered severe loss he explains how they sought refuge: the first in psychosis, and the second in a sado-masochistic retreat.

Video presentation with captions – 52 mins

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Mary Haley
Attachment Trauma, Deprivation and Violent Behaviour: offering psychotherapy to male prisoners in prison

Mary Haley is the lead psychotherapist on a Category B prison wing of 35 prisoners. In this video she describes the task of rehabilitating these men, who have invariably suffered extreme neglect or abuse in childhood. The therapeutic approach consists of living within a democratic therapeutic community, in which the residents learn how to tolerate themselves and each other in close quarters by sharing responsibilities for the community. They have small group, in-depth psychotherapy 3 times each week in which they challenge and support each other in facing both their crimes and the childhood experiences that predisposed them to acts of violence. Bearing what is often extreme past shame and humiliation, facing their demons and accepting personal responsibility takes great courage and Mary Daley movingly illustrates how the longer term residents often show great tenderness and compassion towards new prisoners. She illustrates the combination of attachment theory, object relations that forms the integrative therapeutic approach underlying the work. She also explores the value or otherwise of such terminology as Borderline Personality Disorder, and the therapeutic use of the International Personal Disorder Examination (IPDE).

Video talk to camera – 42 mins

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Professor Onno van der Har
The treatment of complex trauma and dissociative disorders applying a theory of structural dissociation

n this audio presentation, Dr Onno van der Hart explains dissociative disorders as an acute disintegration of the personality into sub-systems that become a fixed ‘structural dissociation’ of the personality, as a result of severe child abuse. This system of self-protection is fully explained, and a phase-oriented treatment approach detailed.

Audio with captions and diagrams – 38 mins

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Professor Jeremy Holmes
A History of Narcissism and its Treatment: An Effective Clinical Approach

In this talk Professor Jeremy Holmes surveys the great analytic and literary thinkers on narcissism, providing a sense of the condition’s unconscious origins, it’s pathological development in childhood and giving examples of its appearance in life, the therapy room and in stories from Eastern and Western Culture. Following Kohut’s notion of the parental task being to offer ‘optimal frustration’ to the child, Professor Holmes concludes that the therapeutic challenge in repairing narcissistic wounding is to ‘walk the line’ offering a deep empathy that is nevertheless tempered by challenging the patient’s isolating self-centredness and illusion of self-sufficiency.

Audio lecture – 50 mins

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Professor Brett Kahr
What Constitutes the Forensic State of Mind?

Fortunately, most people who attend for psychotherapy have never perpetrated acts of criminality and do not suffer from an overtly diagnosable mental illness. A small cohort of non-forensic patients will, however, commit a variety of offences, none of which constitute a breach of the law of the land but which, nevertheless, cause significant suffering to themselves and to others. In this presentation, we shall explore the psychodynamics of the sub-clinical “non-forensic” patient, concentrating on how and why such individuals function in this quasi-forensic fashion and what impact their unconscious “criminality” might have. We will question whether the definition of forensic psychotherapy might need to be expanded in recognition of the broader range of unconscious sadism that we often encounter in our work.

Video lecture with captions and slides – 35 mins

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Dr Jean Knox
Embodied empathy, mirror neurons and unbearable states of mind

Dr Jean Knox suggests that mirror neuron research offers valuable scientific insights into the mind-body dichotomy. She proposes that it challenges the model that privileges mind and thought over bodily enactment as the essence of what makes us human. She suggests that intersubjectivity is increasingly recognised as the embodied relational matrix out of which each individual emerges. The mirror neuron mechanism automatically prompts the observer to resonate with the emotional state of another individual, with the observer copying the motor, autonomic and somatic responses. Dr Knox sees this is the basis for both empathy and emotional contagion, ‘concordant countertransference’ (Racker) and introjection. The therapist often has to relate to states of mind activated by mirror neurons that are unbearable. This may lead the therapist to retreat from embodied inter-subjectivity into defensive positions such as intellectually-based, theoretical stances to the detriment of the therapy, while an understanding of the mirror-neuron mechanism may help therapists to tolerate embodied emotional discomfort.

Video lecture with captions and slides – 32 mins

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Dr Ruth Lanius
The neurobiological underpinnings of social cognition in chronically traumatized individuals, with implications for specific, integrated treatment approaches

Childhood maltreatment has been associated with profound deficits in the sense of self frequently leading the traumatized individual to become isolated and estranged in the secrecy of their trauma. Both intimate and non-intimate relationships frequently either become a way of re-enacting the past or appear unreachable. How do mind, brain, and body prevent traumatized individuals from engaging in social interactions, and how does this affect the therapeutic process? This lecture will describe the neurobiological underpinnings of social cognition, including theory of mind and eye gaze in chronically traumatized individuals and relate these findings to clinical case examples. An integrated approach to treatment of brain, mind, and body, including interventions geared to prevent the intergenerational transmission of trauma will be described.

