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This is a personal account of being supervised by Isabel Menzies-Lyth (1917–2008) when the author was beginning a career as a counsellor for people with multiple sclerosis, when counselling itself was finding its place in society in the early 1980s. Isabel Menzies-Lyth was a sociologist born in Scotland, the only woman amongst those who founded the Tavistock Institute of Human Relations. An analyst, herself analysed by Wilfred Bion, she is best remembered for a paper she published in 1959: 'A case-study in the functioning of social systems as a defence against anxiety. A report on a study of the nursing service of a general hospital'. This paper describes the huge debt owed to her by her supervisee. [ABSTRACT FROM AUTHOR]

This paper addresses the notion of Negative Capability, a phrase coined by the poet John Keats and picked up by the psychoanalyst Wilfred Bion. It explores what each man meant by this phrase, where the concept fits within contemporary psychoanalysis, how it relates to psychodynamic practice, and why it is, I believe, crucial to counselling adolescents. Bion's reference is brief but the quality he identified—the ability to tolerate therapeutic experiences of uncertainty—has been widely endorsed by clinicians, taken up by the British School of Psychoanalysis in particular. I discuss the ways in which I have attempted and struggled to exercise Negative Capability in my practice, with a focus on the challenges and implications of this approach for my young clients; the paper weaves together the two psychoanalytic perceptions of Negative Capability and adolescence. Keats's concept is significant to Bion's metapsychology, as many have noted, linked to his theories of alpha function and the growth of thought, the abandonment of memory and desire, ultimate truth and transformation, and container/contained. With recourse to this last idea, I look at how I tolerated radical uncertainty through the vicissitudes of my own adolescence. I explore Fink's claim that, contrary to what is perhaps commonly believed of psychotherapy, achieving conscious understanding of the unconscious causes of a symptom is not the primary aim of psychoanalysis or counselling, let alone what effects change or is in every case possible. I support Coltart's emphasis on Bion's belief that cultivating faith—in the process of therapy, one's own therapeutic capacity, the client's capacity to change, the very possibility of psychic transformation—is key to sustaining the difficult, disquieting, and sometimes almost intolerable therapeutic experience of Negative Capability, a quality I have come to consider critical to my work with young people. [ABSTRACT FROM AUTHOR]

The article discusses various reports [published within the issue, including the lecture of Ellen Noonan, one by Victor Hood, and another by Jonathan Smith.

An introduction is presented in which the editor discusses various reports within the issue on topics including the term paranoid-schizoid, the relationships of siblings at work, and the trainings for psychodynamic counselling.

The concept of digital therapeutics is becoming increasingly popular. At the end of 2019, NHS England announced that over 300,000 patients were using some form of digital therapy, ranging from CBT and psychoeducation to counselling and psychotherapy. With the advent of the COVID-19 crisis the numbers are now far higher, with most therapists expected, even required, to offer their services via online platforms such as Zoom or Skype. But in the rush to capitalise on the convenience and accessibility of online therapy, it seems as if something, somewhere, has gone missing. In this paper, I will try to characterise and articulate the sense of loss that frequently attends online work, drawing on the work of Freud and the German philosopher and cultural critic Walter Benjamin. [ABSTRACT FROM AUTHOR]

Research supervision in the field of counselling and psychotherapy is a fruitful area for investigation in view of the fact that the research supervisory relationship is powerful and highly charged, whether consciously acknowledged or not. Researchers trained as counsellors and psychotherapists possess the skills to facilitate the emergence of, and work creatively with, impasses and crises, both in the research itself and the supervisory relationship, as a result of their training and experience in dealing with crisis and catharsis in clinical work. This paper will demonstrate these points using a case vignette from my work as a supervisor of research dissertations undertaken by students on a Masters in Therapeutic Counselling course. Drawing on narrative analysis, clinical supervision theory and discursive analysis it will look at the strengths and weaknesses of a 'psychotherapeutic' approach to research supervision. [ABSTRACT FROM AUTHOR]

This paper explores the dynamic context of the primary care setting and its impact on the work of psychological therapy undertaken within this complex frame. Through reference to clinical experience of working within a primary care team the paper elaborates on the proposition that the dynamics of the team itself can be a source of communication about and containment of the therapeutic dyad as well as hold the potential for working against the interests of therapeutic change. Thus work within and about the team enables fruitful therapeutic work to take place. [ABSTRACT FROM AUTHOR]

