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Originally presented at the Journal's one day conference entitled 'Displacement: Contemporary Traumatic Experience' held in London in November 2019, this paper expands on the author's theory of the implicit psychological organizing gestalt, an associated pattern of psychic functions which operate in an integrated way to simultaneously structure and organize our experience of self-cohesion and self-continuity. The gestalt, which implicitly links the formation of psychic skin, body image, cultural skin and both personal and cultural identity with place, functions as an emergent non-conscious permanent presence or background 'constant'. It develops over time and emerges out of embodied emotional experiencing with the total environment - both human and non-human. The author argues that it is the rupture of this gestalt and the disorganizing consequences of its loss which underlies the experience of displacement trauma. If disruptions in the formation of the gestalt and/or its later rupture remain unrecognized and unrepresented then the absence creates a void which can be intergenerationally transmitted. Case material is presented which describes this and which highlights the ways in which the gestalt can contribute to our understanding of collective displacement anxiety, cultural trauma and cultural complexes. [ABSTRACT FROM AUTHOR]

This paper describes a case study of a 60-year-old Peruvian refugee in some detail, focusing on the importance of building emotional resilience in a patient in Spanish in order to create a space for learning the English language - the patient did not speak English after 20 years of living in Britain. The work was carried out with an interpreter and some of the literature on working with interpreters is referred to. The paper also briefly outlines the refugee journey in broad terms, which is a journey from the culturally known to the culturally unknown. The question of how well the literature on resilience, which sits firmly within a Western developmental perspective, can be applied to refugees, most of whom come from group and family-based cultures dominated by ideas of honour and shame, is discussed. The paper also touches on the importance of the receiving country enabling or not, as the case may be, a transitional space for refugees who have lost their home and are seeking to find a safe haven in a strange culture. [ABSTRACT FROM AUTHOR]

The article describes the emotion of shame and its somatic, cognitive and behavioral components. The emotion of shame can be experienced in physiotherapy practice in particular conditions, for example, in patients who are overweight or have urinary incontinence. Furthermore, this emotion can also be experienced as a result of manipulation, physical nudity or more generally in the therapeutic relationship. This emotion could led to avoidance and/or early abandonment of rehabilitation treatment with negative consequences on a patient's health. What are the strategies for managing this emotion within the clinical context? [ABSTRACT FROM AUTHOR]

This article is about the author's experience of being left by suicide and the effect the experience had on her work as an analyst in the consulting room and as a member of psychological organizations. The effects are generalized to others who have been left by suicide based on the writings of those left, and on writings of authors who have researched the subject. Shame and the effects the judgments of society now and in the past have on the person who suffers this experience are central, as well as the positive and negative ways groups are used by a person left by suicide to find solace and to emerge from the darkness of such abandonment. There is a constant longing (often unconscious) for replacement of the lost one. The article seeks to help analysts and those who have been left by suicide understand the suffering and the indelible mark that is experienced when there is a suicide of someone close. Understanding by the analyst is important in order to modulate the shame of this experience. [ABSTRACT FROM AUTHOR]

This second of two papers focuses on the shame which emerged in the first 14 years of analysis of a woman who was bulimic, self-harmed, and repeatedly described herself as 'feeling like a piece of shit'. To explore this intense and pervasive shame I draw on Jung's and Laplanche's emphasis on experiences of unresolvable, non-pathological 'foreignness' or 'otherness' at the heart of the psyche. Images, metaphors, elements of clinical experience, and working hypotheses from a number of analytic traditions are used to flesh out this exploration. These include Kilborne's use of Pirandello's image of shame as like a 'hole in the paper sky' which, I suggest, points to a crack in subjectivity, and reveals our belief in the efficacy of the self to be illusory. Hultberg's observations on shame as having an existential mode (function) are also explored, as is the nature of analytic truth. Using these ideas I describe my patient's process of finding some small but freeing space in relation to her shame and self-hatred. Through enduring and learning from her shame in analysis she realized that it was part of a desperate unconscious attempt to draw close to her troubled father and so to 'love him better'. [ABSTRACT FROM AUTHOR]

This paper is the first of a two-part series which explores some of the theoretical and experiential reference points that have emerged in my work with people whose relationship to their body and/or sense of self is dominated by self-hatred and (what Hultberg describes as) existential shame. The first paper focuses on self-hatred and the second paper focuses on shame. This first paper is structured around vignettes taken from a 14-year analysis with a woman who was bulimic, self-harmed and repeatedly described herself as 'feeling like a piece of shit'. It draws together elements of Jung's concepts of the complex and symbol, and Laplanche's enigmatic signifier to focus on experiences of 'inner otherness' around which we are unconsciously organized. It also brings Jung's understanding that emotion is the chief source of consciousness into conversation with Laplanche's approach to the transference which is that by being aware that they do not 'know', the analyst provides a 'hollow' in which the patient's analytic process can evolve. These combinations of ideas are linked speculatively to emerging understandings of the neuroscience of perception and throughout the paper clinical material is used to illustrate these discussions. [ABSTRACT FROM AUTHOR]

