The Freud Museum

Events Archive

20 March 2016
9.30am - 5.00pm

CONFERENCE: Psychosis and Psychoanalysis

History - Politics - Theory - Technique

The relation between psychosis and psychoanalysis is a paradoxical one. Psychosis is a core term in the theory of psychoanalysis, a site of clinical challenges and radical questioning. Yet it has no place in classic psychoanalytic technique.

Is there a place for psychosis in psychoanalysis? Is there a place for psychoanalysis in psychosis?

This one-day conference brings together eminent practitioners of psychoanalysis from a variety of theoretical perspectives to discuss these complex and topical questions. Drawing on their important contributions to the area of psychosis, the speakers will reflect on the political, theoretical and technical implications of their work.


08.45 - 09.30: Registration and Coffee

09.30: HISTORY
Haya Oakley: Life in the “Anti-Psychiatry” Fast Lane
Brian Martindale: Family and Psychosis (Past & Present)
Chair: Dorothée Bonnigal-Katz

11.00: Coffee break

Jay Watts: Navigating Language Games around Psychosis
Barry Watt: The Politics of Kleinian Technique in Post-war UK
Chair: Anne Cooke

13.00: Lunch break

14.00: THEORY
Kate Brown: Attachment Theory and Psychosis
Stijn VanheuleConceptualising and Treating Psychosis: A Lacanian Perspective
Chair: Peter Nevins

15.45: Coffee break

Clinical Rountable:
Dorothée Bonnigal-Katz (Presenter)
Christos Tombras and Tomasz Fortuna (Respondents)
Moderator: Gwion Jones

17.30: End


Kate Brown: Attachment Theory and Psychosis
This presentation locates understanding of psychosis from an attachment perspective within its historical context, present concerns about the treatment of the mentally ill and explores how attachment theory can inform future understanding of the mentally ill. Disorganised attachment is argued to be intimately linked with psychosis despite Bowlby’s early modesty about how attachment theory could inform our understanding of psychosis. Attachment theory’s stress on the importance of grief, separation, trauma and violence are highlighted as causal factors in the aetiology of mental illness, and important issues to address as part of the healing or recovery. The experience of psychosis are conceptualised within their relational and social context, and therapeutic relationships and social change are proposed as being the treatments of choice.

Haya Oakley: Life in the "Anti-Psychiatry" Fast Lane
David Cooper’s book Psychiatry and anti-psychiatry (1967) was the inspiration for the label applied to what appeared as an international movement within psychiatry. Its reluctant members included the likes of Basaglia, Cooper, Deleuze, Esterson, Fanon, Foucault, Guattari, Laing and Szasz. The divergent, often contradicting ideas expressed in their writings included Michel Foucault’s view that the unchaining of the insane in 1794 did not deal with the question of ‘reason’ and ‘madness’ but fostered a conspiracy of silence in the Western world ‘…which confines insanity within mental illness’ (Madness and Civilization xiv 1967). Thomas Szasz believed mental illness to be a myth created by society; Cooper, the most radical of them all, believed that the family was an instrument of oppression perpetrating the greatest psychological violence on its members. As for Laing, he believed that if one studied the specific forms of communication – conscious and unconscious – within families of schizophrenics, one could, under favourable circumstances, make madness intelligible and therefore amenable to some form of psychotherapy. This short presentation will offer an insider’s account of life in the Philadelphia Association during the late 1960’s-1990’s where some of the ideas of the time were put into practice. It will highlight the evolving understanding, within the members of this group, of psychosis and the relationship of psychosis to psychoanalysis as a theory, a practice and a cultural term of reference. It will wonder, eventually, whether this was a misguided blip in the history of psychiatry or a revolutionary shake-up of a system which has left a worthy and lasting legacy.

