Therapy Today October 2014



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Part II outlines some of the main concepts in body psychotherapy, including the author’s own theory of bodymind – the self as an embodied entity, one that is ultimately experienced and understood both in and through the body.
Finally, Part III offers the reader a window into the clinical work of a relational body psychotherapist through fascinating case vignettes, illuminating some of the conflicts and challenges psychotherapists face when working with the body.
Clinicians and psychotherapists of all modalities will find Touching the Relational Edge a rich source of material. The book will also appeal to ‘curious non-professionals’ – clients or people with a general interest in psychology and psychotherapy.
As a dance movement psychotherapist, I wondered if concepts such as somatic countertransference (or resonance) may feel alien to some of the book’s audience. However I found the sections on history and theory enlightening, and it was helpful for me to see where my own developing practice is situated within the context of the relationship between body psychotherapy and contemporary psychoanalysis.
Diane Parker is a coach, dance movement psychotherapist and editor of Coaching Today

Forensic group therapy


Forensic group psychotherapy: the Portman Clinic approach

John Woods and Andrews Williams (eds)

Karnac, 2014

240pp, £23.99

ISBN 978-1780490496
Reviewed by Christopher Davies
This short book explores the important work of the Portman Clinic, a unique NHS service offering outpatient psychotherapy to offenders, ex-offenders and those whose intellectual disabilities put them at risk. Group members will typically be people who have breached normal social boundaries, having in common a tendency to action and a compulsion – conscious or unconscious – to repeat risky or transgressive behaviours without thought for the effect on others or consequences for themselves. As the editors put it, ‘Please help me stop myself’ is the underlying plea.
Group rather than individual psychotherapy is often more helpful for these clients. It ‘dilutes’ the transference relationship with the therapist, provides reassurance and support for change where others are struggling with equally shameful issues, and enables self-deception to be effectively confronted. The book’s contributors vary slightly in theoretical orientation but all draw on the work of key clinicians, such as Estela Welldon and Mervin Glasser, who have worked in this field. A regular ‘group workshop’, a sort of supervision forum, is attended by all group psychotherapists practising at the Portman – just one part of a very containing environment in which patients are held by therapists who feel themselves to be contained as they work with the difficult material presented in their groups.
In Part 1 the book introduces the principles and approach adopted by the Portman. Part 2 describes a range of themes and applications, and here therapists reflect on their work with individuals who present with histories of sex offending, paedophilia, child abuse and perverse or violent behaviour. Interesting additional chapters explore the use of Anthony Bateman’s ‘mentalization’ approach with those presenting with anti-social personality disorder, as well as an adapted form of group analysis with men with intellectual disabilities. This second part is rich with clinical vignettes, illustrating the significant therapeutic work done with groups that society views as untreatable and unspeakable.
Well-edited and of a manageable length, this volume offers an insight into the therapeutic work of a remarkable team of therapists. I recommend it not just to those working in this area but also to any therapist who wishes to understand better the power of group psychotherapy to work with some of the most damaging and damaged individuals in our society.
Christopher Davies is a group analyst and NHS adult psychotherapist

