Working with Hostility in the Consulting Room
Saturday 7 December 2019 - Dublin
A Special One-day Event with Brett Kahr and Dr. Carine Minne
Although the vast majority of psychotherapy patients conduct themselves with great honourability and pose no physical or emotional threat to the clinician, a small number of individuals will, from time to time, hurl “bombs” into the consulting room. Some patients might confess to criminal activities, or might even stalk or terrorise the psychotherapeutic practitioner, causing great distress.READ MORE...
In this special one-day event, Professor Brett Kahr and Dr. Carine Minne, will present material from their work in both independent and forensic settings, examining the ways in which practitioners can better diagnosis potential clinical “bombs” in advance and, also, exploring how one might better defuse the bombs which patients hurl, inevitably, on certain occasions. The two speakers will not only present some very riveting and, often, shocking details from their own practices but will also provide “live” supervision so that conference participants will have an opportunity to benefit from Kahr’s and Minne’s many decades of professional experience. This conference follows on from the publication of Brett Kahr’s latest book, Bombs in the Consulting Room: Surviving Psychological Shrapnel and with the launch of The International Journal of Forensic Psychotherapy for which Carine Minne serves as Editor-in-Chief.
Registration and Coffee
Dr Carine Minne
Fuses in Psychotherapy: Slow Matches and Quick Matches
A slow match is a very slow-burning fuse presenting only a small glowing tip whereas a quick match is one, which once ignited, burns at top speed. In this talk, the speaker will present a number of clinical vignettes to illustrate situations when the therapist realised there was a sudden unexpected rise in “temperature” of a patient’s mind and why this may have occurred. A fuse was lit but was it a slow or a quick one? She will relate this ignition to the possibility of premature interpretations, or a failure to realise how anxious the patient was in the presence of the terrifying object-therapist and also, patients’ unexpected responses to external interferences during a session. She will describe how these situations unfolded during sessions and how, upon reflection, these could have been diffused differently. The emphasis will be on how best to maintain a psychoanalytic stance but also how to clinically judge when a session must be terminated in order to protect patient and therapist from exploding “bombs” inadvertently ignited by patient or therapist. The importance of supervision and consultation with colleagues will be stressed.
Live Supervision Session
On Patients Who Explode: Surviving Petrifying Psychotherapeutic Experiences
Although most of our patients will enter the consulting room quite quietly, often in a depressive state, internalising their sadistic impulses, a tiny fraction of those with whom we work will attack us in a variety of chilling ways. In this presentation, the author will describe in detail three particularly terrifying clinical experiences in which patients either threatened to kill the psychotherapist or actually sullied the consulting room with bodily fluids. The author will draw upon his work not only with forensic patients and intellectually disabled patients but, also, with those who presented as ordinary “normal-neurotics”. The author will consider the phenomenology of these “bomb”-like explosions and will describe how he attempted to maintain a psychoanalytical focus of understanding, which consisted of a careful scrutiny of the countertransference and a firm commitment to the interpretation of unconscious material, whilst under attack. Furthermore, he will describe the essential role of consulting with experienced colleagues who provided essential supervision or consultation. The author will also emphasise the ways in which many “bombs” can be hurled not only by the more obviously dangerous or disturbed individuals but, with surprising frequency, by those with no criminal history, who, upon first encounter, often present as reasonably healthy.