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site (History of Psychiatry and Psychoanalytic Psychotherapy )
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subscribe our monthly newsletter)
Ce.Psi.Di. (Centro
di Psicoterapia Dinamica "Mauro Mancia")
Maitres à dispenser
(Our reviews about psychoanalytic congresses)
Biblio Reviews
(Recensioni)
Congressi ECM (in italian)
Events (our
congresses)
Tatiana Rosenthal and
... other 'psycho-suiciders'
Thalassa. Portolano
of Psychoanalysis
PsychoWitz
- Psychoanalysis and Humor (...per ridere un po'!)
Giuseppe Leo's Art Gallery
Spazio
Rosenthal (femininity and psychoanalysis)
Psicoanalisi Europea Video Channel
A.S.S.E.Psi. Video Channel
Ultima uscita/New issue:
"Fundamentalism and Psychoanalysis"
(3rd edition)
Edited by Giuseppe Leo
Prefaced by: Vamik D. Volkan
Writings by: H.
Abramovitch L.
Auestad W. Bohleber J. Puget S. Varvin
L. West
Publisher: Frenis Zero
Collection: Mediterranean Id-entities
Year: 2024
Pages: 267
ISBN: 978-88-97479-78-9
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here to buy the book/Compra su Amazon
"Perchè la
guerra in Ucraina ed in Europa? Psicoanalisi, trauma e resilienza"
A cura di Giuseppe Leo
Scritti di: V. Blikhar N.
Kalka
H. Katolyk L. Kuzo G. Leo
A. Marchuk
M. Tsyvinska S. Varvin
V. D. Volkan K. Zaitseva
Editore:
Frenis Zero
Collana: Id-entità Mediterranee
Anno: 2024
Pagine: 253
ISBN: 978-88-97479-76-5
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here to buy the book/Compra su Amazon
"Psicoanalisi in
una Terra Sacra. Possono gli psicoanalisti contribuire al dialogo
israelo-palestinese?"
A cura di Ambra Cusin & Giuseppe Leo
Scritti di: H.
Abramovitch A. Cusin G. Leo
M. Roth M. P. Salatiello V. Volkan
Publisher:
Frenis Zero
Collection: Id-entità Mediterranee
Year: 2024
Pages: 243
ISBN: 978-88-97479-74-1
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here to buy the book/Compra su Amazon
"Psychoanalysis
in a Holy Land" (English Edition)
Edited by Ambra Cusin & Giuseppe Leo
Writings by: H. Abramovitch A. Cusin
G. Leo M. Roth
M. P. Salatiello V. Volkan
Publisher:
Frenis Zero
Collection: Mediterranean Id-entities
Year: 2024
Pages: 227
ISBN: 978-88-97479-47-5
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here to buy the book/Compra su Amazon
"Supervision
and Psychoanalysis" (English edition)
Edited by Giuseppe Leo
Writings by: A.
Bass N.
Hoffmann
G. Leo
N. McWilliams D. Meltzer
G.
Riefolo M. Schmolke et
al.
Publisher:
Frenis Zero
Collection: Borders of Psychoanalysis
Year: 2023
Pages: 200
ISBN: 978-88-97479-46-8
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here to buy the book/Compra su Amazon
"Supervisione e Psicoanalisi" (Italian
edition)
A cura di Giuseppe Leo
Scritti di A.
Bass N. Hoffmann G. Leo
N. McWilliams D. Meltzer G.
Riefolo M. Schmolke et
al.
Editore Frenis
Zero
Collana Confini
della Psicoanalisi
Anno 2023
Pagine 210
ISBN 978-88-97479-44-4
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here to buy the book/Compra su Amazon
"Why War in
Ukraine and in Europe? Psychoanalysis, Trauma, and Resiliency" (English
Edition)
Edited by Giuseppe Leo
Writings by: V. Blikhar N.
Kalka
H. Katolyk L. Kuzo G. Leo
A. Marchuk
M. Tsyvinska S. Varvin
V. D. Volkan K. Zaitseva
Publisher:
Frenis Zero
Collection: Mediterranean Id-entities
Year: 2023
Pages: 235
ISBN: 978-88-97479-42-0
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here to buy the book/Compra su Amazon
"Neuroscience
and Psychoanalysis" (3rd English Edition)
Edited by Giuseppe Leo
Writings by: D.