This paper deals with the selection of training candidates for counselling and psychotherapy, and establishes what the criteria and requirements are the author looks for in the selection interview, which in many respects resembles assessment interviews with patients. She looks for the patient in the helper, using the concept of the wounded healer to make her choice. Drawing on Paula Heimann's classic paper 'The evaluation of applicants for psycho-analytic training' (1967/8), the assumption is that 'the therapist does not have to be an extra-ordinary personality' yet needs to have an ability for 'learning from experience' and three indispensable requirements: empathy, intuition, and the capacity for thinking. The paper is illustrated by vignettes of candidates, who have chosen to train because they 'feel summoned by an internal voice, a call from the super-ego which forms the basis of any vocation'. It concludes that the wish to help is rooted in an experience of suffering. [ABSTRACT FROM AUTHOR]

Introduces the contents of the February 2004 issue of "Psychodynamics Practice." Illustration of the theoretical richness and depth of psychodynamically oriented work; Outline of the applications of psychodynamic ideas to a range of occupational setting as well as to individual clinical work; Analysis of the use of psychodynamic ideas in different occupational settings.

'Whatever can be catalogued is an occasion for despair'. Gabriel Marcel (1964). Ever since the Enlightenment, knowledge has been linked to the metaphor of light. The idea that 'to see is to know' so firmly grounds our current way of being in and understanding the world it is hard to imagine otherwise. But our insistence on open government, freedom of information and the public's right to know privileges not only the visibility of information but also the visibility of the self. In this paper, I consider how we might think about and respond to the ever-increasing demand for transparency in the consulting room. I draw on the ideas of Derrida, Laplanche and Glissant to argue for what has been called 'the right to opacity', suggesting that psychoanalytic practitioners are particularly well placed to offer a critical perspective on today's culture of surveillance. [ABSTRACT FROM AUTHOR]

This paper was given as the Annual Ellen Noonan Counselling Lecture on July 2012 and retains some of the spoken style of the lecture. It uses examples of Ellen Noonan’s work to examine aspects of the process of teaching and learning psychodynamic practice. The difficulties of how to embed theoretical knowledge with its clinical application are discussed and the question of what are the key skills of the self-reflective practitioner is raised with reference to whether, and how, they can be taught or learnt. It is suggested that part of this process consists in helping students, and their teachers, to be more comfortable with not knowing, a concept that is both counter intuitive and counter cultural. From this aspects of contemporary therapeutic practice, with specific reference to psychodynamic short-term therapy, are addressed. The paper looks at the ambivalence felt by many psychodynamic clinicians towards working within a short-term paradigm in current workplace settings and how this might be addressed. The paper discusses the intrinsic qualities of a psychodynamic short-term approach and its relation to contemporary therapeutic modalities. It is suggested that the increasing managerial culture, leading to the ascendance of protocol driven, manualised and structured therapies, represents an attack on the relational and must be challenged. [ABSTRACT FROM PUBLISHER]

This paper takes an explicitly political perspective in examining some of the key arguments which General Practice (GP) counsellors, struggling to make sense of working in a milieu that contradicts their value system, are currently needing to address. Beginning with a brief contextualising of the ‘audit culture’ as a ‘hypermodern’ cultural phenomenon, challenges to the author's previous published writings on GP counselling are then invoked to open up key arguments that are confronting GP counsellors in their work. It is argued that there are major difficulties of values-incongruence for any non-Cognitive Behaviour Therapy (CBT) counsellor now working in an NHS GP milieu, and that for practitioners to find an authentic-enough stance for their client work, resistance, subversion and even organised principled non-compliance might be a necessity for practitioners wishing to stay true-enough to their core beliefs and professional identity. The nature of the National Health Service’s (NHS) current attitude to the psychological therapies could mean that practitioners have to make the stark choice between incongruent compliance, values-congruent subversion, or outright rejection of what they are asked to do (with resignation or even redundancy being one possible outcome). A variety of strategies will no doubt be pursued by different practitioners at different times, and the courage that practitioners are able to garner in this paradigmatic struggle for the ‘soul’ of our work can contribute towards a longer-term, much-needed sea-change in the state's attitude to counselling and psychotherapy as modern healing practices. [ABSTRACT FROM AUTHOR]

