Q&A with Alexandra Knowles

Q. How did you first become aware of or interested in ISTDP?

A. In 2006, after many years working as a psychoanalytic psychotherapist, I had moved out of London and was intending to retire when I attended the First Oxford Conference put on by David and Jennie Malan. I was totally blown away by what was being presented via video and sat in utter amazement as I witnessed the deep, moving exploration of painful pasts. Watching skilled clinicians get to places in the first hour of therapy that I would have been happy to get to in 6 months made me ask myself: “What are they doing, and how are they doing it?” Whilst I could see their results unfold in front of me, it looked low key and seamless and was totally mystifying to me.

Q. Could you tell us a bit about your early background as a psychotherapist – how did you start out?

A. Many decades ago I joined The Arbours Association which was set up for people in distress as an alternative to mental hospitals by psychiatrists and therapists who had worked with Ronnie Laing at Kingsley Hall. It was part of the ‘anti-psychiatry’ movement and what they were doing really excited me and so I started training with them. As a requirement I had to do a residential placement in one of the therapeutic communities. For a year I lived there with my family and up to 12 residents. The ethos of the community was that we were all living together with no clear roles or distinctions between the residents and the trainees. In those heady days the communities attracted a lot of attention and one of our favourite games was watching visitors try to work out who were the ‘mad’ ones and who were the ones ‘in charge’. They usually got it wrong!

This was also the time when Susie Orbach and Louise Eichenbaum set up The Women’s Therapy Centre. Their work was ground breaking and I was very fortunate to be associated with them for many years.

Q. Could you describe your training in ISTDP?

A. Following that Oxford Conference I joined the first UK Core Group Training with Patricia Coughlin. I quickly learnt that what had looked so effortless in the hands of experts, was extremely challenging to learn. On top of this I had to ‘unlearn’ many of the things that I had been practicing before; going from a neutral stance to an active engaged one, from free floating attention to sharp focus, to listen with my ‘eyes’ as well as my ‘ears’, were just a few of the many habits I had to change.

Core training is unlike any other training I had ever experienced in that every-one in the group has to show their work on video and experience being supervised in front of peers; it was no longer possible to hide or gloss over any ineptitude, it was obvious for all to see. Training in ISTDP inevitably means that everyone goes through their own personal crisis and, hopefully, transformation. Certainly for me it was life changing.

Having completed my three years of core training I did a further year of advanced training. I was then privileged to ‘shadow’ Robert Neborsky and Josette ten de Labije through two more Core Training groups before I started teaching myself.

Q. Have there been any ISTDP clinicians who have been a particular influence on your work?

A. I have been lucky to have been taught and supervised by the best in ISTDP. I originally trained with Patricia Coughlin and Jon Frederickson. Subsequently I also trained with Josette ten de Labije and Robert Neborsky. Going through the training process it is inevitable that initially you copy your teachers and I often smile inwardly as I ‘hear’ one of their intonations in my own intervention in the consulting room. Of course, ultimately, everyone has to find their own voice and make it their own but I don’t think that you ever lose those early influences.

Q. At previous conferences, you have discussed the application of ISTDP to treatment of trauma. Could you tell us a bit about your thinking?

A. We all know that helplessness is a key experience in trauma. Because ISTDP is a model of health and autonomy, I have found it hugely helpful in working with victims of trauma and believe that I have been able to help people to places which were just not possible with my old way of working. Indeed, whilst a person may have been a victim in the past, ISTDP focuses on their inherent health and strength so that they no longer have to be a victim – they can be in charge rather than being helpless.

Q. Could you tell us about your involvement with ISTDP-UK?

A.The ten members of the original Core Training decided to form ISTDP-UK and I was the first Chair. At that time the method was unknown in the UK and we wanted to form an organisation that could foster the growth and awareness of ISTDP here. During our training the only way we could have contact with other ISTDP practitioners was to, literally, travel across the world to conferences, workshops and summer schools. It is very pleasing that nowadays people are curious about ISTDP and come to us, having heard about ISTDP. because they want to either train or have therapy for themselves.

Q. if you could have dinner with any psychotherapist/psychiatrist/psychologist, living or dead, who would you choose?

A. Oh that’s easy – all the therapists I have been fortunate enough to meet though my teaching. ISTDP is an international community and the growing band of trained ISTDP therapists in the UK represent that diversity and their enthusiasm, energy and dedication is ensuring that ISTDP has a presence and a future in the UK.

 

 

2018-01-23T14:08:15+00:00