Background: Guilt and shame regulate basic human processes such as social cognition and relations. Both emotions are also involved in the aetiology and maintenance of trauma-related mental disorders such as posttraumatic stress disorder (PTSD). However, a concise scale that adequately captures these constructs is currently lacking, impeding research efforts to understand them more thoroughly.Objective: To this end, we developed the eight-item Guilt and Shame Questionnaire (GSQ-8) in English, German, and Dutch.Method: We examined the reliability and validity of the GSQ-8 in a clinical sample of adults seeking treatment for childhood-trauma-related posttraumatic stress disorder (n = 209), a sample of adults who had suffered at least one traumatic life event reporting different levels of PTSD symptoms (n = 556), and a non-clinical sample of adults (n = 156).Results: Theory-driven confirmatory factor analyses confirmed two correlated latent factors guilt and shame with four items for each factor. Across all samples, two-factor models yielded better model fit than one-factor solutions. Measurement invariance across the three samples, gender, and Dutch and German language was mostly established. Guilt and shame composite scores were associated with PTSD symptoms, depressive symptoms, life satisfaction, mental health-related quality of life, and self-blame, thus supporting scale validity. Importantly, both subscales predicted PTSD symptoms, depression, life satisfaction, and mental health-related quality of life over and above cognitions of self-blame.Conclusions: The GSQ-8 is a parsimonious, reliable, and valid tool to assess guilt and shame in clinical, sub-clinical, and non-clinical populations, allowing applications across a broad range of research questions.
We present the 8-item Guilt and Shame Questionnaire (GSQ-8), a parsimonious tool to assess guilt and shame.We found strong psychometric properties of the GSQ-8 across three samples and different languages.The GSQ-8 can be reliably used to assess shame and guilt in clinical and non-clinical work.

Background: Maladaptive trauma appraisal plays an important role in the development and maintenance of posttraumatic stress disorder (PTSD). While studies have demonstrated the effectiveness of exposure and cognitive treatments for PTSD symptomatology, the effect of such treatments on specific trauma appraisals is still not well understood.Objective: The study investigated the effect of an exposure and a cognitive restructuring internet-based treatment on specific trauma appraisals in Arabic-speaking participants with PTSD.Method: 334 participants received either an exposure (n = 167) or a cognitive restructuring (n = 167) internet-based treatment. PTSD symptom severity (PCL-5) and specific trauma appraisals (TAQ) were assessed at pre- and post-treatment. Changes in specific trauma appraisals within and between the two treatments were analyzed using multi-group change modelling. Associations between changes in PTSD symptom severity and changes in trauma appraisals were evaluated using Pearson product-moment correlation. For both treatments, participants with versus without reliable improvement were compared regarding changes in specific trauma appraisals using Welch tests. Analyses were performed on 100 multiple imputed datasets.Results: Both treatments yielded significant changes in shame, self-blame, fear, anger, and alienation (all ps < .001). Changes in betrayal were only significant in the cognitive restructuring treatment (p < .001). There was no evidence of differences between treatments for any specific trauma appraisal. Changes in PTSD symptom severity were significantly associated with changes in trauma appraisals (all ps < .001). In both treatments, participants who experienced reliable improvement in PTSD symptom severity showed significantly larger pre- to post-treatment changes in specific trauma appraisals compared to those without reliable improvement. Again, differences in betrayal were only significant in the cognitive restructuring treatment.Conclusions: The findings indicate that both treatments are effective in reducing trauma appraisals in Arabic-speaking people with PTSD. Changes in trauma appraisal seem to be associated with changes in PTSD symptomatology.Trial registration: German Clinical Trials Register identifier: DRKS00010245.
Exposure and cognitive restructuring treatment in Arabic-speaking individuals with PTSD yield significant changes in shame, self-blame, fear, anger, and alienation.Changes in PTSD symptoms are positively associated with changes in specific trauma appraisals.There is no evidence of differences between both treatments for any specific trauma appraisal.

