Edited by Fiona Warren FWarren@sghms.ac.uk & Richard Bulmer
Mounted as HTML 21.xi.95 by Chris Evans within the Section of Psychotherapy pages {7kb}. If you want to be kept updated by Email of changes in this and other psychotherapy resources at this site then Email me at: http://www.psyctc.org/cgi-bin/mailto.pl?webmaster Last tweaked 23.xi.95
Welcome to the new-look A.T.C. Newsletter. We are pleased to have been given this "fabulous opportunity" to strive for fame but not fortune and hope to add something new to the newsletter, hopefully this edition will make a good start. We have many interesting contributions in this edition, about work experiences, academic interests and other aspects of being part of the therapeutic milieu.
We would like to thank Rod Adams, our predecessor, for his hard work on previous newsletters, and his advice on editorship.
A.T.C. members enjoy sharing experiences with other members and hopefully the newsletter will offer a less academic arena for this process that will serve to complement the excellent A.T.C. Journal. It's hoped that the Newsletter will increase the awareness of the A.T.C. and relevant issues. The A.T.C. now has a home-page on the internet on which this newsletter will be posted within the next few weeks.
The last few years have seen the therapeutic community movement on the defensive over health service reforms. We hope that this edition shows evidence of a renewed optimism within therapeutic communities, which is also illustrated by the service developments at Henderson and Cassel Hospitals, the move to new premises at Winterbourne, the revival of the experiential weekends and the wealth of interesting material we have been given for this newsletter.
We look forward to receiving your contributions for the next edition!
Joint Editors:
Fiona Warren (FWarren@sghms.ac.uk)
Richard Bulmer
We would welcome contributions from members of the A.T.C., other interested professionals or anyone else with anything interesting to say - articles, reviews, illustrations, letters are welcome.
Suggestions for regular features in future editions include:
Henderson Hospital,
or
fax: 0181 770 3676
or by e-mail to: fwarren@sghms.ac.uk
or, of course, to the A.T.C. office.
All you have to do is review the book of your choice (within reason!) for the International Journal Of Therapeutic Communities. Although they already have a list of books for review on subjects ranging from infertility counselling to group work with adolescents, requests may also be made by writing to:
Peter Griffiths,
TEL: 0181 940 8181
Or contact Peter for a full list of books awaiting review. He also has guidelines for reviewers and has offered to help people who may not have reviewed books before.
1-3 December 1995 -- Weekend
Workshop. Learning from experience in a therapeutic community.
For staff members working in TC's and supportive organisation.
Cost £200 includes two nights accomodation, course fees and
all meals. 35 places only. Details A.T.C. office.
20th January 1996 -- A.T.C. Conference
and A.G.M.
To be held at the Cassel Hospital.
April 1996 -- Workshop at
the new unit, H.M.P. Grendon.
September 1996 -- Windsor
Conference.
Theme to be arranged - suggestions welcome
Applications and further information from: the A.T.C. office.
18 - 19 November 1995 -- Recovering
a Future, Psychoanalysis and the Public Sphere
9th Conference. University of East London. Contact Joan Tremble
- 0181-849-3660.
23rd January 1996 -- Henderson
Hospital Study Day - The Therapeutic Community Approach
Contact Richard Bulmer - 0181-661-1611
23rd February 1996 -- Second
St.George's working across cultures conference: Are Training Needs
Being Met?
Contact Freephone - 0800 716868
12th March 1996 -- Henderson
Hospital Study Day - Managing Personality Disorder.
Contact Richard Bulmer - 0181-661-1611
24 - 27 March 1996 -- Ravenscar
1996. Society for Psychotherapy Research.
Contact Dr Rex Haigh - 01734-561250
September -December 1996 --
Henderson Hospital Introductory Course in Group Work.
Contact Richard Bulmer - 0181-661-1611
We welcome information about events of interest to A.T.C. members to go in the next edition. Contact us!
In this section we hope to bring news from any therapeutic communities up and down the country. We hope to keep the therapeutic community movement informed about new developments, interesting stories and other information. Contact us!
The last six months has been a very busy period at Henderson Hospital with some exciting new developments.
