Psychodynamic Approaches to the Experience of Dementia: Perspectives from Observation, Theory and Practice, 1st Edition (Paperback) book cover

Psychodynamic Approaches to the Experience of Dementia

Perspectives from Observation, Theory and Practice, 1st Edition

Edited by Sandra Evans, Jane Garner, Rachel Darnley Smith


296 pages

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pub: 2019-12-20
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Psychodynamic Approaches to the Experience of Dementia: Perspectives from Observation, Theory and Practice demonstrates the impact of healthcare approaches that take into account not only the practical needs, but also the emotional experience of the patient, their partners, families and friends, lay carers and professional staff.

Currently there is no cure for dementia, but the psychosocial and therapeutic approaches described in this volume have appeared to help people, both patients and carers feel more contained and less lonely and isolated. Psychoanalytic theory provides a disciplined way of thinking about the internal world of an individual and their relationships. Each author provides their own commentary on the personal and interpersonal effects of dementia, endeavouring to understand behaviours and emotions which may otherwise seem incomprehensible. The subject is approached from a psychodynamic perspective, considering the unconscious, previous and current experiences and relationships, including those between patients and staff.

Psychodynamic Approaches to the Experience of Dementia illustrates the practical and theoretical thinking of clinicians from a wide range of disciplines who are engaged in the care of people in late life with a diagnosis of dementia. It will be essential reading for mental health and health professionals in practice and training in the field of dementia.


"This excellent book is a refreshing and valuable contribution to our understanding of the challenges faced by people with dementia and how we might help. By shining the different light of psychodynamics on dementia, the authors and the editors reveal novel insights and opportunities into dementia and how to improve the quality of care provided. The editors, Sandra Evans, Jane Garner, and Rachel Darnley-Smith have done a fantastic job in commissioning and writing a set of chapters that will enable readers to challenge their assumptions and by doing so to think and act differently for the benefit of those with dementia."

- Sube Banerjee, Professor of Dementia and Deputy Dean, Brighton and Sussex Medical School

"I would highly recommend this multi-authored book which brings a psychodynamic understanding to dementia care. This beautifully perceptive and insightful book helps the reader (both professional and lay) develop a greater understanding of the emotions encountered as the illness progresses."

- Amanda Thompsell, Old Age Psychiatrist at SLAM and Chair of the Faculty of Old Age Psychiatry at the Royal College of Psychiatrists

"This is an essential and unique book which courageously explores the subjective world of dementia. So many find too terrifying to contemplate and yet with this book as a guide, clinicians, but also families and carers, will come closer to understanding how the world impacts on the mind of an individual suffering from this disease. It also helps with insights in relation to how the experience of dementia in someone close to them impacts on their experience of the world. This is an extraordinarily helpful and long-awaited book, which will be welcomed by professionals as well as those effected by this illness."

- Peter Fonagy, OBE, Professor of Contemporary of Psychoanalysis and Developmental Science, University College London

"This unique, much needed book movingly and intelligently reflects upon the experience of people living with dementia and their families and carers through a new lens. Collectively, drawing upon psychodynamic and psychoanalytic theories; psychiatrists, analytic psychotherapists, psychologists, arts therapists and counsellors provide new meanings for those living with dementia, their families, carers and therapists. This rich multi-disciplinary perspective will appeal to professionals and family members and carers."

- Professor Helen Odell-Miller, OBE, Director, Cambridge Institute for Music Therapy, Anglia Ruskin University

Table of Contents


Sandra Evans, Jane Garner & Rachel Darnley-Smith

Chapter 1 Encountering Dementia

Louis Resnick

Chapter 2 Where Lies the Expert

Jane Garner

Chapter 3 Working with people with mild neurocognitive disorders (mild NCD) or mild cognitive impairments (MCI)

Julia C. Segal

Chapter 4 Prognosis and planning: advance care planning through a psychoanalytic frame

Juliette Brown

Chapter 5 The Experience of Loss in Dementia: Melancholia without the mourning?

Sandra Evans

Chapter 6 Dementia and dialogue: acute hospitals and Liaison Psychiatry

Mathew Hagger

Chapter 7 Psychodynamic Interventions in Dementia: The Australian and New Zealand experience

Neil Jeyasingam

Chapter 8 Art therapy with people with dementia: the present and the past

Angela Byers

Chapter 9 Attachment in Dementia

Sandra Evans

Chapter 10 The Fragile Thread of Connection: Living as a Couple with Dementia

Andrew Balfour

Chapter 11 Maintaining boundaries: counselling in a care home

Susan Maciver, Chris McGregor, Tom C. Russ

Chapter 12 Music as Mirror in the care of elderly people with Dementia

Rachel Darnley-Smith

Chapter 13 Groups for people with cognitive impairment and with dementia: what should we be doing?

Sandra Evans

Chapter 14 Disintegration and integration in dementia care: mentalisation as a means to keep whole

Stephanie Petty, M. Potts and Daniel Anderson

Chapter 15 A Psychoanalytic & Philosophical exploration of boredom and disengagement in Dementia

Sandra Evans

Chapter 16 Continuing Care Review: a report on a thoughtful project and its untimely demise

Jane Garner

Chapter 17 Negotiating the border: music therapy for people in the last hours of dementia

Adrienne Freeman

Chapter 18 Can anything good be born of a dementia: potential for reparation?

Jane Garner

About the Editors

Sandra Evans has been an NHS psychiatrist, teacher and trainer for over 30 years. Sandra is a Group Analyst also in private practice with GANLondon.

Jane Garner has over 30 years clinical experience in the NHS using psychodynamic ideas to inform psychiatric practice and teaching particularly in the areas of old age and dementia services, continuing care, institutional abuse, sex and relationships.

Rachel Darnley-Smith is a music therapist and Senior Lecturer at Roehampton University, UK. She has worked with people with dementia over many years, mostly in the NHS and published widely on music therapy, aesthetics, and psychoanalysis .

Subject Categories

BISAC Subject Codes/Headings:
PSYCHOLOGY / Psychotherapy / General
PSYCHOLOGY / Mental Health