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This is a multi-authored book on the complex subject of psychic trauma as encountered at different stages of the life-cycle, and describes some of the clinical challenges, technical issues and differing theoretical approaches that arise when working with the traumatized individual.The concept of psychic trauma is a complex subject, but one which has more recently gained prominence. This book contains a collection of papers which grew out of a series of talks given by the Psychoanalytic Forum of the British Psychoanalytical Society entitled Trauma Through the Life Cycle. The authors, all highly respected authorities in their fields, give insights into what we mean by psychic trauma, what constitutes a traumatic event, and the psychopathological sequelae to trauma at different stages of life. Judith Trowell and Nick Midgley look at the effects of infantile and childhood traumas. Catalina Bronstein and Sara Flanders, from differing psychoanalytic perspectives consider how childhood traumas can become reactivated in adolescence and colour subsequent developmental situations. Ron Britton and Joanne Stubley consider the effects of trauma on time and memory, the concept of Nachtralichkeit, and Britton makes the distinction between endogenous and exogenous aspects of trauma. Arturo Varchevker and Isky Gordon consider what factors may be intrinsically traumatic for the person reaching old age, illness or death. Francis Grier considers a more recently acknowledged source of trauma, which is the hidden nature of the cumulative trauma of the child who is sent away early to boarding school and its effects on the developing adult's capacity for intimate couple relationships. Finally, Michael Brierley and Nicholas Stargardt both write convincingly on societal traumas, Brierley on the social and cultural traumas endured by the native American Indian tribe, the Crow, and how individual experiences resonated with group experiences, and the historian, Stargardt on his ground-breaking work on the experiences of German children during the Second World War.

This special edition of Psychoanalytic Psychotherapy draws on three public events organized by the Psychoanalytic Forum of the British Psychoanalytic Society on the topic of Totalitarian States of ...

SUMMARY This paper addresses the difficulties which surround the economic analysis of psychoanalytic psychotherapy. Economic evaluations have as their explicit aim the allocation of scarce resources. The methodology of economic research remains crude, with little consensus over what constitutes costs and benefits, and how they can be measured in the field of mental health. The value of psychotherapy may be undermined by narrow economic considerations, for both defensive and destructive purposes, and we need to differentiate between these differing attitudes. Using one of Auden's poems, ‘Numbers and Faces’, the paper addresses how economic analysis takes a perspective on psychotherapy that focuses more on ‘numbers’, as opposed to process research that more sticks to ‘faces’. The detrimental effects of adopting a belief in numbers is discussed. Two clinical vignettes highlight the limited application of economic evaluation to the clinical setting. The Kingdom of Number is all boundaries Which may be beautif...

This paper describes a supervision group for senior house officers which focused on the psychodynamics of their working relationships with patients. The SHOs worked in a variety of hospital specialties as well as general practice. The description includes details of how such a group was set up and some of the practical difficulties in maintaining the SHOs' attendance. Brief details are given of the types of cases the SHOs were most eager to discuss, and the nature of the leading anxieties connected with the cases. The SHOs found this type of supervision supportive and enlightening as they developed and improved their clinical skills.

“Are you going? Well, I'll go, if you go.” I had not attended our 10th anniversary reunion. But our 20th reunion found me beating a path to Peebles Hydro for a gathering of the Glasgow Zeta '76 Club. Here are a few words for the unwary. Attenders at such reunions are a self selected bunch, and you need to feel that you have achieved some success in at least one major area to brave the self inflicted ordeal. Success can come in many forms–for example, marital status (can you beat the four times married?); number of children (prize given to a happy paediatrician with six children); career status (you …

In a series of 271 transplantations of renal allografts, performed over 10 years, the rates of graft survival, patient survival, and morbidity in the recipients of allografts from living related donors (47 allografts) have been compared with those in the recipients of cadaveric allografts (224 allografts). The one-year graft survival rates were 88% for allografts from living related donors (100%, if these were HLA-identical) and 55% for cadaveric allografts, while the patient survival rates were 97% and 87%, respectively, in the same period. Morbidity rates (expressed as the number of days spent in hospital) for recipients of allografts from living related donors were approximately 50% of those for recipients of cadaveric grafts. Complications in the living related donors were minimal, and acceptable. It is concluded that transplantation of allografts from living related donors has many advantages over transplantation of cadaveric kidneys, and is a valuable adjunct to a cadaveric renal transplantation programme. Greater use of living related kidney donors should be encouraged in Australia.