Training in the Conversational Model which was pioneered by Robert Hobson and Russell Meares in the late 1960’s started 27 years ago at Westmead Hospital. A multidisciplinary group participated in the first course – consisting of psychiatrists, registrars, psychologists, social workers and clinical nurses. The Masters of Medicine, University of Sydney, was awarded on completion of the 3 years course, which consisted of a clinical and theoretical component; the former consisted of work with two patients with Borderline Personality Disorder, the latter consisted of yearly essays and clinical viva; and a treatise at the end of three years.
Research has been an important component of the program – the first longitudinal study was published, followed by a cost-benefit analysis, and several papers were published on outcome studies and further follow-up studies. Psychiatry registrars also receive their supervision from staff of the Complex Trauma Unit. This model has advanced our understanding of the role of early trauma in the pathogenesis of Borderline Personality Disorder; it continues to evolve, keeping abreast of the most recent research in infant developmental, trauma theory, memory research and linguistics. Most importantly, training in the model has helped students develop their abilities in communicating and understanding disturbed people.
Somatization Disorder – a polysymptomatic syndrome - is a chronic preoccupation with somatic complaints, for which medical care is repeatedly sought, and clinical dilemmas often presented, resulting in disproportionate health care utilization. Affect is isolated or split off and attention is focused on the body, resulting in more awareness of the physical than of psychological aspects of the individual. As an Axis 1 disorder it may be accompanied by Borderline or Obsessive Compulsive Personality Disorders or traits.
The concept of dissociation continues to be vague, confusing, and even controversial, (Dell, 2009, p.225). A principal controversy concerns the notion of defence. In this talk neurophysiological data