DPL5

DPL5

DPL5-1 – LD History

Learning Disabilities ܹ
Traditional Approaches and History

DDP71 ܹ Developmental Theories of Distress Session 1

  • The Nature of Learning Disabilities
    –  Definition
    –  Causes
  • Classifications
  • History of learning disability
  • Impact when thinking about a disability psychotherapy approach
  • Required Self Directed Learning (SDL)

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DPL5-10 – Case Studies

2 Case Studies

DDP71 Lecture 10

Overview of Session:

  • To provide more in-depth case studies to help consolidate learning in issues covered so far in DDP71 and 72
  • Individual Therapy case and working through staff teams.

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DPL5-11 – Learning Disability

DDP71 Lecture 11

To Cover:

  • Already covered background information about LDin previous sessions
  • This session about clinical issues and contexts in LD
    – Cognitive impact of LD
    – Mental illness
    – Challenging behaviour
    – Offending behaviour
    – Sexual abuse

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DPL5-12 – Physical Disability

DDP71 Lecture 12

To Cover:

  • Definitions
  • Psycho – emotional impact of disability
  • Experience of oppression
  • Fears and fantasies around disability
  • Role of psychotherapy

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DPL5-13 – Acquired Brain Injury

DDP71 Lecture 13

To Cover:

  • Overview of types of brain injury
  • Impact of brain injury
  • Cognitive and emotional impact

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DPL5-14 – Mental illness & PD

Mental Illness and Personality Disorder

DDP71 Lecture 14

INTRODUCTION:

  • Mental Health problems (Mental Illness)
    – Short term mental health problems can be dealt with in primary care
    – Chronic, enduring disabling conditions that can be life long are our consideration
  • Personality disorder
    – Impaired personality development due to early experiences leading to emotional disability
    – Is a chronic disabling condition
    – Historically seen as untreatable

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DPL5-15 – Age Related Disability

DDP71 Lecture 15

INTRODUCTION:

  • Overview of issues of aging
  • Pertinent issues for psychotherapy approach
  • Dementia
    – Information about
    – Psychotherapeutic thinking

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DPL5-16 – Freud – The contribution of psychoanalysis to understanding the impact of the inner world

DDP72 Lecture 1

INTRODUCTION:

Sigmund Freud (1856—1939) – Taken fromhttp://www.iep.utm.edu/freud

Sigmund Freud, physiologist, medical doctor, psychologist and father of psychoanalysis, was an influential thinker of the twentieth century. Working initially in close collaboration with Joseph Breuer, Freud elaborated the theory that the mind is a complex energy-system, the structural investigation of which is proper province of psychology. He articulated and refined the concepts of the unconscious, of infantile sexuality, of repression, and proposed a tripartite account of the mind’s structure, all as part of a radically new conceptual and therapeutic frame of reference for the understanding of human psychological development and the treatment of abnormal mental conditions. Notwithstanding the multiple manifestations of psychoanalysis as it exists today, it can in almost all fundamental respects be traced directly back to Freud’s original work. Further, Freud’s innovative treatment of human actions, dreams, and indeed of cultural artefacts as invariably possessing implicit symbolic significance has proven to be extraordinarily fecund, and has had massive implications for a wide variety of fields, including anthropology, semiotics, and artistic creativity and appreciation in addition to psychology. However, Freud’s most important and frequently re-iterated claim, that with psychoanalysis he had invented a new science of the mind, remains the subject of much critical debate and controversy.

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DPL5-17 – Klein – Understanding the impact of very early development on the development of self

Melanie Klein

DDP72 Lecture 2

INTRODUCTION:

http://mythosandlogos.com/Klein.html

Klein is significant in looking at the earlier stages of development, beginning with birth or before birth.

She made much of the attachment to the breast as a part object of the mother and this has become a mainstay of the theories about splitting.

She described stages of psychological development from the paranoid schizoid, through the depressive to the stage of resolution.