Spaces are invested with all sorts of meanings; they are a place of potential, of creativity and of spirituality. Post-modern approaches to the concept of spatiality emphasize the reading of spaces by actors rather than the writing of behavioural imperatives within the physical structure of the built environment. Spaces are not determining yet can be co-opted to serve particular bodies of knowledge, power interests or subjectivities. In other words, spaces are not discursive; they may be read in ways other than those in which they have been written (Fox, 1999). Informed by the work of Gaston Bachelard, Arthur Young, David Bohm, Donald Winnicott and the artist Anish Kapoor, this paper focuses on the concept of space as it is experienced within the therapeutic relationship, more specifically through the process of psychotherapy and counselling. This study, which formed the basis of a funded research project, examines the interface between the experience of space, presence and containment and the development of self-awareness through reflection. [ABSTRACT FROM AUTHOR]

Contributions from psychotherapy to psychiatry are extensively described but surprisingly few focus on trainees' early encounters with psychotherapeutic work and the value this might have in the context of psychiatric training. Our aim in this paper is to explore the experience of a Balint-style group from the perspectives of facilitator (a psychotherapist trained in social work) and a junior psychiatric trainee group member. We try to convey something of the impact of crossing boundaries between the disciplines and ways of thinking about psychiatric disorder. [ABSTRACT FROM AUTHOR]

This paper examines the relationship between how counsellors report working with religious faith in the consulting room and psychodynamic theory concerning religious faith. Drawing from the author's research, extracts from interviews with psychodynamic counsellors are offered in exploration of three theoretical themes. Two areas of tension and pressure that arose for co-researchers in responding to clients' religious faith are examined. The paper concludes with suggesting that, for the counsellors interviewed, theory, in the general rather than the particular, was integral to how they reflected upon their work, and that, for some, their identity as psychodynamic was problematic. [ABSTRACT FROM AUTHOR]

The author begins this paper by noting the continued growth of counselling in Primary Health Care and that increasingly counselling is being delivered in Managed Care services. He describes his own role as a manager and supervisor of one such service operating on the front line of an inner city. He outlines the contribution that a regular meeting time for the counsellors has made to their ongoing support. The fortnightly Organizational meeting has provided a reflective space for the counsellors in which it has been possible for them to share the pain and the difficulties of their work in their respective surgeries. This in turn has contributed to their ability to maintain depressive-position functioning in the face of the complex emotional demands of their work. The author goes on to describe how he applied open systems theory in identifying and defining the nature of his own role and tasks as manager of the service. By placing himself at the boundary of the service, and attending to the various boundaries that the service had with the external environment, he shows how he was thereby more able to facilitate the counsellors in their own work and practice in the surgeries. This in turn contributed to the ability of the service to remain focussed upon its Primary Task, and to lessen the likelihood of it developing a self-assigned impossible task. The author explores the compatibility of his role as supervisor with his role as manager in a counselling service where the managerial role is facilitatively placed on the boundary. The paper concludes with a description of a crisis in the counselling service that required a re-focussing of attention on new boundaries with the external environment. [ABSTRACT FROM AUTHOR]

Winnicott and Milner conceptualise the baby as being psychically part of the mother in the earliest stages of development. They develop a theory of separateness between mother and baby through the use of the infantile illusional area and transitional phenomena. In this paper, three examples are explored in depth, one developmental, the other two clinical. The first example is of a patient's description of her transitional object when she was a child, which became terrifying to her. In the second example, the emotional development of an 11-month-old baby boy is explored, who is beginning to develop a sense of being a separate self from his mother, which comes under threat through a premature separation. The third example explores the dynamics of a borderline patient in long-term psychotherapy who cannot bear separateness and reacts with dissociation. Winnicott's theory of illusional space and Milner's ideas of the therapist becoming an 'answering activity' are used in order to understand the case material. The purpose is to show how these concepts lead to interesting ways of thinking about the development of a baby's separateness and the stage before separateness. The implications for therapeutic practice with patients who have borderline tendencies or fundamental problems in the area of separation are also examined. [ABSTRACT FROM AUTHOR]

