Welcome to my first editorial written for the journal after my first year in the post as one of the submissions editors. I think my relative newness in my work as an editor for the journal and as a psychotherapist means I’m looking for certain things when it comes to papers. I really appreciate being able to peek into someone else’s therapy room and learn from their countertransference to show that they’re human, their interventions but also their mistakes. I also really value receiving practical and direct ideas on techniques, what to say, how to say it, when to say it and whether to say it at all. I think that what pulls the main four papers together in this issue is their grounded desire to help therapists in their work. And despite a rigorous theoretical and clinical approach, there are no lofty aspirations here. Instead, all three main papers seek to suggest how to work with clients using humble expectations for what might actually be possible and a transparency that doesn’t shy away from examining feelings of failure. And even if you’re a seasoned pro, that doesn’t mean there’s not something here for you too. All four main papers are united in their ability to make you think about your own practice and reconsider what you might previously have taken for granted.
Natasha Reynolds, David Rupert and Steven Sandage in ‘Therapeutic progress and symptom elevation in treating dismissive attachment’ want to help to therapists working with clients who have a dismissive attachment style by identifying potentially useful interventions and common struggles and uncertainties. They also raise important questions about therapists’ expectations and what is actually possible in psychotherapy with clients who tend to operate in this way. Reynolds et al. remind us that studies have shown that those with dismissive attachments tend not to seek help, disclose less, experience a higher level of distress and less symptoms remission during therapy and are also more likely than others to drop out. How against all odds can therapists go about creating a relationship where they matter to clients who tend to dismiss and diminish the importance of others?
This piece comes at a time when it’s seemingly more and more trendy to show how emotionally unavailable you are. Perhaps as a recoil response to a focus on likes and followers on social media, distancing yourself from others has become something to be proud of. Scanning through my feed on Instagram I’ve come across numerous popular memes describing the wish to hibernate. People ask – who are these odd people who want to make connections when it’s much more safe, comforting and secure to stay within ourselves or a small circle of connections? A particular post stands out, an image of Homer from The Simpsons sleeping contentedly in bed with the caption ‘How I feel knowing nobody really knows me because I let nobody in’. If it is becoming increasingly the culture to distance ourselves from others, this paper is all the more relevant and important.
In Reynolds et al.’s paper, we meet ‘Paul’ who comes to therapy to address a disconnect between his seemingly happy external circumstances and how he feels inside. Through the paper Reynolds et al. analyse what might be happening when there are difficulties connecting in the therapy room, the client offers hardly any information at intake, when the client struggles to ‘begin’ the session and respond to reflective questioning. As a therapist who is just beginning in my own private practice, I value the paper’s detailed analysis but more than this I appreciate its practical techniques and ideas for therapists trying to engage with a dismissive client.
Roger Lippin in ‘Three fragments on trauma and time’ wonders how trauma and traumatic bereavement influence a client’s and a therapist’s experience of time inside therapy. He asks what the therapist can do to remain responsive to how time might now register differently after a traumatic event. Time, Lippin argues, doesn’t freeze but appears to circle in a narrow compass, buffering between a cluster of key moments surrounding the traumatic rupture. It is up to the therapist, he says, to regulate the tempo of the sessions when the client’s own experience of time has become so dysregulated. The therapist can bring understanding but also with the more realistic and subtler expectation to be able to get time moving again, beyond the confines that it occupies in trauma.
Lippin allows us to be a fly on the wall in three fragments of short-term psychotherapy with clients who all experience a yearning to return to the state before the traumatic event took place. Lippin suggests that it is important to explore previous traumatic experiences, as the one they are presenting with may not be the first in the series. Understanding the meaning of the current trauma can only really be created, he says, while taking into account past traumas as well. With an ever-realistic approach characteristic of this issue, Lippin questions the effectiveness of therapy in the immediate aftermath of trauma. And in response to the trauma experienced Lippin sometimes boundaries his work to receiving the client’s words, metabolising them and returning them – listening and occasionally directing lines of thinking. Lippin reminds us of what progress might look like working with a client after trauma, that the experience of time might return to more of how it felt before – enabling movement between memory and the future, and also a more creative engagement with right here and right now.
Lynn Stammers and Anthony Williams in their paper ‘Recognising the role of emotion in the classroom; an examination of how the psychoanalytic theory of containment influences learning capacity’ aim to alert those working in education to the unconscious complexities of the classroom. The pair writes how addressing the unconscious through play can be an important way of containing and working through a child’s conflicts so that they can get to a place where they want to and can learn. Stammers and Williams are concerned that the national curriculum’s focus on cognition, success and results has lost sight of the significance of engaging emotionally with children. They say it is this emotional attunement, not tests and results, that can free up a child’s capacity to learn.