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DPL5-18 – Bowlby – The role of early relationships in facilitating the integration of the whole person

John Bowlby

DDP72 Lecture 3

INTRODUCTION:

http://www.simplypsychology.pwp.
blueyonder.co.uk/bowlby.html

http://en.wikipedia.org/wiki/
John_Bowlby

John Bowlby contributed significantly to the care of children in hospitals. He noticed that hospitalised children go through a process of protest when left, followed by resignation, which was interpreted as acceptance of the fact that they were left. He realised that they were, in fact, despairing, not accepting and he began to look at mourning in children.

From his observations he came to the term “The Secure Base”, the use of which has fallen into common parlance.

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DPL5-19 – Winnicott – Using Winnicott’s ideas in a person centred approach to people with disabilities

Donald Winnicott

DDP72 Lecture 4

INTRODUCTION:

http://changingminds.org/disciplines/
psychoanalysis/theorists/winnicott.htm

Donald Winnicott was working at the same time as Bowlby. They were both paediatricians in their original profession and came to psychotherapy from their study of children.

Winnicott was used by the government during WW2 to do radio broadcasts to help parents to cope with the trauma of the War and separations. He discovered that anxious children do not do well in school.

He is the founder of the term “good-enough mothering” and described in detail what children need in order to develop to their optimum. He was keen to stress that children need to be frustrated in order to learn so he was not in favour of making life perfect for them as this hindered learning. He was vilified at one time for referring to “refrigerator mothers” of autistic children and fell from popularity for some time.

He also raised the issue of the importance of play. He used the squiggle game, where he put a mark on paper for the child to add to, then take turns until a squiggle is produced that can then be talked about and analysed. The joint working on the squiggle was a significant part of its effectiveness.

Winnicott is widely published and his work is becoming more and more recognised in all settings, including secure units and prisons.

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DPL5-2 – Behavioural Phenotypes

DDP71 Theories of Distress Lecture 2

What is a Behavioural Phenotype?

  • A behavior phenotype refers to the behavioral characteristics that are found to occur more frequently than would be expected normally in the presence of a particular syndrome.
  • A syndrome is identified when a cluster of characteristics are found associated with a genetic or chromosomal abnormality.

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DPL5-20 – Mahler – Stage theory of emotional development leading to the integrated self

Margaret Mahler

DDP72 Lecture 5

INTRODUCTION:

Margaret Mahler was researching in the 1970s in America and carried out a substantial study of children from birth to about 5 years old. She wrote a book called “The Psychological Birth of the Human Infant” and within this described behaviours that are observable as the child develops through stages to individuation, which is the point at which the child can be separate with manageable anxiety.

This work has been used extensively by Pat Frankish with people with learning and other disabilities. The stages of development can be observed and, once the stage has been identified, an intervention put in place which will facilitate further development.

External Links:

http://www.margaretmahler.org

http://www.childdevelopmentmedia.com/
margaret-mahler-child-development-pioneer.html

http://books.google.co.uk/books?id=OqVlNN08idQC&dq

The last link here is a full book that is available free on Google Books

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DPL5-21 – Bion – Bion change to – Bion’s contribution to the humanistic approach to relationships

Wilfred Bion

DDP72 Lecture 6

INTRODUCTION:

Bion developed his theories from his work with war veterans.

He was particularly interested in trauma and its consequences for the traumatised person and people working with them.

He did a lot of work on group processes which is covered in the second year of the four year course.

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DPL5-22 – Malan – Using Malan’s triangles to facilitate the understanding of the whole person

David Malan

DDP72 Lecture 7

INTRODUCTION:

David Malan has become the reading of choice for beginning psychotherapists. His book “Individual Psychotherapy” is a clear presentation of therapy, making extensive use of case material. He also provides an excellent description of how to do a good preliminary assessment for therapy.

Malan did not work with disabled people but his theory has useful meanings for all therapeutic work.