The plastic brain


Neuroscience for counsellors

Rachal Zara Wilson

Jessica Kingsley Publishers, 2014

288pp, £24.99

ISBN 978-1849054881
Reviewed by Angela Cooper
Did you know that autism spectrum disorder is often accompanied by dyspraxia, and that knowing the difference between procedural and declarative memory is vital in working with cases of dissociative identity disorder? Were you aware that a proposal has been made to replace the Diagnostic and Statistical Manual of Mental Disorders (DSM) with a diagnostic classification based on brain plasticity or that sleep is governed by the ‘circadian clock’, partly regulated by planetary dark–light cycles?
These are just some of the many fascinating subjects Wilson explores as she reviews the latest neuroscience discoveries and their implications for counselling. The key learning in neuroscience relevant to counsellors concerns the plasticity of the functional brain. As Wilson says, psychology and neuroscience are moving closer together, and it is important that counselling is not left behind.
The book explains the neurological processes in a number of conditions, ranging from post-traumatic stress disorder to psychosis, and how the counsellor can use this knowledge when working with a client with that diagnosis. The focus throughout is on encouraging the client to practise different ways of thinking, acting and responding so they establish new neural pathways.
This is an accessible work on a complex subject that is constantly producing new findings. Even as she finished the book, Wilson was aware of the wealth of new material coming through. I hope she brings out an updated version.
I have a few minor reservations. I was unsure about the use of the word ‘forgiveness’ as a necessary goal when working through anger, and would have welcomed further exploration of the concept of plasticity. Overall, however, this excellent book is essential reading for trainees, experienced counsellors and trainers.
Angela Cooper is a counsellor and supervisor

Overcoming avoidance


Beyond the frustrated self: overcoming avoidant patterns and opening to life

Barbara Dowds

Karnac, 2014

304pp, £26.99

ISBN 978-1782200529
Reviewed by Jane Cooper
This book is a fascinating study of the consequences of avoidant attachment. We follow ‘Brenda’, who is caught in a self-frustrating pattern, stressed by closeness, her need for connection denied, and trapped in a left brain, analytical place. We see how she dips in and out of various therapeutic processes and eventually finds transformation in play and spiritual practice.
Barbara Dowds does not hide the fact that ‘Brenda’ is based on her own experience. A humanistic and integrative psychotherapist, her first career was in molecular genetics and what is special about this book is its integration of the scientific and the poetic. I finished it wanting to read Proust and fascinated by the neuroscience of repression.
The book follows Brenda through her four main difficulties – with energy regulation, boundaries, power in the social world and lack of narrative memory. It is succinctly written yet draws widely on attachment theory, neuroscience, body therapies, psychodynamics and psychodrama, and is studded with memorable examples from literature. Dowds is particularly good at summarising the key points of others’ work and making delightful and surprising connections between them.
This is a book for all of us – clients and practitioners – but also for all citizens of the 21st century. The insights are many and diverse. They range, for example, from how meritocracy sustains competitive individualism to why play is of evolutionary benefit.
Towards the end of the book, Dowds focuses on her own psychotherapeutic practice, sharing with us an innovative way of working with avoidant attachment that focuses on feeling tone rather than strict chronology. In the penultimate chapter she draws on the work of Dan Siegel to promote her thesis of integration (ideally a right brain, left brain, right brain dance) as the desirable outcome of the therapeutic process.
I found this book profound, refreshing and accessible. It brings new meaning to the phrase ‘being in your right mind’. Once or twice I wondered if it would work with a male protagonist but maybe that will be the focus of Dowds’ next book?
Jane Cooper is a counsellor and supervisor

Critiquing psychology


The therapeutic turn: how psychology altered western culture

Ole Jacob Madsen

Routledge, 2014

194pp, £24.99

ISBN 978-1138018693
Reviewed by Colin Feltham
Part of the Concepts for Critical Psychology series edited by Ian Parker, Madsen’s book looks at how psychology has made itself so influential in the last century, and how therapy has become so central within psychology.
Its nine chapters look at consumerism, religion, the self-help industry, neoliberalism and the psychology profession itself. A short chapter on psychology and sport initially seems out of place but Madsen stresses the role that the ‘mental part’ has come to play in top level sports coaching, and is quick to show the serious limitations of psychology in this arena. Among his other targets are the ‘ADHD epidemic’ and how this relates to prevailing socio-economic conditions that are rarely understood by psychologists.
Madsen is a Norwegian academic psychologist and draws on many well-known continental philosophers, such as Adorno, Foucault and Zizek, critical psychologists like Parker and Prilleltensky, as well as sociologists like Furedi, Sampson and Illouz. Curiously, far less in evidence for such a topic are names such as Epstein (US) and Smail (UK). He does refer to Rose’s magisterial Governing the Soul, a sociologist’s analysis of the psychologisation of the 20th century that I think is unlikely to be bettered.
Its Scandinavian references may appear to limit its applicability to the UK reader but its exposure of psychology to political scrutiny makes it significant reading for trainee and practising counselling and clinical psychologists, and for counsellors and psychotherapists interested in considering the limitations and distortions of the profession.
Colin Feltham is Emeritus Professor of Critical Counselling Studies, Sheffield Hallam University
To read the introduction to this book, please visit http://www.ewidgetsonline.net/dxreader/Reader.aspx?token=6e324be65d944d5c87966b72759a6258&rand=1121222236&buyNowLink=&page=&chapter=

