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Seminars, conferences and online resources on psychotherapy and human relationships
The Affronting Patient
How do we work effectively with patients whose behaviour disturbs us at the level of morals or values?

Saturday 2 November 2013

This event invites experienced clinicians to explore how we can best negotiate strong differences in morals or values which arise between therapist and patient. These may range from the therapist's dislike of a patient's unpleasantly narcissistic attitude to actual crimes against others; from an aversion to their politics to revulsion at overtly abusive behaviour.

When psychotherapeutic treatment is prescribed as a result of a crime then it is clear that the underlying causes of the criminal behaviour will be the main focus of the treatment. But when a patient's more subtle, perceived unethical behaviour or values become a concern in the course of a non-forensic therapy, this confronts the therapist with a thorny cluster of technical and moral issues that are open to personal judgment and social context.

We will be asking how such challenges can be relationally worked-through and where the therapist should position their own values and morals with the patient who is not just a victim but also a perpetrator. How, as good therapists, can we sustain empathy in the face of transgressions that we find objectionable? What pressures do these place on the process? And, ultimately, we will ask whether the goal of therapy is to reform or simply understand. The event includes contributions from practioners of psychiatry, psychotherapy and philosophy.


Dr Clara Mucci

Clara Mucci, PhD is a psychoanalytically-oriented psychotherapist practicing in Milan and Pescara, Italy. She is Full Professor of Clinical Psychology at the University of Chieti, where she taught English Literature and Shakespearean Drama. She received a PhD from Emory University, Atlanta, and was a fellow in 2005-2006 at the Institute of Personality Disorder, New York, directed by Otto Kernberg. The author of several monographies on Shakespeare, Psychoanalysis and Literary Theory, she has taught in London (Westminster College), Atlanta, and New York (Hunter College).

Dr Maggie Turp

Maggie Turp, PhD is a psychodynamic psychotherapist and supervisor in private practice and a chartered psychologist. Her academic career has included lectureships at the University of Reading and at Birkbeck College, London. Since retiring from mainstream academic life, she has been a visiting lecturer at the Tavistock and Portman NHS Trust.

For the past decade, Maggie's educational work has included the provision of CPD training workshops for regionally based associations of counsellors and psychotherapists. These reflect her longstanding interest in the emergence of psychological distress in the physical realm and the enduring nature of early, body-centred modes of relating. The clinical themes addressed in the workshops include self-harm, depression, psychosomatic illness, and the aftermath of trauma. A more recent area of interest concerns integrity and fraudulence as experienced in the consulting room and work in progress includes writing and organising workshops around these themes.

Maggie is a member of the Editorial Boards of the journals 'Psychodynamic Practice' and 'Infant Observation' Her publications include several journal papers and two books, 'Psychosomatic Health: the body and the word' (2001 Palgrave) and 'Hidden Self-Harm: narratives from psychotherapy' (2003 Jessica Kingsley). She welcomes correspondence at

Dr Gwen Adshead

Dr Gwen Adshead has been a Consultant Psychotherapist at Broadmoor Hospital since 1998. She is a practising group psychotherapist and a Member of the Institute of Group Analysis. Dr Adshead has published over 100 papers on Post Traumatic Stress Disorder, Forensic Psychotherapy, and Ethics in Forensic Psychiatry in peer reviewed journals and chapters of books. Her current research interests include moral reasoning in psychopathy and the attachment characteristics of maltreating mothers. She is founder member of the International Association of Forensic Psychotherapy and has been a member of two Royal College of Psychiatry working parties, and three Department of health sub-committees. She was Chairman of the Ethics Committee of the Royal College of Psychiatrists for 5 years. Dr Adshead is registered with the Law Society as an Expert Witness and approved under Section 12 of the Mental Health Act as having special experience in the diagnosis and treatment of mental disorder.

Dr Edward Harcourt

Edward Harcourt, PhD is a lecturer in Philosophy at Oxford University, and has been a Fellow of Keble College since 2005. Before that he was Lecturer and then Senior Lecturer at the University of Kent; Domus Fellow and Tutor in Philosophy at Lady Margaret Hall, Oxford, and held visiting appointments at Berkeley and Leipzig. His research interests include ethics and moral psychology, literature and philosophy, and Wittgenstein. He is a director of Oxford's Mind, Value and Mental Health Summer School in Philosophy and Psychiatry, and a convenor of the 'Meaning and Mindedness: Encounters between Philosophy and Psychoanalysis' seminar series at the Tavistock Clinic.


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Please read our booking conditions before making your booking

Self-funded: £120
Organisationally-funded: £180
CPD Hours

Certificates of Attendance for 6 hours will be provided at the event

5th Floor Lecture Theatre
Tavistock Centre
120 Belsize Lane

Registration: 9.00
Start: 10.00
End: 17.30