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DPL5-23 – Rogers – Applying Rogers theory to the development of the integrated self in people with a disability

Carl Rogers

DDP72 Lecture 8

INTRODUCTION:

Carl Rogers (1902–1987) is the most influential psychologist in American history. His contributions are outstanding in the fields of education, counseling, psychotherapy, peace, and conflict resolution. A founder of humanistic psychology, he has profoundly influenced the world through his empathic presence, his rigorous research, his authorship of sixteen books and more than 200 professional articles. His best known books are: On Becoming a Person, Client Centered Therapy, Freedom to Learn, A way of Being, Carl Rogers on Personal Power, and Becoming Partners: Marriage and Its Alternatives. Two of his books have been published posthumously: The Carl Rogers’ Reader, a collection of his most influential writings, and Carl Rogers’ Dialogues, which features interchanges with such other giants in the field as Paul Tillich, B.F. Skinner, Gregory Bateson, and Rollo May.

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DPL5-24 – Casement – Learning from Disabled People in order to integrate their human experience

Patrick Casement

DDP72 Lecture 9

INTRODUCTION:

Patrick Casement is famous for his book “On Learning from the Patient”. As the title suggests he is advocating for therapists to listen to the people they see and learn from what makes sense to them. His is a humble style and moves away from the adherence to technique that is advocated by some theories. This style, which is more relaxed, works well in the disability field, where it is often necessary to move away from “the rules of engagement”. Disability Therapists may find themselves working outside, in a playroom, over coffee or any other venue. The session may last anything from 5 minutes to an hour. It has to be what the individual can stand. Casement would be supportive of using whatever makes sense to them.

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DPL5-25 – Fairbairn – Translating Object Relations into a humanistic and integrative model for application to a wider group, including people with disabilities

Ronald Fairbairn

DDP72 Lecture 10

INTRODUCTION:

Ronald Fairbairn was working in the same time frame as Winnicott and Bowlby but working with adults as opposed to children. There were a group of analysts who published a range of texts with theories that built on what Freud has said. Fairbairn is chosen as an example of this school of thought and adds to the total picture.

Fairbairn very kindly produced a synopsis of his theory of the Object Relations theory of development. This is a move away from Freud’s idea of the id, ego and super-ego. Fairbairn states that there is only the ego and the libido (no death instinct) and that both are object seeking. The quality of the relationships with objects (other people) therefore determines the development of the personality.

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DPL5-26 – Sinason – The Human Condition and its application to disability

Valerie Sinason

DDP72 Lecture 11

INTRODUCTION:

Valerie Sinason trained as a Child and Adult Psychoanalytic Psychotherapist

Father was pioneer in setting up Village Communities so Valerie grew up in close contact with people with disabilities

Worked at the Tavistock and set up the Mental Handicap Workshop which was/is a multi-disciplinary meeting to discuss and develop ways of working

Worked at St Georges and set up a long-term psychotherapy group for people with LD

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DPL5-27 – Kahr – Looking into the impact of disability on the sexual self

Brett Kahr

DDP72 Lecture 12

INTRODUCTION:

Brett has written extensively on sexuality in his own right and has also edited work by Donald Winnicott. He is an ardent follower of Winnicott. He is a psychoanalyst.

This session will deal with exhibitionism, as it is one of the inappropriate sexual behaviours that occurs frequently in disabled groups (LD and ABI particularly).

Exhibitionism can be conceptualised as a manifestation on mental illness, as a sexual perversion and as a form of criminality. The term generally refers to the showing of the genitals in public. It is, however, obvious that people are exhibitionist in other ways. Brett sees other forms as a defence against invisibility. He also sees that extreme inhibitionism, very evident in today’s society, is a denial of healthy exhibitionism ie the right to be seen and recognised without promoting envy.

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DPL5-28 – De Groef – The European perspective on therapeutic work with people with disabilities

Johann de Groef

DDP72 Lecture 13

INTRODUCTION:

A group of European psychotherapists working with people with learning disabilities held conferences in 1996 and 1997 and published the papers from them in a book called Psychoanalysis and Mental Handicap. These papers summarise the knowledge base and variety of applications at that time.