Film reviews


Dog eats dog in scramble for survival
Julian Edge reviews Two Days, One Night (Deux Jours, Une Nuit), a powerful exploration of morality among people struggling to survive on the margins of western neo-liberal society

Sandra (Marion Cotillard) has been off work due to ‘depression’. Now deemed recovered, but still fragile, she discovers that her employer has made her 16 co-workers an offer: a €1,000 bonus so long as they agree to Sandra’s job being cut. They vote on Monday. Sandra has Saturday and Sunday to visit them at home and ask them to forego their bonus.


In other words, the Dardenne brothers bring us a film that works as both a narrative of a harrowing personal struggle and a scathing social commentary. Here we see a society reduced to a dog-eat-dog morality in the scramble to survive on the scraps left over by the brutalities of neo-liberal economics.
As Sandra proceeds from colleague to colleague, we feel the tension and share her revulsion at what she is being asked to do. We also sense a distance between them as they meet. While she sometimes encounters warmth and generosity, there is also a palpable sense of anger, guilt and fear. In her wake she may leave acrimony, marital abuse or inter-generational violence.
Sandra sinks back to declaring her own worthlessness, returning repeatedly to the antidepressant tablets that she has been told to stop taking. They give her the boost that she needs for each interaction, and we know, as therapists, that she risks facing the need for ever-increasing doses, possible side effects, addiction and withdrawal.

I found myself wondering, ‘What is it that I wish for Sandra?’ The courage to win this squalid dog fight? The strength to contest the terms of battle? The serenity to walk away from it all?


As a counsellor, I can say that I want to help Sandra reach her own decision. As I watch her make every effort to change these other people, I recall the aphorism, ‘You can only change yourself.’
However, I cannot avoid struggling with the idea that it is therefore also my task sometimes to help people accept injustice. The strength of the film from this perspective is the way it reminds me of the complex interacting tensions that come together in my therapeutic practice.
I work to be there in the moment of interpersonal relationship with the client. I work to foster the locus of evaluation in the client. I also work to be aware of the client in her social contexts and I monitor the influence of my own socio-political positions. But the issue of justice does not go away.
I found all these tensions powerfully brought home in this narrative, and was deeply affected by Marion Cotillard’s portrayal of resilient vulnerability.
Julian Edge is a counsellor in private practice and with Age UK Manchester.
Two Days, One Night (Deux Jours, Une Nuit) is directed by Jean-Pierre Dardenne and Luc Dardenne. Les Filmes du Fleuve, 2014 (15; 95 minutes). In French with English subtitles.

Have you seen a new film or been to a concert, exhibition or event that you think has special resonance for counsellors/psychotherapists? If you’d like to write a short, lively review for this page, please contact Chris Rose, Reviews Editor, at reviews@bacp.co.uk

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TherapyToday.net reviews

Lilting


Written and directed by Hong Khaou

Film London/BBC Films/Skillset, 2014 (15, 86 minutes)