Video lecture with captions and slides – 55 mins

Neuroscientifically-based effective therapeutic interventions for patients displaying altered states of consciousness following trauma

Four dimensions of consciousness, including time, thought, body, and emotion often become drastically altered as a result of traumatic experience. Even though such alterations in consciousness can be adaptive during the encounter of traumatic events, they can frequently lead to tremendous hardship in the aftermath of the trauma. How do we recognize such alterations in consciousness? Is there a dissociative versus a non-dissociative presentation of each dimension of consciousness? What predicts the occurrence of altered states of consciousness? How can we intervene effectively to overcome such altered states and how are those changes represented in mind, brain, and body? This lecture will describe a four dimensional model (4-D Model) outlining a dissociative and a non-dissociative dimension of each of these four dimensions of consciousness. Furthermore, the neurobiological underpinnings and a detailed approach to treatment of each dimension of consciousness will be described.

Video lecture with captions and slides – 57 mins

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gill-mcgauley
Gill McGauley
Attachment and Mentalisation in Understanding the Roots of Violent Crime

This presentations suggests that a key assumption, central to forensic psychotherapy, is that the offence has a meaning to the offender and can be understood in the context of their internal world, developmental history and relationships. The offence is considered as a symptom. Once it has been committed a line has been crossed where psychic reality has been acted out in external reality. Just as with physical diseases, the offence often has a prodromal period – a time when the disease process has begun but is not yet clinically manifested. If the underlying symptoms and mechanisms are not recognised and understood by the patient then the risk of similar offending remains. In this presentation Professor Gill McGauley theoretically explores how forensic psychotherapy can help us recognise and understand more about this prodrome to murderous attacks. She presents qualitative and quantitative data to illustrate how the patient’s representation of their index offence, their offence narratives and capacity to mentalise can help us predict and treat the unfolding of both aggressive and prosocial behaviour.

Video lecture with captions and slides – 30 mins

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susan-mizen
Dr Susan Mizen
Borderline Personality Disorder a disordered relationship with self, other and the body, arising from neurobiological or relational deficits and psychodynamic defences: A Relational Affective Hypothesis

Dr. Mizen presents her theory of a neurobiological and developmental pathway for symbolisation and its failures in those with borderline presentations.

Her ‘Relational Affective Hypothesis’ describes how neurobiological mechanisms promote mother infant interaction launching a developmental process through which the ability to symbolise emerges. Triangulation, which is key to developing the capacity to symbolise, may fail through relational or the psychodynamic defence mechanism of projective identification leading to a concrete emotional world and a disordered sense of physical and psychological identity.

The result is the emergence of two conflicted states of mind and patterns of interpersonal relating which give rise to the affective instability and impulsiveness of people with a diagnosis of borderline personality disorder and a disordered sense of what belongs to whom.

Video lecture with slides – 45 mins

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phil-mollon
Dr Phil Mollon
The Development of Pathological Narcissism as a Defence Against Psychotic Fragmentation

Pathological narcissism can be interpreted as a defence against the terror of fragmentation, a fear Kohut referred to as, ‘the deepest anxiety a man can experience.’ Drawing on ideas from Lacan, Bollas, Kohut and Buddhist philosophy, Dr Phil Mollon suggests that we all bound to make identities from the culture we are all born into, the images others have of us in their minds.

However, pathological narcissism develops because there is no negotiation at all between the infant’s own nascent grandiosity and his mother’s idea of her perfect baby. This causes the infant to split off his own grandiosity and a personality develops that swings between self-regard and self-denigration in an ongoing effort to avoid the psychotic outbreak of a still fragmented underlying psychic structure.

Audio lecture – 45 mins

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anna-motz
Anna Motz
The Many Faces of Eve - Women in Forensic Psychotherapy

In this talk Anna Motz describes the unique manifestations of female perversion and violence, with illustrative clinical material. She draws on Welldon’s (1988) model of female personality and consider in particular whether the concept of psychopathy has any relevance to women, or if it is a misappropriation of a construction related to men. She will also describe societal responses to crimes perpetrated by women, and how details of the potential for female violence and perversion only serves to perpetuate unhelpful stereotypes and vilify those women. Finally, she will outline therapeutic approaches for working with violent and sadistic women.

