Public Lectures for 2013

The GCP holds a series of public lectures each spring which are open to the public as well as psychotherapists and health professionals. The lectures are held at the United Reform Church, 83 Portsmouth Rd, Guildford, Surrey GU2 4BS  (Directions & map)

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This year’s lectures were:

Saturday, 2nd February  2.00 - 4.30 pm

Complex and Severe Trauma in Adults:
a psychoanalytic approach

Speaker: Dr Sarah Majid, Consultant Psychiatrist and Psychotherapist, Tavistock & Portman Foundation Trust

Due to unexpected circumstances, Dr Joanne Stubley has had to cancel her lecture on 2nd February.  We are delighted, however, to welcome Dr Sarah Majid, also from the Tavistock Centre, who has kindly agreed to be with us that day.

Complex trauma is not currently included in formal psychiatric classifications and at present there are no NICE guidelines on how to treat these patients. Nevertheless complex trauma is increasingly used by clinicians to refer to those who have suffered chronic, repetitive or prolonged traumatic experiences. Cases typically present with characteristic Post Traumatic Stress symptoms (intrusive phenomena, hyper-arousal and avoidance) alongside dissociation, somatization, re-victimization, identity disturbance and affect deregulation. Some may also become severely depressed and suicidal, and in some cases psychotic. This population includes asylum seekers and refugees, victims of domestic violence, holocaust survivors, prisoners of war and so on. There has been considerable confusion in the literature around the diagnosis and the overlap with developmental and single episode adult trauma, and this may contribute to the lack of an evidence base for treatment.

A psychoanalytic understanding of the impact of traumatic experiences on an individual’s life allows for an exploration of meaning. Trauma disrupts time, memory and identity and if it is not possible to mourn the losses that traumatized individuals inevitably face, the disruptions can persist, severely impairing the individual’s capacity to form new relationships and rebuild their lives, even when externally the trauma may appear to be ‘over’.  The exploration of meaning in the context of an extended psychoanalytic consultation can in some cases be therapeutic in itself.

The Tavistock Trauma Service offers a psychoanalytic approach to trauma alongside trauma focused Cognitive Behavioural Therapy. The service offers a variety of therapeutic packages for single episode trauma, complex and developmental trauma.

In this presentation, Sarah Majid gives a theoretical overview of the concept of Complex Trauma, including the diagnostic considerations. She draws on her clinical work with traumatized refugees and asylum seekers to explore a range of clinical presentations demonstrating the profound impact of trauma on mental functioning.  She considers assessment issues regarding appropriate management, risk and suitability for psychotherapy treatment. She will also introduce a case of single episode trauma, a traumatic bereavement, with a patient seen at the Tavistock Clinic for a 6 session extended therapeutic consultation.

Dr Sarah Majid is a Consultant Psychiatrist in Psychotherapy working at the Tavistock Clinic and in private practice. She has specialist experience of working with Refugees and Asylum Seekers through her work with the Tavistock Trauma Service and the Tavistock Immigration Legal Service. She also has worked in individual and group therapy with those who have experienced trauma in individual and group therapy, and has been actively involved in teaching and training in this field.

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Saturday, 16th February 2.00 - 4.30 pm

The Unbearable Nature of Meaning: neuroscience, dissociation, shame and the sense of self

Speaker: Dr Jean Knox

In this lecture, Jean Knox explores the enduring impact of early relational trauma on a person’s psychological and emotional development.  She highlights neuroscientific research that helps to explain how early relational trauma has a devastating impact not only on the infant in the short-term but also has continuing life-long effects on a person’s cognitive, emotional, relational  and social functioning.

Patients presenting with dissociative states of varying degrees of severity are increasingly recognized as bearing a history of trauma, having experienced differing levels of emotional/physical neglect or abuse from those people they most loved and depended on. This does not just apply to unusual instances of extreme trauma or abuse: research suggests  that a ‘hidden trauma’  may arise from an ordinary level of unavailability in a responsive attachment figure who is unable to comfort and regulate the stressful events that are a daily part of  an infant’s experience.

Drawing on clinical research and casework, Dr Knox presents the neuroscientific processes that underpin dissociative states, emphasizing  the need to provide targeted treatments to reduce dissociative symptoms before attempting to explore traumatic memories. She discusses and illustrates the modifications to psychoanalytic technique needed when working with severely dissociative patients.

Dr Jean Knox is a psychiatrist and Jungian analyst. She is a Training Analyst of the Society of Analytical Psychology, a Senior Member and Training Therapist of the British Association of Psychotherapists, Consultant Editor of The Journal of Analytical Psychology and senior lecturer at the University of Exeter.  She has written and taught extensively on the relevance of attachment theory and developmental neuroscience to psychotherapy theory and practice. She is the author of Archetype, Attachment, Analysis: Jungian Psychology and the Emergent Mind (Routledge, 2003) and Self-Agency in Psychotherapy: Attachment, Autonomy and Intimacy (W.W. Norton, 2010). Dr Knox is currently involved in a qualitative research project to explore how agency is expressed by both therapist and patient in transcripts of psychotherapy sessions.

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