How to Wash a Heart-Review of Bhanu Kapil’s Work-New Associations, BPC journal, 2021

Bhanu Kapil’s iconic poetry articulates the unbearable, the difficult-to-say story of what some might consider ‘ungratefulness’- the immigrant who finds himself/herself in someone else’s country/home. How to Wash a Heart, her most recent poetry received the T.S. Eliot prize this year.

This is a review of her work, published in the BPC journal New Associations, in August 2021.

Freud Study Group – September 2021

https://www.bcat-team.org.uk/training

Sigmund Freud was the founder of psychoanalysis that formed the basis for all subsequent talking therapies up to the present day. His writing is original, and his ideas helped to shape the modern world to such an extent that we now take such concepts as the unconscious for granted as it has become adopted by western culture in art, movies and advertising.

Yet many of us, even as trained therapists, haven’t really read Freud’s own writing. This study group will provide a space to explore four important papers which still have plenty to say about current issues and concerns.

The papers will be sent out in advance and each week in September we will be talking about a paper, introduced and facilitated by Smita Kamble who is a BPC registered psychoanalytic psychotherapist, supervisor and trainer.

Attending the study group you can expect:

  • To feel more anchored within the psychodynamic framework
  • To feel Freud is more accessible and to talk about his ideas in simple language
  • To interest anyone who wants to understand Freud and his impact on the history of ideas and human psychopathology

The group will be on zoom on Monday evenings at 7pm in September for 90 minutes a session. You can join for all four sessions or choose individual sessions.

WEEK 1: 6th September – The Interpretation of Dreams

WEEK 2: 13th September – Beyond the Pleasure Principle

WEEK 3: 20th September – Narcissism

WEEK 4: 27th September – Mourning and Melancholia (Depression)

COST:

The cost will be £25 per session, or a discounted £90 for all four sessions. Each session will count as 1.5 hours certificated CPD or 6 hours CPD for all four.

PAYMENT: 

Pay by direct bank transfer to Coop Bank, Bedford Counselling Centre,sort code 089299,account number 65682890 putting FREUD SD as a reference.

 

Book now and receive the papers in advance to allow time to read, they are a mixture of short and long papers.

We hope you will be interested.

Getting It Right-New Associations, BPC journal, March 2014

Getting it ‘right’ –afterthoughts on completing a psychoanalytic training

Indian Classical Music 101 With Ravi Shankar : NPRWith a comparison between Indian classical music training and a psychoanalytic one  

This article appeared in ‘New Associations’, a BPC (British Psychoanalytic Council) journal in its 2014 summer edition.

“During my psychodynamic training at Rewley House, Oxford, a visiting lecturer exclaimed in the middle of her presentation about transference and countertransference ‘ your training is only two or three or five years old, you have lived much longer than that and brought all that with you !’

A classical training is long and arduous, like the psychoanalytic one,  and seems to renegotiate ‘all that you have brought with you’. Any training can be long and arduous but the psychoanalytic one becomes more so maybe because it does not have the assured ‘pot of gold’ at the end, an assured job or income, and tests one’s limits of mental endurance like few other trainings can.

It reminds me of the other classical trainings where one has to spend more time to just set the first note right with no assurance of income, knowing well that you may perform to a small, critical and select audience while the rest go off and listen to something short and popular, a bit like the shorter approaches to therapy which lead to immediate gratification, what we call ‘flight into health’.

In Indian classical music, students undergo a tremendous amount of training to set the first note ‘sa’. This takes precedence over everything because if the first note is not right, the rest of the rendition will fall apart. It is a bit like the first position in Tai chi where you spend time trying to hold a space between your hands but cannot get the tension right. And like the psychoanalytic session, where if you don’t hold the tension and think before saying something, the session may fall apart.

