Brisch, Karl Heinz (München/Germany & Salzburg/Austria)
Attachment-oriented milieu therapy in inpatient psychotherapy: The group as healing attachment experience
Children who have experienced severe trauma in infancy and early childhood are generally not able to function well in groups. Because they have difficulty controlling affect and behaving empathetically, they often feel provoked by other children.
They then react with extreme aggressive behavior toward others, and in some instances they may already have been suspended from nursery school and later from classrooms. Sometimes they have even been expelled from school altogether. Other children may present problems in a group because they show signs of serious depression and anxiety, or because they dissociate.
In milieu therapy, an established structure is important at a variety of levels, because it provides the children and those who work with them a safe and protected environment. In addition, it guarantees that everyday life on the unit functions smoothly, and it enables all who are involved to manage crisis situations. Multidisciplinary cooperation is especially important in crises. The professional personnel must be supported by colleagues at all levels. Intensive information exchange about, but also with, the patients is critical to developing individually tailored strategies on the unit. Coregulation and intensive one-on-one contact help to overcome an acute crisis and make it possible for the child to return to the group. The children then come to experience the group not as a place of threat; rather, they internalize the group experience as a support and the community in the group as an additional source of emotional security. This process will be demonstrated in this presentation based on a variety of examples.
Curriculum Vitae (CV)
Univ.-Prof. Dr. med. habil. Karl Heinz Brisch specializes in child and adolescent psychiatry and psychotherapy, adult psychiatry and neurology, including psychosomatic medicine, psychoanalysis, trauma psychotherapy, and group psychoanalysis. He is head of the Department of Pediatric Psychosomatic Medicine and Psychotherapy at the Dr. von Hauner Children’s Hospital at the University of Munich, Germany.
Dr. Brisch holds the first ever Chair in Early Life Care at Paracelsus Medical University in Salzburg, Austria. He also lectures at the Psychoanalytic Institute in Stuttgart, Germany.
Dr. Brisch’s main research and clinical interest is in early child development and attachment psychotherapy in all age groups. He has published numerous books, papers, and articles on attachment development in high-risk infants and clinical attachment research. He developed the prevention programs SAFE® - Secure Attachment Family Education and B.A.S.E.® - Babywatching for use in educational and other settings. He is a founding member of the German-Speaking Association for Infant Mental Health (GAIMH) and led the organization for many years.