Over the course of 20 years' experience counselling more than 600 clients, I have come across many relationships which seem to have been severely compromised by one partner nearly dying. In some cases, the partner of the ill client has withdrawn affection and become cold; in others, the partner has found a lover, ex- or new, temporary or permanent. All of the clients concerned were people with considerable experience of the world. All of them were confused and puzzled by the way the partner reacted to their illness. Some of them had not made the link to their own illness until we uncovered it in counselling. This paper arises out of attempts to make sense of this. Drawing on material from many sources, including work with carers, I suggest that life-threatening illness can be experienced as a flirtation with death, producing something of the same feelings of betrayal in the healthy partner, and, in some cases, some of the same reactions as any other threat of abandonment. [ABSTRACT FROM AUTHOR]

The paper sets out to stimulate interest in counsellors and therapists about the unconscious relationships which people form with their work, through describing and analysing what goes on in work-related counselling with a psychodynamic approach. The author draws on twentyfive years of experience to reflect on the changing nature of what was once termed 'vocational guidance', and offers some short case studies, as examples of ways in which a person's world of work can become intertwined with their internal world in a confusing and disabling way. The core concepts and techniques which have evolved are identified and discussed; attention is directed particularly to the importance of the client's expectations, the effect of time limitation, the place of work in the whole life, and dealing with transference. [ABSTRACT FROM AUTHOR]

This paper documents the outcome of conducting research into the effect on counselling/psychotherapy practice of an absent father in the therapist's childhood. This area of research emerged from a personal interest of the researcher who had both experienced an absent father in childhood and is a practising therapist. The study was conducted employing the heuristic research method as described by Moustakas (1990). Eight co-researchers who met the selection criteria and who were also practising therapists participated in taped individual interviews with the researcher. From transcriptions of the tapes, researcher immersion in the research material and periods of incubation, themes emerged. In relation to therapeutic practice these themes were: endings; working with clients of the opposite sex; over-responsibility; boundaries; waiting and silence; envy; empathy; ethics; supervision; career choices; choices made within a career in counselling and psychotherapy; and training. Each of these is illustrated through documentation of co-researcher narratives together with a composite depiction and creative synthesis of the experiences being researched. Finally, some methodological considerations were documented and potential further research was suggested. [ABSTRACT FROM AUTHOR]

Within the context of growing interest in citizenship and the role of psychotherapy in the defence of human rights, this article considers some dilemmas of the therapeutic relationship with particular reference to the writings of Derrida and Levinas. The question when the other is put first, how to position oneself? was suggested to me as a title for a symposium paper on Ethics, Psychotherapy and Human Rights (European Association of Psychotherapy, 1999). At the start of 2003, there were 174 475 Web Sites in existence on the subject of European Citizenship(MSN). Habermas (1998) argues that developments relating to sovereignty and citizenship in Europe are leading to the progressive undermining of national sovereignty. [ABSTRACT FROM AUTHOR]

It is therefore a crucial element of training that organizations work together well enough; for example, in negotiating differences in views of a trainee's competence between placement and training provider. In relation to students who undertake training while in an I established i workplace, it has been concluded that the potential isolation of the student in, or alienation from, their workplace can be addressed by enhancing the partnership between student, course and workplace; in order to ensure that all parties gain maximum benefit (Kegerreis, [20]). Some training institutions have their "own" placements, that is, perhaps a "research clinic" model where a training institution offers accessible therapy service staffed by its own trainees. One aspect of this is the loss of holding provided in the training institution by the modality of training; students may find themselves with colleagues, managers, supervisors, and, most exposing, in supervision groups, where they have to "defend" or represent their modality while still unsure about it. [Extracted from the article]

A research study using a Foucauldian discourse methodology was undertaken in a third-level student counselling service to explore the little researched but widespread practice of short contract counselling. Short contract counselling was defined as a standardised small number of counselling sessions, in this case six, which was offered to all clients. Discussion of psychotherapy literature relevant to this topic and its relationship to the findings from this study form the basis of this article. Consideration was given to some of the major changes in the higher education environment which link to the penetration of neoliberalism into education and health which then provides the conditions of possibility for the emergence of short contract counselling. This practice has developed and is described as a means of allocating scarce resources in the face of high demand for services. Although it is widespread it has not received much specific attention from researchers but tends to be seen as an inevitable and taken for granted background to the delivery of student counselling. The focus of this study is not to evaluate the short contract model but rather to explore the context which allowed it to come to such a position of prominence in a relatively short period of time. The study findings drew attention to a range of discourses drawn on by the study participants who were both student clients and counsellors working in a service which operated this model. These were the discourses of productivity, managerialism and risk management. These discourses illustrate the influence of neoliberalism and highlight how disciplinary power can operate within the short contract model. [ABSTRACT FROM AUTHOR]