Background: Victims of physical/sexual violence or sexual abuse commonly experience defense responses that result in feelings of guilt and shame. Although trauma-focused interventions are effective in treating post-traumatic stress disorder symptoms, the presence of trauma-related shame and guilt can potentially hinder the process of disclosure during treatment, thus diminishing their overall effectiveness. It is hypothesized that providing psychoeducation about common defense responses will reduce feelings of shame and guilt, thereby increasing receptivity to trauma-focused treatment.Objective: This paper describes the rationale, study design, and methods of the BLAME-LESS study. The effects of a brief online psychoeducation program will be compared with a waiting-list control group. The intervention aims to reduce feelings of trauma-related shame and guilt that adolescents experience regarding their own defense responses during and after physical/sexual violence or sexual abuse.Methods: Adolescents (12 - 18 years old) with a history of physical/sexual violence or sexual abuse who suffer from trauma-related feelings of shame and guilt can participate in the study. The study follows a two-arm RCT that includes 34 participants. The primary outcomes includes trauma-related feelings of shame and guilt. The secondary outcomes includes PTSD symptoms, anxiety and depression symptoms, traumatic cognitions, readiness to disclose details of memories of the trauma, and motivation to engage in trauma-focused therapy. Assessments take place after screening, at baseline, two weeks after allocation to the intervention or waiting-list, and, only for the waiting-list participants, seven weeks after allocation to the intervention.Conclusions: There is a need for treatment approaches that target trauma-related feelings of shame and guilt. A recently developed brief online psychoeducation program on defense responses during and after trauma offers victims of physical/sexual violence or sexual abuse a free and accessible way to obtain reliable and valid information. The proposed RCT will evaluate the effectiveness of this online psychoeducation program.Trial Registration: Request is pending.
Some defense responses to physical/sexual violence or sexual abuse, such as tonic immobility and appeasement behaviour, are common but unknown and raise feelings of shame and guilt.BLAME-LESS (In Dutch: On(t)schuldig) is a newly developed online psychoeducation programme that aims to reduce feelings of trauma-related shame and guilt. This programme includes explanatory animations, in-depth interviews with experts and victims, and written information accompanied by case reports.The proposed study examines the effectiveness of the brief online psychoeducation programme BLAME-LESS in a well-controlled study.

Background: Guilt and Shame, two core self-related emotions, often emerge following trauma and play an important role in the development and maintenance of post-traumatic stress disorder (PTSD). Importantly, Guilt and Shame exhibit specific focal and non-specific global impacts of trauma on self-perception, respectively.Objective and Methods: Integrating psychological theories with neuroscientific knowledge, we suggest a scheme of two diverging clinical phenotypes of PTSD, associated with distinct self-related processes and differential functionality of relevant neural networks.Proposal: The Guilt-driven phenotype is characterized by preoccupation with negative self-attributes of one\'s actions in the traumatic event. It involves altered functionality of both the salience network (SN) and the default-mode network (DMN), associated with heightened interoceptive signalling and ruminative introspection which may lead to hyperarousal and intrusive symptoms, respectively. On the contrary, the Shame-driven phenotype is characterized by global, identity-related negative self-attributions. It involves altered functionality of both the SN and the DMN, associated with blunted interoceptive signalling and diminished introspection which may result in withdrawal and anhedonia symptoms together with dissociative experiences, respectively.Conclusion: The proposed PTSD phenotypes may inform neuropsychological therapeutic interventions (e.g. self-focused psychotherapy and neuromodulation) aiming to restore the function of large-scale self-related neural processing.
Guilt and Shame are two self-related emotions that often emerge following traumatic events and may contribute to the clinical profile of post-traumatic stress disorder (PTSD).Our framework suggests Guilt and Sham driven phenotypes of post-traumatic psychopathology, associated with two self-processing deficiencies related to specific action or global identity, respectively.The proposed phenotypes may inform neuropsychological treatments aiming to restore dysfunctional neural networks, later to be evident in alleviating Guilt and Shame and improving clinical outcomes.

