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PDF New Discoveries in Child Psychotherapy Findings From Qualitative Research Margaret Rustin Ebook Full Chapter
PDF New Discoveries in Child Psychotherapy Findings From Qualitative Research Margaret Rustin Ebook Full Chapter
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“What a treasure trove we have in this book. It exemplifies my belief
that psychoanalysis should be viewed as the natural history approach
to psychology much as Darwin's study of the natural world opened up
biology. This method of work requires sustained observation and
builds theory from the observed data as the writers in this volume
have done, across a wide range of topics of clinical interest. I recom-
mend it most warmly.”
Ronald Britton, psychoanalyst and author,
past President of the British Psychoanalytic Society
The chapters are the result of the psychoanalytic clinical and observational prac-
tices of their authors, allied to their use of rigorous qualitative research methods, in
particular Grounded Theory and interpretative phenomenological analysis (IPA).
They describe developments of child psychoanalytic knowledge in several fields,
including autism, psychotherapy with severely deprived children, and the study of
early infancy. They demonstrate advances in child psychoanalytic theories and
methods and the development of new forms of clinical service provision. Contested
issues in psychoanalytic research are thoroughly evaluated, showing how it can be
made more accountable and rigorous through the adaptation of established qualita-
tive research methods to the study of unconscious mental phenomena.
and by Routledge
52 Vanderbilt Avenue, New York, NY 10017
© 2019 selection and editorial matter, Margaret Rustin and Michael Rustin; individual chapters,
the contributors
The right of Margaret Rustin and Michael Rustin to be identified as the authors of the editorial
material, and of the authors for their individual chapters, has been asserted in accordance with
Sections 77 and 78 of the Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form
or by any electronic, mechanical, or other means, now known or hereafter invented, including
photocopying and recording, or in any information storage or retrieval system, without
permission in writing from the publishers.
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used only for identification and explanation without intent to infringe.
Typeset in Palatino
by Swales & Willis, Exeter, Devon, UK
CONTENTS
Introduction 1
Margaret Rustin & Michael Rustin
I
Mainly theory and clinical method
vii
viii CONTENTS
3 The desert, the jungle, and the garden: some aspects of autistic
functioning and language development 84
Carlos Tamm
II
Mainly practice: contributions to service development
S
ince it was founded in 1920, the Tavistock Clinic—now the Tavi-
stock and Portman NHS Foundation Trust—has developed a
wide range of developmental approaches to mental health which
have been strongly influenced by the ideas of psychoanalysis. It has
also adopted systemic family therapy as a theoretical model and a clin-
ical approach to family problems. The Tavistock is now one of the lar-
gest mental health training institutions in Britain. It teaches up to 600
students a year on postgraduate, doctoral, and qualifying courses in
social work, systemic psychotherapy, psychology, psychiatry, nursing,
and child, adolescent, and adult psychotherapy, along with 2,000 multi-
disciplinary clinicians, social workers, and teachers attending Continu-
ing Professional Development courses and conferences on
psychoanalytic observation, psychoanalytic thinking, and management
and leadership in a range of clinical and community settings.
The Tavistock’s philosophy aims at promoting therapeutic methods
in mental health. Its work is based on the clinical expertise that is also
the basis of its consultancy and research activities. The aim of this
Series is to make available to the reading public the clinical, theoretical,
and research work that is most influential at the Tavistock. The Series
sets out new approaches in the understanding and treatment of psy-
chological disturbance in children, adolescents, and adults, both as
individuals and in families.
ix
x SERIES EDITORS’ PREFACE
W
e are grateful to the many child psychotherapists who have
played a part in supporting the research work described in
these pages, as clinical colleagues and supervisors. In par-
ticular, Catrin Bradley and her course team, together with their aca-
demic administrative colleagues, have been a much-valued resource for
this doctoral programme of whose outcomes this book represents only
a part.
We would like to thank Margot Waddell, Kate Stratton, and Jocelyn
Catty for their encouragement and help in the production of this book.