Outreach Service: A new team has been recruited to set up a new service of peripatetic clinics throughout the South Thames (West) Region. The team will offer assessments, treatments and consultation. The team comprises Dr David Fainman, Consultant Psychotherapist, Ms Maggie Hilton, Consultant Clinical Psychologist, Ms Danke Gordon, Clinical Psychologist and Ms Gillian Roberts, Secretary. The clinics will take place at sites in Tooting, Sutton, Littlehampton, Redhill and Farnham. The service will be fully operational in November 1995.
Refurbishment: A major refurbishment of the Hospital was completed in June 1995. Henderson Hospital was temporarily relocated in cramped and inadequate conditions at Sutton Hospital. This period was extremely difficult for the whole community and it was with much relief the Henderson returned to its Homeland Drive home.
Staffing Changes: The last few months have seen a number of additions to the staff team at Henderson Hospital including 2 new nurses and a new social worker, as well as the outreach staff.
On a sadder note, everyone at the Henderson regrets the departure of Okeke Azu Okeke after 25 years of service and while wishing him all the best for his retirement, will miss his wisdom and humour.
Winterbourne Therapeutic Community was set up at Fair Mile Hospital at the end of the 1960's where it has lived until this year. It is part of the West Berkshire Psychotherapy Service, which is run by the local Community and Mental Health Trust. It has to undergo considerable changes to remain a viable and thriving part of the NHS as all the reorganisations and changes have gone on around it.
The most recent of these is moving from the "Stone Mother" of Fair Mile - which is a large Victorian institution in the countryside due for closure in the next three years - to a refurbished three storey house in a residential part of Reading. As you might imagine, this has not been without its problems.
Winterbourne Therapeutic Community would like to invite you to a housewarming party on Saturday 11th November 1995.
Afterwards, anybody who would like to stay behind is warmly welcomed to join the Winterbourne team for a drink or two and an inexpensive meal in a local restaurant. If you want to do this please phone before the conference (01734-561250)
Discussions have been taking place regarding the development of a "second Grendon" between the Directorate of Health Care and the Prison Directorate. This very positive endorsement of the therapeutic community model, recommended as the best researched and best supported mode of treatment for psychopathic and antisocial personality disorders in the governmental Reed Report (1994).
It all started when I told my friend Jimmy (a social anthropologist) that I had been seconded to attend the Annual conference on therapeutic communities at Windsor. Looking me in the eye, Jimmy wasted little time in putting me straight.
"Be careful about those people", he said, "they are very funny people. When you get up there, for a start you'll find that they go on about nothing else except 'awareness', awareness of this, awareness of that, they'll drive you mad with awareness. And 'space'", says Jim, "you'll find them totally pre-occupied with space."
"What? Outer space?".
"No, idiot! Not that kind of space....space within, boundaries, they'll go on a lot about boundaries. Oh, and the transference: EVERYTHING will be draped in transference."
"Well, Jimmy, I might just give them a bit of an argument about that."
"You can't. Because they'll call it transference."
"But," I insisted, "they're nice people aren't they? I have heard that they are very nice people."
"People?", replied my friend, "people? They're not people. They're therapists!"
In the event, I visited my therapists and, nice people or not, they did talk about some very interesting things. We had a paper ostensibly about a journey into nonsense but which said some quite startling things about Lacanian psychoanalysis. Another speaker used Homer's Odyssey to characterise aspects of the therapeutic journey. From a male chauvinist perspective we had what was, in my view, the most Homeric journey of all, namely the baking of a cake. In fact, this was an enterprising account by a Cassell therapist (who insisted she was a nurse!) about the restorative benefits of baking a cake with a client. Midway in the week I rose to give my own talk on the misinterpretation of terminology by nurses in Rapoport's 1960s study at the Henderson. This went down quite well and I was asked to speak again about the community and the individual. In order to explicate my views I drew from the guest lecture given by Horst Flegel in which he had said that:
"The task of man in his age and generation is to respect the subjectivity of the other."
Flegel played with notions of the merger of self, selfhood and the social, and he did this by means of a kind of transcendental view of things:
"Is not sensuality," he asked, "indispensable to invest spirituality with structure?"