Mann
G.Northoff
J. Przybyła A. N.
Schore
R. Stickgold B.A. Van Der
Kolk G.
Vaslamatzis M.P. Walker
Publisher:
Frenis Zero
Collection: Psychoanalysis and Neuroscience
Year: 2023
Pages: 321
ISBN: 978-88-97479-40-6
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here to buy the book/Compra su Amazon
"Infant
research e psicoanalisi" (ediz. italiana)
A cura di: Giuseppe Leo
Scritti di: B.
Beebe K.
Lyons-Ruth J. P.
Nahum D. Schechter E. Solheim
C. Trevarthen E. Z.
Tronick
L. Vulliez-Coady
Editore: Frenis Zero
Collana: Confini della psicoanalisi
Year: 2022
Pages: 276
ISBN: 978-88-97479-38-3
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here to buy the book/Compra su Amazon
"Crisi ecologica e pandemia. Una sfida per la
psicoanalisi"
A cura di Giuseppe Leo
Scritti di: Hilda
Catz, Anna Ferruta, Marco Francesconi, Pietro R. Goisis, Robert
Hinshelwood Giuseppe Leo, Nancy McWilliams, Giuseppe Riefolo, Merav
Roth, Cosimo Schinaia, Daniela Scotto Di Fasano, Robert D. Stolorow
Editore: Frenis Zero
Collana: Confini della Psicoanalisi
Anno: 2022
Pages: 268
ISBN: 978-88-97479-36-9
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here to buy the book/Compra su Amazon
"Enactment in
Psicoanalisi"
(Edizione Italiana)
A cura di Giuseppe Leo &
Giuseppe Riefolo
Scritti di: Galit Atlas Efrat
Ginot
Jay Greenberg Jessica
Kraus Giuseppe
Leo Giuseppe
Riefolo Jeremy Safran
Editore: Frenis Zero
Collana: Confini della Psicoanalisi
Anno: 2022
Pages: 320
ISBN: 978-88-97479-34-5
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here to buy the book/Compra su Amazon
"Blown Lives. A Tale
for Spielrein, Gross, Tausk and the other losers of
psychoanalysis" by Giuseppe Leo
Editore/Publisher: Edizioni Frenis
Zero
ISBN: 978-88-97479-32-1
Anno/Year: 2021
Pages: 284
Click here to buy the
book/Compra su Amazon
"My Ideas Felt Like
Outsize Clothes. A tale for Etty Hillesum" (Second Edition)
by Giuseppe Leo
Editore/Publisher: Edizioni Frenis
Zero
ISBN: 978-88-97479-28-4
Anno/Year: 2021
Pages: 128
Click here to buy the
book/Compra su Amazon
"Infant
Research and Psychoanalysis" (Third Edition) edited by
Giuseppe Leo
"
Edited by Giuseppe Leo
Writings by: B.
Beebe K. Lyons-Ruth J. P. Nahum D.
Schechter E. Solheim C.
Trevarthen E. Z.
Tronick
L. Vulliez-Coady
Publisher: Frenis Zero
Collection: Borders of Psychoanalysis
Year: 2021
Pages: 285
ISBN: 978-88-97479-24-6
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here to buy the book/Compra su Amazon
"Psychanalyse,
Lieux de Mémoire et Traumatismes Collectifs" (Third Edition) edited
by Giuseppe Leo
Writings by: J.
Altounian, S. Amati Sas, W. Bohleber, M. El Husseini, R. El Khayat, Y.
Gampel R. Kaës, J. Kristeva, G. Leo, A. Loncan, P. Matvejević, M.-R.
Moro, S. Resnik, S. Varvin
Editore/Publisher: Edizioni Frenis
Zero
ISBN: 978-88-97479-22-2
Anno/Year: 2021
Pages: 546
Click
here to buy the book/Compra su Amazon
"Enactment
in Psychoanalysis" - Second Edition) edited by Giuseppe Leo
& Giuseppe Riefolo
Edited by Giuseppe Leo &
Giuseppe Riefolo
Writings by: G. Atlas
E. Ginot J.R. Greenberg J.
Kraus J.D. Safran
Publisher: Frenis Zero
Collection: Borders of Psychoanalysis
Year: 2020
Pages: 333
ISBN: 978-88-97479-19-2
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here to buy the book/Compra su Amazon
"My Ideas Felt Like
Outsize Clothes. A tale for Etty Hillesum" by Giuseppe Leo
Editore/Publisher: Edizioni Frenis
Zero
ISBN: 978-88-97479-33-8
Anno/Year: 2020
Pages: 122
Click
here to order the book/Ordina
su Lulu
"Environmental
Crisis and Pandemic. A Challenge for Psychoanalysis" edited
by Giuseppe Leo (Second Edition)
Writings by: H.