Reviewed by Rachael Peacock
Lilting offers an intimate portrayal of love, grief and cultural difference in contemporary London.
Kai (Andrew Leung) has unexpectedly died in a road traffic accident. Those closest to him, his male lover and his mother, are mourning his sudden loss and remember him through flashbacks. These say much how about Kai lived two cultural lives: the life with his British lover, Richard (Ben Whishaw), and his intense relationship with his mother, Junn (Pei-pei Chung), a Chinese-Cambodian woman living in a retirement home. Junn does not speak English and Kai acted as interpreter for his mother while never disclosing his own sexual identity to her.
Throughout, Lilting delicately balances the cultural loneliness of Junn, a woman stubbornly lost in the privacy of her grief, with Richard’s dogged attempts to connect with her emotionally and linguistically through the services of a Mandarin interpreter, Vann (Naomi Christie).
The complexity of cross-cultural communication is handled sensitively and perceptively, emphasised by the key area that Vann chooses to leave out of her interpretation – the nature of Kai’s relationship with Richard. The power of withholding is painfully evident in the scene where Richard attempts to tell the truth about his love for Kai. Vann’s decision to omit this from her interpretation of his words is carried through to devastating effect, and Ben Whishaw superbly conveys the pain and frustration of failing to bridge the cultural gap with Junn.
Grief is quietly depicted through the multilingual dialogue, illuminated by the ochre half-light that shrouds the film. It is explored in depth as an experience evoking vulnerability, longing and denial in unique ways for both characters, paying attention to the cultural conventions that inform their grief.
Overall, the film attempts to find a balance in how it explores both characters and the complexity of their situations. Flashbacks convey the fragility of memory, allowing the audience to feel empathy for both characters while experiencing Kai’s ambiguous feelings about coming out to his mother. Despite Junn’s rejection of Richard’s offer of connection, we are encouraged to empathise and understand how difficult it must be for her to have lost her son and only connection to life in Britain. Equally, the scenes spoken in Mandarin that do not have English subtitles provide insight into Richard’s experience of being unable to communicate with the woman he considers to be the key connection to Kai.
Bereavement is not depicted as a neat process of ‘stages’; the film patiently sits with the pain of loss in an authentic way, and ‘coming out’ is similarly presented as a continual, life-long process rather than a single event. This sensitive depiction of cultural differences and their associated impact on sexuality and grief makes Lilting an invaluable film for trainee and experienced counsellors alike.
Rachael Peacock is a trainee person-centred counsellor
August: Osage County [DVD]

Directed by John Wells

Smokehouse Pictures, 2013 (15, 120 minutes)
Reviewed by Jude Fowler
I’m fascinated by what it is that binds families together and the psychological wounds they pass from generation to generation. Working with children and adolescents, I see their yearning for fulfilling relationships with parental figures again and again. And I see adults who repetitively configure their relationships in the same destructive patterns from childhood, hoping for a different outcome.
The Westons, the fictional family central to the film August: Osage County, are a powerful example of these destructive and seductive processes. The film exposes the ways in which the matriarch, Violet (Meryl Streep), can reel her adult children back in – even the ones who thought they’d got away. Addicted to prescription drugs, she holds court like a black widow spider at the centre of her web. She hated her own mother, doesn’t like herself and rages at her daughters, all of whom have developed their own coping mechanisms to protect themselves.
The action takes place in the stifling heat of August on the plains of Oklahoma, flat as far as the eye can see. The writer, Tracy Letts, grew up here and uses the relentless space to reinforce the aching emptiness of the characters. Barbara (Julia Roberts) states, ‘This is the plains – a state of mind, a spiritual affliction, like the blues.’
Originally written as a stage play, the film retains a heightened realism that in some scenes feels too theatrical. The men are, on the whole, portrayed as sensitive and loving but weak in the face of such overbearing women. However the emotional intensity of the relationships in this film conveys a truth that resonated with me.

Despite the brutal onslaught of ‘honesty’ from a number of the characters, it is the secrets that are the most toxic. Secrets are stored for future use when their disclosure will cause the maximum harm. The film is bleak and as Barbara says, ‘Thank God we can’t tell the future. We’d never get out of bed.’