I recalled a visit which I had made to Rome where I came upon Bernini's stature of St. Theresa with its fantastic spirituality emanating from the physical ecstasy of its from. Flegel's serpentine talk, indeed, brought back many images and thoughts: I have since considered the possibilities which straddle the borders between the religious and the profane and am in little doubt, at least, about the form which traditional religious structure gives (necessarily, witness recent religious 'outbursts') to the spiritual impulse. Perhaps we see another merger at the intersection with therapy and contemporary attempts to attach a moral structure to it in the guise of Codes of Conduct, accreditation and so on.
From the start, and not withstanding Jimmy, it seemed as if I was embarking upon some kind of journey: I recalled an Irish joke which about summed up for me much of the psychotherapeutic process. This is where a tourist asks an old farmer the way to Kerry and the farmer replies, "Well..if I was on for going to Kerry I wouldn't be startin' out from here."
Indeed, even when started, therapy can sometimes be akin to helping a blind man to see in the dark. This kind of musing is not fashionable these days, of course; too many people appear to be too sure of too many things. Listening to a cognitive-behaviourist recently strut his stuff, I recalled what someone had said about Lord Macauley: "I wish I could be as sure of something as he seems to be of everything."
During my talk, I reviled the kind of revisionism which prizes efficiency whilst debunking people who mattered in a different way. Warts and all, Ronald Laing made it embarrassing to be seen or heard talking down to patients. He did not stop the practice; no one will ever do that, but he made it an uncomfortable activity for anyone with an ounce of sensibility in their body. Preaching to the converted perhaps, but by far the best sermon I ever heard.
Lets finish the journey with something Laing said:
"We do not regard it as pathologically deviant to explore the jungle or Mount Everest. We feel that Columbus was entitled to be mistaken in his construction of what he discovered when he came to the new world. We respect the voyager, the explorer, the climber and the space man. It makes far more sense to me as a valid project - indeed as a desperately and urgently required project for our time - to explore the inner space and time of consciousness."
On reflection, Jimmy was right about space.
Liam Clarke Social Anthropologist from Sussex University.
Windsor Conference, September, 1995 - My Impressions
A number of interesting and rich papers were given covering a wide range of topics relating to therapeutic communities and psychotherapy. The participants were not asked to keep to the conference title, which itself was open, and so the area covered was extensive. a few recurring themes did emerge spontaneously, which seemed to reflect issues that were potentially debatable. These themes included at what level you can successfully make transference interpretations in large community meetings; whether or not nurses and other staff working in therapeutic communities can be called therapists; and what we mean by a "culture of enquiry", and how it can be put into action. Although different opinions were voiced it felt difficult to explore these differences in case people offended each other. The atmosphere was therefore polite over all, leading to a pleasurable time. I believe a more fulfilling experience could be gained if further exploration was allowed with the risk of disagreement, producing a more lively exchange of ideas. A more focused approach to a given subject for the whole conference, and more space for discussion in the form of large group meetings might also help.
Alice Levinson. Senior Registrar in Research & Psychotherapy at the Cassel Hospital.
Return to Windsor
It was a great pleasure to be back at Cumberland Lodge after five years. Just getting there felt positive as in '93 and '94 I'd had to cancel at the last minute due to staffing and funding threats.
Was it just me, or was there generally a sense of optimism, that those from TC's that have survived the last decade have emerged the stronger, with a clearer sense of what we can offer, and a more confident relationship with the outside world. Certainly I came away less weary with a sense of solidarity and excitement, and a renewed sense of how privileged we are, doing this type of work. Perhaps next year, there will be less need for people to have their work affirmed, and more space to be vulnerable and struggle with the difficulties.
Dr Penelope Campling, Consultant Psychotherapist, Francis Dixon Lodge.
As yet there is no theme for next year!
The A.T.C./VWPG would welcome suggestions for interesting and topical titles for the 1996 Windsor conference. Contact details
Studio upstairs, Diorama Arts, 34 Osnaburgh St., London NW1 3ND
The Studio Upstairs offers a totally innovative and unique style of therapeutic day care for people with mental health difficulties. Our aim is to maintain, support and develop the art work of people, many of whom have just left psychiatric care.
The Studio is large communal space managed by a team of Artists, Art Therapists and a Psychotherapist. The Studio is about making art and being a forum for self-expression, but with a therapeutic concern. Attention is given to dialogue and the need to be heard, encouraging movement away from isolation to relating.