Catz, A.
Ferruta,
M. Francesconi, P. R. Goisis, R. D. Hinshelwood, G. Leo, N.
McWilliams, G. Riefolo, M.
Roth, C. Schinaia, D. Scotto
Di Fasano, R. D. Stolorow
Editore/Publisher: Edizioni Frenis
Zero
ISBN: 978-88-97479-37-6
Anno/Year: 2020
Pages: 312
Click
here to order the book/Ordina
su Lulu
Click
here to buy the book/Compra su Amazon
"Psychanalyse,
Lieux de Mémoire et Traumatismes Collectifs" sous la direction
de Giuseppe Leo
Writings by: J.
Altounian, S. Amati Sas, W. Bohleber, M. El Husseini, R. El Khayat, Y.
Gampel R. Kaës, J. Kristeva, G. Leo, A. Loncan, P. Matvejević, M.-R.
Moro
Editore/Publisher: Edizioni Frenis
Zero
ISBN: 978-88-97479-29-1
Anno/Year: 2020
Pages: 482
Click
here to order the book/Ordina
su Lulu
"Fear
of Lockdown. Psychoanalysis, Pandemic Discontents and Climate
Change" edited by Giuseppe
Leo
Writings by: H.
Catz, A.
Ferruta,
M. Francesconi, P. R. Goisis, G.
Leo, N. McWilliams, G.
Riefolo, M. Roth, C.
Schinaia, D. Scotto Di Fasano
Editore/Publisher: Edizioni Frenis
Zero
ISBN: 978-88-97479-21-5
Anno/Year: 2020
Pages: 295
Click
here to order the book/Ordina
su Lulu
Click
here to buy the book/Compra su Amazon
"Rock Music & Psychoanalysis"
Second Edition
Edited
by: Giuseppe Leo
Authored
by/autori: Lewis
Aron Heather
Ferguson Joseph LeDoux Giuseppe Leo John
Shaw Rod Tweedy
Editore/Publisher: Edizioni Frenis Zero
Collection/Collana: Borders
of Psychoanalysis
Anno/Year: 2020
Pagine/Pages: 221
ISBN:978-88-97479-35-2
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here to buy the book/Compra su Amazon
"Essere nella cura"
Authored
by/autori: Giacomo
Di Marco & Isabella
Schiappadori
Editore/Publisher: Edizioni Frenis Zero
Collection/Collana: Confini
della Psicoanalisi
Anno/Year: 2019
Pagine/Pages: 210
ISBN:978-88-97479-17-8
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here to order the book
"Enactment
in Psychoanalysis"
Edited by Giuseppe Leo &
Giuseppe Riefolo
Writings by: E.
Ginot J.R. Greenberg J. Kraus J.D. Safran
Publisher: Frenis Zero
Collection: Borders of Psychoanalysis
Year: 2019
Pages: 326
ISBN: 978-88-97479-15-4
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here to order the book
"Infant Research and Psychoanalysis"
Edited by Giuseppe Leo
Writings by: B.
Beebe K. Lyons-Ruth J. P. Nahum E. Solheim C.
Trevarthen E. Z. Tronick L.
Vulliez-Coady
Publisher: Frenis Zero
Collection: Borders of Psychoanalysis
Year: 2018
Pages: 273
ISBN: 978-88-97479-14-7
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here to order the book
"Fundamentalism
and Psychoanalysis"
Edited by Giuseppe Leo
Prefaced by: Vamik D. Volkan
Writings by: L.
Auestad W. Bohleber S. Varvin
L. West
Publisher: Frenis Zero
Collection: Mediterranean Id-entities
Year: 2017
Pages: 214
ISBN: 978-88-97479-13-0
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here to order the book
"Psicoanalisi,
luoghi della resilienza ed immigrazione"
Edited
by/a cura di: Giuseppe Leo
Writings by/scritti
di:
S. Araùjo Cabral, L.
Curone,
M. Francesconi,
L.
