A joint one day conference for psychiatrists, for people who are treated by psychiatrists and for people who work with them or commission their services – hosted by ISPS UK and RCPsych Medical Psychotherapy Faculty.

Speakers and chair: Kevin Healy, Jen Kilyon, David Kingdon, Rose McCabe, Brian Martindale, Carine Minne, John Read, Elisabeth Svanholmer

Summary: Psychiatrists affect people with psychosis not just through the treatments they prescribe, but through their everyday interactions with patients and colleagues, and through the ways in which they understand and discuss psychosis and its causes. The ‘good enough’ mother described by psychoanalyst Donald Winnicott was ordinary, imperfect and busy – and also able to support her child to reach their fullest potential.

This conference will explore what it may mean to be ‘good enough’ as a psychiatrist.

Fees

ISPS UK members: £85 up to 30th April (Early Bird), £115 from 1st May 2013

Non-members: £115 up to 30th April (Early Bird), £145 from 1st May

Unwaged service users and family: £40 (Please also enquire about free places)

Download: Good Enough Psychiatry Poster | Programme and Application Form

Payment Options

Non ISPS members £145.00 GBP ISPS Members £115.00 GBP Unwaged Service Users & Carers £40.00 GBP

Hearing The Voice, in partnership with Jacqui Dillon of the Hearing Voices Network, are advertising for trainees interested in facilitating Hearing Voices Groups in the North East. The 3 Day Hearing Voices Group Facilitation & Network Development Course runs in Durham from 11-13 February 2013. For more information, please see: www.hearing-voices.org or email Victoria.patton@durham.ac.uk

May 15th, 2013, Meads Site in Eastbourne

“The Abandoned Illness” – what now?

This day conference will provide participants with an opportunity to reflect on, explore and discuss the implications for policy and practice arising from the recent ‘Schizophrenia Commission report’ findings.  This informal day will involve a keynote presentation by Paul Jenkins who is Executive Director of National Rethink Mental Illness and member of the ‘Schizophrenia Commission’.  The conference experience will be supplemented by reflective group work, an afternoon workshop series and plenary sessions.

The conference is free, but please fill in and return a booking form ISPS SCN joint Tigger Conference Flier 2013 (1)

For more information contact Bill McGowan

The day started with a focus on the exceptional wards at the Maudsley Hospital (first Ward 1, later moving to Ward 6) which developed distinctive styles of working with psychotic patients in the 70s and 80s. Ex-staff from Wards 1/6 (Ben Thomas, Beatrice Stevens, Rita Bourke and Gary Winship) described the wards’ organisation and principles, and Murray Jackson’s central contribution to them. For example, full (and often lengthy) case discussions by the whole multi-disciplinary team, leading to genuine care planning (rather than a formulaic filling-in-the-forms exercise), were a regular element, reinforcing the sense of a full team response to patients’ struggles. Murray Jackson’s routine attention to detail (reading thoughtfully through the whole file of each patient in advance), and perhaps above all the seriousness with which he approached the task of talking with patients, came across clearly – references were made repeatedly to the way in which to witness Murray Jackson talking with a patient was to participate in a masterclass. Even after his retirement from the NHS, Murray Jackson continued to contribute towards the spread of progressive approaches to psychosis, providing valuable consultation and supervision in Scandinavia for a further 15 years, as described by Anne-Sofie Pourtaheri from Sweden.

David Bell (another ‘graduate’ of Ward 6) proceeded from a masterly outline of psychoanalytic thought about psychosis to an exciting commentary on Dennis Potter’s TV series from the 80s, The Singing Detective, showing the power of the ways in which Potter dramatised psychotic processes. Of course, one of the crucial elements in psychoanalytic thinking about psychosis is its insistence that psychotic processes are universal, rather than being restricted to those who have had manifest ‘psychotic episodes’: through dreams, in our infancy, and unconsciously underlying our everyday mental life, none of us are strangers to psychotic process. On this account the content of psychotic phenomena (such as ideas or voices that are regarded by others as symptoms of psychosis) are seen as always meaningful, and, further, the concerns expressed through them are seen as no different from anyone else’s concerns; psychosis is not seen as expressing distinctive things, but rather as involving distinctive ways of expressing the same kinds of things (eg, fears of abandonment, feelings of unloveableness). Thus, in the case of The Singing Detective, the main character, Philip Marlowe, is literally crippled by feelings of guilt, reduced by severe psoriasis to near immobility. At one point he experiences a therapeutic breakthrough, where he remembers and acknowledges a real and specific cause of guilt – a memory of shifting blame at school onto a vulnerable classmate. This painful recognition temporarily frees him up from his previous all-pervasive and inhibiting sense of shame, but then he finds himself bullied by frightening hoodlums who seem at the same time to appear out of nowhere, and yet to have been there all the time – figures from his inner world energetically opposing the possibility of real change, akin to the ‘internal mafia’ described in Rosenfeld’s writings. Bell sees The Singing Detective as a great drama, and he made a strong case for its greatness, and for its striking portrayal of psychotic processes.

