MINDinMIND

In this legacy interview, leading psychologist Clinical Professor (at the University of California and New York University) Stephen Seligman, shares his lifetime’s clinical practice and thinking as an acclaimed psychoanalyst/psychotherapist with adults, children and infants.  He argues that today’s research on attachment and human development changes how we should think about babies, brains, families and psychotherapy. Stephen discusses his extensive work with children and families, teaching and writing on childhood and his in-depth study of psychoanalytic theory and practice alongside developmental and attachment research. In this wide-ranging discussion with Jane O’Rourke, Stephen challenges colleagues to get out of their ‘theoretical and professional silos’ to embrace new research and ideas alongside traditional thinking so we can better serve the children and families we work with. He also discusses what the Relational School is in psychoanalysis and why it's a helpful approach. Hightlights: 0:00 Start 0:55 Why did Stephen Seligman become a psychotherapist? 1:45  Importance of bringing in thinking from different areas of expertise, getting out of our ‘silos’ makes us do better work. 3:35  Reference to Stephen Seligman’s latest book, ‘Relationships in Development’. 3:40 The Relational School what it is - led by Stephen Mitchell He ‘offered a more flexible and open stance with regard to theory, contact with adjacent disciplines and clinical work’. Relational psychoanalysis encourages us to acknowledge us as humans and understand development. 5:35 Meaning of a ‘Developmental’ approach in psychotherapy. It’s the capacity of individuals and systems to change over time. Children have the most growth potential, forward-moving development is important to keep in mind, along with the restrictions of the past. 7:41 Intersubjectivity – what it is and why it’s so important in relationships and shaping who we are in every moment. 9:24 How can relational, developmental and intersubjective approaches be helpful working with children? 10:39 We are responsive to others’ suffering and lots of other influences. We should not be ashamed of that. Our capacity to connect and respond to others is a resource we can share with colleagues. 11:39 Emotions and reflection lie at the heart of intersubjectivity.  Emotions are individual and social simultaneously.   13:20 Importance of early intervention with young children. Picture of James Heckman’s The Heckman curve – shows economic impact of investing in early childhood learning.   15:21 Brain development in the first few years. Early relationships are the most important predictors of developmental outcomes in later years   17:09 The history of Attachment Theory 18:55 Rivalries between different schools of thinking in psychoanalysis   20:20 Melanie Klein’s theories can be very valuable for incorporating into thinking, especially for post-traumatic situations             21:16 Sometimes, though, “psychoanalysts are not always thinking about real children”.   23:00 The history of parent-infant psychotherapy: Working with parents and the influence of Selma Fraiberg infant-parent program   26:33-35:12  Case examples of parent-child psychotherapy   36:54 ‘Relationships in Development: Infancy, Intersubjectivity and Attachment’ by Stephen Seligman. Discusses his book 47:27 How child psychotherapy training benefits therapeutic work with adults.    50:11 Relational psychoanalysis & self-disclosure. 53:32 Crucial role and contribution of women to psychoanalysis eg Anna Freud and Melanie Klein