We are seeking volunteers with a genuine interest in art to assist, maybe one or two days a week.
If interested please phone Pippa Micheals on 0171 916 5431.
The Studio Upstairs is a part of Diorama Arts Centre (a registered charity) containing a number of studios for professional artists, a gallery, a music and theatre venue, rehearsal space and its own cafe.
Looking back it doesn't seem that long ago, since I arrived at Lower Shaw Farm with my fellow participants. We had gathered to form our own Community, to experience "life on the other side" of the divide.
This was in 1982 when the A.T.C. would regularly put on these weekends. I was thirsting for some input in an experiential setting, to grapple with conflict, to divest myself of my staff role, to see what would become of me. I also felt valued by the institution where I worked, I was seconded to do this and so some investment in my development was being made.
"Who the hell do these people think they are, making me feel anxious, small and deskilled?". The thoughts came flooding in as I sat in the large group. One of the staff was particularly provocative, but also correct in what he said. He was prepared to question assumptions that the rest of us had, and prepared to receive the scorn that came his way. I appreciated and respected what he said because he made me think, even though initially I was blind and caught up with the prevailing climate of my peers.
Each small group took turns in preparing the meals and these became ever more fanciful affairs. I recall one group dressing up as Italian waiters and serving us with their food along with the lingo!
My one blank spot was where I slept for the two nights. I know I was (and still am) the very model of a pure and clean mind/life, and I didn't get drunk, so I'm not trying to hide any impropriety on my part. Nevertheless, I wonder why, when that question is often the first to be asked by other who are intrigued by the possibility of any "goings on".
These are some of my lasting impressions of that weekend, something I look back on as extremely rewarding. I am inclined to say that everyone working in a TC should be subject to this experience, there are so many valuable points to learn for our own and other's benefit.
My best wishes to the new w/e communities - Bon appetito!
P.S. I would enjoy hearing other recollections of these events, perhaps we were on the same one, where do we progress to after such an experience?
Neil Palmer
There is an A.T.C. Experiential Weekend forthcoming in December
Jane: 'Oh that's just John's idiosyncrasies'
John: 'Things must be getting worse.....I came in hear with a personality disorder now I've got an idiosyncrasy as well'
Mission Impossible
Well here it was, mission impossible. To go to the Henderson and hopefully blend inconspicuously into the background, avoiding drawing attention to myself, not a hope !
Firstly in the staff meeting a name round is done and I pronounce myself to be the new placement student, who will be causing them all innumerable amounts of extra hassle, by constantly bugging them over obvious details of the day to day running of the Henderson. But from the initial contact with the staff a warm feeling was gained, did they know something I did not ?
Next was to be my first nine fifteen community meeting with the residents. A chance for me to sit quietly and lap up how the Henderson operated. Wrong again it was time once more for introductions, getting up and saying that I was a mere placement student seemed to lack punch, why should they let a student into their therapy ? but thankfully they did, and a three week induction period ensued, where I had the opportunity to experience all the work groups , meetings and aftergroups.
I had had a snapshot of the Henderson from a previous one day visit, but this was full on, I was realizing that this placement was living up to all I hoped it would.
After an intense three weeks I am beginning to settle down and I am beginning to find my place in the flattened hierarchy of the Henderson, at the bottom of the pile. But this is what I had expected, I now await the dogs-body work that is part of my placement. But this I will do readily if the following eight months hold as much prospect as the first one has.
Philip Coombes. Placement Student at Middlesex University working as a Clinical/ Research Assistant at the Henderson Hospital .
We would like to encourage you to help the A.T.C. increase its membership. If you know of colleagues in your therapeutic community who are not members of the A.T.C. or of people who may be interested in the therapeutic community ideals please let us know and we will send a free copy of the Newsletter, A.T.C. information and an application form to join the A.T.C..
Name of person who may be interested.............................................................................
Address................................................................................................................................
.............................................................................................................................................
.............................................................................................................................................
Please post to:
A.T.C. Office,
Glossy delegate packs, herbal tea and piped musak - even the delay of conference proceedings publication was handled smoothly. I felt like I was in a dream. Nothing, however, could detract from the power of the statistics and detailed descriptions of the horrors of domestic violence which one in four women has experienced (e.g. Mooney, 1993).