Moral injury is an emerging concept that captures the psychosocial consequences of involvement in and exposure to morally transgressive events. In the past decade, research on moral injury has grown exponentially. In this special collection we review papers on moral injury published in the European Journal of Psychotraumatology from its inception until December 2022, that have a primary focus on moral injury as evidenced by the words \'moral injury\' in the title or abstract. We included 19 papers on quantitative (n = 9) and qualitative (n = 5) studies of different populations including (former) military personnel (n = 9), healthcare workers (n = 4) and refugees (n = 2). Most papers (n = 15) focused on the occurrence of potentially morally injurious experiences (PMIEs), moral injury and associated factors, while four papers primarily concerned treatment. Together, the papers offer a fascinating overview of aspects of moral injury in different populations. Research is clearly widening from military personnel to other populations such as healthcare workers and refugees. Focal points included the impact of PMIEs involving children, the association of PMIEs and personal childhood victimisation, the prevalence of betrayal trauma, and the relationship between moral injury and empathy. As for treatment, points of interest included new treatment initiatives as well as findings that PMIE exposure does not impede help-seeking behaviour and response to PTSD treatment. We further discuss the wide range of phenomena that fall under moral injury definitions, the limited diversity of the moral injury literature, and the clinical utility of the moral injury construct. From conceptualisation to clinical utility and treatment, the concept of moral injury matures. Whether or not moral injury becomes a formal diagnosis, the need to examine tailored interventions to alleviate moral injury is clear.
Moral injury is increasingly studied outside military populations, such as in healthcare workers and refugees.Among the most impactful potentially morally injurious experiences (PMIEs) are those involving children, but betrayal trauma may be the most prevalent type of PMIE.There is a need for tailored, evidence-based interventions to alleviate moral injury.

Background: Suicide-loss survivors (SLSs) are recognised as an at-risk population for several psychiatric complications, including complicated grief (CG) and depression (SI). However, whereas shame is known as one of the characteristics of this population, knowledge about possible psychological processes which may moderate the contribution of shame levels to CG and depression in the aftermath of suicide loss is sparse. This study examines the role of self-disclosure - the inclination to share personal information with others - as a possible moderator of the associations of shame with CG and shame with depression over time.Method: Participants were 152 suicide-loss survivors, aged 18-70, who completed questionnaires tapping CG and depression at three time points (T1- index measurement, T2-two years after T1. and T3-four years after T1) and questionnaires tapping shame and SD at T3.Results: Hierarchical regression analyses showed that shame significantly and positively contributed to CG at T3 and to depression at T3, beyond the CG/depression trajectories. Notably, two significant interactions were found: Self-disclosure moderated the contribution of shame to CG at T3 and to depression at T3. At lower self-disclosure levels, shame\'s contribution to CG and depression was higher.Conclusion: The study\'s findings highlight shame as a significant facilitator of CG and depression in the aftermath of suicide loss. Moreover, the role of interpersonal interaction on SLSs\' distress levels and grieving process was underscored, as this interaction may serve as a buffer against the deleterious sequelae of the suicide of a loved one.
Shame significantly and positively contributed to CG and depression at trajectories.Self-disclosure moderated the contribution of shame to CG and depression at T3 beyond their natural trajectories.Interpersonal activities may serve as a buffer against the deleterious effects of suicide in the family.

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.
Cet article a été présenté initialement à la conférence du Journal intitulée « Le Déplacement: Une expérience traumatique contemporaine » qui s’est tenue à Londres en novembre 2019. Il développe la théorie de l’auteur d’une gestalt implicite d’organisation psychologique, un schéma associé de fonctions psychiques qui opère de manière intégrée pour simultanément structurer et organiser notre expérience de cohésion de soi et de continuité de soi. Cette gestalt, qui relie implicitement la formation de la peau psychique, de l’image du corps, de la peau culturelle et de l’identité personnelle et culturelle avec le lieu, fonctionne comme une présence permanente, non-consciente et émergente, une « constante » de fond: elle se développe au fil du temps et émerge à partir de l’expérience émotionnelle incarnée avec l’environnement total - humain et non-humain. L’auteur soutient que c’est la rupture de cette gestalt et les conséquences perturbantes de sa perte qui sous-tendent l’expérience du traumatisme de déplacement. Si des perturbations dans sa formation et/ou sa rupture ultérieure restent non-reconnues et non-représentées, alors l’absence crée un vide qui peut être transmis d’une génération à l’autre. L’article présente du matériel clinique décrivant ceci. Ce matériel souligne les façons dont cette gestalt peut contribuer à notre compréhension de l’angoisse collective de déplacement et du traumatisme culturel.