Trauma can have long lasting effects on a child’s mental health and physical health. Learn more about the latest research and interventions for traumatised children in this interview with leading psychiatrist and researcher, Professor Helen Minnis. What interventions are most helpful for children and their families who have experienced trauma? This is a question that Helen Minnis, Professor of Child and Adolescent Psychiatry at the University of Glasgow, is seeking to answer. She has become one of the leading research Psychiatrists of her generation , working for many years therapeutically and researching children who have been abused and neglected. In this interview with Jane O’Rourke, Helen discusses what she is finding leading three research projects examining different therapeutic interventions with children and their families. Professor Helen Minnis was also one of the first female black psychiatrists to qualify in the UK. She tells Jane how her own life as a black woman and clinician, has shaped her research. We know that many fostered and adopted children come to their new families severely traumatised, and many also have problems such as ADHD and Autism.  In this interview, Jane asks Helen how fostered and adopted children can best be helped in their new placements? 0:22 Background to Helen Minnis and her latest research  0:53 BeST? Services Trial, randomised controlled trial of an infant mental health intervention for children aged zero to five coming into foster care.  2:52 New Orleans intervention originally developed by Charley Zeanah and Julie Larrieu and the GIFT and LIFT interventions  4:45 Challenging the UK practice of Foster Carers being short term carers to prioritise the needs of children? Why US practice registering Foster Carers being there for the long term if the child needs.  6:20 Foster care commitment - a measure that was developed by Mary Dozier called the This is My Baby or This is My Child Interview  7:35 Partnership for Change Trial: intervening before a child goes into child protection.  8:50 Experts by Experience Shaping Services for Children  11:05 Neurodevelopmental conditions  ADHD, autism, tic disorders linked with child neglect and abuse  11:33 Working with Parents Without An Agenda 12:44 Parents experience of being suicidal  14:36 Cultivating Compassion for Parents and holding back judgement  17:05 Randomised Controlled Trial of Dyadic Developmental Psychotherapy developed by Dan Hughes  19:20 What is DDP?  21:35 Results of DDP trial so far 22:58 What are the Main Predictors of Successful Adoptions?   24:17 Adopted Children are More Emotionally Resilient than Others   25:10 Heritable Problems in Adopted Children  26:00 Traumatised Children Who Can’t Ask For Help  28:33 Supporting Adoptive and Foster Parents  29:35 Attachment Disorders affecting fostered and adopted children such as  reactive attachment disorder and disinhibited social engagement disorder  33'10 Why sparked Helen's interest working with children: How an Orphanage Sparked a Career With Adopted and Fostered Children   35:00 Professor Eric Taylor as a mentor   37:19 How has Helen's experiences as a black woman and clinician  informed her research? Influence of Kwame McKenzie  38:19 Black woman in white spaces

Legacy Interview with Dr Jeanne Magagna    Jeanne is a Child, Adolescent and Family Psychotherapist, who during a career spanning more than fifty years has contributed substantially to the field of child mental health.     Jeanne led the Psychotherapy Services at Great Ormond Street Hospital for Children in London for 24 years where she specialised in eating disorders.     Her latest book Psychotherapeutic Understanding of Children and Young People with Eating Disorders has just been published.  Listeners to the MINDinMIND podcast can get a 20% discount with this code: FLR40. In this interview with Jane O’Rourke, her psychoanalytically informed perspectives on the factors that contribute to eating disorders, and how they are best treated, will offer you fresh insights. She also insists that with the right care, no young person should ever die of an eating disorder.   Jeanne explains why the art of observing babies, a technique based on the model taught by the Tavistock Clinic which she has taught all over the world, can transform our understanding of children and their families.     She describes what it was like to learn the craft from the originator of infant observation, Esther Bick. Being taught by Mrs. Bick, Jeanne says was an inspiring experience though also challenging as, “Mrs. Bick was in touch with the powerful anxieties of infancy as she faced the end of her life”. Jeanne also describes how it is possible for parents to learn infant observation to deepen their understanding of their children. This led her to inspiring a very special nursery in Rome and she wrote a book with them, ‘Being Present for your Nursery Age Child’.      Somehow during a very busy clinical career, Jeanne has found time to write over 90 articles and books.  She says her most important book is The Silent Child: Communication without Words, in which describes her work with children who aren’t speaking, walking or eating. Of course, by their very nature, silent children are difficult to treat in talking therapies, but Jeanne’s skill in observation has made her a particularly insightful clinician and in doing so, she has helped children to have their voices heard and save their lives.  Jeanne’s capacity for careful observation was honed at a very early age, which is why it felt appropriate to begin this interview by asking her about her childhood and its influence on her work.

