SPEAKERS AND TITLES
Catherine Freeman
What is mentalising? An overview
Mary Target
Mentalisation within intensive analysis with a borderline patient
Nicola Abel-Hirsch
Bion, alpha function and the unconscious mind
Jean Knox
Epistemic mistrust - a crucial aspect of mentalisation in people with a history of abuse?
Peter Fonagy
Clinical Case Presentation, followed by Plenary discussion with all speakers
Conference chair: Ann Scott
Speakers' Biographies
Catherine Freeman MA is a Professional Member of the Association for Group and Individual Psychotherapy. She was Consultant Mental Health Nurse Specialist and Clinical Manager at Halliwick Unit, St Ann’s Hospital, London, between 1988 and 2008, where she worked with Professor Anthony Bateman. She participated in the development of mentalisation based therapy (MBT) in conjunction with Professor Peter Fonagy. She has contributed to a chapter in the Handbook of Mentalising in Mental Health Practice (eds Bateman and Fonagy). She is currently in private practice, teaches and is a clinical supervisor to personality disorder services in the NHS.
Mary Target PhD is a Fellow of the British Psycho-Analytical Society, Professor of Psychoanalysis at UCL, and Director of the MSc in Theoretical Psychoanalytic Studies at UCL. She was Professional Director of the Anna Freud Centre, London, from 2003 to 2013. Her research focuses on social and emotional development and attachment, personality functioning in adulthood, the process and outcome of psychotherapies for children, adults and couples, and qualitative research on the experience of illness. She is Joint Series Editor of the Karnac Series in Psychoanalysis, and of the Yale Series on Developmental Science and Psychoanalysis. Since 1997 she has also maintained a half-time adult psychoanalytic practice.
Nicola Abel-Hirsch MSc is a Fellow of the British Psychoanalytical Society, and works in private practice. As the recent Visiting Professor at the Centre for Psychoanalytic Studies, University of Essex (2013/2015), and also through annual visits to Taiwan (2005-2012), and teaching seminars in the UK, she has explored and discussed the work of Bion widely. Her writings on Bion include: ‘Freud and Bion on the life instinct’, ‘Narcissism and socialism’, ‘Bion’s containing and Winnicott’s holding’, ‘Sexuality’, ‘On the difference between maternal reverie and analytic “alpha function”’, ‘The mind-body relation’, and ‘Bion on observation’. She is the editor of Hanna Segal’s last book, Yesterday, Today and Tomorrow.
Jean Knox PhD MBBS MRCPsych is a psychiatrist and a Jungian analyst with a relational and attachment-based approach. She is Associate Professor at the University of Exeter, for the Doctorate in Clinical Practice and the Professional Qualifying Training in Psychodynamic and Psychoanalytic Psychotherapy. She is a Training Analyst of the Society of Analytical Psychology, a Senior Member and Training Therapist of the British Psychotherapy Foundation and former Editor-in -Chief of the Journal of Analytical Psychology. She has written and taught extensively on the relevance of attachment theory and developmental neuroscience to psychotherapy theory and practice, and is the author of two books on attachment and psychotherapy.
Peter Fonagy PhD, FMedSci, FBA, OBE is Freud Memorial Professor of Psychoanalysis and Head of the Research Department of Clinical, Educational and Health Psychology at University College London and Chief Executive of the Anna Freud Centre, London. He is also Director of UCLPartners Integrated Mental Health Programme and National Clinical Lead of Children and Young People’s Improving Access to Psychological Therapies. He is a Senior Investigator for the National Institute of Health Research and a Visiting Professor at Harvard University.
Ann Scott BA PgDip is a Senior Member of the British Psychotherapy Foundation (Psychoanalytic Psychotherapy Association), working in private practice, and Editor-in-Chief of the British Journal of Psychotherapy. She is the author, with the late Mary Barnes, of Something Sacred: Conversations, Writings, Paintings and of Real Events Revisited: Fantasy, Memory and Psychoanalysis, and is the literary executor of Isabel Menzies Lyth. She is a member of the British Psychoanalytic Council’s Advisory Group on Research and the Evidence Base, and of the Executive of ISPS UK (The International Society for Psychological and Social Approaches to Psychosis).
Abstracts
Catherine Freeman
What is mentalising? An overview
This paper attempts to summarise the evolution of interest in the concept of mentalisation which has been researched and enriched by the linking of many disciplines alongside that of psychoanalysis and attachment theory. Taking into account the work of Professors Fonagy and Target, the paper describes factors that enable the development of the capacity to mentalise and those that interfere. It will consider how the quality of attachment affects the transformation of pre-mentalised modes of experience to the recognition of psychic reality of self and other. While mentalising is part and parcel of all therapies, a mentalisation based therapy was developed in the context of treatment of Borderline Personality Disorder patients by Profs Bateman and Fonagy. The paper will also suggest that a deficit in the mentalising ability and its consequences can be observed across diagnoses and that a mentalising focus can be useful in all psychotherapeutic treatments.
Mary Target
Mentalisation within intensive analysis with a borderline patient
This paper discusses whether the concepts of mentalisation are helpful within intensive, individual analysis with a borderline patient. Child and adult technique within the ‘widening scope’ of psychopathology build on, for example, ‘developmental help’ (studied at the Anna Freud Centre from the sixties) to reach ‘atypical’ children who could not use classical analysis. The first two years of work with Jenny were anchored by developmental research on attachment and early parent-infant relating. Later, when her capacity to symbolise, tolerate and communicate affect had greatly improved, she could hear interpretation, and working in the transference was gradually able to be accepted as thinking and not only as action. The hypothesised modes of experiencing psychic reality will be illustrated, and the status of attachment within psychoanalysis reconsidered. Finally, how and why each particular analyst shapes the process of change will be discussed using the concept of ‘marked mirroring’.
Nicola Abel-Hirsch
Bion, alpha function and the unconscious mind
The paper will identify why and how Bion’s ideas about dream-work and alpha function evolved, and the profound implications of this development for what he calls ‘practical psychoanalysis’. Andre Green interestingly comments that for Bion the ‘model of the dream’ was unusually more important than the ‘model of the baby’; and I will consider in particular the question of ‘models', and their relation to the making of the accurate observations of unconscious functioning we need to underpin our analytic work. It is hoped the paper will contribute to the clinically relevant question of whether there is an important link between Bion’s ‘alpha function’ and mentalisation theory.
Jean Knox
Epistemic mistrust - a crucial aspect of mentalisation in people with a history of abuse?
The concept of mentalisation includes that of unconscious epistemic trust, which develops as a generalisation of secure attachment experiences in early life. But patients who have been severely abused in childhood by those they loved and depended on also generalise from their experience and develop unconscious epistemic mistrust - a sense and expectation that other people’s desires, emotions and attitudes are bewildering and dangerous. Psychotherapists base our work on a belief that epistemic trust is a crucial manifestation of mentalisation that we wish to help our patients to reach. But severely abused patients may unconsciously experience this as the therapist’s attempt to enlist their trust in order to control them, as their abuser did. The acceptance of epistemic mistrust as a realistic view of many human relationships is therefore essential for therapists working with abused patients. Our professional models need not pathologise the patient’s epistemic mistrust but recognise it as a form of mentalisation, in that the sense of other people’s minds as dangerous is articulated and explored.
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