CAP/TWCYP Intensive Study Event (ISE)* - ‘A crippled trust’ in ‘a crooked heart.’ Establishing epistemic trust in the hostile territory of the therapeutic encounter with the coerced patient.


Wednesday 19 May 13:30 to 16:00


This is an online event that will take place on Zoom


Gerry Byrne


Suspect too much sweet talk

But never close your mind.

It was a fortunate wind

That blew me here. I leave

Half-ready to believe

That a crippled trust might walk

And the half-true rhyme is love.

From The Cure at Troy

Seamus Heaney (1990)

O look, look in the mirror,

    O look in your distress;

Life remains a blessing

    Although you cannot bless.

O stand, stand at the window

    As the tears scald and start;

You shall love your crooked neighbour

    With your crooked heart.

From As I walked out one evening

W. H. Auden

The title of this talk is a fusing together of quotes by two poets, namely, Seamus Heaney and W. H. Auden. I intend its reading in two ways. Firstly, bearing in mind Bion’s observation that “in every consulting room there ought to be two rather frightened people”, I will explore how the coercion of parents into engaging with our services by the Courts or Social Care presents both a serious challenge and a unique opportunity for the establishment of a collaborative therapeutic relationship. Challenging because parents arrive with deep epistemic mistrust of our services. This can be at best anxiety provoking for us as clinicians because we fear for their children’s safety. But it is also a unique opportunity: if epistemic trust can be established, it will transform the parent’s view not only of the child, but also of therapies on offer and of the potential of help elsewhere in the community.

I will define epistemic trust and its role in child development and the transmission of culture; and I will outline, some hypotheses about its role in therapy. I will then illustrate with clinical examples the achievement of epistemic trust within parents with borderline personality disorder and histories of developmental (and additional) traumas showing how it enables them to acknowledge their dangerousness to their children.

In thinking about process I will argue that the patient can be viewed as leaving with a crippled trust in the crooked heart of the therapist. By which I mean that the therapist offers containment only when he too can acknowledge the disturbance brought to the therapeutic encounter by his own both destructive and reparative capacities.


13:30 – 14:30  

Welcome and Speaker Introduction

Talk: ‘A crippled trust’ in ‘a crooked heart.’ Establishing epistemic trust in the hostile territory of the therapeutic encounter with the coerced patient

14:30 – 15:00 

Comfort break

15:00 – 16:00

Workshop: Projective Identification Note to participants: the workshop will be participative and involve a ‘real play’*

*You may be familiar with role plays.  A ‘real-play’ is where you participate as yourself rather than assuming the role of a patient/parent. We offer this with some guidance and cautionary advice not to bring unprocessed personal material that may render you vulnerable beyond the reach of the workshop to contain and awareness that you are likely to experience, as parents in our group programme do, strong feelings associated with important figures in your childhood. Where participants have chosen ‘real-play’ they have felt that they understood at a deeper level, the power of the programme and the experiences of the parents in the programme.

A ‘real-play’ is taking part in an exercise (usually discussion and reflection on Lighthouse material or similar). After 30 minutes we will then reflect and discuss as a large group.


  • No cost for HDS students and staff who are currently part of the CAP and TWCYP training programmes
  • £30 per person NB Limited to 10 spaces only

Limited spaces

Spaces are limited to 10 (excluding HDS students and staff who are currently part of the CAP and TWCYP training programmes).

About the presenter - Gerry Byrne

Gerry Byrne is consultant nurse and child psychotherapist (Tavistock) and Head of Attachment and Perinatal Services, Oxford Health NHS Foundation Trust (including Family Assessment & Safeguarding Services - FASS, Infant Parent Perinatal Service – IPPS and ReConnect). He is Clinical Lead for Child and Adolescent Psychotherapy for the Trust (Oxfordshire and Buckinghamshire) and the originator of the Lighthouse Mentalization-Based Treatment Parenting Programme (LPP). He is an MBT tutor/supervisor (Anna Freud National Centre for Children and Families), and a D. Phil student in the Department of Social Policy & Intervention, University of Oxford. He has authored a children’s picture book, ‘All at Sea’ (2018, Walker Books).

Refund Policy

  • A cancellation can be made up to 4 weeks before the event and a full refund will be issued. 
  • After this date, a refund cannot be processed, unless under exceptional circumstances.
  • No refund will be issued for non-attendance.
  • We can accept substitute delegates at any time, although sufficient notice should be given where possible.

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ISE with Gerry Byrne

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