Video lecture with captions and slides – 23 mins

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clara-mucci
Dr Clara Mucci
Past generations, trauma, loss and the modes of psychic transmission

Clara Mucci asserts, “We don’t just get a patient. We get someone who is the last part of a chain of family heritage.” This presentation examines the paths that intergenerational trauma takes as it transmits from one generation to the next. Within a framework of psychoanalytic and attachment theory, Clara Mucci elaborates how early relational trauma in the form of disorganised attachment is the most damaging means via which trauma from one generation passes to the next. This is explained by the primary care-giver’s incapacity to offer the emotional regulation that is necessary for healthy development. Furthermore, a parent who has adopted the defence of dissociation is likely to have a dissociating child. She proposes that secure attachment mediates against future traumatic effects, by enabling one to negotiate loss and process future traumas. Therapy for intergenerational trauma, she suggests, occurs in the form of enactment, where the trauma of past generations may become expressed. Clinical and theoretic material is drawn upon from her own practice and also from such authors as Giovanni Liotti, Dori Laub, Ilany Kogan, Philip Bromberg and Allan Schore.

Video lecture with slides – 44 mins

Past generations, trauma, loss and moving beyond the victim-persecutor dyad

This presentation builds on Clara Mucci’s theoretical discussion in Part I, and considers psychoanalytic treatment approaches for the effects of the traumatic experiences in the lives of parents, grandparents and ancestors. One clinical challenge is the decreasing clarity, symbolisation, narrative formulation of the original trauma as it passes from generation to generation. Somatic awareness or even psychosis may be the only way that it is expressed. Equally striking is a tendency towards victim-persecutor relational dynamics. We will look at the possibility of raising these effects to consciousness, easing symptoms and ultimately going beyond these dynamics into greater psychic freedom.

Video lecture with slides – 50 mins

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sandi-richman
Alexandra Richman
Distinguising complex childhood trauma from PTSD in the otherwise healthy adult- PART 1

The seminar covers the key diagnostic issues in identifying traumatic experiences that are rooted in childhood and differentiating these from traumas experienced by otherwise healthy adults that may result in PTSD and a disruption in their self-reflective functioning. The seminar considers implications for planning an appropriate treatment strategy and is illustrated with case material. Â

Video lecture with captions (part 1) – 47 mins

Treatment approaches for complex PTSD and simple PTSD in the otherwise healthy adult – PART 2

This lecture considers implications and differences in planning an appropriate treatment strategy for people with single incident PTSD and complex PTSD. Illustrated with case material.

Video lecture with captions (part 3) – 45 mins

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adah-sachs
Dr Adah Sachs
Who done it, actually? The meaning of truth in Dissociative Identity Disorder

Dissociative Identity Disorder (DID) (American Psychiatric Association 2013) is examined in this presentation from the perspective of its relevance to the criminologist. As this psychiatric condition is linked to severe and prolonged childhood abuse, accounts of DID patients inevitably involve reports of serious crimes, in which the person was the victim, perpetrator or witness. These reports can thus contain crucial information for criminal investigations by the police or for court proceedings. However, due to the person’s dissociative states, such reports are often very confusing, hard to follow or believe and difficult to obtain. Through the analysis of clinical examples, Dr Adah Sachs explores how decisions are made by a person with DID, the notions of choice and’competent reasoning’, and the practical and ethical ways for interviewing a person with DID who has witnessed or participated in a crime.
(A version of this presentation was published (2015) at the International Journal for Crime, Justice and Social Democracy)

Audio presentation with captions and slides – 30 mins

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allan-schore
Dr Allan Schore
Borderline Personality Disorder as a Maturational Failure of the Right brain

Borderline Personality Disorder (BPD) is a severe disturbance of personality-functioning. It is characterised by affect and impulse-control disturbances associated with deficits in emotion regulation, as well as a pervasive pattern in self-image and persistent difficulties in interpersonal relationships. Current models of the aetiology and adaptive dysfunction of BPD are now converging as an attachment disorder that formed in the first years of life. These patients commonly experienced abusive and neglectful developmental backgrounds, a growth-inhibiting relational environment not only for social-emotional development but for early brain maturation.

Models of developmental psychopathology suggest that borderline attachment histories alter the development of regulatory cortical-sub-cortical limbic-autonomic circuits of the early developing right brain. In line with these models, a number of recent neurobiological studies now show right brain and orbitofrontal deficits in BPD patients. The clinical relevance of this documented maturational failure for diagnosis and treatment is discussed in the light of research.