Educational institutions should ensure that students develop a professional identity, as well as safeguarding their well-being and activating awareness and change processes. The aim of this study was to assess the efficacy of group psychodynamic counselling as a means of reinforcing academic identity – considered the forerunner of professional identity – and psychological well-being in a group of final-year undergraduates studying clinical psychology. Thirty-three final-year-students of clinical psychology who participated in six group psychodynamic counselling sessions were compared with sixteen final-year students of clinical psychology who had never participated in an intervention of this kind. The results suggested that group psychodynamic counselling made students feel more capable of managing their lives and more open to new experiences as well as encouraging them to perceive their relationships as more positive and satisfying, to believe that their life is meaningful, and to achieve greater self-acceptance. The in-depth exploration also prompted students to consider their commitment to their choice of career. Group psychodynamic counselling also reinforced students’ educational choice, as the likelihood of students becoming less committed to this choice was reduced after the intervention. Thus, the study confirmed the efficacy of group psychodynamic counselling as a means of reinforcing both academic identity and promoting well-being and demonstrated that it is a tool clinical psychologists and university teachers could use to activate self-reflection and change within educational settings. [ABSTRACT FROM AUTHOR]

This article describes an approach to counselling and psychotherapy which complements dominant discourse approaches to clinical evaluation based on New Public Management systems which underpin the Improved Access to Psychological Therapies scheme within the field of therapy. It is based on an approach to research and practice development which I will call practitioner microphenomena research. In order to demonstrate the method, I will examine an extract from a single case study of a client with major depressive disorder from the point of view of intersubjective theory and a little-known approach to therapy called anthroposophic psychotherapy based on the work of Rudolf Steiner. I will show how the two clinical methods are well suited to examining the microphenomena of practice and can be integrated into a coherent whole. A central feature of the account will be the anthroposophical view about the central importance of our individuality or ‘I’ which has similarities with the Jungian self but is still distinct from it. [ABSTRACT FROM PUBLISHER]

A personal narrative is presented which explores the author's experience during her counselling psychology training wherein she tried to fight the feelings that evoked in her but expressed in her counseling relationship with her client, a bereaved mother whose only child died through suicide.

This article explores the key assumptions that underpin the National Institute for Health and Clinical Excellence's (NICE) approach to guideline development and describes how those assumptions have led to the current reduction in the range of available therapies in primary care. This reduction, it is argued, conflicts with the government's recent commitment to increase patient choice. It is suggested that we are witnessing a paradigm war between those who seek to treat psychotherapy and counselling as if it was a drug and those who regard it fundamentally as a dialogue. Further, it is contended that though NICE may acknowledge the serious debates concerning the relevance and appropriateness of its approach, by subjecting issues of mental well-being to a biomedical model of research it is effectively ignoring those debates. NICE's process is deconstructed and areas of contradiction and ambiguity within NICE's own work are highlighted. The case is made for NICE to move beyond its use of strict diagnostic categories and follow the lead of the American Psychological Association (APA) in adopting a pluralistic approach to psychotherapeutic and counselling research evidence. [ABSTRACT FROM AUTHOR]

This discussion summarises and examines the utility of Schein's recently proposed theory of helping. In a small volume, Helping (2009), Schein seeks to develop a general theory of helping, employing concepts from several social science disciplines. It is a theory about the universality of helping, its occurrence in all cultures and in all human activities. It is not a theory about therapy or nursing or business consultation, or any other narrowly defined context. A prominent focus of Schein's theory is the differentiation of helpful from unhelpful help. With its initiation, helping sets in motion a social and psychological process with the provider of help in a 'one-up' or superior position and the receiver of help in a 'one-down' or inferior position. The 'one-down' experience involves one or a combination of several unpleasant affects - dependency, powerlessness, neediness, inferiority or uncertainty. Success depends on the establishment of a more equitable equilibrium. Helping relationships begin in ambiguity and ignorance which must also be resolved. A variety of modes of inquiry provide the helper with tools for eliciting what he or she needs to know. Four modes of inquiry are proposed and described. Schein further proposes that effective help occurs when the helper adopts the proper helping role and describes a repertoire of three - the doctor, the expert and the process consultant. Schein's theory is essentially descriptive and pragmatic. Limited in conceptual complexity and by its ambitious reach, the model creates space for enrichment by various psychodynamic theories without specifying or privileging any of them. The pragmatic focus of Schein's theory keeps before us the need not only to understand but to evaluate the effectiveness of helping efforts. Case material from the author's professional practice provides varied contexts for exploring the utility of Schein's theory. [ABSTRACT FROM AUTHOR]