Indian classical music has its origins traced to 1500–1000 BCE, in the sacred Hindu scripts called ‘Vedas’. The student lives at his chosen guru’s home and performs household duties, like cleaning and cooking, to learn the art form. To reach its highest accolade, which is to be considered a Pundit (for Hindus) or Ustad (for Muslims) in India, you must have practised for many years and shown what we call ‘lagan’ or devotion to your art form.  The performer will prove how he has learned the classics –the ‘raagas’, which manifests in a 45 to 60 minute performance,  and possibly made his/her own improvisation as well as how or what he/she did to spread the art form in the world. Indian classical music or dance is not an assured form of income and it is understood that its continuity depends on individual achievement and marketing which will inspire others to follow and therefore keep it alive.

These days, in an Indian post modern world, students continue with normal school while they live at the guru’shouse. Recently, a famous Indian vocal performer who happened to be my guest  before her performance in London, told me how she scolded her students when they got caught up in schoolwork and did not practice, with ‘do you forget to breathe? No? Then don’t forget to sing!’ how else can an art form which does not bring income like other lucrative professions, survive without a bit of attitude from the guru?  It is probably this kind of ‘native conditioning’ which has seen me through the various ‘attitudes’ of supervisors and therapists during my psychoanalytic training.

During a public performance, the Indian classical performer does not rush into his performance. The audience is treated to a pre performance act where the artistes, while sitting infront of their audience, tune their instruments quietly or engage with each other sporadically, creating a mood, a concentration and tension which forms the preamble to the performance.  These are just a few of the details of Indian classical art life.

Before coming to the UK, this is what I knew to be a good and ancient training. Being one of the few Indians born and brought up in India, training to be psychoanalytic here, I had my moments of complete disorientation and the dreaded feeling that I was ‘losing my culture’. This coincided with the fact that I had actually lost my physical environment completely and  at such times, trips to Southall help only marginally.  In India, you can have the option of walking down a street where culture can waft out of windows and pervade your consciousness. You may be fortunate enough to live next to classical performers or have one in your family. I have been fortunate.

To reassure myself in my training years, I thought of drawing parallels from similar Indian traditions like Indian classical music.  I compared increased frequency of sessions in therapy and supervision to living in a psychoanalytic ‘home’ made up of therapist, supervisors, training institute and training patients so that I could try to ‘internalise’ a tradition without too much resistance- breathe it, digest it, internalise it, till it was as natural as breathing itself- like the Indian singer expected her students to do.

It is only when the Indian performer has got his note right, will he/she perform and then there will be a thunderous applause and personal satisfaction. The waiting and tuning creates the tension needed to sink into something deeper, more unconscious and infinitely more satisfying.  As a trainee, one loses one’s ‘notes’, including one’s beliefs, flails helplessly on the surface and cannot sink into a deeper connection. At such times, in my anxiety to perform, I have said things which were not personally satisfying and received a thunderous criticism from my supervisor, greeted in various ‘notes’ –from silence to censure and sarcasm, and then the rare compliment when I got it right again.  How much more welcome it is then!

Now that my training is behind me, I find myself more  quiet, less pressurised and less concerned with my client’s immediate demands. Like the audience at a performance who come into the auditorium from various settings with things on their mind, clients come in from the outside world under tremendous pressure at times but it is I, their therapist, who must tune into a psychoanalytic environment, sink into the inner world and set the mood ‘right’, either with my silence or my words.

Going back to the length and time it takes to establish the first note and the atmosphere for rendering it, I value this first moment and the setting up of the session more than anything that follows afterwards. Only in psychoanalytic therapy have I experienced that special moment when one anticipates one’s session and the therapist ushers you into this empty live space which is different from the outside world because it makes no social demands – you can be quiet if you want, not say ‘good morning’… whatever…It welcomes you to shut out the outside world and develop an inner meditative stillness, a little like the Indian performer who tunes himself infront of his audience and silently invites them to slow down and wait or like Tai chi, where you learn to hold an imaginary space between your hands. It is a very special space and it takes a long training to hold it and get it right.  And I think it would not be the same if there was an assured ‘pot of gold’ at the end.”

 

 

 

 

 

 

 

 

 

 

 

 

 

Psychoanalytic Therapy Evidence?

Psychoanalytic based treatments are evidence-based forms of therapy which can effectively treat emotional problems and a wide range of mental health conditions such as depression, eating disorders and anxiety.

