Margaret Rustin

Margaret Rustin is a pioneering figure in child psychotherapy who has contributed significantly to our understanding of what psychoanalytic ideas have to offer the field of child and adolescent mental health.

In this Legacy Interview, Margaret explores the legacy of her five decades of clinical work as former Head of Child Psychotherapy and Dean of the Tavistock Clinic in London – one of the most influential mental health treatment and training institutions in the world.

This legacy interview offers a rare opportunity to hear how Margaret and her special guests helped reshape the field. In particular, Margaret’s career at the Tavistock has been marked by a range of significant contributions. As the former Head of Child Psychotherapy and later Dean of the Tavistock and Portman Foundation Trust in London, Margaret was instrumental in transforming child psychotherapy training, extending the reach of training programmes across the UK and cultivating a new generation of skilled practitioners equipped to meet the complex and changing needs of children and families.

Margaret and her special guests discuss their groundbreaking and innovative work with severely traumatised children, parentwork, establishing the Under Fives Service, and extending Child Psychotherapy training and services beyond London.

Margaret’s special interest in infant observation has been fundamental to her thinking. ‘Closely Observed Infants’, which she contributed to and co-edited has become a must-read for anyone interested in the role of psychoanalytic observation and has deepened our understanding of early childhood development and the vital skills basic to therapeutic approaches for the youngest patients and their carers.

Key points from the interview

• Applying psychoanalytic approaches to work with severely traumatised children
• Exploring her innovative approaches to assessment and parent work
• The importance of adapting our clinical work to our patients
• The necessity of diversifying and extending the reach of child psychotherapy training
• The challenges of making mental health support accessible to underserved communities
• Exploring the importance of infant observation in training
• The role of the workshop model in supporting clinicians working with vulnerable children
• The challenges and rewards of working with looked after children and refugee children and their families

Special Guests

Anne Alvarez

Anne is one of the most influential psychoanalytic Child Psychotherapists still practicing today. She worked alongside Margaret at the Tavistock Clinic and is known for her fearless approach to working with children experiencing complex emotional and psychological needs, including Autism. Her books include ‘Live Company’ and ‘The Thinking Heart.’

She shares insights on:

• Working alongside Margaret during the Tavistock’s “golden age”
• Their parallel development of approaches for severely disturbed children – which have since shaped the field
• Deepening on our understanding of the complexities of work with refugees and severely traumatised populations such as Looked After Children
• Margaret’s model of working with parents that she adopted – its evolution and how and why its necessary to bring parents alongside as we work with children

Lisa Miller

Lisa Miller, alongside Margaret, helped develop and refine psychoanalytic approaches to understanding children’s emotional needs. As the former Head of the Under Fives Service at the Tavistock Clinic, she advanced early intervention techniques. She was founding editor of the Infant Observation Journal and has held key leadership roles including Chair of the Association of Child Psychotherapists.

She shares insights on:

• Developing the Under-5 Service with Margaret
• The links between infant observation and clinical practice
• Working with parents of very young children
• The value of multidisciplinary workshops at the Tavistock and shared reflective spaces

Neil Altman

Neil Altman is a leading figure in psychoanalysis who has focussed his career on making psychoanalytic thinking relevant to today’s social challenges. As a faculty member at both the William Alanson White Institute in New York and the Massachusetts Institute for Psychoanalysis, Neil has helped shape the thinking of generations of psychoanalysts while expanding the field’s engagement with issues of race, class, and culture

He discusses:

• Differences between UK and US approaches to psychotherapy
• Making psychoanalytic work accessible to diverse populations
• The integration of social awareness with clinical practice, and the challenge of bringing community into the consulting room

Simon Cregeen

Simon is an experienced clinician specialising in work with Looked After Children and adoptive families. As former Professional Lead for Child & Adolescent Psychotherapy in Manchester and Salford NHS CAMHS, he has enhanced mental health support for vulnerable children and families. His supervision with Margaret spans two decades.

He discusses:

• The impact of establishing psychotherapy services in Northern England, led by Margaret
• Margaret’s role in developing and deepening work with looked-after and adopted children
• The importance of clinical companionship and its role in supporting complex case work

Rajni Sharma

Rajni is Director of Child and Adolescent Psychotherapy Training at the Northern School of Child and Adolescent Psychotherapy. She continues Margaret’s vision of extending training beyond London while making the profession more representative of diverse communities.

She discusses:

• Continuing Margaret’s vision at the Northern School
• Making training more accessible to diverse communities
• Adapting psychoanalytic approaches for public sector contexts
• The unique British model of child psychotherapy

Key Quote

“Unless we are a bit in touch with our own confusions and difficulties, we’re not going to be much use to anybody else.” – Margaret Rustin

Interviewer

Margaret is in conversation with Jane O’Rourke.

Jane O'Rourke, founder of MINDinMIND and a former award-winning BBC Producer turned Child and Adolescent Psychotherapist, brings her storytelling and listening skills to thoughtful conversations with leading mental health clinicians. Her unique background allows her to weave together the personal and professional threads of her guests' journeys, capturing the experiences that have shaped their clinical work.

Details correct at time of recording on 20 November 2024

Bibliography & Resources

Publications:

Rustin, M. (1983-2021). Finding a way to the child: Selected clinical papers (K. Stratton & S. Cregeen, Ed.). – A second volume of papers on Psychoanalytic Theory,  Infant Observation, Supervision, Research, and Literature is in preparation.

Rustin, M., & Rustin, M. (2019). New discoveries in Child Psychotherapy: Findings from qualitative research. Tavistock Clinic series. Routledge.

Cregeen, S., Hughes, C., Midgley, N., Rhode, M., & Rustin, M. (2017). Short-term psychoanalytic psychotherapy for adolescents with depression: A treatment manual. Tavistock Clinic series. Karnac/Routledge.

Rustin, M., & Rustin, M. (2017). Reading Klein. The New Library of Psychoanalysis. Routledge.

Rustin, M., & Adamo, S. M. G. (2014). Young Child Observation: A development in the theory and method of infant observation. Tavistock Clinic series. Karnac/Routledge.

Bradley, J., & Rustin, M. (2008). Work Discussion: Learning from reflective practice in working with children and families. Tavistock Clinic series. Karnac/Routledge.

Rustin, M., & Rustin, M. (2002). Mirror to Nature: Drama, Psychoanalysis and Society. Tavistock Clinic series. Karnac/Routledge.

Rustin, M., Dubinsky, A., Dubinsky, H., & Rhode, M. (1997). Psychotic states in Children. Tavistock Clinic series. Duckworth (Reprinted Karnac 2002, now Routledge).

Rustin, M., & Rustin, M. (1987). Narratives of Love and Loss: Studies in modern children’s fiction. Verso (Revised edition Karnac 2001).

Miller, L., Rustin, M., Rustin, M., & Shuttleworth, J. (1989). Closely Observed Infants. Duckworth (Now Bloomsbury, Second edition planned for 2025).