Gerry Byrne is consultant nurse and child psychotherapist (Tavistock) and Head of Attachment and Perinatal Services, Oxford Health NHS Foundation Trust (including Family Assessment & Safeguarding Services (FASS), Infant Parent Perinatal Service (IPPS) and ReConnect). He is Clinical Lead for Child and Adolescent Psychotherapy for the Trust (Oxfordshire and Buckinghamshire) and the originator of the Lighthouse Mentalization-Based Treatment Parenting Programme (LPP). He is an MBT tutor/supervisor (Anna Freud National Centre for Children and Families), and a D. Phil student in the Department of Social Policy & Intervention, University of Oxford. He has authored a children’s picture book, All at Sea, (2018), Walker Books.

Gerry Byrne writes – I work as Head of Attachment and Perinatal Services and Clinical Lead for Child Psychotherapy at Oxford Health NHS Foundation Trust. This includes the Family Assessment & Safeguarding Service, which offers multidisciplinary expert witness assessments and NHS treatments for severe parenting problems, including child abuse and neglect.

The title of this talk is a fusing together of quotes by two poets, Seamus Heaney and W. H. Auden. I intend it to be read in two ways. Bearing in mind Bion’s observation that “in every consulting room there ought to be two rather frightened people”, I will explore how the coercion of parents into engaging with our services by the Courts or Social Care presents first a serious challenge, and second a unique opportunity for the establishment of a collaborative therapeutic relationship. It’s challenging because parents arrive with deep epistemic mistrust of our services. This can be at best anxiety-provoking for us as clinicians, because we fear for their children’s safety. But it is also a unique opportunity. If epistemic trust can be established, it will transform the parent’s view, not only of the child, but also of therapies on offer and of the potential of help elsewhere in the community.

I will define epistemic trust and its role in child development and the transmission of culture; and I will outline some hypotheses about its role in therapy. I will then illustrate with clinical examples the achievement of epistemic trust within parents with borderline personality disorder and histories of developmental (and additional) traumas, showing how it enables them to acknowledge their dangerousness to their children. In thinking about process I will argue that the patient can be viewed as leaving with a crippled trust in the crooked heart of the therapist. By which I mean that the therapist offers containment only when he too can acknowledge the disturbance brought to the therapeutic encounter by his own both destructive and reparative capacities.

Follow up discussion for attendees on 28thJanuary.

OPS members will be sent zoom details to attend the talk; non-members should contact Ruth McCalman at secretary@oxfordpsychotherapysociety.org.uk for details.