Clinging, gripping, holding, containment: Reflections on a survival reflex and the development of a capacity to separate

Thinking the unthinkable: trauma, defence and early states of mind in the work of Alessandra Cavalli

From my experience of working with her as the editor of many of her papers, this paper seeks to elucidate the late Alessandra Cavalli's clinical and theoretical approach to analytic work through a study of the editorial process her papers went through on their way to publication. This highlights a consistent theoretical synthesis integrating Klein, Fordham, Bion, Matte-Blanco and Ferrari in an archetypal structure that was firmly rooted in Jung. This synthesis, closely interwoven into Alessandra's clinical work but never fully articulated, was primarily concerned with the impact of trauma on the developing self and how this could be ameliorated through the analytic process, especially through the transformation of raw primitive affect into representational form via the containment provided by an emotionally attuned other.

Assessing individual differences in attitudes towards touch in treatment settings: Introducing the touch & health scale

Individuals commonly receive touch in treatment settings, but there is limited research on how they perceive it. The current project sought to address this gap by: 1) developing the Touch & Health Scale (THS) - a novel instrument to measure attitudes to touch in treatment settings 2) assessing inter-individual differences in THS scores, and 3) examining the association between individuals’ THS scores and wellbeing. Data of a large U.K. adults sample ( N > 12,000) were used. THS showed Cronbach’s α between 0.636 and 0.816 and significant correlations ( p < 0.001) with day-to-day attitudes to touch. THS scores differed as a function of extraversion and avoidant attachment style. Participants with more positive attitudes to touch in treatment settings showed greater wellbeing. Overall, the study highlights the importance of a personalised approach to touch in treatment settings and provides a new scale that may act as a screening tool for this purpose.

Noah's Ark: technical and theoretical implications concerning the use of metaphor in the treatment of trauma1

In this paper, using my clinical work with a 3-year-old boy who lost his hearing when he was between 9 and 12 months old, and whose disability was only discovered when he was 22 months old, I will explore two issues of paramount technical importance when working with trauma. Firstly, it is crucial to create a boundary around the traumatic event, so that life before, during and after the trauma can be circumscribed and the traumatic event explored and hopefully understood and integrated. Secondly, it is of paramount importance to establish the level of developmental organization at the time of the trauma, especially in relation to the capacity to integrate bodily affects into mind. I will show how trauma and its vicissitudes are directly dependent on the person's capacity to resolve the splitting that trauma creates in the mind, and also the key role played by the use of metaphors in the process whereby trauma becomes thinkable and can therefore be integrated into the self.