Psychoanalysis started with the discoveries of Sigmund Freud a century ago, but its methods have changed and developed a great deal since then. It has the most developed theoretical base of all the talking treatments and has had a significant influence on all talking treatments.

Psychoanalytic therapies involve talking to a trained therapist, usually one-to-one, but sometimes in a group or with a partner or family members. This kind of therapy addresses underlying issues and causes, often from your past, which may be concerning you, or affecting your relationships with others. In your sessions you will be encouraged to talk freely and to look deeper into your problems and worries. It differs from many other talking therapies in that it aims to help people make deep seated change in personality and emotional development, alongside relieving troubling symptoms. It can help you discuss feelings you have about yourself and other people, particularly family and those close to you.

Some people seek help for specific reasons, such as eating disorders, psycho-somatic conditions, obsessional behaviour, or phobic anxieties. Some seek help for underlying feelings of depression or anxiety, difficulties in concentrating, dissatisfaction in work or in marriage, or for an inability to form satisfactory relationships. It may benefit anyone. It can help children and adolescents who have emotional and behavioural difficulties which are evident at home or school, like personality problems, depression, learning difficulties, school phobias, eating or sleeping disorders.

Read more : https://www.bpc.org.uk/information-support/what-is-therapy/

Is Psychoanalytic Therapy useful ?

Was I mentally ill? I suppose I was, though the first time someone in my family used the phrase “verge of a nervous breakdown”, or something like it, I was taken aback. Probably I was about as far from well as it was possible to be while still going about my business: essays, lectures, friends and so forth (I was a student at the time). A broken heart – that, is, a rejection so disappointing I couldn’t bring myself to accept it – was the trigger. But it brought up all manner of shit. By the time I went to talk to a psychoanalyst, I had feelings so muddled that sharing them with anyone else would have been weird.‘After, I feel ecstatic and emotional’: could virtual reality replace therapy?Read more Eight months later, the shrink and I had somehow decided that once a week wasn’t enough, and I signed up for the full whack: 50 minutes five times a week. This was cut down to four, but I carried on going until I was 26. It was a huge help. I know lots of people who see, or have seen, a psychotherapist or counsellor of some sort, but hardly anyone has psychoanalysis. Literally, hardly anyone. There are no official figures, but I’d be surprised if there are more than 500 people in the UK currently “in analysis”, or intensive psychotherapy, by which I mean appointments at least three times a week. There are loads of good reasons for this. Non-neurotic, uninhibited people who cope well with life – family, work, money, sex, food, other people – don’t need any help. (Well done, those people.) But plenty of others, for reasons that range from obvious to unfathomable, don’t manage all that well. Some of those become ill, and mess up their lives and other people’s as a result. I think shrinks could help many of these people. Everyone should have psychoanalysis – that is, the chance to dig into their past and reflect critically on their personality, helped by a professional – if they want it.
A government-funded study found it to be as effective as psychiatry and CBT at treating depressed adolescents
It doesn’t have to be five times a week in a private consulting room, either. Fiercely divided in their views of human nature, psychoanalysts also disagree about what psychoanalysis actually is: just how much time and money do you have to spend on the couch for it to count? But in the real world, including in the cash-strapped NHS, therapists have developed a variety of ways of working (once a week, therapy groups and so on) that don’t take years and cost the earth. Grouped under the broad heading psychodynamic – which refers to the idea, derived from Freud but with many twists and turns since, that human beings have unconscious as well as conscious minds – their aim is to provide insight and relief from distress. The prospect of so much state-sanctioned soul-searching will send many, perhaps even most people, running for the gym, the medicine cabinet or the hills. After all, there are plenty of therapists out there and if more people wanted to employ their services then presumably they would. While there is reams of interesting anecdotal evidence about psychoanalysis, not to mention The Sopranos, clinical trials have been thin on the ground. That is changing and a recent UK government-funded study found it to be as effective as psychiatry and cognitive behavioural therapy (CBT) at treating depressed adolescents. Read more : https://www.theguardian.com/commentisfree/2017/oct/09/access-psychoanalysis-help-mental-illness

How Psychoanalysis influenced the field of Psychology

Psychoanalysis is defined as a set of psychological theories and therapeutic techniques that have their origin in the work and theories of Sigmund Freud. The core of psychoanalysis is the belief that all people possess unconscious thoughts, feelings, desires, and memories.

