Books published by Karnac Books

Using the Kleinian concept of projective-identification, with special reference to intrusive identification with internal objects, this work examines claustrophobic phenomena and its relations to the treatment of borderline and adolescent patients.

This book attempts to do justice to the depth and complexity of depression - as to its causes and its treatment in psychotherapy. It challenges the reductive medical view of depression as a serotonin deficiency resulting in a collection of undesirable symptoms to be dispatched with antidepressants or CBT exercises. Rather, it locates the origins of depression in childhood adversity, primarily caused by unattuned, cold, critical, hostile or abusive caregiving. Insecure attachment interacts with other elements of a stressful life history as well as with genetic makeup to pave the way for depression. Such a childhood has long-term impacts on the setting of the stress and threat responses of the nervous system. Depression fundamentally indicates a weak and non-resilient sense of self, coupled with limited capacities for trust and either autonomy or intimacy in relationships. These are the issues that must be tackled in psychotherapy. Since depression carries a message for the sufferer, it must be investigated for its meaning. Why has the individual withdrawn from life and what are they being asked to change in how they live and relate? Before this reparative and creative phase of therapy can begin, however, we must remember that depression is not just 'low' mood but also 'stuck' mood. Rigid beliefs and processes that block therapeutic engagement can be gently questioned by helping the client see that they are held by only one part of the self, whereas other 'for growth' parts carry hope and a willingness to play and explore. Overall, it is crucial in working with depression to see and to relate to the client as a whole person; not simply a bundle of cognitive shortcomings to be corrected, but as an emotional, organismic, relational, existential and spiritual being. Depression: An Introduction presents a biopsychosocial model, combining developmental and attachment perspectives with genetics and neurobiology. Its therapeutic orientation is humanistic and integrative but has much to offer anyone wanting to know more about this widely known but little understood condition.

In recent years, there has been an explosion in the number of children and young people who diagnose themselves as gender dysphoric, or trans. In the UK, and worldwide, there is a growing tendency to refer them on to 'specialist' gender services almost as soon as they express any confusion or distress about their biological sex or gender identity. Due to the rapidly rising numbers and various pressures on the system, patients are increasingly likely to be offered life-altering medication and/or surgical treatments, often with little exploration of their emotional world. As so little is yet known or understood regarding this increase in gender incongruent patients, it seems precipitous to proceed onto physical treatments before any assessment work is undertaken. Many who present as gender dysphoric have complex needs with comorbid problems such as autism, histories of abuse or trauma, social phobias, depression, eating disorders, and other mental health symptoms. Therefore, all aspects of the individual's life deserve thorough assessment and therapeutic work. This book is aimed primarily at clinicians working in the field to provide a model for understanding, assessing, and treating gender dysphoria. The model uses a psychoanalytic framework to help explain disturbed states of mind and how psychic defences can be enlisted unconsciously to avoid overwhelming psychic pain. This offers professionals a way of trying to think with, and offer understanding to, their trans-identifying clients. Clinical examples are given to illustrate these processes and promote the understanding of transgender children, adolescents, and young people and their internal worlds, their thinking, and their interpersonal relationships. As well as clinical exploration and understanding, the book includes an overview of the current political, social, and clinical environments which have all impacted on the clinical care of trans-identifying individuals. As well as professional and trainee clinicians, this book might also prove useful to parents, other professionals, and possibly the gender dysphoric person too.

It is important to point out that these essays are about character types; it is not to suggest that all borderlines, narcissists or manic depressives are the same. Everyone is an individual and are who they are for many different reasons. What they have in common is a typical relation between their subjectivity and the world they inhabit. In other words, Christopher Bollas has identified the axioms that these individuals share. Following a discussion of the features of each type, the axioms are delivered in the character's own voice. By placing ourselves within their own logic, we can begin to identify and empathise with them. At the root of all character disorders there is mental pain and each disorder is an intelligent attempt to solve an existential problem. If the clinician can grasp their specific intelligence and help the analysand to understand this, then a natural process of healing can begin. Three Characters is a masterclass based on decades of lectures presented to psychoanalysts, analytical psychologists, and psychotherapists, and is a must-read for all psychoanalytic enthusiasts.

Stelios Kiosses invites us into the therapy room to experience the unfolding of some incredible stories of peopleâEUR(TM)s not-so-everyday lives. A revealing and sensitive portrayal of what happens in psychotherapy sessions accompanied by absorbing explorations of the theories underpinning the therapy.

In this gripping book, Professor Brett Kahr examines the nature of criminality throughout history, exploring the ways in which we have progressed from the ancient methods of torture and the execution of offenders to a more humane and psychologically sophisticated approach.

The New Sexual Landscape and Contemporary Psychoanalysis surveys modern sex culture and suggests ways psychoanalysis can update its theories and practice to meet the novel needs of today's generations.

This volume explores contemporary notions of normality and how the therapy profession is engaging with that question today. Can 'being normal' ever be observed and tested? Who defines the norm of the mental health? Is it constrained by a social concept of normal? And how do we ever reach an understanding of 'not normal'.

Pathologies of the Self draws on almost 40 years of clinical practice to explore the nature and structure of human identity. In this fascinating book Phil Mollon explores narcissistic phenomena in both the clinic and everyday life, demonstrating the illusory nature of the self, and showing how, beneath our defences, we are all 'borderline'.

Describing the neuroscientific basis for effective psychotherapy, Professor Holmes draws on the Free Energy Principle, which holds that, through 'active inference' - agency and model revision - the brain minimises discrepancies between incoming experience and its pre-existing picture of the world.

What stands between us and authoritarianism seems increasingly fragile. Democratic practices are under attack by foreign intrusion into elections; voter suppression restricts citizen participation. Nations are turning to autocratic leaders in the face of rapid social change. Democratic values and open society can only be preserved if citizens can discover and claim their voices. We access society through our organisations, yet the collective voices and irrationalities of these organisations do not currently offer clear pathways for individuals to locate themselves. How can we move through the mounting chaos of our social systems, through our multiple roles in groups and institutions, to find a voice that matters? What kind of perspective will allow institutional leaders to facilitate the discovery of active citizenship and support engagement?This book draws on psychodynamic systems thinking to offer a new understanding of the journey from being an individual to joining society as a citizen. With detailed stories, the steps – and the conscious and unconscious linkages – from being a family member, to entering outside groups, to taking up and making sense of institutional roles, illuminate the process of claiming the citizen role. With the help of leaders who recognise and utilise the dynamics of social systems, there may be hope for us as citizens to use our institutional experiences to discover a place to stand.