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Valerie Sinason – a prime mover in psychotherapy

for people with learning disabilities

Valerie Sinason pioneered psychotherapy for people with The IPD’s first motto was “treating with
learning disabilities, often in the teeth of opposition from the respect”. This was an acknowledgement
profession itself. David O’Driscoll celebrates her 75th birthday of how, historically, patients with learning
disabilities had not been treated
with respect.
Sinason was trying to develop an interest
recently hosted, in my capacity as a multidisciplinary group that met weekly in the psychotherapeutic community and
chair of the Institute of Psychotherapy to listen to case presentations. convince those involved in mental health
I and Disability (IPD), a 75th birthday I was struck that such a diverse group of that psychoanalytic psychotherapy could
celebration for the charity’s founder professionals was attending – psychiatrists, be an important treatment option for
and a most inspirational figure, nurses, teachers, and social workers with people with learning disabilities.
Dr Valerie Sinason. different theoretical approaches. To this end, she was also involved in the
The IPD was set up to promote Sinason fostered an open inquiry with Royal College of Psychiatry’s Faculty of
psychotherapy for people with intellectual all views welcome, not just a Intellectual Disability’s report into
disabilities. In attendance were many psychoanalytic approach. psychotherapy. This report highlighted
senior figures from the world of many difficulties around access to and the
psychotherapy but, sadly, few from the Landmark publication quality of psychological support for
learning disability community. Since then, she has contributed a people with learning disabilities.
Why was this? I wondered. I believe continuous output of published work
Sinason is the most critical thinker in our including her book Mental Handicap and
field in my lifetime. Today, she is primarily the Human Condition: an Analytical Some handicapped people
recognised as the principal innovator of a Approach to Intellectual Disability, which
psychotherapeutic approach for people is considered a landmark publication in behave like smiling pets for
with learning disabilities, a group of psychotherapy publishing. fear of offending those they
people who have attracted only It was first published in 1992, has been are dependent on
intermittent psychological interest. reprinted almost yearly and the second
Sinason developed her ideas at the edition, with three further chapters, was
Tavistock Clinic in London, establishing the published in 2010. Sinason is currently
first specialist clinic and training on revising it for a new edition. Currently, the IPD is discussing a new
working therapeutically with people with Sinason is the foremost innovator registration section for disability
learning disabilities. behind “disability psychotherapy”. Several psychotherapists with the British
My first contact with her was at the contemporary commentators have noted Psychoanalytic Council.
Tavistock Clinic in 1997, where she chaired the historical reluctance of mental health It is now established that
specialists to provide psychotherapists need to work with
psychotherapy greater flexibility and willingness to
treatment for people engage with wider systems.
with learning disabilities. In Sinason’s approach to learning
The IPD, which she disability, the critical element is not
was instrumental in intelligence but emotional response.
setting up in 1992, “However crippled someone’s external
aimed to promote functional intelligence might be, there still
psychoanalytic can be intact a complex emotional
psychotherapy. One of structure and capacity,” she wrote.
its intentions was to
promote a new breed of Trauma and the ‘handicapped smile’
psychotherapists Today, there is a lot of new interest in
called disability trauma, but Sinason’s ideas on trauma have
psychotherapists, who always been at the core of her thinking.
would be specially She has suggested that symptoms
trained and qualified for resulting from trauma are significantly
this role. under-recognised in people with learning Henderson Hills Flickr CC BY-ND 2.0; Clinic for Dissociative Studies
disabilities and society’s responses to
disability tend to exacerbate the
Therapy: Sinason aimed to
convince mental health initial trauma.
professionals that Two of her key concepts were the
psychotherapy could be “handicapped smile” and “secondary
benefit people with handicap”. (At the time, handicapped was
learning disabilities the term used for people with disabilities.)
28 Vol 35 No 4 | Summer 2022 Community Living www.cl-initiatives.co.uk