Brian Martindale: Family, Psychoanalysis and Psychosis (Past & Present)
The problem of blame has long been such a ‘hot’ topic with respect to families where there is psychosis that it has seemed often impossible for members of any discipline to want to make contact with / touch families where there is psychosis. Families are now complaining vigorously about this lack of contact. Historically, psychoanalysis has got caught up in these issues. In my talk I will outline some aspects of the history of psychoanalysis in the family that I think contributes to an understanding of the present neglect of families where there is psychosis and of the unfortunate consequences. Time allowing I will offer clinical vignettes.

Stijn Vanheule: Conceptualising and Treating Psychosis: A Lacanian Perspective
Starting from the hypothesis that psychosis makes up a structure, with a precise status for the unconscious, Stijn Vanheule explores how, from a Lacanian point of view, the treatment of psychosis is organized. Special attention is paid to the specificity of the psychotic symptom, or elementary phenomenon, and to the way transference characteristically takes shape. Crucial to this approach of treatment is that the psychoanalyst aims at restoring a place for the subject in relation to the Other, which is threatened in episodes of acute psychosis.

Barry Watt: The Politics of Kleinian Technique in Post-war UK
In the period following the end of the second world war in Britain, Kleinian psychoanalysis rapidly established itself as an influential paradigm for the treatment and understanding of the psychoses, within both psychoanalytical and medically minded psychiatric circles. Medically qualified psychoanalysts such as Hanna Segal, Herbert Rosenfeld and Wilfred Bion all made seminal contributions and the institutional approval and establishment ratification of their work, continues to be strongly felt to this day. In this paper, we will take up some arguments from the Canadian philosopher of science Ian Hacking, in order to look again at the tightly prescribed clinical techniques of Kleinian psychoanalysis of the period, especially in terms of the relationship between the social conditions of their analytic frame and the kind of theory of the psychoses this frames enables. In the twenty-first century, as we continue to battle to understand and provide effective treatments for those experiencing severe emotional distress, this paper hopes to remind us of the sensitive connection between the way in which we build theories of the mind out of the way we work with our patients and, in turn, the effect these theories have on those who seek our help.

Jay Watts: Navigating Language Games around Psychosis
If someone is hearing voices, or in acute distress, language can have an extra significance. Words can feel like a direct violation of the body, or devoid of all meaning. Language can hide early history in a protective fashion, making it easy for psychiatry to dismiss psychotic experience as meaningless. Psychoanalytic practitioners have thought deeply about the role of language within the consulting room, yet our contribution to current thinking around psychosis is minimal. Though this is partly due to a neoliberal stress on ‘quicker, faster, and cheaper’ techniques, it is also due to our reluctance to engage with wider discourse around psychosis, and to adapt our technique for patients so persecuted by language that our approach comes across as threatening. I will present details of a case where navigating language around psychosis and the consulting room was at least as important as face-to-face work. I will argue that we must work actively to unknot certain ideas around psychosis which float around the consulting room, and in society more generally. In doing this, we may help produce more space for symptoms and the unconscious to speak, the core function surely of our work.


Dorothée Bonnigal-Katz
is a psychoanalyst and a translator. She is a member of the SITE for Contemporary Psychoanalysis and one of the editors of Sitegeist: A Journal of Psychoanalysis and Philosophy. She is the founder of the Psychosis Therapy Project. She has translated a number of psychoanalytic works including Dominique Scarfone’s Laplanche: An Introduction (2015) and she translates for the International Journal of Psychoanalysis on a regular basis.

Kate Brown
is a Bowlby Centre trained UKCP registered attachment based psychoanalytic psychotherapist who started her career in therapeutic communities working with adults with a variety of mental health difficulties, and with adolescents individually and in groups. She has worked with young mothers and in mainstream community psychiatric services with patients’ families. She has also provided time limited therapy with former servicemen who had experienced complex trauma. She teaches at The Bowlby Centre and has also delivered freelance training. Kate completed an MSc in psychotherapeutic approaches in mental health in 2012. She is a member of the Attachment Journal editorial group, former chair of the clinical forum at The Bowlby Centre. Kate has recently begun a PhD in the psychoanalysis department at Middlesex University in the history of the therapeutic community movement and the treatment of trauma. Kate has recently moved to Bournemouth where she will be developing a private practice.