Psychoanalysis suggests that people can experience catharsis and gain insight into their current state of mind by bringing the content of the unconscious into conscious awareness. Through this process, a person can find relief from psychological distress. Psychoanalysis also suggests that:

  • A person’s behavior is influenced by their unconscious drives.
  • Emotional and psychological problems such as depression and anxiety are often rooted in conflicts between the conscious and unconscious mind.
  • Personality development is heavily influenced by the events of early childhood (Freud suggested that personality was largely set in stone by the age of five).
  • People use defense mechanisms to protect themselves from information contained in the unconscious.
  • Skilled analysts can help a person bring certain aspects of their unconscious mind into their conscious awareness by using psychoanalytic strategies such as dream analysis and free association.

Read more : https://www.verywellmind.com/what-is-psychoanalysis-2795246

Sticking plaster over a deep wound

Listen to the BBC Radio 4 coverage of the joint BPC & UKCP survey on quality psychotherapy services in the NHS, published earlier this year 

Service user Louisa, shares her experience of psychotherapy services, both in the NHS and privately, poignantly describing lower intensity treatments as a sticking plaster over a deep wound and that psychoanalysis gave her a language for the things that she couldn’t speak of before. here

Valued psychotherapy and counselling services are currently facing closure, threats of closure or various forms of downgrading. Some of these are psychoanalytically-based but the cuts are being experienced across the board.

A survey of over 800 members of the British Psychoanalytic Council and the UK Council for Psychotherapy working in the NHS found that in the last year there has been:

Increased negative outcomes for clients:

  • 77% of therapists reported negative outcomes for clients as a result of cuts to psychotherapy services such as longer waiting lists, premature ending of treatment and reduced choices around therapy types.
  • Therapists reported that waiting too long for therapy or getting the wrong type of therapy or not enough of the right type could lead to increases in clinical symptoms.

Greater need but fewer services:

  • Over two thirds (68%) reported that they are being relied upon to deal with increasingly complex cases.
  • But at the same time there is an increasing pressure to use much shorter term (CBT informed) interventions that are not suitable for all clients.
  • Fewer psychotherapy services are being commissioned (48% noted decreases in the number of psychotherapy services commissioned, with only 5% reporting increases). 63% of therapists reported decreases in the number of psychotherapy posts.

See the summary findings of the joint survey on the BPC site : here

Why TherapyFriends?

I thought I would pen a few lines for those who are wondering if I have gone ‘off’ and created TherapyFriends and whether this means I don’t practise as a psychoanalytic psychotherapist.

I do practise as a psychoanalytic psychotherapist. I am rooted in it and in fact, TherapyFriends demonstrates this amply. It hopes to circumvent the over interference of the superego and create a space for all of us neurotics!

If this means I am ‘off’ to some, I will further argue, that actually I am ‘on’ and able to embrace my neurosis and therefore, open to the neurosis of others.

I used to work in print and television before and in a way, TF brings together my past and present professional life.

Anxiety Symptoms?

The Clinical Symptomatology of Anxiety Neurosis. This list is compiled from – Freud,S. (1925-26). In Vol.10, Inhibitions, Symptoms and Anxiety. P.94-97.

The first person account, the ‘I’, mentioned at times in the list is Freud’s voice.

 The clinical picture of anxiety neurosis comprises the following symptoms:

 

  1. General irritability. Common nervous symptom. “Increased irritability always points to anaccumulation of excitation or an inability to tolerate such an accumulation-that is, to an absolute or a relative accumulation of excitation. One manifestation of this increased irritability seems to me to deserve special mention; I refer to auditory hyperaesthesia , to an oversensitiveness to noise-a symptom which is undoubtedly to be explained by the innate intimate relationship between auditory impressions and fright. Auditory hyperaesthesia frequently turns out to be a cause of sleeplessness, of which more than one form belongs to anxiety neurosis”.
  2. Anxious

“Anxious expectation, of course, shades off imperceptibly into normal anxiety, comprising all that is ordinarily spoken of as anxiousness–or a tendency to take a pessimistic view of things; but at every opportunity it goes beyond a plausible anxiousness of this kind , and it is frequently recognized by thepatient himself as a kind of compulsion. For one form of anxious expectation -that relating to the subject’s own health-we may reserve the old term  hypochondria.