Lydia Tischler was one of the first child psychotherapists to train with Anna Freud.  Her advocacy for children began early and in traumatic circumstances in concentration camps where she spent her teenage years caring for younger children during the Second World War.  She came to the UK as a refugee and embarked on a seventy-year career that’s been marked by courageous innovation. "One of the ways you can mother yourself is to mother other children", Lydia tells Jane O’Rourke in this interview. Lydia’s mother was tragically murdered in the Auschwitz concentration camp. After qualifying, Lydia became the first Child Psychotherapist at the Cassel Hospital in London where mentally ill mothers and their babies were treated.  She went on to transform their treatment by establishing a family unit, saving many seriously at-risk children from being taken into care. Her contribution to the teaching and organisation of child psychotherapy has also been significant.  She has been a key figure at the British Psychotherapy Foundation and Association of Child Psychotherapists but her contribution to the mental health of children internationally is also impressive. For the last thirty years as co-founder of the European Federation of Psychoanalytic Psychotherapy, she has established adult and child therapy trainings and services in Central and Eastern Europe. Remarkably although she is now in her 90’s, she is still supervising and teaching. Lydia began by telling Jane O’Rourke about how her early experience of loss and helping other traumatised children in the concentration camps, led her aged only 23 to begin training as a child psychotherapist with Anna Freud. Go to www.mindinmind.org.uk for more information about Lydia Tischler and to sign up to our email list to be notified of future podcasts Interview recorded 2019 Filmed & edited  by Izzy Cooper Post-video Production Pawel Chichonski Tributes for Lydia Tischler  The Association of Child Psychotherapists welcomes the film on Lydia Tischler and talked to Ann Horne, ACP Consultant Child and Adolescent Psychotherapist about Lydia:  'From the time she arrived in the UK, age 16, in Windermere in 1945, by way of Auschwitz and Theresienstadt (Terezin), Lydia Tischler has lived a life advocating and innovating for the mental health of children and families. Trained by Anna Freud, she was the first child psychotherapist at the Cassel Hospital where, with her future husband, she established the Family Unit which admitted whole families whose functioning had completely and dangerously broken down – ‘the family as in-patient’.  In ‘retirement’, she was co-founder of the European Federation of Psychoanalytic Psychotherapy, ensuring that many countries of Central and Eastern Europe, in rediscovering their psychoanalytic histories, also developed child and adolescent psychoanalytic psychotherapy trainings. And she joined the organising staff group of the British Association of Psychotherapy (now IPCAPA - Independent Psychoanalytic Child & Adolescent Psychotherapy Association at the British Psychotherapy Foundation), an enabling and loved teacher, tutor and supervisor.   It is not surprising that she is an Honoured member of the Association of Child Psychotherapists; the profession owes her much. For the MINDinMIND viewer who is meeting her for the first time, you are fortunate! A woman of generosity and wisdom, integrity and energy, Lydia is someone we all hold near to our hearts'.

