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.
View Content For This SpeakerA History of Narcissism and its Treatment: An Effective Clinical Approach
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.
View Content For This SpeakerBorderline Personality Disorder as a Maturational Failure of the Right brain
In this talk Ruthie Smith explains how a person with a disorganised attachment (Type D) has suffered from wounding and complex attachment trauma in early infant development, which adversely affected their subsequent personality development. Such clients attract less empathy than those with other emotional difficulties or behaviours, not least because as a result of their fragmentation and weak ego boundaries, they unconsciously project painful and uncomfortable feelings into others. Clients who exhibit disorganised attachment patterns have traditionally diagnosed as suffering from ‘borderline personality disorder’.
Ruthie proposes that it is helpful to view and work with this client group through the lens of trauma, working with the body as well as the mind. Good results in facilitating affect-regulation and gradually transforming relational patterns have been found using Energy Psychotherapy techniques in combination with talking therapy, which can also be used as self-help tools by the client. Since these methods work at the level of cellular memory in the body they have the capacity to help break down otherwise seemingly intransigent patterns, although this is long term and complex work. Ruthie’s talk is informed by neurobiology.
View Content For This SpeakerDisorganised Attachment as a Reframing of Borderline Personality Disorder
Epigenetic modifications to genes can be transient, altering gene expression for a short period of time. But some changes are very stable and may last for the entire lifetime of an individual. In this session we will examine some of the evidence that addresses how epigenetics can create and maintain long-term patterns of gene expression, and the potential effects this has. Topics will include the adult consequences of early abuse or neglect, the changes in gene expression that are induced by drugs of addiction and the delayed clinical responses to antidepressants. The potentially reversible nature of epigenetic modifications to genes means that there is the scope for altering these responses, but will this increased mechanistic understanding change practice?
View Content For This SpeakerEpigenetics and Life-Long Events
In this interview, Susie Orbach explains how her focus on the bodily-self arose from her project of theorising the body as a developmental, relational phenomenon. She has reformulated Winnicott’s maxim, “There’s no such thing as a baby,” to “There’s no such thing as a body”. The body, as much as the self, is the outcome of relationship.
Furthermore, she argues that the parental/child relationship is one that occurs within a particular cultural moment which has impacted upon the parental body, which itself has been marked by geography, class, religion, gender and so on. This will be bequeathed to the developing child’s sense of her or his own body.The complexity of messages we receive from culture about what a body should be is leading to increasing confusion of identity in people’s search an integrated and stable bodily-self. Orbach talks about cosmetic surgery in all its forms as part of the search for safety rather than an act of self destruction. Whether it’s the person with anorectic behaviours or person who has had many cosmetic procedures, the search is for safety.
To illustrate her understanding of bodies in relationship, Orbach describes an adult patient with chronic colitis. This woman had experienced early disturbance as a baby who was unable to manage her feed, with a mother unable to receive her most basic bodily needs. In the countertransference, she describes how she came into a great contentment in her own body. The patient was able to use her as an external body for herself, and begin the process of deconstructing the defensive false body with which she was struggling. The goal of therapy, she suggests, is to develop a body, just as would aim to develop a psyche, and that the relationship is the means of doing so.
View Content For This SpeakerInhabiting the Body: a relational endeavour
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.
View Content For This SpeakerThe neurobiological underpinnings of social cognition in chronically traumatized individuals, with implications for specific, integrated treatment approaches
The last decade has challenged psychotherapists to integrate a massive amount of data and information into their practice with highly vulnerable patients. How do we decide what is essential to adapt to our practice and with specific patients? Here Sharon Stanley outlines the major shifts in terms of relational principles governing psychotherapy today and richly illustrates her presentations with scientific detail.
View Content For This SpeakerThe Neuroscience of Somatics – background and theory
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.