A further expression of anxious expectation is to be found in the inclination to moral anxiety, to scrupulousness and pedantry.

Anxiousness-which, though mostly latent as regards consciousness, is constantly lurking in the background-has other means of finding expression besides this. It can suddenly break through into consciousness without being aroused by a train of ideas, and thus provoke an anxiety attack. finally, the feeling of anxiety may have linked to it a disturbance of one or more of the

 

bodily functions-such as respiration, heart action, vasomotor innervation or glandular activity. the feelingof anxiety often recedes into the background or is referred to quite unrecognizably as ‘being unwell’ ‘feeling uncomfortable’ and so on.

  • Anxiety attacks accompanied by disturbances of the heart action, such as palpitation, either with transitory arrhythmia or with tachycardia o longer duration which may end in serious weakness of the heart and which is not always easily differentiated from organic heart affection; and, again, pseudo­ angina pectoris-diagnostically a delicate subject!
  • Anxiety attacks accompanied by disturbances of respiration , several forms of nervous dyspnoea, attacks resembling asthma, and the like. I would emphasize that even these attacks are not alwaysaccompanied by recognizable anxiety.
  • Attacks of sweating, often at
  • Attacks of tremor and shivering which are only too easily confused with hysterical
  • Attacks of ravenous hunger, often accompanied by
  • Diarrhoea coming on in
  • Attacks of locomotor vertigo.
  • Attacks of what are known as congestions, including practically everything that has been termed vasomotor
  • Attacks of (But these seldom occur without anxiety or a similar feeling ofdiscomfort.)
  1. Waking up at night in a fright (the pavor nocturnus of adults), which is usually combined with anxiety, dyspnoea , sweating and so on, is very often nothing else than a variant of the anxiety But thepavor can also emerge in a pure form, without any dream or recurring hallucination.
  2. Vertigo’ occupies a prominent place in the group of symptoms of anxiety neurosis. In its mildest form it is best described as ‘giddiness’; in its severer

 

manifestations, as ‘attacks of vertigo'(with or without anxiety), it must be classed among the gravest symptoms of the neurosis.

Furthermore, I am not sure whether it is not also right to recognize alongside of this a vertigo a stomacho laeso [of gastric origin].

  1. On the basis of chronic anxiousness (anxious expectation) on the one hand, and a tendency to anxiety attacks accompanied by vertigo on the other, two groups of typical phobias develop, the first relating to general physiological dangers, the second relating to locomotion. To the first group belong fear of snakes,thunderstorms, darkness, vermin, and so on, as well as the typical moral over-scrupulousness and forms ofdoubting mania . Here the available anxiety is simply employed to reinforce aversions which are instinctively implanted in everyone.

The other group includes agoraphobia with all its accessory forms, the whole of them characterized by their relation to locomotion.

  1. The digestive activities undergo only a few disturbances in anxiety neurosis; but these are characteristic Sensations such as an inclination to vomit and nausea are not rare, and the symptom of ravenous hunger may, by itself or in conjunction

with other symptoms (such as congestions), give rise to a rudimentary anxiety attack. As a chronic change, analogous to anxious expectation, we find an inclination to diarrhoea, and this has been the occasion of the strangest diagnostic errors.

The behaviour of the gastro-intestinal tract in anxiety neurosis presents a sharp contrast to the influenceof neurasthenia on those functions. Mixed cases often show the familiar ‘alternation between diarrhoea and constipation’. Analogous to this diarrhoea is the need to urinate that occurs in anxiety neurosis.