98 YEARS OLD ISCA WITTENBERG ON SHAPING SERVICES AND OUR THINKING ON CHILD & ADOLESCENT MENTAL HEALTH Go to www.mindinmind.org.uk for more information including a transcript of this interview When Isca Salzberger-Wittenberg was 11 years old she wrote in her diary, ‘I want to help people when I grow up.’ She is now probably the oldest living child psychotherapist and without a doubt has fulfilled her young self’s wish. Over the course of a career which has extended more than 70 years, Isca has had a lasting impact on mental health services for children and adolescents at the Tavistock Clinic in London. She has also helped shape the thinking of generations of child psychotherapists whom she trained. Many of the tributes that have come from her colleagues with the release of this interview are many that include the recognition of her ability to cross professional boundaries and in doing so deeply influencing the fields of education and social work.  Isca was one of the first people to undertake the child psychotherapy training at the Tavistock Clinic, London, set up by John Bowlby and Esther Bick after the Second World War. Isca’s contribution is made all the remarkable having fled Nazi Germany as a child. But perhaps surviving the trauma of the holocaust has made her a particularly good guide for others experiencing loss. In her book ‘Experiencing Endings and beginnings’, she wrote: ‘What makes it possible to accept the transience of life, to bear increasing losses, face the loss of one’s own life, and yet go on growing, gaining, or at least maintaining emotional and spiritual strength?’ During this challenging time of the Covid pandemic, many of us have had to endure the death of loved ones, illness and loss of freedom.  Isca says that no matter what is happening, we must be thinking about and preparing for the loss of others and even our own demise. For over fifty years Isca worked at the Tavistock Clinic in London, where she eventually rose to be its Vice Chair. Her colleagues were some of the greatest names in psychotherapy such as Donald Meltzer and Neville Symington. Isca was in analysis with Dr Sonny Davidson for four years when he tragically died. Hear her reflections on why she decided she wanted Wilfred Bion as her analyst. Having taught infant observation for over 50 years, Isca explains her passion for it and why it is an essential part of understanding babies and their parents. She also reveals the challenges of working with one of the key creators of Infant Observation, Esther Bick. Isca discloses how her own experience growing up led her to gravitate towards helping adolescents experiencing mental health difficulties. She developed a young peoples counselling service at the Tavistock where for the first time they could refer themselves. Hear too why a deep interest in spirituality alongside psychoanalysis runs through Isca’s life and work and why at 98 she’s learning to play the piano! Remarkably, Isca is continuing in her work as a Consultant Psychoanalytic Child and Adolescent psychotherapist and Adult Psychotherapist from her home in North London. Interview recorded 2019 with Jane O’Rourke

Neil Altman believes that whilst there is great human suffering and anxiety provoked by Covid-19, it also provides an opportunity for children to grow emotionally and cognitively. In this hopeful and stimulating interview with Jane O'Rourke, he urges us to be brave about what we talk about with children so they can be helped to avoid the blindspots adults have over issues such as racism and inequality. Neil also discusses the links between psychoanalysis and the progressive education movement. Please go to www.mindinmind.org.uk to read Neil's written blog and see our other interviews with leading child mental health professionals

Jay Perkins in conversation with  Jane O'Rourke for www.mindinmind.org.uk.  After struggling to find a way to support marginalised, stigmatised and excluded children, young people and families from within the mental health system, Child and Adolescent Psychotherapist, Jay Perkins has recently done something different, he’s taken his therapeutic work outside of clinics and with colleagues formed Partisan. They partner with communities with the aim of understanding what the local mental health challenges are and develop trauma-informed approaches which are more  attuned to their needs.   Go to www.mindinmind.org.uk to watch the video version of this interview and read Jay's written piece about how marginalised young people and families can be helped by mental health practitioners supporting community initiatives.  Jay Perkins trained as a Child, Adolescent, and Family Psychodynamic Psychotherapist at The Tavistock and Portman. In his work he draws on his clinical training, as well as his youth work background, systemic ideas, other relational and mentalization-based approaches, and trauma specific treatment (EMDR). He has 14 years experience supporting children, young people and families, and is best known for his work alongside communities; co-producing highly flexible trauma-informed support outside of clinics and addressing structural and systemic discrimination in a bid to make mental health service accessible for everyone. Head to www.partisanuk.org to find out more.

Jane O'Rourke interviews Graham Music, a child adolescent and adult psychotherapist who has a passion for neurobiology, psychoanalysis, attachment theory, mindfulness and well that’s to name just a few areas. Because Graham’s curious mind is always on the look out for the less explored areas of psychotherapy and how to think about difficult subjects– and this subject today is – somewhat ironically – overlooked.   We are talking about Neglect.  Graham says that people who have experienced early neglect are often stuck in shut-down dampened states and do not ask for help, as they’ve not learnt it is possible to have it. Emotional neglect as a therapeutic challenge is too little understood. Neglect is different from abuse and overt trauma as it is about the good experiences which are not received, not the bad ones that are suffered.  To quote Graham he says neglect is not about omission not commission, about the effects of not receiving the growth inducing experiences that help minds grow, emotional lives thrive and hearts come alive. It is being held in mind, understood, thought about, cherished and enjoyed which gives rise to emotional growth. This is just what neglected children do not get."  Hear more in this interview with Graham about even though many therapists might be tempted to give up, consistently showing curiosity, interest and pleasure can re-awaken buried potentials for interaction.  Here he describes the different types of neglect, the neurobiological findings and the clinical techniques which might be helpful.   You can also read Graham’s written Thought Piece and find our downloadable PDF which Graham has written about neglect at www.mindinmind.org.uk and many other interviews, podcasts and thought pieces to deepen our understanding of child mental health.