Audio lecture with slides – 1 hr 40 mins

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Mark Solms
Professor Mark Solms
Neuroplasticity: Implications for New Clinical Techniques

Recent research into the brain mechanisms of emotion has identified the primitive ‘natural kinds’ of mammalian emotion. This research reveals some surprising findings about the emotional circuitry of the human brain, which radically change our classifications of the basic emotions, and which have substantial implications for our understanding of psychopathology. This talk will summarise the relevant findings and will discuss the clinical implications, in relation to, for example, addiction, mood disorders, anxiety disorders and thought disorders, and more generally for theories of human sexuality and aggression.

Video with captions and slides – 1 hr 13 mins

Brain mechanisms of emotional consciousness: implications for clinical technique
Most forms of psychoanalytical psychotherapy conceptualise therapeutic change as a process whereby the unconscious parts of the mind are rendered conscious. Classically this involves a clinical technique which endeavours to attach words to preverbal and nonverbal mental processes. This is the essence of the ‘talking cure’. In this presentation, new findings regarding the brain mechanisms of consciousness will be reported which require us to turn the classical conceptualisation of talking therapy on its head. The parts of the brain that generate ‘instinctual’ ways of thinking and behaving are the same parts of the brain that generate all consciousness. The parts of the brain that are associated with verbal cognition, by contrast, are intrinsically unconscious and are only capable of generating conscious thinking to the extent that they are activated by the more primitive, instinctual-emotional parts of the brain. Some implications of these findings for psychotherapeutic technique will be discussed.

Video with captions and slides – 51 mins

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celia-taylor
Dr Celia Taylor
Psychopathic Personalities and the Impact on the Clinician

Working with people with antisocial or psychopathic personality disturbance can have a profound impact on clinicians. Many of the offences committed by these individuals are of a highly sadistic kind and therefore traumatic to hear about and process, leading to angry and punitive responses. On the other side of the coin, some staff identify strongly with the victim within the offender, since childhood histories of appalling abuse and disrupted attachments are common. Team splitting and conflict frequently ensue, thus undermining the best efforts at treatment. This talk will consider the dynamics impacting on teams’ ability to function together in this work, and what measures can be taken to mitigate these effects.

Video lecture with captions and slides – 47 mins

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estela-welldon
Dr Estela Welldon
The Impulse to Murder: Shame and Childhood Trauma

Dr Estela Welldon suggests the principle cause of violent crime is the need to express rage, helplessness and humiliation rooted in unconscious childhood memories of abusive experiences and domestic violence. When these experiences have been extreme, and there has been a lack of loving containment by an attachment figure, something powerful is held inside the psyche until it is released in adulthood through loss of control, often triggered by a repeated trauma. Although the violent act may appear irrational, in the context of the patient’s past experiences it may be very meaningful. The violent act, furthermore, provides a sense of agency, of being seen and experienced by others. The key to forensic psychotherapy is for the patient and therapist to uncover the unconscious meanings of the act, through language. Hopefully this will be aired before the ‘splash’ – the moment when the crime is committed – if that person has access to therapeutic help. By gaining an understanding of their own past experiences of rage, impotence and humiliation the patient may resolve the unconscious impulses underlying the crime. We see that in effective psychotherapy, talking and thinking replace the acting-out.

Video talk to camera – 26 mins

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Professor Brett Kahr
Week 1 - Introducing Psychopathology: Historical and Contemporary Perspectives

In this introductory lecture, Professor Brett Kahr will provide an historical overview of the concept of psychopathology, exploring the ways in which our predecessors conceptualised the treatment of insanity from ancient Greece to the present day. Drawing upon the extensive research on the history of psychiatry, Kahr will consider the century-long tension between the conceptualisation of madness as either a spiritual curse or as a brain disease, unrelated to one’s personal biography, or as a consequence of early childhood experiences, especially those of a traumatic nature. After reviewing medieval models of mental illness and its treatment, Kahr will focus on the landmark year of 1856 – the date of birth of both Emil Kraepelin (who would become the father of biological psychiatry) and Sigmund Freud (who would, of course, become the father of psychoanalysis). We shall conclude with a study of the anti-psychiatry movement of the 1960s and the critical psychiatry movement of the 1970s and beyond, exploring the tension between the biomedical model, the psychoanalytical model, and the deconstructive model which has questioned whether psychological distress should be conceptualised as a condition requiring treatment at all.