As a parent, I am just about to go through the process of choosing my child’s school. A lot feels at stake that is explored beautifully in this piece. I want her to maintain a sense of her own uniqueness and keep hold of what she is curious about and what she finds interesting. I don’t want that squashed in any way. I want her to keep turning up to Christmas carol concerts wearing her batman costume. But at the same time, I want her to achieve within the system. But Stammers asks us, achieve at what cost?
Stammers allows us a glimpse into her ‘rainbow room’ where she supports a young boy through a process of self-discovery. In contrast, she then observes another young boy in the classroom who is expected to comply with the instructions of his teachers despite his waning attention levels. Stammers and Williams argue that maintaining a level of attunement to childrens’ emotional needs, even when reaching within a prescribed curriculum, can help a teacher to remain aware of when children are able and unable to learn.
Joanna Ryan in ‘Class in psychodynamic theory, research and practice’ thinks about what happens when you start considering class as a factor in psychodynamic and psychoanalytic work. She examines access to therapy and psychotherapy training, how we might understand the psychic embodiment of class, the internal class politics of the therapeutic professions, the hierarchies that exist and what judgements these create. I was particularly taken with Ryan’s frank look at her own middle-class cultural shame and fear when faced with how her own class status is often angrily and resentfully identified with the therapy relationship. But instead of letting this stunt discussion, she thinks that it should be put to good use by opening up debate.
Ryan argues that the psychosocial should be given an equivalence to intrapsychic processes, since they are not so dissimilar. She reminds us that class has intergenerational aspects that are handed down through the family just as psychic processes are. Being the daughter of an immigrant to England, the class has always seemed an ‘other’ to me. I have previously felt like my father’s immigrant status and ‘different’ culture, despite him marrying my mother – a British white, middle-class woman – set us as a family apart from the usual ways of thinking about class in the UK. But perhaps as Ryan says, this is a way that I disown my own middle-class roots, because despite my father starting his career cutting sugar cane in the fields, he retired a university lecturer. Readers, however they see their own class, will benefit from Ryan’s no nonsense approach that nudges us all towards considering how we see ourselves and others.
Our first Open Space paper is by Nick Barwick on ‘Stronger together: the value of working in groups’. Barwick considers global nations and the unsettling nature of accepting their interconnectedness by looking at global warming, the EU referendum, the Trump administration and nationalism. He wonders how an idea of shared humanity and vulnerability may cause some nations to cry ‘stronger together’ and others, ‘stronger apart’ and asks why and how the larger group tends to threaten a permeable sense of self. Barwick then considers how the therapy group represents a microcosm of society and just as nations struggle to survive and grow so do a group’s therapy members. Barwick praises group therapy work as a unique experience and a field which encourages true growth and debates its merits in comparison with individual and couple work.
Our second open space paper is by Sue Kegerreis on ‘Managing our time and ourselves in the way we now work’. While many therapists might welcome the opportunity to work from home or set up a private practice that doesn’t require them to be a member of an organisation, Kegerreis points out how it can also be potentially tricky and problematic for our mental health. She looks at what might happen to our projective processes if we are not encountering enough real people regularly enough on a deep enough level. She reminds us that when we are in a workplace setting, how we see others, e.g. the office rebel, the authoritarian boss, relates to the disowned and projected parts of ourselves. We learn from this, and have a chance to see what happens to these bits and can take them back and own more of our ourselves. Kegerreis asks, what happens to us when we work from home and we’re not able to park aspects of ourselves in other people?
This open space paper also considers difficulties in managing time – thinking of how going to a workplace allows us to keep our id in check and puts our ego firmly in charge. I write this working from my kitchen table so Kegerreis’ paper couldn’t be any more relevant as I battle with a way to remain focused despite my fears associated with writing my first editorial and without an external boss telling me to just get on with it.
I encourage you to take a dip into our book reviews. This issue, among other things, they consider the influence of anxiety, what it might be like to have coffee with Freud, how psychotherapy can become more relevant to minority groups and how much of working with clients who have eating disorders is a waiting not knowing whether you are going to be able to help.
I hope you enjoy this issue. It really is a brilliant medley and its authors will be very pleased to hear if their writing has in any way made you think twice, consider, or think differently about your psychodynamic practice, so do get in touch.