Frattini,
S. Impagliazzo, D. Centenaro Levandowski, G. Magnani, M. Manetti, C.
Marangio, G.
A. Marra e Rosa, M.
Martelli,
M. R. Moro, R. K. Papadopoulos,
A. Pellicciari,
G. Rigon,
D. Scotto di Fasano, E. Zini, A. Zunino
Editore/Publisher: Edizioni Frenis Zero
Collection/Collana: Mediterranean
Id-entities
Anno/Year: 2017
Pagine/Pages: 372
ISBN:978-88-97479-11-6
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here to order the book
"Psicoanalisi
in Terra Santa"
Edited
by/a cura di: Ambra Cusin & Giuseppe Leo
Prefaced by/prefazione
di:
Anna Sabatini Scalmati
Writings by/scritti
di:
H. Abramovitch A. Cusin M.
Dwairy A. Lotem M.
Mansur M. P. Salatiello Afterword
by/ Postfazione
di:
Ch. U.
Schminck-Gustavus
Notes by/ Note di: Nader Akkad
Editore/Publisher: Edizioni Frenis Zero
Collection/Collana: Mediterranean
Id-entities
Anno/Year: 2017
Pagine/Pages: 170
ISBN:978-88-97479-12-3
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here to buy the book
"Essere
bambini a Gaza. Il trauma infinito"
Authored
by/autore: Maria
Patrizia
Salatiello
Editore/Publisher: Edizioni Frenis Zero
Collection/Collana: Mediterranean
Id-entities
Anno/Year: 2016
Pagine/Pages: 242
ISBN:978-88-97479-08-6
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here to buy the book
Psychoanalysis,
Collective Traumas and Memory Places (English Edition)
Edited
by/a cura di: Giuseppe Leo Prefaced by/prefazione
di:
R.D.Hinshelwood
Writings by/scritti di: J.
Altounian W.
Bohleber J.
Deutsch
H. Halberstadt-Freud Y.
Gampel
N. Janigro R.K.
Papadopoulos
M. Ritter S. Varvin H.-J. Wirth
Editore/Publisher: Edizioni Frenis Zero
Collection/Collana: Mediterranean
Id-entities
Anno/Year: 2015
Pagine/Pages: 330
ISBN:978-88-97479-09-3
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here to buy the book
"L'uomo dietro al lettino" di Gabriele Cassullodi Gabriele Cassullodi Gabriele Cassullo
Prefaced by/prefazione di: Jeremy
Holmes
Editore/Publisher: Edizioni Frenis Zero
Collection/Collana: Biografie
dell'Inconscio
Anno/Year: 2015
Pagine/Pages: 350
ISBN:978-88-97479-07-9
Click here to order the book
"Neuroscience
and Psychoanalysis" (English Edition)
Edited by/a cura di: Giuseppe Leo
Prefaced by/prefazione di:
Georg Northoff
Writings by/scritti di: D.
Mann A. N. Schore R.
Stickgold
B.A. Van Der
Kolk
G. Vaslamatzis M.P. Walker
Editore/Publisher:
Edizioni Frenis Zero
Collection/Collana: Psicoanalisi e
neuroscienze
Anno/Year: 2014
Pagine/Pages: 300
ISBN:978-88-97479-06-2
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here to order the book
Vera
Schmidt, "Scritti su psicoanalisi infantile ed educazione"
Edited by/a cura di: Giuseppe
Leo
Prefaced by/prefazione di:
Alberto
Angelini
Introduced by/introduzione di:
Vlasta
Polojaz
Afterword by/post-fazione di: Rita
Corsa
Editore/Publisher: Edizioni Frenis
Zero
Collana: Biografie dell'Inconscio
Anno/Year: 2014
Pagine/Pages: 248
ISBN:978-88-97479-05-5
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here to order the book
Resnik,
S. et al. (a cura di Monica Ferri), "L'ascolto dei sensi e dei
luoghi nella relazione terapeutica"
Writings by:A.
Ambrosini, A. Bimbi, M.
