Attachment, MBT & Toxic Couple Relationships: Video Course

At this practical and intellectually stimulating workshop, which is aimed at therapists working with couples whose relationships have turned toxic, as well as victims and perpetrators of intimate partner violence, Dr Gwen Adshead and Gerry Byrne integrate psychological and criminological data with clinical illustrations to examine the complex manifestations and specific causes of toxicity in couple relationships. The workshop draws on perspectives from Attachment Theory to evaluate the roles played by the individuals involved and examines the addictive nature of these damaging relationships; while demonstrating and explaining mentalisation based therapeutic techniques that we can use, when working with couples. Looking through examples and discussing specific case examples, our aim is to assimilate the therapeutic approaches that work best in such cases. Interactive exercises will also allow delegates to evaluate their own case materials.

Key discussion themes for the day include:

• A review of theories that explain how intimate relationships develop in humans; with particular reference to Attachment Theory and the development of mentalisation skills
• The effect of intimate relationships on affect regulation and how this explains linkages between personal and social identities
• The influence of cultural and social stereotypes on how intimacy is conceived and perceived – and how this affects couples
• The addictive force and power of violent relationships – the roles of passion, destructiveness, jealousy and a wish to control one’s partner
• The forces that keep toxic relationships going, with reference to intra-psychic as well as social factors
• How early experiences of disturbed attachments are repeated and re-enacted in toxic relationships
• We discuss a typology of violent relationships, looking at the destructive dynamics that maintain these and the unconscious fantasies of security and love that underlie them

Using illustrative case vignettes and discussions, the workshop offers clinical examples of therapy and examines the evidence base for interventions with violent couples, specifically drawing on MBT and psychoanalytic couple therapy.

About the speakers

Dr Gwen Adshead is a Forensic Psychiatrist and Psychotherapist. She trained at St George’s Hospital, the Institute of Psychiatry and the Institute of Group Analysis.  She is trained as a group therapist and a Mindfulness-based cognitive therapist and has also trained in Mentalisation-based therapy. She worked for nearly twenty years as a Consultant Forensic Psychotherapist at Broadmoor Hospital, running psychotherapeutic groups for offenders and working with staff around relational security and organisational dynamics. She is the co-editor of Clinical topics in Personality Disorder (with Dr Jay Sarkar) which was awarded first prize in the psychiatry Section of the BMA book awards 2013; and she also co-edited Personality Disorder: the Definitive Collection with Dr Caroline Jacob. She is the co-editor of the Oxford Handbook of Forensic Psychiatry (2013) and the Oxford Handbook of Medical Psychotherapy (2016). She is also the co-editor of Munchausens’s Syndrome by Proxy: Current issues in Assessment, Treatment and Research.

Gwen was visiting professor at Yale School of Psychiatry and Law in 2013; and also honoured with the President’s Medal for services to psychiatry that same year for her work on ethics in psychiatry. She was awarded an honorary doctorate by St George’s hospital in 2015; and was Gresham Professor of Psychiatry 2014-2017. She now works in a medium secure unit in Hampshire in a service for high risk offenders with personality disorder; and in a women’s prison.