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COURSE COMPLETION

CPD level

Tasks:
Attendance of minimum of 25 lectures
Award:
A certificate of attendance for a max of 60 hours CPD Level

Certificate level

Tasks:
Attendance of a minimum of 25 lectures
3 group tutorials
21 Hours of home study video
Completion of an online test

Award:
A Certificate in Psychopathology: Theory and Practice

Diploma level

Tasks:
Attendance of a minimum of 25 lectures
21 hours online home-study via our pre-recorded talks
3 group tutorials
Submission of 5000-word (by 15 Dec 2020)

Award:
A Diploma in Psychopathology: Theory and Practice

ADMISSIONS CRITERIA

We welcome applicants who are psychotherapists, counsellors, psychoanalysts, social workers, psychologists, psychiatrists, or creative arts therapists. We also welcome applications from mental health campaigners and policy makers. As the majority of participants will be working with clients or patients who present with psychopathological concerns and difficulties, we would expect permission from their place of work to bring relevant clinical material (appropriately and confidentially disguised) for discussion.

Possession of an undergraduate degree or its equivalent will provide a sufficient foundation for one’s ability to manage the reading and writing requirements, however we will also accept practitioners who do not possess a degree.

CORE TEACHING STAFF

Professor Brett Kahr – Senior Course Director

Professor Brett Kahr will serve as Course Director. He has taught psychopathology in various university and clinical training contexts since 1979. He is Senior Fellow at Tavistock Relationships in the Tavistock Institute of Medical Psychology in London, and Senior Clinical Research Fellow in Psychotherapy and Mental Health at the Centre for Child Mental Health, also in London. A Consultant in Psychology to The Bowlby Centre and a Consultant Psychotherapist at The Balint Consultancy, he has worked with a large range of psychopathologies over the last forty years. He is also a trained historian. More >>

Kahr has authored or edited twelve books, and he has served as series editor for over fifty-five additional titles, having worked as founding Series Editor for the “Forensic Psychotherapy Monograph Series” at Karnac Books (now published by Routledge) and, also, for both the “History of Psychoanalysis Series” and for “The Library of Couple and Family Psychoanalysis”. His recent books include Tea with Winnicott and Coffee with Freud, as well as an edited collection, New Horizons in Forensic Psychotherapy: Exploring the Work of Estela V. Welldon. His forthcoming books on Bombs in the Consulting Room: Surviving Psychological Shrapnel and, also, his study on The Traumatic Roots of Schizophrenia will be both published by Routledge in 2019.

Brett maintains a long-standing clinical and historical interest in a variety of forms of psychopathology, including, most especially, schizophrenia, forensic psychopathology, and intellectual disabilities. He is a founding member and Fellow of the Institute of Psychotherapy and Disability and a former Board Member of the International Association for Forensic Psychotherapy.

He is a Trustee of the Freud Museum London and of Freud Museum Publications. A media psychologist of long-standing, he has worked as “Resident Psychotherapist” for BBC Radio 2 and as Spokesperson for the BBC’s mental health campaign; and in recognition of his work on the interface between psychoanalysis and the media, he became Honorary Visiting Professor in the Department of Media, Culture and Language at the University of Roehampton and, more recently, Honorary Professor at Bournemouth University in the Faculty of Media and Communication.

Biographies of the Visiting Lecturers to below:

Dr Gwen AdsheadDr Arnon BentovimTamsin CottisRichard CurenDr Matthew HaggerRaffaella HiltyProfessor Brett KahrMichael KnightElizabeth Wilde McCormickDr Carine MinneDr Phil MollonMaria Pozzi MonzoSian Morgan, Dr Joel Oberstar, Marian O’ConnorGabrielle RifkindJenny RiddellDr Adah SachsDr Richard SherryDr Valerie SinasonDr Maggie TurpMartin Weegmann and Marcus West.

CORE STAFF

Senior Course Director
Professor Brett Kahr

Director of Confer
Jane Ryan

Course Manager
Cressida Moger

Deputy Course Tutors
Raffaella Hilty and Dr Richard Sherry

FEES

CPD level:
£495 (SOLD OUT)
(or 12 monthly payments of £45)

Certificate level:
£1,185 (SOLD OUT)
(or 12 monthly payments of £100)

Diploma level:
£1,895 (SOLD OUT)
(or 12 monthly payments of £160)

VENUE

The October Gallery
24 Old Gloucester Street
London
WC1N 3AL
DIRECTIONS & MAP >>

DATES

19 September 2019 - 4 June 2020

TIME

Thursday evenings, 19:30-21:30