Little miss F goes swimming

Little miss F loves swimming. She also loves talking and running around. For the dada and mama, this can be a bit of a nightmare since as soon as we take her anywhere that has space to move she starts crying “run-a-run-a-round”. But we love her to bits so we mostly let her do what she wants.

The swimming happens for 15 minutes on a Saturday morning and her teacher (Julia aka Doowah) has a good rapport with her. The first time we took miss F there she was quite reluctant to get into the water without L and a little wary of this new person. By the end of the lesson she was wailing “bye bye Doowah, bye bye Doowah” from the changing room as the next little girl was having her lesson.

To say that she actually swims would be stretching the point but she does float nicely on her pool noodle, she does a few kicks, throws the toys into the box and makes a good attempt at ‘monkey walks’. She also keeps up a running commentary on the whole proceedings.

Miss F: Minnie (a penguin) ….. wee-wee (a fish) … duckie … Munny! (her bunny)

Mama: Bunny doesn’t like swimming, you can have him later.

Miss F: Munny! Munny!

Mama: Munny is right here but he doesn’t like water so you will see him later.

Miss F: Leah! Leah! Doowah. Doowah.

Mama: Yes, you’re Leah and that’s Doowah.

Sometimes I fear that she has OCD and that’s why she repeats things so often. But I think she just loves the interaction.

Yesterday I took her to the library (‘run-a-run-around’) and once I’d carried her up the ramp, she was let loose on the books. Her book selection strategy is quite random. She will grab the nearest book off the shelf, drag it to the middle of the floor and plonk herself down. She also confidently walks up to another little girl who is sitting reading quietly and takes one of her books.

“No, Leah, that’s this girl’s book. You have your own book.”

Eventually we made it out of there with The Runaway Dinner , Each Peach Pear Plum , a Quentin Blake and The Bear Under the Stairs as well as The Dance of Anger which is for my anger research.

The biggest treat of the week though will be tonight when she gets to watch some new episodes of Uki, who is her absolute favourite TV character. I’m quite relieved that it’s not one of the Tee-baas (teletubbies) and that these episodes are only five minutes long. Uki is sunny and cheerful, has a best friend who is a bunny and loves reading. She’s also smart as any bee can be and solves problems. A pretty good role model for any little girl. Instead of dialogue or voice-over they have a pretty clever musical accompaniment and this is sanity-preserving for any parent.

Most evenings when I get home miss F will greet me with a happy “Udi! Udi!”

Dada: Do you want to watch some Uki?

Miss F: Alright, Alright.

For and against psychoanalysis

Freud’s couch

One of the biggest debates in psychology is that between the psychodynamic school of thought and the cognitive behavioural school. I remember as an undergraduate participating in just such a debate and arguing for the CBT side. Unfortunately the other debater on my side didn’t consult with me beforehand and used her speech to attack Freud for all the reasons that people usually criticize him. She said he was sex-obsessed and addicted to cocaine. I was trying to put forward a more nuanced position, that while the psychodynamic school has a lot to offer, the CBT proponents are more relevant and focused on the present rather than the past. It was not that I strongly believed in this position but I was interested to debate the merits of both forms of psychotherapy.

Which brings me to the 44th Maudsley debate held quite recently at University College London. Peter Fonagy and Allessandra Lemma were in favour of the motion that “psychoanalysis has a valuable place in modern mental health services” while Paul Salkovskis and Lewis Wolpert were against.

Here’s the summary from the University College London website:

The debate opened with a striking majority in favour of psychoanalysis with 251 pro the motion, 36 abstainers and 44 against.

Prof. Peter Fonagy reviewed the evidence base for psychotherapies, noting that psychodynamic therapies fared no worse than CBT. He emphasised the convergence of psychodynamic and neuroscientific accounts of development.

Opposing the motion, Prof. Paul Salkovskis likened psychoanalytic schools to cults, criticised the absence of a symptom-based approach and some of the theories underpinning psychoanalysis.

Prof. Alessandra Lemma drew on her experience in psychoanalysis and CBT to argue for an eclectic approach, but argued that psychoanalysis provides an unrivalled framework for understanding interactional processes.

Prof Lewis Wolpert shared his personal negative experience with psychoanalysis when suffering from severe depression, and described it as a pseudoscience with no evidence to back it up. He also accused his opponents of conflating psychodynamic therapies with psychoanalysis.

It closed with 260 in favour of the motion, 33 abstainers and 38 against.

Listening to a podcast of the debate, I was struck initially by how the two sides seemed to be debating different things. Fonagy and Lemma argued for the value of psychodynamic psychotherapies while Salkovskis and Wolpert focused their attack on the practice of psychoanalysis itself.

