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White, Andrew; Herbert, Abi; Marshall, Pierise
doi: 10.1080/02668734.2021.1953116pmid: N/A
The Camden and Islington Personality Disorder Service (PDS) increasingly provides clinical consultation to external services. There is a dearth of research on the experience of clinicians delivering such consultation. Interviews were conducted with clinicians from the PDS, and a semantic Thematic Analysis was conducted on transcripts to answer the question, ‘What is the experience of Personality Disorder Service staff providing input to staff in external services?’ 13 sub-themes under four overarching themes were identified (these latter were: Anxiety, Fragmented Co-working, Task Difficulty, and Positive Outcome). These themes provide an overview of the experience of consulting clinicians. Themes are explored through Kleinian psychoanalytic theory, with reference to Bion’s work on containment and groups. Findings suggest that staff need to retain thinking space to work effectively, to feel safe and recover a sense of competence when it is attacked, highlighting the need for access to structures such as supervision. The responsibility for trying to reduce distress, risk (to self, to and from others) and functional disability of people with a diagnosis of personality disorder cannot belong to one person or service but services need to be able to think together to gain a better understanding and have an agreed cross-service response.
doi: 10.1080/02668734.2021.1938188pmid: N/A
Infant observation is an integral part of training in child and adult psychotherapy. Psychotherapy trainees and qualified health professionals may benefit from using psychoanalytic observations in other settings. This study aimed to explore the effect on these professionals of observational experiences during their training. The study comprised of a systematic literature review with pre-specified eligibility criteria. It used a systematic search strategy and provided a summary of the literature on the topic. The effects on the trainee and professional were related to the role undertaken by them as observers during the observation and the use of the observer’s countertransference in furthering understanding of the observation. Overall trainees found observation experiences useful and effective for training.
doi: 10.1080/02668734.2021.1938650pmid: N/A
In this paper, I describe my experience of the aesthetic countertransference in relation to one patient’s artwork in an Art Therapy group as part of a Therapeutic Community for people with a diagnosis of Borderline Personality Disorder within the NHS. The paper discusses how my practice became informed by Mentalization-Based Treatment which places a strong emphasis on clarifying intentional mental states. However, when looking at the artwork I encountered a situation whereby I could not easily put the experience into words. I provide a description of the patient’s overall trajectory within the treatment model, her progress in the Art Therapy group itself, and present a hypothesis for the function of the artwork which the patient produced. I draw upon a model of art therapy I have previously devised combining art psychotherapy theory, art critical theory, mentalization (MBT) and psychoanalytic theory. Drawing on Grotstein’s notion of formulations in the ‘Kleinian-Bionian mode’ I go on to elaborate my concept of the ‘art-psychotherapy object’ being the totality of the triangular relationship (creator/artwork/viewer), in itself unknowable, but the derivatives of which can be understood through the paradigm of transference-countertransference-projective (trans)identification-reverie, and used to explore the dimensions of its planes.
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