It’s not an exaggeration to say that Dilys Daws’ contribution to the field of child mental health and child psychotherapy has been immense.  Spanning over five decades, her career as a Child & Adolescent Psychotherapist is notable in many respects as a clinician and shaping public opinion and government policy about the importance of infant mental health. In the 1980’s Dilys began speaking to the public and government about the work of child psychotherapists with their patients, raising awareness of the profession and the difficulties babies and parents experience in a way that had never been done before. Her books, such as Through the Night, which focus on the difficulties infants and parents experience , have become classics for therapists and new parents alike.  Their popularity is perhaps due to the fact that they are based on fifty years of careful observation of babies and their families, many of them spent in the same baby clinic. It is Dilys’ ability to influence government policy and collaborate with different child professions, as well as her extraordinary clinical work which is really quite remarkable which mark her out as one of the most important child psychotherapists of her generation.  Because since 1976, Dilys has been transforming the lives of children and parents in what might be to some an unconventional setting for psychotherapeutic work. Each week she has been going to the James Wigg GP Practice, in Kentish Town, London to stand by the weighing scales, observing what takes place as parents bring in their babies to be checked.  In this interview with Jane O’Rourke, hear Dilys discuss: Highlights: 3’00:   Parent-infant work in the community setting of a baby clinic 5’00:  The importance of child therapists being brave in their clinical work 7’40  How experiencing difficulty herself, as a young mother, led Dilys to become a child psychotherapist 13’05  How Dilys broke the taboo of child psychotherapists speaking to the media about child mental health in the early 1980’s 13’55  The importance of acknowledging the emotional turmoil which having a new baby can provoke in parents. 17’00  The discoveries parents can make by observing their babies 18’00   The importance of helping new fathers who are struggling 21’13  Ghosts in the nursery: connections between a baby’s problems and their parents’ childhood traumas 24’25  The taboos of breastfeeding, such as the sensuality of it 30’00  A child psychotherapist’s advice for others after nearly 60 years of clinical work Dilys Daws’ writings and activities in promoting child psychotherapy are significant.  In 1996 she set up the Association for Infant Mental Health UK, a networking body for professionals working with infants. Dilys cofounded the Child Psychotherapy Trust in 1989 and had a significant role in developing awareness of child psychotherapy in the UK among the public and the government.  Following this, the training for child psychotherapy was negotiated by the Association for Child Psychotherapy within the NHS.  It was during this time under her tenure in the early 1990’s, that she encouraged fellow child psychotherapists to speak to the media about child mental health and the difficulties their patients were experiencing - and perhaps broke a taboo that had existed until then. 

How can you get the best out of therapeutic practice with children online? What happens to the therapeutic relationship when it is mediated by technology? How can our work be as effective as possible despite the challenges? And are there even some benefits to online working such as therapy by email or even text - which some adolescents might prefer? And how about taking children for a walk in the woods before commencing online therapy? Carolyn Hart, Child Psychotherapist gives some innovative therapeutic approaches for helping children and adolescents at this challenging time, in a Thought Piece with Jane O'Rourke. Case examples have been anonymised. See Carolyn Hart's written Thought Piece on this subject on our website https://www.mindinmind.org.uk/thought-pieces/ Carolyn Hart is a Child & Adolescent Psychotherapist who works both in a specialist Child Adolescent and Mental Health team for looked after children in Sheffield and also in private practice. She has a particular interest in integrating findings from biology and neuroscience into her work. In 2016 she completed a postgraduate diploma concerned with remote ways of working and has been using various technologies since.