Psychodynamic counselling can be an effective approach for those who seek help in resolving their problems of addiction. In common with other modes of counselling, the prospects for a good outcome for the client are highly contingent on the quality of the alliance established between counsellor and client and this is especially the case for 'Relationally-orientated Addictions Counselling' (ROAC) approaches. It is suggested that the conduct of counselling is variously helped or hindered by the environmental and contextual ambience in which it occurs. Four areas of potential threat to the effective conduct of ROAC in contemporary practice are outlined with some suggestions as to how these threats might be countered. [ABSTRACT FROM AUTHOR]

In this essay I present the clinical work with a client that I have been working with for 9 months now. The essay is divided into sections, each one indicative of one phase of the counselling relationship. In each of them I present the therapeutic process (my client's and myself) by highlighting some newly-acquired psychodynamic concepts, sharing some difficulties encountered, the learning gained though supervision and the progress of the client. [ABSTRACT FROM AUTHOR]

Focuses on the general practice of counseling. Impact of general practice counseling on the area for developing a more self-consciously deconstructive approach to therapy; Characteristics of the trans-modern post-professional therapy; Flexibility of the general practice therapeutic framework.

This is an article of two halves. The first half profiles primary care counselling research that grew out of the introduction of evidence-based practice in the late 1990s. The key characteristic of this stage of the evidence evolution is that the majority of services awaited supportive evidence as passive recipients. By contrast, the second half of this article profiles an example of current activity in which services have a much less passive role as they rise to the new challenges bought about by the new National Health Service [NHS] performance management and clinical governance agendas. [ABSTRACT FROM AUTHOR]

Focuses on the psychotherapy of cultural conflict. Ideological stances of cultural conflicts; Social consequences of psychotherapeutic and counseling practices; Radicalized modernism in the training of counselors and psychotherapists.

Melanie Klein's concept of projective identification is now in common use by counsellors and psychotherapists. Julia Segal describes her own hypothesis about the way it works as well as her use of it in her practice, working as a counsellor for people with multiple sclerosis, members of their families and professionals working with them. When a person cannot bear to feel an emotional state they can evoke the feeling in someone else, not only a therapist or counsellor but also others within the family. Segal describes the way powerful emotions can be evoked in the counsellor; in particular the feeling that a certain idea cannot be shared with a client. She also describes working with clients who are on the receiving end of such projected feelings, sometimes evoked by illness within the family. She also points out that unresolved emotional states suffered in childhood can leave adults unable to bear certain feelings. If the feelings threaten to re-emerge in adulthood, perhaps triggered by their own children reaching a certain age, parents sometimes attempt to rid themselves of the emotional state by projective identification and in the process, evoke a version of the feelings in their own children. This may, for example, exert pressure on parents to divorce just as their own children reach the age they were when they themselves lost a parent. [ABSTRACT FROM AUTHOR]

The article presents a list of contributors to the February 2005 issue of the journal "Psychodynamic Practice." Robert Waska has been in the field of psychology for over twenty-five years. He is a certified psychoanalyst, graduated from the Institute for Psychoanalytic Studies and maintains a private psychoanalytic practice in San Francisco, California and Marin County, California. Paul Terry is a Consultant Clinical Psychologist and Psychotherapist. In 2002, following four years working in Australia, he returned to live in London, England. He works in the National Health Service, at Birkbeck College at the University of London where he is a lecturer in Counseling, and in private practice.

The article profiles several authors including Jean White, author of the book "Generation: Preoccupations and Conflicts in Contemporary Psychoanalysis," Michael Jacobs, author of the book "Psychodynamic Counseling in Action," and Robert Waska, author of five textbooks.