Particular thanks are also due to Eric and Klara King of Communica-
tion Crafts and to Natalie Clark of Swales & Willis for their meticulous
editing of its final text, and to Algy Craig Hall for the cover image.
xiii
ABOUT THE CONTRIBUTORS
xv
xvi ABOUT THE CONTRIBUTORS
Origins
Since 1995, many child psychotherapists who trained at the Tavistock
Clinic (now the Tavistock and Portman NHS Trust) have undertaken
research as part of a professional doctorate programme,1 accredited for
many years through the Tavistock’s partnership with the University of
East London, and in particular its (then) Faculty of Social Sciences.2 In
the first years, these researchers were already qualified child psycho-
therapists, who were able to prepare for doctoral study through a
supplementary programme concerned with research methods.3 But, at the
same time, this professional doctorate was incorporated as an option into
the child psychotherapy curriculum, and many trainees have chosen to
pursue research projects during or soon after the completion of their clin-
ical training. To date, over 80 child psychotherapy doctoral theses have
been completed within this framework (their authors and titles to date are
listed in the Appendix at the end of the book).4 This volume presents
accounts of research findings from nine of these completed projects,
together with two chapters written from PhD theses that were supported
by parallel supervision arrangements at the Tavistock.
This doctoral programme was based on a distinctive approach to
research in psychoanalysis and child psychotherapy. Its assumption was
that psychoanalysis, since Freud, has always been a research programme,
1
2 MARGARET RUSTIN & MICHAEL RUSTIN
Study (Trowell, 2011), the TADS Study (Fonagy et al., 2015), and the
IMPACT Study (Goodyer et al., 2017), each of them highly significant
examples of their kind. However, it has been a central feature of our
research programme that it has been focused on central goals of psycho-
analytic research broader than that of treatment effects. Its research inter-
ests have included the development of personality, the phenomena of the
transference and the countertransference, the development of new forms
of treatment and intervention, and other issues fundamental to psycho-
analytic understanding. There is a risk that such “fundamental” research
questions are being relegated to insignificance by the insistent demand to
measure treatment efficacy, above all else. Yet if there had never been fun-
damental research of the kinds this collection of theses demonstrates, no
treatments in psychoanalysis or child psychotherapy would exist.
Another line of relevant “internal critique” of psychoanalysis has
called for a closer engagement between psychoanalysis and adjacent
fields of research into the mind. Such convergences—with the develop-
mental psychological study of infancy by researchers such as Daniel
Stern (1985) and Colwyn Trevarthen (2010), or in a renewed rapproche-
ment with attachment theory (Fonagy, 2001), or with neuroscience, in
the work of Mark Solms (2015) and Jim Hopkins (2004)—are necessary
and beneficial. Indeed, they offer the possibility of setting psychoanaly-
sis on a broader base of scientific evidence. However, although refer-
ences to such convergences are to be found in the chapters of this
book, they are not its main topic.
validated by the method it has set out. It has turned out that these
academic challenges were sometimes helpful in enabling psychoana-
lytic psychotherapists to respond to the methodological criticisms to
which their field has long been subjected.
Significant for the development of our programme was an earlier
battle that raged in the broader field of the human and social sciences,
which concerned the justification for qualitative as distinct from quanti-
tative research methods. An orthodoxy, derived from a conception of
the hierarchy of credibility of the natural sciences that placed physics at
its summit, held that what could not be measured in quantitative terms
had only an inferior scientific status. Much of biology, which had been
long concerned with the description and classification of “kinds” of
organism, conformed poorly to this model. But for the human and social
sciences, where differences of cultural and subjective meaning were fun-
damental to most forms of useful understanding, this insistence on
quantitative measurement as the sole criterion of scientific validity was
potentially catastrophic, excluding from view many “qualitative” aspects
of phenomena which are of the greatest significance. The necessity for
recognizing the significance of qualitative differences was recognized
since the inception of sociology and anthropology as social sciences, but
it has nevertheless remained contentious.
In fact, the development of systematic methods of qualitative analysis
in the social sciences (including some sub-fields of psychology) was the
precondition for the emergence of qualitative research methods for inves-
tigating psychoanalytic phenomena. Indeed, it has been possible to trans-
pose, as several chapters in this book demonstrate, methods such as
grounded theory, thematic analysis, and interpretative phenomenological
analysis (IPA) from their original fields of sociology and psychology,
while adapting them to the study of the phenomena of unconscious
mental life which are distinctive in psychoanalytic inquiry.
Thus, a second purpose of this book, complementary to its dimension
of “discovery” and innovation in the domains of concepts, theories, clin-
ical techniques, and interventions, lies in the field of research methods.
We aim to show that the discoveries described are of both substantive
and methodological interest. This will be through demonstrating that they
have been achieved through the use of more systematic and rigorous
qualitative research methods than are customarily displayed in clinical
psychoanalytic writing.9 It is nevertheless the case, of course, that such
clinical writing has often conveyed great depths of theoretical understand-
ing. Our purpose is to show how the procedures of psychoanalytic discov-
ery can be enhanced, not to devalue or discredit the established body of
10 MARGARET RUSTIN & MICHAEL RUSTIN