Outcome studies in group psychotherapy

The treatment manual is intended to serve more than one purpose. It is designed to be a research tool, making possible the standardization and validation of a treatment method. It is also a highly condensed primer and a practicum, offering a description of psychoanalytic group therapy which will act as a handbook for the beginner and as an aide-memoirefor the more experienced therapist. Many therapists will have had some experience with individual patients but wonder how they are to convert that knowledge into the practicalities of running a group, in which seven or eight patients are seen simultaneously. For young practitioners in a National Health Service setting, this can be a daunting prospect. It is difficult to do group therapy well, yet when it is done well it provides an invaluable therapeutic medium for a collection of patients it might be neither possible nor wise nor even necessary to see in individual treatment. In other words, there are many patients for whom a group is the treatment of choice

Complex trauma in a time of crisis: The Covid-19 pandemic

The impact of the COVID-19 pandemic was evolving as this book was being written. Stubley writes from the early months of the pandemic to describe the re-traumatization that the threat of the virus and the realities of lockdown and social distancing were causing in some of the patients in the service

On Redescribing the Indescribable: Trauma, Psychoanalysis and Psychedelic Therapy

The psychedelic state can be thought about as an interdependent intrapsychic, somatic, interpersonal and spiritual happening which encourages, perhaps both to the relief and dismay of those participating in the experience, the shocking and impressive emergence of one's unconscious desires and traumata's; a state which may be experienced as cathartic or healing, and as anxiety-provoking and confusing. Often, in clinical trials investigating psychedelics in mental health conditions, these go hand in hand. Amid a renewed, at times hyperbolic, interest in psychedelics as a potential treatment for mental ill health, significant gaps of knowledge remain. Additional studies exploring the impact of the extra-pharmacological factors and adjunct therapeutic models on treatment outcomes are needed. Drawing from psychoanalytic perspectives, this paper explores points of intersectionality between psychedelic therapy under investigation and psychoanalysis in the context of traumatic stress. To that end, the psychedelic state will be considered an attempt to make the unconscious conscious by immersing self in a bewildering waking-dream to better tolerate reality; immersing self in a wilful state of vulnerability, to develop trust in one's agency and capacity to trust others; immersing self in an indescribable experience to learn how to redescribe, to self and to others the traumatic past

Complex trauma: Working with other modalities within a psychoanalytic frame

Two clinical cases are used to describe how the use of trauma-focused treatment interventions—trauma-focused cognitive behavioural therapy (tf-CBT) and eye movement desensitization and reprocessing (EMDR)—can be brought into a psychoanalytically informed trauma treatment when either an impasse is reached, or engagement is difficult. The chapter emphasizes the tightrope one inevitably walks when more active interventions are used and the possibility of enactments is heightened

Working with Trauma and Dissociation in the NHS

Using a composite clinical case, this paper describes working with complex trauma, non-recent child sexual abuse and dissociative identity disorder within an NHS setting. The clinical work of an NHS trauma service is described in both historical and current terms. The case history elucidates the use of specialist group work for non-recent child sexual abuse and then individual work within a trauma team setting as the diagnosis of dissociative identity disorder comes to light. The recognition of the role of shame in both non-recent sexual abuse and dissociative identity disorder presentations serves to highlight the countertransference experiences of disbelief or inauthenticity. This is linked to the history in psychoanalysis of the shift away from external realities of abuse and to its exploration of the concept of dissociation. The question of acknowledging and attending to the reality of abuse continues to be an issue within many aspects of British psychotherapy and psychoanalysis and has perhaps added to the disbelief that the diagnosis of dissociative identity disorder often seems to engender. The consideration of setting in relation to the NHS and limitations on lengths of treatment is also addressed for these complex patients