Objective: The clinical research on shame has highlighted the role of this emotion on individual well-being, interpersonal functioning, and psychological disorders. The aim of this article is to analyse the role of shame in relation to some psychopathological variables and interpersonal abilities, also considering the potential role of early maladaptive schemas and alexithymia, in a sample of healthy individuals. We hypothesize that shame plays a mediating role in the relationship between interpersonal functioning (i.e., interpersonal sensibility, need for social approval, and lack of sociability) and psychological discomfort. Method: 110 individuals from the general population (average mean age=37.8, DS=11.9; 67 women, 43 men) completed a series of scales in order to measure for shame levels (Experience of Shame Scale, ESS), psychological dysfunction (Symptoms Check List 90, SCL-90), alexithymia's levels (Scala Alessitimica Romana, SAR), interpersonal problems (Interpersonal Problems Inventory 47, IIP-47) and early maladaptive schemas (Young Parenting Inventory, YPI). Correlation and mediation analysis have been performed. Results: A positive significant association was detected between shame intensity, psychological distress (i.e., SCL-90 subscales of anxiety, depression, phobia, paranoid ideation and hostility), interpersonal problems, alexithymia and some dysfunctional parental schemas. Mediation analyses showed that shame fully mediated the effect of interpersonal problems (i.e. lack of sociability) on levels of anxiety, paranoid ideation, phobic anxiety and hostility. Other significant, but partial, mediations have been detected when considering some other investigated variables. Conclusions: Results showed a positive relation between specific interpersonal difficulties (e.g., social approval and interpersonal sensitivity) and different levels of psychological distress (e.g., hostility, anxiety). Specifically, shame plays a pivotal role in the relationship between variables related to the lack of sociability and several criteria such as anxiety and paranoid ideation. Partial mediation of shame has been found between both alexithymia and psychological distress and interpersonal difficulties and depression. Future researches could extend these study's results involving a clinical sample and controlling for the degree of shame. [ABSTRACT FROM AUTHOR]

This paper explores the evolution of Michael Fordham's ideas concerning 'defences of the self', including his application of this concept to a group of 'difficult' adult patients in his famous 1974 paper by the same name. After tracing the relevance of Fordham's ideas to my own discovery of a 'self-care system' in the psychological material of early trauma patients (Kalsched ), I describe how Fordham's seminal notions might be revisioned in light of contemporary relational theory as well as early attachment theory and affective neuroscience. These revisionings involve an awareness that the severe woundings of early unremembered trauma are not transformable through interpretation but will inevitably be repeated in the transference, leading to mutual 'enactments' between the analytic partners and, hopefully, to a new outcome. A clinical example of one such mutual enactment between the author and his patient is provided. The paper concludes with reflections on the clinical implications of this difficult case and what it means to become a 'real person' to our patients. Finally, Jung's alchemical views on transference are shown to be useful analogies in our understanding of the necessary mutuality in the healing process with these patients. [ABSTRACT FROM AUTHOR]

Shame is a complex, socially driven, negative emotion, being characterized by specific thoughts and behaviors, and characterized by a precise emotional halo. This emotion regulates the sharing of social norms and its main goal is to protect individual's good-image and self-esteem. Shame has an adaptive function, as it guarantees affiliation to the group, maintaining its' hierarchical organization, and thus allowing survival. Intense and frequent feelings of shame play a significant role in the onset and maintenance of psychological manifestations, such as eating disorders, borderline personality disorder, post-traumatic stress disorder and, last but not least, social phobia. Although the role this emotion in regulating social relations is widely recognized, little is known about its specific role in different emotional disorders. The aim of this manuscript was to review previous findings investigating the role of shame in the onset and maintenance of specific psychological disorders, highlighting the role of early maladaptive experience and negative beliefs in the development of pathological shame feelings. In the last section of this article we reviewed the most recent clinical models that have focused on specific shame related psychotherapeutic interventions. [ABSTRACT FROM AUTHOR]

According to the model of Goal-Driven Behaviour (GDB), the mind is a system working for the control of purposeful behaviour on the basis of representations. It is constantly activated in order to detect discrepancies between the representations about how things are whished or should be (goals), and representations of how things are (beliefs). This model was used to identify the cognitive components of social emotions such as envy, shame and sense of guilt. The study aims to verify how often, in the course of cognitive-behavioural therapy (CBT), these cognitive components are present in the thoughts associated with these emotions. Moreover, the study aims to investigate which of these verbalizations can predict the severity of psychopathology. Thus, it has been taken into account the thoughts associated with feelings of envy, shame and sense of guilt, collected through the ABC of 73 patients, clustered into two groups according to severity (evaluated by means of both, the diagnosis and the functioning). Descriptive, univariate and multivariate analysis were performed. The results indicated that the categories identified by the theory of GDB "catch" appropriately the verbalizations occurred in clinical practice. In particular, the data revealed significant differences in verbalizations among severe and not severe patients relative to the emotions of envy and guilt, whereas no difference emerged concerning to the verbalizations associated with shame. Multivariate analysis showed that in all these emotions, the presence of specific verbalizations predicts a decrease in the global functioning of the patient. [ABSTRACT FROM AUTHOR]

The author argues that relations between addicts and others are dominated by untruth. Lying is explored with regards to its origin in the primordial desire for love, while it is argued that the addict regards every question posed to them as a question about their lovability. The place of deception in Twelve-Step Fellowship movement is noted and it is also argued that the latter's notion of 'rock bottom' can be understood existentially as that place where truth cannot be denied. It is further argued that addiction itself is a form of untruth, which distorts or destroys the ambiguous lived tension of existence. This form of relating leads to the destruction of self-esteem, the development of shame and distrust and the breakdown of relationships. Truth is replaced by false narratives that are individualistic and alienating. Instead of 'dwelling in truth', the addict instrumentally alters their moods to suit their own needs. The addict escapes from this position by hitting 'rock bottom', accepting the process of truth and by opening up to the other. These notions are relayed through an exploration of phenomenological theorists and a grounded example. [ABSTRACT FROM AUTHOR]