A
brief history of the Centre
Origins
The
origins of the Centre go back to 1976 when an organisation
was formed based on the work of Karen Horney and named after
her: the Karen Horney Association of Psychoanalytic Counsellors.
Many influences, intellectual, and personal, have contributed
to the history of CAPP. All organisations change and develop
but some themes have been present consistently. From the outset
the organisation has been located in the psychoanalytic tradition
and yet insisted on a critical freedom in relation to it.
Freud’s
legacy and the centrality of relationships
One
such theme is the rejection of classical drive theory. The
formulation of Freud’s theory of instincts became increasingly
rigid in the middle decades of the last century producing
a dominant conception of individual development and of psychoanalytic
psychotherapy as a process of creating adaptations of disruptive
and dangerous drives.
In
contrast Karen Horney and others, including Erich Fromm, Adolph
Mayer, James S. Plant, Henry Stack Sullivan and Clara Thompson
in the US and Ronald Fairbairn, Donald Winnicott, Marjorie
Brierley, and John Bowlby in the UK were developing an understanding
of human development based on the centrality of human relationships
in their specific cultural contexts.
Much
of Sigmund Freud’s work remains central. His work on
the unconscious world, mourning, trauma, and the compulsion
to repeat is fundamental. His use of free association, his
development of working with transference and counter- transference,
and his understanding of the meanings that might be drawn
from symptoms and from dreams are essential to psychotherapeutic
practice. His broadening of the conceptualisation of erotic
life continues to provide vital insights into relationships
and identities. Karen Horney was a pioneer in challenging
patriarchal ideals and the devaluing of the female experience.
Her feminist perspective presented a radical challenge to
established cultural assumptions in the psychoanalytic world.
Trauma
and abuse
The
early years of the Karen Horney Association in the late seventies
and early eighties coincided with a growing social awareness
of the scale of the problem of child sexual abuse. Alice Miller’s
prolific and highly accessible early writing broadened the
understanding of child abuse to include emotional as well
as physical abuse. Often the most profound aspect of all abuse
is that the child is abandoned and left alone at times of
great suffering and despair. Alice Miller proposed that having
contacted the hurt child within the adult, the therapist aims
to be an advocate for that person and encourages the process
of mourning to enable healing to take place.
The
idea of being an advocate for the child within struck a chord
with Karen Horney’s idea of psychoanalysis as an assisted
self-analysis - ideas also developed by Theodore Reik. In
1989 the organisation was reformed as the Institute of Self-Analysis
and the training was launched. For a time therapists were
referred to as advocates. The idea is of great value in the
respect it shows towards the individual coming into therapy
and in the sense that the nurturing of the emergent self of
the client is the task of psychotherapy.
On
the other hand the idea of the emergent self has its problems.
Karen Horney herself had described how the client and the
therapist might understand things very differently.
“Although
both may talk in terms of evolution, growth, development,
they mean entirely different things. The analyst has in mind
the growth of the real self; the patient can only think of
perfecting his ideal self” (Neurosis and Human Growth,
1950). This demands a deeper understanding of how individuals
are formed in relationship and how that can be explored in
later life. This required a revisiting of psychoanalytic ideas
on the transference and the counter-transference, on the negative
transference and the erotic transference. It also required
rethinking ideas about the formation of the self and the de-centred
self.
Valuing
difference and diversity
The
importance of valuing difference and diversity has been a
strong theme in CAPP throughout its development. There is
strong concern about the social and political dimensions of
exclusion and prejudice. As well as the feminist perspectives
on gender outlined above, issues in relation to race, culture,
class and disability are part of this.
Attachment
theory
It
was in this context that the link was made with John Bowlby
and the Institute for Self-Analysis. This evolved into the
Centre for Attachment-based Psychoanalytic Psychotherapy.
The dominant themes: rejection of classical drive theory,
emphasis on the importance of environmental factors –
particularly relationships, the crucial place of mourning,
the link between attachment, security and exploration, all
contributed to the development of the still emerging organisation
into an attachment-based psychoanalytic psychotherapy centre.
Although
attachment theory is now becoming very widely accepted, for
many years it was rejected by the dominant stream of British
psychoanalysis strongly influenced by Melanie Klein. Klein
had by degrees reworked drive theory from the classical model
and had like, Karen Horney, mounted an important challenge
to the phallocentric bias in Freud’s theorising. Bowlby
trained with her and followed her in focussing on the earliest
years of life and the relationship with mother. He separated
from her over the absolute importance she attached to the
inner world.
Attachment theory is a response to the need to develop new
approaches to the relationship between the psychological and
the biological. It addresses this in a limited and pragmatic
way, inviting further exploration. This approach fits much
more
readily to the state of scientific development in this field.
Neuro-psychobiological study of the brain and the understanding
of the interaction of neural development with psychological
development are rapidly evolving. This is an exciting area
of controversy and investigation.
Multiple
points of view
The
new approach emphasises the importance of studying the same
phenomena from many points of view. The claim of the clinical
encounter to be a method of scientific enquiry can only be
sustained if there is a willingness to relate the data gathered
and the theoretical perspectives proposed to other forms of
enquiry. Bowlby was most concerned to make links with academic
research and ethology.
Attachment
researchers established two crucial methods linking psychoanalytic
theorising and psychological research. Mary Ainsworth developed
the Strange Situation Test as a method of study of the attachment
patterns of early life. Mary Main developed the Adult Attachment
Interview as a method of enquiry into the attachment patterns
of adults. Another vital contribution has come from observational
studies of infants. The training offered by CAPP incorporates
infant observation studies based primarily on the work of
Margaret Mahler and Daniel Stern.
The
Internal World
Bowlby
was concerned about the need for care in theorising in the
internal world. Towards the end of the volume on Attachment
(the first of the trilogy Attachment, Separation and Loss)
he referred to these “profound questions” and
the “giant controversies” and recognised how much
research is still needed (Bowlby, 1969).
CAPP
has drawn on a wide range of approaches including the British
object relations school, the American interpersonalist school,
theories on the development of the self, and contemporary
work on trauma and dissociation to provide a breadth and depth
of insight into the structure and dynamics of the internal
world. The common themes that run through them all are the
importance of unconscious communication, of the transference
and the counter-transference, of containment and the acceptance
of difference, and an emphasis on two person psychology.
The
development of our theoretical base is a dynamic and continuing
process. The Centre will continue to adapt and develop in
the light of new research, contemporary developments and clinical
experience.
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