Ferri,
G. Gabbriellini, A. Luperini, S.
Resnik,
S. Rodighiero, R. Tancredi, A. Taquini
Resnik, G. Trippi
Editore/Publisher: Edizioni Frenis
Zero
Collana: Confini della Psicoanalisi
Anno/Year: 2013
Pagine/Pages: 156
ISBN:978-88-97479-04-8
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here to order the book
Silvio
G. Cusin, "Sessualità e conoscenza"
A cura di/Edited by: A. Cusin
& G. Leo
Editore/Publisher: Edizioni Frenis
Zero
Collana/Collection: Biografie
dell'Inconscio
Anno/Year: 2013
Pagine/Pages: 476
ISBN: 978-88-97479-03-1
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here to order the book
AA.VV.,
"Psicoanalisi e luoghi della riabilitazione", a cura di G. Leo e G.
Riefolo (Editors)
A cura di/Edited by: G. Leo
& G. Riefolo
Editore/Publisher: Edizioni Frenis
Zero
Collana/Collection: Id-entità
mediterranee
Anno/Year: 2013
Pagine/Pages: 426
ISBN: 978-88-903710-9-7
Prezzo/Price:
€ 39,00
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here to order the book
AA.VV.,
"Scrittura e memoria", a cura di R. Bolletti (Editor)
Writings by: J. Altounian, S. Amati Sas, A. Arslan,
R. Bolletti, P. De Silvestris, M. Morello, A. Sabatini Scalmati.
Editore/Publisher: Edizioni Frenis
Zero
Collana: Cordoglio e pregiudizio
Anno/Year: 2012
Pagine/Pages: 136
ISBN: 978-88-903710-7-3
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here to order the book
AA.VV.,
"Lo
spazio velato. Femminile e
discorso
psicoanalitico"
a cura di G. Leo e L. Montani (Editors)
Writings by: A. Cusin, J. Kristeva, A. Loncan, S.
Marino, B. Massimilla, L. Montani, A. Nunziante Cesaro, S. Parrello, M.
Sommantico, G. Stanziano, L. Tarantini, A. Zurolo.
Editore/Publisher: Edizioni Frenis
Zero
Collana: Confini della psicoanalisi
Anno/Year: 2012
Pagine/Pages: 382
ISBN: 978-88-903710-6-6
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here to order the book
AA.VV., Psychoanalysis and its Borders, a cura di G. Leo (Editor)
Writings by: J.
Altounian, P. Fonagy, G.O. Gabbard, J.S. Grotstein, R.D. Hinshelwood,
J.P. Jimenez, O.F. Kernberg, S. Resnik.
Editore/Publisher: Edizioni Frenis
Zero
Collana/Collection: Borders of
Psychoanalysis
Anno/Year: 2012
Pagine/Pages: 348
ISBN: 978-88-974790-2-4
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here to order the book
AA.VV.,
"Psicoanalisi e luoghi della negazione", a cura di A. Cusin e G. Leo
Writings by:J.
Altounian, S. Amati Sas, M. e M. Avakian, W. A.
Cusin, N. Janigro, G. Leo, B. E. Litowitz, S. Resnik, A.
Sabatini Scalmati, G. Schneider, M. Šebek,
F. Sironi, L. Tarantini.
Editore/Publisher: Edizioni Frenis
Zero
Collana/Collection: Id-entità
mediterranee
Anno/Year: 2011
Pagine/Pages: 400
ISBN: 978-88-903710-4-2
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here to order the book
"The
Voyage Out" by Virginia Woolf
Editore/Publisher: Edizioni Frenis
Zero
ISBN: 978-88-97479-01-7
Anno/Year: 2011
Pages: 672
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here to order the book
"Psicologia
dell'antisemitismo" di Imre Hermann
Author:Imre Hermann
Editore/Publisher: Edizioni Frenis
Zero
ISBN: 978-88-903710-3-5
Anno/Year: 2011
Pages: 158
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here to order the book
"Vite
soffiate. I vinti della psicoanalisi" di
Giuseppe Leo
Editore/Publisher: Edizioni Frenis
Zero
Edizione: 2a
ISBN: 978-88-903710-5-9
Anno/Year: 2011
Click
here to order the book
"La Psicoanalisi
e i suoi confini" edited by Giuseppe Leo
Writings by: J. Altounian, P. Fonagy, G.O. Gabbard, J.S. Grotstein,
R.D. Hinshelwood, J.P. Jiménez, O.F. Kernberg, S. Resnik
Editore/Publisher: Astrolabio
Ubaldini
ISBN: 978-88-340155-7-5
Anno/Year: 2009
Pages: 224
Prezzo/Price: € 20,00
"La
Psicoanalisi. Intrecci Paesaggi Confini"
Edited by S. Fizzarotti Selvaggi, G.Leo.