Maud Mannoni makes the point that difference needs to be celebrated and that we should stop telling people that they have to be “normal”.

Evelyn Heinemann reminds us, based on the work of Frances Tustin, that we can work with people who are autistic and recognise that the “rejecting mother” is not helpful. We need to recognise that autistic people are hypersensitive and that this interferes with their ability to relate. She sees that they have a role in rejecting, or not being able to relate to, the mother and that it is an interaction from the beginning. Providing therapeutic space where the sensitivity can be tolerated and explored enables progress to be made.

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DPL5-29 – Tavistock Group – Review of existing therapeutic work with people with disabilities

Tavistock Group

DDP72 Lecture 14

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DPL5-3 – Social Learning

DDP71 Theories of Distress Lecture 3

TO COVER:

  • Socialisation process
  • Normalisation
    –   Values questionnaire
  • Social Role Valorisation
  • Pro-Social skills
  • Social Skills Groups

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DPL5-30 – IPD – The Institute of Psychotherapy and Disability

DDP72 Lecture 15

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DPL5-31- How to Keep a Reflective Log

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DPL5-4 – Syndromes

Syndromes and Chromosomal Abnormalities

DDP71 Lecture 4

INTRODUCTION:

  • If a person looks different or disabled they will have the insight that they have a condition as other people will treat them differently
  • People often labelled by syndrome either by themselves or others
    –  he’s got autism / he’s got down syndrome’
    –  Stereotypes of expectation affect how people are treated and reacted to
    –  This in turn affects how the person learns to be with others through social learning
  • Important to always remember the human being

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DPL5-5 – DP Overview

Disability Psychotherapy Overview of Ideas

DDP71 Lecture 5

INTRODUCTION:

  • To help consolidate the knowledge gained so far in DDP71 and DDP72
  • This is a presentation called Introduction to Disability Psychotherapy that is given to various staff groups.
  • It covers some of issues covered so far and hopefully will help you to understand how it is all integrated

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DPL5-6 – Joan Bicknell

Joan Bicknell – Effects on the family

DDP71 Lecture 6

INTRODUCTION:

  • Joan Bicknell – Psychiatrist – Early Pioneer in Disability Psychotherapy
    –  Psychopathology of Handicap 1983
    –  Seminal paper of impact on the family of handicap and the compounded impact on the disabled family member
  • Written at time when
    –  people were leaving hospital or not being sent there
    –  family issues were becoming more apparent.
  • This paper was the earliest to identify the issues faced by individuals in families which is absolutely relevant to today
  • Uses terms handicap and disability interchangeably

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DPL5-7 – Social Attitudes

Social Attitudes to Disability

DDP71 Lecture 7

INTRODUCTION:

  • Social attitudes to disability have changed significantly in the last 50 years
  • We have already covered some historical issues to show this and covered some of the dreadful experiences and exclusion disabled people experienced in the past
  • Things have changed because to changes in models of understanding

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DPL5-8 – Pain of Difference

The Pain of Difference – Valerie Sinason

DDP71 Theories of Distress Lecture 8

PAIN OF DIFFERENCE:

  • Term coined by Valerie Sinason in her book Mental Handicap and the Human Condition
  • To coverEmotional pain associated with Difference
    –  How this pain is dealt with on a societal level
    –  How this pain is dealt with by individual

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DPL5-9 – Death Making

Wolf Wolfensberger – Death Making

DDP71 Theories of Distress Lecture 9

Wolfensberger – INTRODUCTION:

  • Was a major driver in Social Role Valorisation (SRV) movement US and Canada
  • Was a prolific writer with over 300 publications
  • Later in career looked at the threats to people with disabilities
  • His arguments and views intensified as time went on and he developed the concept of ‘death making threats’ to vulnerable people
  • His arguments are very powerful and can be difficult to hear and upsetting to contemplate
  • Will be helpful if you are able to discuss or process this further.
  • Writings in this area began in 1980’s from US and Canada – but still very relevant today in our society

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