Psychoanalytic Thinking in Occupational Therapy
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This book is the first to use psychoanalysis as a basis for exploring how occupational therapists do their work, and it incorporates a new conceptual model to guide practice. The authors emphasize the role of the unconscious in all that people do and are, and argue that activities (or occupations) are simultaneously real (i.e. tangible) and symbolic. Ideal for academic and clinical occupational therapists, this book will also appeal to psychotherapists.


Lindsey Nicholls, PhD, is a lecturer at Brunel University, London, UK. Her doctorial study used psychoanalytic theory to explore the symbolic and relational encounters between occupational therapists and their clients in acute medical settings.

Julie Cunningham-Piergrossi is a psychoanalytically trained occupational therapist, Milan, Italy.

Carolina de Sena-Gibertoni is a psychoanalytically trained occupational therapist, Milan, Italy.

Margaret Daniel is a Clinical Specialist OT in Psychotherapy working in a NHS Psychotherapy Clinic in Glasgow, Scotland and is a senior accredited counsellor with the British Association for Counselling and Psychotherapy.


Foreword by Sheena Blair vii

Foreword by Paul Hoggett ix

Acknowledgements xi

1 Introduction 1

Section 1 Psychoanalytic Theory Interwoven with Occupational Therapy 13

2 The ‘Therapeutic Use of Self’ in Occupational Therapy 15

3 An Occupational Therapy Perspective on Freud, Klein and Bion 32

4 The Function of ‘Doing’ in the Intermediate Space: Donald Winnicott and Occupational Therapy 57

5 Beyond Bowlby: Exploring the Dynamics of Attachment 68

6 Re-awakening Psychoanalytic Thinking in Occupational Therapy: From Gail Fidler to Here 87

Section 2 Psychoanalytic Occupational Therapy: A Relational Practice Model and Illuminating Theory in Clinical Practice 103

7 MOVI: A Relational Model in Occupational Therapy 105

8 Let the Children Speak 128

9 Working with Difference 145

Section 3 Further Psychoanalytic Thinking: Research and Training 163

10 Psychoanalytic Thinking in Research 165

11 Understanding the Use of Emotional Content in Therapy Using Occupational Therapists’ Narratives 186

12 Training Experiences to Develop Psychoanalytic Thinking 202

13 The Relational Space of Supervision 222

Index 239


"This is a valuable book in stimulating our thinking around psychoanalytic theory and how this can be embraced into occupational therapy practice. It provides many references to seminal materials and the reader should explore these for a greater breadth of understanding."  (British Journal of Occupational Therapy, 1 April 2014)