Here is a family caught in destructive patterns of relating, with little or no insight into the dynamics. It made me appreciate even more the need to understand our family dynamics, to shed light on our current ways of relating and offer hope for more effective and fulfilling relationships in the future.
Jude Fowler is a counsellor working with children and young people

The Lunchbox [DVD]

Directed by Ritesh Batra

DAR Motion Pictures, 2013 (PG, 105 minutes)


Reviewed by Chris Rose
This engaging and gentle film is set in Mumbai, where the bustling street scenes and packed trains provide the backdrop for a story of isolation and loneliness.
Ila (Nimrat Kaur) prepares the daily lunchbox for her unfaithful husband in the hope that her cooking will make him notice her. When the lunchbox is mistakenly delivered to Saajan (Irrfan Khan), a sour widower about to retire from 35 years as an accounts clerk, her culinary talents are finally appreciated. From this a relationship develops that is conducted through food and brief, handwritten notes. The camera never lingers on the food, but the aromas seem to waft from the screen, connecting the characters and the viewers. The written notes are equally powerful, speaking volumes in two or three lines.
This eccentric relationship brings both Ila and Saajan a vision of other possibilities, symbolised in the shared fantasy of life in Bhutan, where happiness is more important than GDP. But it is hope, rather than actual romance, that in the end changes their lives.
‘The wrong train may take you to the right station,’ is a saying repeated in the film. Saajan and Ila might want the destination to be a ‘real life’ relationship with each other, but the train doesn’t seem to stop at that station. Instead it takes them to the ‘right station’: a new appreciation of self and others, the emergence of hope, and a motivation to change what needs to be changed.
I was reminded of the stage that often occurs in long-term therapy, where the client longs for a personal and intimate relationship with the therapist. We know that fulfilling this fantasy will not bring the changes that the client desires. The therapeutic relationship offers another route, through creating a different experience of relating and a new understanding – and, like the relationship in the film, by bringing hope.
Saajan softens and opens himself to others: he befriends a young colleague, an orphan who in many ways is equally isolated. Ila finds the strength to plan her escape from her loveless marriage – a courageous step in a society where, as the film demonstrates, women’s roles are so often limited to caring for men.
Beautifully acted throughout, the film pulses with a quiet and contained expression of emotion, drawn from body language and restraint rather than drama and declaration. We can make of the ending what we will. It resists the temptation to deliver the stereotypical romance, playing with it but never fully succumbing to the clichés. Instead it offers a more subtle and thought provoking take upon our ever-present need for genuine connection.
Chris Rose is a group psychotherapist, author, blogger and Reviews Editor for Therapy Today

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From the Chair
Thank you to everyone
BACP Chair Amanda Hawkins writes her final column in the role

So here I am, writing my very last Chair’s column. Stepping down is an interesting space, often reflective and quite confusing at times. I find myself unable to remember what I have done in my time as Chair, or feeling alternately proud of what I have achieved, that I have not done enough, and that I could have done more. But I did what I did and now it’s time to hand over the baton to someone else and move forward.


Before I go I want to shine a light on some of the unsung heroes who I feel contribute a huge amount to BACP and the profession but very rarely get acknowledged – our families. My husband David Exall, who is also a counsellor and a member, has supported me unflinchingly through these past three years, without a murmur of complaint. He has looked after our children, mopped me up when things have been tough and put his own career aside to support my work with BACP. Without him, I don’t think I could have coped. My children have also donated their time, patience and understanding, watching their mother unpack an overnight bag only to pack it again, but very rarely moaning and protesting. A huge big thank you to you all.
Many partners, children and families have donated this level of support to the role and to past Chairs over the years. The Chair’s role has changed dramatically as the organisation and the profession have grown. It is a voluntary position, with just a small amount of recompense for loss of income. Time spent away from family is not compensated, unlike in a paid position. I entered into the role fired with passion for the profession of counselling. In this reflective space I find myself aware that it has taken more from me and my family than we probably realised, and this feels important to acknowledge. Perhaps passion is not enough; looking forward, perhaps we need to think more about how we support the Chair in this critical role? It is important to enable a wide mix of people to take it on and not be restricted to those who are financially secure and have no family responsibilities.


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