Fordham Prizewinner 2018 – Monica Luci
The Journal of Analytical Psychology has awarded Monica Luci has won the Michael Fordham Prize 2018 for her important paper on working with refugees, entitled, ‘Disintegration of the self and the regeneration of ‘psychic skin’ in the treatment of traumatised refugees’. The paper was published in the Journal of Analytical Psychology in April 2017 (vol. 62, 2). It can be downloaded free, until 2019.
The Fordham Prize is awarded annually for the paper published in the JAP in the previous year that demonstrates the most creative and original approach to clinical analytic thinking. Monica’s paper fulfils that superbly as it demonstrates innovative clinical work, bringing in the use of the group and the wider setting in addition to individual work, including the group functioning imaginatively as their patient’s ‘psychic skin’, whilst effectively addressing his complex trauma, dissociation and deep distress.
This paper presents a tentative understanding of the characteristics of extreme traumas, elsewhere called ‘complex PTSD’, that some refugees and asylum-seekers bring into therapy. It suggests that these kinds of traumas suffered in adulthood may involve a disintegration of the self and a loss of ‘psychic skin’. This conceptualisation is derived from the treatment of a refugee who survived multiple extreme traumas and with whom efforts were made in therapy to identify a complex methodology making use of supplementary therapeutic tools in addition to individual psychotherapy. The case demonstrates how the disintegration of self implies not only a deep somato-psychic dissociation, but also a loss of intrapsychic and interpersonal space. In the treatment this was worked through via repetition of the victim-aggressor dynamics at multiple levels. In the end, the therapeutic context was structured like a set of concentric layers, creating a ‘bandage’ over the patient’s wounds whilst his ‘psychic skin’ was able to regenerate. The conditions triggered by extreme traumas in refugees challenge some of the cornerstones of individual psychoanalytic technique, as well as the idea that individual therapy may be thought of as existing in an environmental vacuum.