Recipient of the Michael Fordham Prize 2017


Monica Luci - Fordham Prizewinner 2017

for her paper:

'Disintegration of the self and the regeneration of 'psychic skin' in the treatment of traumatised refugees'; JAP vol. 62, 2

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In this brief video Monica Luci introduces her prizewinning paper. 

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Abstract of the paper: 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.