As a psychologist with several years of experience I realized that I was still not entirely sure what psychoanalysis is and how it differs from psychodynamic psychotherapy. I had an idea that psychoanalysis involves four sessions a week on the couch with a trained analyst and that this goes on for a few years. Psychodynamic therapy by contrast usually involves once or twice weekly sessions and the client and therapist sit facing each other in comfortable chairs. I’ve always thought that this was a better way of doing therapy than lying down with the psychotherapist sitting behind you. Just because Freud practiced in this way doesn’t mean that this is the way that therapy should be done. Analysis also seemed to me to be a much harsher and less friendly way of doing therapy since there is less interaction and the analyst is not encouraged to bring their subjectivity to the therapy. Of course this is all just what I’ve read or heard and so I was hoping to be a bit more enlightened by this debate.

Well no. As I said, Fonagy and Lemma argued, very convincingly I thought, that psychodynamic therapy has a valuable role in modern mental health services while the other two raised some valuable points about the problems with classic psychoanalysis. In the general discussion that followed, members of the audience commented that they would like to see a greater dialogue between psychodynamic therapies and CBT. I’m aware of two examples of how both sides have incorporated methods and insights from the other. Psychodynamic therapists do challenge irrational beliefs and thoughts while CBT therapists at times try and uncover deep-seated (or unconscious) beliefs about the self (called schemas).

I was disappointed that Fonagy and Lemma didn’t address the perceived shortcomings of the practice of psychoanalysis itself but I can also see why they would consciously choose not to. At a time when the NHS is cutting back on psychodynamic psychotherapies (and other therapies), it would be foolish to provide any ammunition for this. But I suspect that many psychodynamically-oriented psychologists are slightly suspicious of the apparently elite psychoanalytic guilds. Within the psychodynamic school, those who can claim to be analysts are afforded greater respect (it seems) and sometimes appear to speak with more authority.

Moving to the broader issue of psychoanalysis as a body of knowledge and a theory of human motivation, behaviour and personality development, this has been invaluable in many disciplines and not just psychotherapy. As Lemma put it, psychoanalysis offers us a way of understanding personal interactions which is unrivalled by any other theory.

But I still find it rather intimidating to be confronted with the weight of psychoanalytic thought. Just researching this post, for example, I found an essay on Lacan and realised that I know almost nothing about him. Perhaps I need to do a “Lacan for beginners” post in order to educate myself.

But I’m also interested in broader debates around psychoanalysis and psychodynamic therapies and interventions. In South Africa we don’t even have a national health system and so psychotherapy is often out of reach of the majority of the population. There are also issues of elitism when we compare clinical psychology, counselling psychology, community psychology and social work. I certainly see the value of a clinical training and one that encompasses psychodynamic training. But even that is no guarantee that the therapy will be a good one.

I certainly came away from the debate with my belief in an eclectic approach intact. The only trouble with this is that an eclectic approach can be rather unfocused. But if being eclectic means being flexible enough to respond to the needs of our clients, then I’m all for it.

Friday bullets

• It’s been a not-so-great week here since one of our staff at school died in a motorbike accident last Friday. I didn’t know him well since he worked in the IT department but I would chat to him occasionally at lunch or when he came to fix one of the computers. He was a great guy and we’ve all been in shock about this. One of my colleagues commented about how short life is and how we need to treasure the time that we have. He was only 21 years old, lived at home with his parents and was actively involved in his church’s youth group. The accident happened in the road outside the house where we used to live and so I know that stretch of road very well. Apparently he and another motor cyclist were travelling quite fast in quite poor visibility and a car came out of nowhere in the morning rush-hour and took them both out. A terrible loss.

• This weekend L and I and little L are heading off to Hermanus with L’s parents. Should be a good break. We will actually be able to go out for dinner (just the two of us). That is if we can stay awake!

• Reading-wise, I finished Mrs Dalloway a while back but find myself quite incapable of reviewing it. I did enjoy it in parts but also struggled with the style of it. I think my expectations were shaped by the movie The Hours and so perhaps I had unrealistic expectations. I definitely enjoyed To the Lighthouse more than Mrs Dalloway. But I do wonder if I didn’t miss something here. Don’t people rave about this book?

• I’m listening to an audiobook on my Kindle (Rachel Drask’s A Girl Walks into a Bar). It’s funny and engaging and very light.

• Quite a nice change from my research at the moment which is “Anger Management”. I was encouraged to suggest a topic I can address during one of our Staff Development sessions and so I volunteered this since I have quite a lot of research on it. Interesting definitely but quite difficult and my brain is not used to research.

• I’ll probably post something on this in the weeks to come. In the meantime, bags to pack and girls to round up. Looks sunny here and pleasantly warm for a change.