Parenting and Personality Dysfunction: clinical implications
A one-day seminar with Dr Gwen Adshead
London, 10 February 2017 (Friday)
The ‘orchid-dandelion’ hypothesis of child development (Ellis, 2008) suggests that there are some ‘environments’ that can damage even the most resilient children. Parental harshness, chronic hostility and a rejecting stance might form part of such hazardous environments – the incidence of which may be more common in parents with personality disorders. Evidence shows that such ‘maladaptive parental behaviour’ is not just associated with high rates of child and adolescent psychopathology; but also with higher manifestations of conduct and / or oppositional defiant disorders in children.
As therapists, we also realise that parental personality dysfunctions can have attachment implications. Frightened or frightening parenting behaviours lead to disorganised attachment in children, which in turn is symptomatic of a range of abnormal childhood behaviours. Our challenge in working with such parents and families however, is that abusive parents with personality disorders are often hard to engage. They may feel defensive and reluctant to building a trusting relationship over time with therapists.
At this practical and therapeutically oriented seminar which would be especially relevant for psychotherapists, psychologists, counsellors and psychiatrists, Dr Adshead draws on her extensive clinical experience, recent neurobiological findings and relational thought to help us comprehend:
- How personality disorders (across the three DSM-5 clusters) affect the interpersonal function and can be viewed as relational disorders
- Core parenting skills that create attuned sensitivity (and hence, secure attachment patterns) and how these can be negatively impacted through personality dysfunctions
- The links between personality disorders and high-risk states of mind
- The evidence that shows the risk to child development, both in terms of genetic vulnerability and environmental stress factors
- Clinical interventions for parents with personality disorders
Maintaining the view that therapeutic interventions for parents with personality disorders are both effective and preventive, Dr Adshead explains how therapists can apply these learnings in clinical settings and allow for provision of relational security at multiple levels.
About the speaker
Dr Gwen Adshead is a psychotherapist, group analyst and forensic psychiatrist. She trained as a psychiatrist, and then as a forensic psychiatrist after completing a master’s Degree in medical law and ethics at King’s College, London. She was lecturer in victimology at the Institute of Psychiatry, where she studied interpersonal trauma and its effects; then trained as a psychotherapist, with a particular interest in Attachment Theory. She first started work at Broadmoor Hospital as a senior psychiatric trainee in 1990; and over the last twenty years has worked as a responsible clinician, as well as a consultant psychotherapist.
Her research interests include moral reasoning in psychopaths and antisocial men; the attachment narratives of abusive mothers; and how psychotherapies work with violent people. Gwen has published over 100 papers, book chapters and commissioned papers; co-edited three books and is working on three more.
Gwen’s principle training is group dynamic; but she also has experience of cognitive approaches to therapy, DBT, and mentalization based therapies.
10:00AM: Session 1: Disorders of Relational Capacity?
In the first session, we look at how parenting requires an individual to balance appropriate limits and boundaries with maximal affection and attuned nurturing. Parents need to be both empathic and sympathetic towards ongoing vulnerability and dependence: the sort of dependence that, in children, inevitably leads to repeated requests for attention. We consider both direct and indirect impacts on such functions where personality disorganisation or dysfunction exists.
11:30AM: Coffee Break
12:00 noon: Session 2: Impact on parenting skills and outcomes
Our discussion in the second session examines how different personality disorders impact parenting outcomes. Specifically, we consider the impacts of:
- Anti-social and narcissistic personality disorders
- Somatising disorders
- Borderline personality disorders
- Eating disorders
1:30PM: Lunch Break (a light lunch is provided as part of the seminar)
2:30PM: Session 3: Therapeutic Interventions
We look at therapeutic implications of our discussions and consider:
- Screening tools and the reliance we can place on these
- Psychological therapies that focus on repairing relational skills
- Interventions that promote parental mentalizing and self-reflective functions
- Generalized interventions that address metacognitive function
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