Writings by: Salomon Resnik, Mauro Mancia,
Andreas Giannakoulas, Mario Rossi Monti, Santa Fizzarotti Selvaggi,
Giuseppe Leo.
Publisher: Schena Editore
ISBN 88-8229-567-2
Price: € 15,00
Click
here to order the book
|
The most frequent question is always the same: what exactly does a
psychologist in Gaza?
It is almost impossible to think of a psychological intervention in a
context that appears purely medical and, of course, in an emergency
connotation.
An amputated limb, a fracture, burns and pain are closest to the object
represented in structuring a first form of intervention. It could be a
form of meaning that could be defined as ‘Adaptive Mode’ in a context
in which, every single reference to the reality represented by our
psychic conditions is lost.
The almost total destruction of entire cities, the destruction of
social construction and every form of self-determination, of individual
drive, leaves space for a mere motion of survival instinct: an
expression often used by the Gazawi is: ‘in Gaza we don't live, we
survive’.
In this context, the family no longer exists (a small clarification:
when the family does not exist, it is the community that somehow takes
care of the surviving person) and if it does exist, it is a source of
discomfort, constantly expressed by the fear and inability to care. If
I survive, I have to think of myself, how can I instead think of the
other who is different from me?
In fact, almost all of our patients reported that: ‘To stay means to
die. Seeking a place to shelter, in an area where there are no safe
places, means putting your life and that of your family at risk. It is
a responsibility that you can hardly take'.
In addition, as mentioned above, many of our patients reported anxiety
about having to go to the hospital and leave their family exposed to
the constant danger of the bombardment, as well as an inability to
decide whether to leave Gaza and separate from their family.
One woman responded thus to her husband's request to leave the Gaza
Strip with her two children: ‘If I leave and you stay here, I will die
every day. If I stay here with you, we will only die once’.
The Gaza Strip looks like a land covered in rubble, the inhabitants of
what was once Gaza City, Khan Younis, Deir Al-Balah, Rafah, struggle to
find their way around, to recognise the rubble of their homes.
What is striking is not only seeing the destruction of entire
neighbourhoods, but also the streets being torn up by the power of the
explosions. One moves with difficulty between the paths carved out
between the destroyed buildings. Instead of solid buildings there are
millions of tents. Millions of tents piled up to make room for almost
1.5 million displaced people.
To try and give a clear picture, just think that Rafah, once a small
town of 250,000 inhabitants, hosted until the time of the last invasion
(May 2024), around 1.4 million displaced people seeking shelter in what
had been defined as a ‘safe zone’.
This means not having enough space to move around in, there was toilets
1 for every 100 people, it means no privacy and it means no possibility
of escape. There is no electricity, and the water points are noticeably
overcrowded with long queues and several hours of waiting before
drinking water can be accessed.
Gaza thus presents itself as a unique context in which, even though the
framework of meaning seems to be disappearing, the clinic remains an
intersubjective exercise with sufficient possibilities for reorganising
the experience itself. Something that is lacking or still little
practised at the moment, but which is necessary for the reorganisation
of one's emotional experiences.
And so it is on this level that psychological intervention has entered,
trying to manage the space between the mind and perceived reality. In
other words, trying to work on what appears to be an individual's
inability to anchor meanings or internal representations.
And for me, this might already be the premise that could answer the
specificity of the context of intervention with respect to the question
expressed at the beginning of my speech.
To be more specific, and to contextualise what has been done and what
is still being done in Gaza, the intervention remains at a level, I
would say, more accessible, directed mainly at the emotions associated
with the representation of the outside world and that is focusing on
only one part of the experience: that of loss.
Médecins Sans Frontières has been working for several years now in
contexts where assistance for mental disorders and psychosocial
problems is extremely scarce. This happens especially during crises,
such as natural disasters or wars and violence. I am thinking not only
of Gaza but also of the war in Ukraine, the Covid-19 epidemic, the
earthquake in Syria and Turkey, and so on.
In the Gaza Strip in particular, mental health care has become a
priority that requires a constant presence on the ground to support
precisely a population affected by years of violence and conflict.