Dr Tomasz Fortuna trained as a psychoanalyst at the Institute of Psychoanalysis in London. He is a member of the British Psychoanalytical Society, Hanna Segal Institute for Psychoanalytic Studies and the scientific committees of both organisations. He has worked as a psychiatrist in the NHS for over ten years and currently, he works at the Portman Clinic, Newham Adolescent Mental Health Team and is in private psychoanalytic practice. His professional interests include the relationship between psychoanalysis and the arts and the understanding of severe emotional disturbance. He published an essay Tension at the Border, Emotional Freedom and Creative Process and is a guest-editor of Empedocles: European Journal for the Philosophy of Communication

Dr Brian Martindale is a psychoanalyst and psychiatrist. He was founder (with colleagues) of the EFPP, the European Federation of Psychoanalytic Psychotherapy in the Public Sector, its first chairperson and is now Honorary President. He was chair of the ISPS, International Society for the Psychological and Social Approaches to Psychosis from 2010-2015 and past editor of the ISPS book series. He is now an Honorary Lifetime Member. He represented psychiatry for Western Europe to the World Psychiatric Association (WPA) for six years. After many years as a Consultant Psychiatrist in Psychotherapy, he worked in a NHS early intervention in psychosis service for 7 years before retiring in 2012 and now works in private practice outside Newcastle.

Haya Oakley has been practising psychoanalysis in London since 1968. After a brief spell at the David Cooper 'anti-university' group she joined the Philadelphia Association where she worked for many years with R.D. Laing and colleagues training psychotherapists and working in 'therapeutic households'. In 1997 she left the Philadelphia Association and set up, with others The Site for Contemporary Psychoanalysis. She has been a member of the Guild of Psychotherapists since 1982 and is a founder member of The College of Psychoanalysis UK. Honorary Fellow of UKCP. Haya’s interests include the politics of psychotherapeutic organisations, the issues surrounding State regulation of the 'impossible profession', the comparative study of psychoanalytic theories and the question of psychosis. Haya is involved in teaching, supervising and analysing and has contributed to a number of publications as well as TV and radio programmes.

Christos Tombras trained as a psychoanalyst with the Centre for Freudian Analysis and Research. He is a member of CFAR and of the College of Psychoanalysts - UK, and has his private practice in North West London. His research interests include the relationships between psychoanalysis and continental philosophy.

Stijn Vanheule is professor of psychoanalysis and chair of the Department of Psychoanalysis and Clinical Consulting at Ghent University (Belgium), and a psychoanalyst in private practice (member of the New Lacanian School for Psychoanalysis and World Association of Psychoanalyse). He is the author of The Subject of Psychosis – A Lacanian Perspective (Palgrave Macmillan, 2011) and Diagnosis and the DSM – A Critical Review (Palgrave Macmillan, 2014), and of multiple papers on Lacanian and Freudian psychoanalysis, psychoanalytic research into psychopathology, and clinical psychodiagnostics.

Barry Watt is a psychoanalyst in private practice and a member of the SITE for Contemporary Psychoanalysis. He is one of the senior practitioners at the Psychosis Therapy Project as well as a housing advocate and community activist.

Dr Jay Watts is a Clinical Psychologist and Psychotherapist working from Systemic and Lacanian orientations. She is Honorary Senior Research Fellow at Queen Mary, University of London, as well as being in full time private practice. Jay has held a number of senior academic and NHS posts, including leading Early Intervention in Psychosis and Integrative Psychotherapy Teams, heading research for a NHS trust, and developing teaching modules as Senior Lecturer in Counselling Psychology at City University. Jay continues to teach on a number of Clinical and Counselling Psychology trainings, and has published widely. She is Practice Editor for the European Journal for Counselling and Psychotherapy, and is Foreign Correspondent for ‘Mad in America’.

Venue Details
South Hampstead High School
3 Maresfield Gardens

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