At one end of the continuum of violence the threats, manipulation and other passive symbols of hostility which seriously intimidate and abuse women as well as do the sickening extremes such as genital penetration with forks, bottles and guns (Mezey, 1995). These last examples are cited in cases where women killed their abusers. Most do not, developing coping strategies which fall into line with their abusers' demands to protect themselves, their dependants, their lives (Horley, 1995).
The far-reaching psychological, legal, social, medical and financial implications of all such coping mechanisms , and subsequent labelling responses such as "battered women syndrome" were presented effectively in valuable critiques that highlighted for me the political aspects of this debate. To create lasting change, societal acceptance must change (Stanko, 1995); to ensure this occurs the law must change (Stanko, 1995). Lawyers feel that this is Parliament's domain (Horder, 1995). Pressure must therefore be directed at Government (Stanko, 1995). The presence of Clare Short MP (Shadow Minister for Women) further politicized debate.
One feeling which I carried away from the conference concerned the vehemence of opinions held by most speakers. Not only absent politicians but psychiatrists, psychologists, GPs, the police and men were often critically represented - in my own opinion partially misrepresented as well. When statistics show the vast numbers of people who are affected, it is no wonder feelings ran high. These personal issues were not even addressed tokenistically. If they had been (or had been considered more profoundly), the powerful hostility felt by some members of the audience may have been converted into a more constructive energy.
Zoe C Graham is a Trainee Clinical Psychologist at the University of East London.
I was nervous as I arrived at the conference organised by the Bristol Crisis Service for Women (a group set up by women who used to self-injure to support women who currently self-injure). Had I pandered sufficiently to my preconceptions of the conference, as I turned up with a male (one of only five out of 130 delegates) consultant psychiatrist (probably the only one at the conference) to advocate TC treatment. Nevertheless, I was looking forward to the meeting of "survivors" together with "professionals", and learning a lot from a group of experts - those who had first-hand experience.
The opening speaker, a "survivor" of self-injury, described very movingly some of the feelings and childhood experiences which led to her cutting as coping. Feelings were clearly running high (one woman burst into tears after the first paper) but the aetiology of self-injury was then extended to include the patriarchal society in which all women are oppressed (except the treacherous ones). Attempts from other delegates to counter this were very faintly successful.
The contribution of powerlessness and lack of choice to self-injury was precisely the point on which I thought therapeutic communities would appeal. (Perhaps also as radical allies in radical and anti-psychiatry motivation). However, the Henderson was criticised for expecting women to be comfortable talking about self-harm in a large group which included men. Depriving people of sleep by expecting them to get up in the night for referred meetings; automatic discharge for cutting; prohibition of medication and the one-to-one were also seen as therapeutically suspect. Even the glowing recommendation from a woman in the group who attributed an enormous improvement in her life to time spent in a therapeutic community twenty years ago did nothing to melt the hostility.
In addition to my disappointment at the dismissal of the TC, it was more disillusioning that very little dialogue seemed possible. It seemed rather to be a one-way forum for the expression of anger at being continually misunderstood, by therapists, families, society, and in this way to mirror what the group seemed to want for the self-harmer. This was the possibility to express their pain and extreme anger without restraints, to a sympathetic, (preferably untrained) ear.
On reflection, I didn't think that the conference was a wholly negative experience - perhaps that it took place at all and the service voiced its views is a good start which does not necessarily mean that statutory and voluntary services, including TCs and the BCSW, will not work together in the future.
This service is certainly providing a valuable resource as a national help line for women who self-injure and is heightening the awareness of the issues through the media. This last week alone there have been two programmes on the subject, on Radio 4 and Channel 4. Perhaps next year's conference will benefit from this awareness.
Fiona Warren is an Assistant Psychologist at the Henderson Hospital.
A.T.C. Members are entitled to 30% off subscriptions to the International Journal of Social Psychiatry as part of a reciprocal deal with the British Association For Social Psychiatry.
Details:
Dr. David Kennard
A.T.C. Newsletter editors:
Henderson Hospital,fax: 0181 770 3676
FWarren@sghms.ac.uk Feedback about the WWW/HTML publication to http://www.psyctc.org/cgi-bin/mailto.pl?webmaster