Conflicts that have not only weakened the entire health system,
especially the inability to provide holistic health care, but also,
through the long and constant exposure to trauma, violence, extreme
living conditions, forced displacement, detention and torture, make
this place one of the most affected areas in the world, with a
devastating impact on the psychological well-being of the population in
the medium and long term.
This is one of the reasons why in Gaza, as well as in the Occupied
Palestinian Territories, MoH and other medical actors, no longer speaks
of PTSD but of Ongoing Traumatic Stress Disorder to define the
uniqueness of the context and of the devastating and continuous
traumatic impact on those affected.
The psychological intervention is therefore aimed at responding on from
one side to the hospitalised patient, victim of burns, fractures or
amputations as we said before, in a transversal and patient-centred
approach.
The team composed of psychologists, psychiatrists, social workers and
counsellors, by taking charge of the patient, the caregiver and the
needs expressed by the situation experienced, focuses its intervention
mainly on pain management (through, for example, relaxation techniques,
imaginative visualisation and distraction techniques), loss and primary
needs often absent in this context.
On the other hand, the presence of a non-local
psychologist/psychotherapist ensured a psychological intervention aimed
at giving support to the helper. Our medical team, active from the very
first moments of the Israeli counteroffensive, provided aid in various
hospitals in the strip, moving from time to time following the
systematic evacuation orders transmitted by the Israeli army. Their
intervention, focused on patient care, gave no space for
self-redefinition in this new situation.
In fact, many colleagues reported during our meetings: ‘we left our
homes and started to help our fellow citizens, thinking that the war
would last little more than a couple of weeks and that, above all, it
would only affect a few members of the community, only to realise that,
within a few days, we were all the main targets’.
Hence, a recursive discourse that sees common components among both the
patients and the medical team itself. On the one hand, the presence of
clearly visible physical signs such as a dark and burnt skin (due to
continuous exposure to the sun), soliloquy, grey hair, weight loss, a
rigid facial expression.
But also psychological symptoms related to depression such as depressed
mood, loss of interest, feelings of guilt and self-pity, desire to die
in order not to experience this constant exposure to pain and loss.
Symptoms due to exposure to trauma such as recurrent thoughts,
flashbacks, avoidance, disorientation, feelings of helplessness, and
physical and psychological exhaustion.
And, finally, purely anxiety symptoms such as constant fear,
insecurity, uncertainty, catastrophic thinking. The idea of the
tomorrow does not exist and cannot be thought of as the here-and-now is
already a strong expression of uncertainty.
To conclude and to give space for possible questions or clarifications,
I would just like to emphasise that there is a clear gap in health care
for people with mental disorders and psychosocial problems worldwide,
and this lack of effective mental health care is most pronounced in the
humanitarian field.
According to WHO estimates, between 76% and 85% of people with severe
mental disorders in low- and middle-income countries receive no
treatment for their disorder, while the gap is between 35% and 50% in
high-income countries.
The projection of mental disorders in the adult population affected by
the conflict, again according to WHO data, is 5.1% for severe mental
disorders, 17% for mild and moderate mental disorders, while normal
distress and other psychological reactions occur in a higher percentage
among the whole population.
Now, we are obviously collecting data on what has been observed in
Gaza, and although these are not yet official data, but estimates
linked to the intervention of these months, and above all, they are
data also linked to the impossibility of structuring, for the moment, a
definitive intervention plan, which we must remember can only be
implemented after a cease-fire, which I sincerely hope will be imminent
and lasting, we can without a shadow of a doubt state that distress and
psychological reactions linked to the conflict in progress, are
observed in a very high percentage that almost reaches the full
totality of the people assisted.
These projections together with the devastating impact of the war on
Gaza show how it is necessary to structure an appropriate psychological
intervention from the very first moments of crisis.
A need expressed by the need to flank medical intervention (compliance)
in a holistic approach that helps the person to be an active part of
the treatment process and to find support in that often neglected field
that is psychological well-being.
I conclude with the words of a patient suffering from Covid-19 in the
intensive care unit in Baghdad, which, although outside the current
context, sums up exhaustively what has been said so far: ‘You know
doctor, it is not so much the physical pain. We (patients) know that
our doctors are doing everything to make us well. Instead, the biggest
problem is in our heads. We cannot adapt to this condition. We need
psychologists. We need psychotherapy'.
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