'Whose life are They Going to Save? It's Probably Not Going to be Mine!' Living With a Life-Shortening Condition During the Coronavirus (COVID-19) Pandemic: A Grounded Theory Study of Embodied Precarity.

This article explores the experiences of young adults with a life-shortening condition in the first wave of the Coronavirus (COVID-19) pandemic in the UK. It presents the findings from an inclusive qualitative research study using constructivist grounded theory which aimed to examine the unintended consequences of pandemic control measures (lockdown and 'shielding') on this population. Purposive and theoretical sampling methods were used to recruit young adults with a life-shortening condition, employing a range of recruitment methods such as social media, advertising in newsletters and snowballing. Twenty-six young adults (aged 22-40 years), with a wide range of life-shortening conditions participated in the study. Seventeen participants were female and nine male. The majority identified as White British/Other and the remainder as Black British (2), Mixed Race (2) or Latin American (1). Data were generated iteratively using in-depth guided interviews and analysed collectively by an inclusive research team using the constant comparative method. The article explores a theory of embodied precariousness of living with a life-shortening condition during the first wave of the Coronavirus pandemic in relation to three categories: the rationing of life-saving treatment, the deterioration of health and retraction of healthcare provision, and the disruption of typical care arrangements. The findings show that the pandemic control measures introduced to keep people safe have intensified the precarity of this group promoting inequalities in healthcare and health outcomes. The article identifies some implications for practice to support the future management of unexpected and unwanted change.

Dying for love: An attachment problem with some perpetrator introjects.

This paper focuses on some problematic victim-perpetrator dynamics in psychotherapy with patients with Dissociative Identity Disorder where there has been longstanding multi-perpetrator organized abuse described, which also involves family members. Additionally, in this specific sample, there have been reported experiences of serious assaults from attachment figures in which the patient felt close to death. The clinical concern is expressed that only in the nearness of death is a connection felt to the attachment figure and this leads to extra suicidality in the patient and extra vulnerability to secondary traumatization for the therapist. This group faces not only relational betrayal dynamics with their reported external abusers, who provide toxic "love", but with internal perpetrators, victim-perpetrators, and victims too. The impact of an incestuous and rivalrous civil war in the body and mind that replicates the external system and is projected into the therapeutic encounter poses particular problems for therapists and patients. There are different problems for the treatment according to how the perpetrator-identified dissociative system is in need of a near-death connection.

An interview study of people with learning disabilities' experience of, and satisfaction with, group analytic therapy.

A number of clinicians have developed psychodynamic treatments for people with learning disabilities, but there have been few studies assessing the impact of psychodynamic therapy with this population. In particular, there have been no studies in which investigators have asked clients about their experience of psychodynamic treatment. The current study is an attempt to rectify this by exploring people with learning disabilities' experiences of, and satisfaction with, two psychodynamic groups provided by an inner city service. Nine learning-disabled clients, four from a sexual offenders' group and five from a women's group, were interviewed about their experience of psychodynamic group psychotherapy. Their responses were analysed using Interpretive Phenomenological Analysis. Participants suggested that they valued the therapists and the group, and appreciated the opportunity to talk about painful experiences and be included and valued in the group. However, participants also indicated that they found the group emotionally painful, on occasion found it hard to identify with other group members, and were often unaware of any positive change in themselves. These interview findings complement ongoing quantitative attempts to establish the impact of psychodynamic treatment for this population.