In the later part of the day the role of the nurse became a central theme, with Len Bower (Professor of Nursing at King’s College, London) forcefully reminding us of its intensity and immensity. What has stuck in my mind ever since his presentation is the shocking series of images he showed of scenes of chaos and mess with which nurses have to engage (e.g., faeces smeared on walls, rickety disorganised heaps of objects in a patient’s home). There was something singularly powerful about seeing these bleak physical representations of internal disturbance, and they were highly effective in drawing attention to the nurse’s predicament: is the nurse going to stay in real emotional contact with the unimaginable storms, or are they going to make for their own safe haven (such as the nurses’ office) even if it means deserting the patient? The need for nurses to get the support potentially available through the kind of full multi-disciplinary approach of Wards 1/6 was obvious, and one element within it was the focus of the next presentation, by Marcus Evans (of the Tavistock Clinic): reflective practice sessions.

He was particularly good at conveying the ambivalence that is inevitable in these sessions, often played out in relation to the group facilitator, who is likely to be credited some of the time with exceptional perceptiveness, but at the same time is liable to be suddenly dethroned when he or she struggles and hesitates in the face of the work’s complexity. The throne is a position that is both attractive and dangerous, and Marcus was humorously self-aware of his hankering after it, and his anxiety – all the more justified as someone who, from the standpoint of ward-based staff, is usually ‘safely behind the lines’. However, with consistency and commitment on the part of the facilitator, there are few better investments of time in services which lack the built-in therapeutic multi-disciplinary expertise of Wards 1/6, especially in the current context where the average severity of state of inpatients is greater than in the past (as Len Bower had shown). Marcus Evans’ presentation was followed by a notably thoughtful and interesting plenary discussion, in the course of which Brian Martindale floated the idea of further conferences focusing on psychodynamic approaches to psychosis – a proposal that the ISPS Committee is taking up. Certainly, the day reminded me of the potential role of psychodynamic approaches to psychosis in general, and to inpatient care in particular. It also reminded me of the importance of ISPS’s role in bringing together people with special interests in this area. Thanks are due above all to Brian Martindale, Gary Winship and Ali Haddock for organising the day.

At the end of the day we heard from Brian Martindale that on the day of his death Murray Jackson had sent a picture of himself raising a glass of wine to ISPS; this was movingly echoed in a toast we drank to him.

Nigel Bunker

Psychiatrists have an impact on people with psychosis not just through the treatments they prescribe, but also through their everyday interactions with patients and colleagues, and through the ways in which they understand and discuss psychosis and its causes.  Psychiatrists will hope this impact can be mostly positive, but at times it can be unintentionally negative.  The conference will explore these issues, highlighting effective practice.

The conference will be relevant to psychiatrists in a wide range of specialities and also to people who seek help from psychiatrists, who work professionally with them and who commission their services.

We are aiming for the day to consider these issues from a range of different perspectives, including most importantly those of people with experience of psychosis and their families.  Topics will include the impact of assessment, diagnosis and formulation, and of psychiatrists’ relationships with patients, families and colleagues.

This event is a joint venture between the Royal College of Psychiatrists Medical Psychotherapy Faculty and the UK network of ISPS (International Society for Psychological and Social Approaches to Psychosis.)

A detailed programme will be available shortly.  To register your interest please contact Ali Haddock.

Madness: a creative way of dealing with pain

Rufus May will be delivering the annual Marion Beeforth Memorial Lecture this year so there is a strong focus on psychosis.

10th April 2013, Meads Site, Eastbourne

14th Annual Conference flier

Application form -14th AMHC

(Places are free, but offered on a first come, first served basis, so early applications are advised)

For more information contact Bill McGowan

Please click here ISPS-UK Oct 12 conference delegates reflections to read reviews that delegates have written on the conference. If you would like to add a review please contact the ISPS UK office: admin@ispsuk.org

Psychosis UK
Building bridges to understanding

Psychosis UK
Promoting psychological and social approaches

Psychosis UK
Promoting psychological understanding

These are important changes in the way we ‘position’ our organization in the mental health field, hopefully attracting new members and spreading our ideas.

What do you think? The more discussion and debate we can generate before the AGM, the more decisive we can be when it comes to the vote.