Working with planned and unplanned breaks in clinical work
EVENT POSTPONED
Saturday 01 July 2023
A live webinar or In Person event with Charles Brown, Linda Cundy, and Prof Joy Schaverien
CPD Credits: 3.5 hours
- Includes a subtitled recording of the event and a transcript, with access for a year (14 days post the event)
- Bookings close at 9:00am BST Wednesday 28 June
This conference will explore the roles and meanings of planned and unplanned breaks in therapy, how they may be experienced by client and therapist, and their impact on the therapeutic process.
READ MORE...From traditional five-times weekly psychoanalysis through to the more common weekly sessions, fortnightly or ad hoc appointments, the time between therapeutic contact creates structure, rhythm and space.
Pauses are an inevitable feature of therapeutic work, but it is important to reflect on how they are experienced by the client, many of whom may feel rejected or abandoned due to their relational history. A change of rhythm to the therapy can give us access to the client’s internal worlds and attachment patterns.
Planned breaks such as the therapist’s holidays, sabbaticals, and parental leave provide opportunities for clients to fantasise about, and project onto the therapist; many will fall back on schizoid defences and some may protest at the separation. We will include a session on the boarding school client who may be particularly sensitive to breaks as a repetition of the comings and goings of breaks in term time as a child or show no response at all.
Unplanned breaks on the part of therapist may cause a rupture in the therapeutic alliance and raise questions around therapist self-disclosure regarding how to explain an unexpected absence and repair a therapeutic alliance. Unplanned breaks by the client may leave a therapist confused about how to follow-up if non-attendance persists, which is important to unpack and process in supervision.
With many practitioners now working partly or exclusively online, we will also consider how routine breaks and unexpected ruptures are experienced by clients and by practitioners when therapy is conducted ‘remotely’. We will explore the micro-breaks, disruptions and breakdowns that are often a feature of online therapy, which can provide important material for reflection.
The importance of taking breaks for the therapist’s self-care, as part of our duty of care to our clients, will also be considered.
FULL PROGRAMME
13.30 BST
Registration and Coffee (attending in person only)
14.00
Introductions
14:10
Linda Cundy
The spaces in between: from separation anxiety to security
How clients respond to breaks in therapy encapsulates their core pattern of attachment and defenses against separation. While some patients welcome time out, perhaps introducing extra breaks by missing sessions, others protest or collapse in the absence of the therapist. Unexpected breaks due to therapists’ life events are particularly challenging and sometimes catastrophic. But, while the regularity and rhythms of therapy help to create a secure base, the spaces between appointments are essential, holding different meanings at different stages of the work. Drawing on both Attachment Theory and the work of Winnicott, this presentation also considers the aim of psychotherapy and how breaks, including the therapist’s holidays and sabbaticals, provide essential developmental opportunities.
Learning objectives
- Identify clients’ core pattern of attachment through reactions to gaps between sessions and the therapist’s holidays.
- Evaluate how to help clients manage their anxieties during breaks, taking into consideration their core pattern of attachment.
- Explain why breaks apart from the therapist contribute to the development of secure attachment.
15.00
Q&A with Linda Cundy
15.15
Break
15:35
Charles Brown
Breaks in online ‘remote’ therapy: Avoidance, intimacy and loss
This presentation explores some of the challenges regarding the experience of breaks, comparing screen-mediated practice to traditional in-person therapy. Referring to Freud’s seminal paper, Mourning and Melancholia, the presenter considers both macro breaks such as gaps between sessions, holidays and due to illness as well as micro disruptions and moments of disconnection in online ‘remote’ therapy. Charles will explore the more profound, unconscious ways in which clients and therapists respond to the experience of loss as it emerges through breaks in therapy.
Learning objectives
- Evaluate the impact of technology on the therapeutic relationship and breaks.
- Examine how to provide a psychic space for thinking for processing challenges.
16.20
Q&A with Charles Brown
16.35
Break
17:00
Prof Joy Schaverien
Breaks and the Repetition of Trauma. A Hidden Aspect of Boarding School Syndrome
Why is it that some adults, who attended boarding school as small children, may seem impervious to breaks in analysis? Abandoned, Bereaved and Captive, children in boarding school learn to Dissociate. This is the ABCD of Boarding School Syndrome. This is not a single psychological wound but a series of traumas that is repeated every term time and every holiday break. The pain of these broken attachments is such that, unconsciously, children learn not to be aware of their own suffering; they cut off from feeling. Many people are traumatised in childhood; and abandonment, separation anxiety and abuse are not exclusive to ex-boarders. But it is the repetition of these losses that makes ex-boarders particularly sensitive (or insensitive) to breaks in the frame.
Learning objectives
- Identify the suffering and ruptured attachments caused by boarding away from home; this includes children in other situations such as residential care
- Analyse breaks in analysis and how those traumatised by early boarding may react, or apparently not react
- Assess how the therapist may need to attune to the client but be more active than in other analytic situations.
17.45
Q&A with Prof Joy Schaverien
18.00
Panel session with all speakers
18.30
End