  1. The paraesthesias which may accompany attacks of vertigo or anxiety are interesting because they, like the sensations of the hysterical aura, become associated in a definite sequence; although I find that these

associations, in contrast to the hysterical ones, are atypical and changing. A further similarity to hysteria is provided by the fact that in anxiety neurosis a kind of conversion takes place on to bodily sensations, which may easily be overlooked-for instance, on to rheumatic muscles. A whole number of what are known as rheumatic individuals-who, moreover, can be shown to be rheumatic- are in reality suffering from anxiety neurosis.Along with this increase of sensitivity to pain, I have also observed in a number of cases of anxiety neurosis a tendency to hallucinations; and these could not be interpreted as hysterical.

  1. Several of the symptoms I have mentioned, which accompany or take the place of an anxiety attack, also appear in a chronic form. In that case they are still less easy to recognize, since the anxious sensationwhich goes with them is less clear than in an anxiety attack. This is especially true of diarrhoea, vertigo and paraesthesias (an abnormal sensation, typically tingling or pricking (‘pins and needles’), caused chiefly by pressure on or damage to peripheral nerves. Just as an attack of vertigo can be replaced by a fainting fit, so chronic vertigo can be replaced by a constant feeling of great feebleness, lassitude and so”

 

Anxiety – Symposium -BCAT

This event is now over. Thank you to all at BCAT for a wonderful morning!  Pleased about how it went-the facilitation by Nick Hall and the people I met.  

Saturday, March 20th 2021 –  Zoom

https://www.bcat-team.org.uk/training#SYMPOSIA

Anxiety Symposia with Smita Rajput Kamble

Anxiety affects daily life. Development and growth is that rare human achievement when we can overcome anxiety and it’s debilitating affects. This symposium will get to grips with understanding anxiety via a psychodynamic lens.

WHEN: Saturday 20th March, 2021 – 10am to 1 pm (with breaks).

WHERE: Online  COST: £60.

Payment:

You can pay by direct bank transfer to Coop Bank, sort code 089299, account no. 65682890, putting your own name as a reference and email us to say you have done this, or send a cheque payable to Bedford Counselling Centre to Bedford Counselling and Training, 71 Gwyn Street, Bedfordshire MK40 1HH.

Why do this workshop?
We experience anxiety and fear every day of our lives-whether it is about work, our health and safety and/or our relationships with others. Anxiety and generalised anxiety disorder almost always tops the chart of most browsed mental health subjects. This symposium will give you an in depth understanding of anxiety and its roots in guilt, hate and fear of castration. In the therapeutic space of group and individual work you will be able to understand how you as a practitioner help people manage their anxiety and begin to heal.

Aims

  1. To understand what is anxiety –its function in normal and abnormal conditions. The effect of fear and anxiety on possibilities of growth and development.
  2. The psychodynamic lens: pre-oedipal and oedipal anxiety. Klein and Freud on anxiety.
  3. To discuss how and why we help clients become less anxious and more contained.

Process for symposium

There will be a speaker presentation on the history of and psychodynamic theories about anxiety as well as examples of its presentation in the consulting room. The presentation will be followed by participant discussion. The speaker will then

facilitate pair and group work so that participants can apply theory to their own clinical practice examples.

Target Audience

This symposium is suitable for qualified and training psychodynamic psychotherapists, counsellors and mental health practitioners. The primary theoretical focus will be psychodynamic, but practitioners of other modalities are welcome to attend as long as they have made themselves familiar with some of the pre-course reading.

Smita Rajput Kamble 

Smita is a psychoanalytic psychotherapist in private practice. She is a training supervisor at Bedford Counselling

Foundation. In the past, she was one of the faculty at WPF Therapy, London Bridge where she taught the Advanced Clinical and Theoretical Issues seminar to Year 3 and 4 psychodynamic psychotherapy trainees. She also conducts CPD activities within the psychodynamic community in London.

*Please note that this symposium may either be held at the University of Bedfordshire in Bedford or on Zoom, depending on the state of Covid 19 restrictions by March.


CONTACT US TODAY TO BOOK A PLACE:
TEL: 01234 219905 – EMAIL: enquiries@bcat-team.org.uk
Please email us if you are interested in receiving up to date information about our CPD programme, courses and conference and we will add you to our mailing list.