The Organic and the Inner World by Doctor Ronald; Lucas Richard; & Richard Lucas

Author:Doctor, Ronald; Lucas, Richard; & Richard Lucas
Language: eng
Format: epub
Publisher: Routledge

Chapter Four

Discussion of “Mechanisms of change in mentalization-based treatment of borderline personality disorder” by Peter Fonagy and Anthony Bateman

Robin Anderson

Many years ago, when I began my psychiatry training at the Maudsley Hospital, my first placement was under Dr Ted Hare, who said, in a reasonably even-handed way, that psychiatrists tended either to develop a special interest in research or in psychotherapy, and it was not long after that that I decided that my future lay in psychotherapy. Perhaps this was an unfortunate classification which I seemed to have rather too quickly internalized. However, in one sense I think he was drawing attention to those of us who, despite medical training (the field for scientists who cannot do maths!), had an interest in an understanding of humanity and the human condition of a more philosophical literary kind. When I first came across Henri Rey at the Maudsley, it was not so much his complex classification of psychosis that first grabbed me; it was the way he could succinctly describe the essence of a patient’s dilemma in a simple and compassionate way which both moved and greatly impressed me. I had a similar emotional experience and depth that I get from a work of literature, or, say, from watching a Beckett play. How did he get there from the same data that I had just heard and yet had not even left first base? So, that was what I went looking for, and I found it, or at least the path to it, through psychoanalysis: my own and later, that of my patients.

The satisfaction of being able to have a shared experience of profound understanding arrived at after hard painful work by patient and analyst is deeply satisfying. This satisfying experience carried with it a deep sense of conviction to patient and analyst/ therapist, and I found that it would often lead to permanent change, usually slowly, but sometimes surprisingly quickly. Sometimes, in the context of very disturbed suicidal patients, one had the conviction that one had saved their lives, and in others that one had opened up possibilities for them that it was hard to believe could have happened in any other way. Of course, not all patients could be helped, and I found that we were not that good at deciding in advance who might benefit most. It did not seem to be related just to the severity. As Peter Fonagy and Anthony Bateman have shown, some borderline patients could change dramatically. In considering psychotherapy as a treatment, some take the view that psychoanalysis is an endeavour that is a quite different kind of investigation and, for some, not a treatment at all. This was not Freud’s view, and his statement that psychoanalysis is the transformation of neurosis into ordinary human unhappiness, like so many of his aphorisms, condenses so much, but one could say of it that the helping of our patients to be ordinarily unhappy can help them find peace and, paradoxically, even happiness, and this is certainly a worthy treatment outcome.

Download

Copyright Disclaimer:
This site does not store any files on its server. We only index and link to content provided by other sites. Please contact the content providers to delete copyright contents if any and email us, we'll remove relevant links or contents immediately.