Ursprünglich vorgestellt auf der eintägigen Konferenz des Journals mit dem Titel ‘Displacement: Contemporary Traumatic Experience\', die im November 2019 in London stattfand, erweitert dieser Artikel die Theorie des Autors über die implizite psychologische Organisationsgestalt, ein verflochtenes Muster von psychischen Funktionen, die auf integrierte Weise funktionieren, um unsere Erfahrung von Selbstzusammenhalt und Selbstkontinuität simultan zu strukturieren und zu organisieren. Die Gestalt, die implizit die Bildung von psychischer Haut, Körperbild, kultureller Haut und sowohl persönlicher als auch kultureller Identität mit dem Ort verknüpft, fungiert als eine auftauchende unbewußte permanente Präsenz oder \'Hintergrundkonstante\'; sie entwickelt sich im Laufe der Zeit und entsteht aus dem verkörperlichten emotionalen Erleben der gesamten Umwelt - sowohl der menschlichen als auch der nichtmenschlichen. Die Autorin argumentiert dahingehend, daß es der Bruch dieser Gestalt und die desorganisierenden Folgen ihres Verlustes sind, die der Erfahrung des Vertreibungstraumas zugrunde liegen. Wenn Zerrüttungen ihrer Formation und/oder ein späterer Bruch nicht erkannt und nicht dargestellt werden entsteht eine Lücke, die generationsübergreifend übertragen werden kann. Es wird Fallmaterial vorgestellt, das dies beschreibt und aufzeigt, wie die Gestalt zu unserem Verständnis von kollektiver Vertreibungsangst und kulturellem Trauma beitragen kann.
Presentato in origine alla conferenza del Journal intitolata ‘Dislocamento: Esperienza Traumatica Contemporanea’ tenutasi a Londra nel novembre 2019, questo articolo amplia la teoria dell’Autrice sulla gestalt organizzatrice implicita, un modello associativo di funzioni psichiche che operano in modo integrato per strutturare e organizzare simultaneamente la nostra esperienza di coesione del Sè e continuità del Sè. La gestalt, che connette implicitamente la formazione della pelle psichica, l’immagine corporea, la pelle culturale e le identità sia personali che culturali con il luogo, funziona come una presenza permanente inconscia emergente o una ‘costante’ di fondo; si sviluppa nel tempo ed emerge dall’esperienza emotiva incarnata con l’ambiente totale - sia umano che non-umano. L’Autrice sostiene che è la rottura di questa gestalt e le conseguenze disorganizzanti della sua perdita che sta alla base dell’esperienza del trauma del dislocamento. Se le interruzioni nella sua formazione e/o successiva rottura rimangono non riconosciute e non rappresentate, l’assenza crea un vuoto che può essere trasmesso a livello intergenerazionale. Viene presentato il materiale di un caso che descrive tutto ciò e che evidenzia i modi in cui la gestalt può contribuire alla nostra comprensione dell’ansia collettiva da dislocamento e del trauma culturale.
Первоначально представленная в виде доклада на однодневной конференции «Перемещение: современный травматический опыт», проведенной журналом аналитической психологии в Лондоне в ноябре 2019 года, эта статья дополняет теорию автора об имплицитном психологическом организующем гештальте, наборе психических функций, которые действуют согласованным образом и мгновенно структурируют и организуют наш опыт собственной связности и непрерывности. Гештальт, который имплицитно соединяет формирование психической кожи, образа тела, культурной кожи, личностной и культурной идентичности с местом, функционирует как возникающее неосознаваемое постоянное присутствие или фоновая «константа»; оно развивается со временем и возникает из воплощенного эмоционального переживания общей среды - как созданной человеком, так и нерукотворной. Автор утверждает, что именно разрыв этого гештальта и дезорганизующие последствия его утраты лежат в основе травмы перемещения. Если нарушения в его формировании и/или последующий разрыв остаются нераспознанными и непредставленными, то затем его отсутствие создает пустоту, которая может передаваться из поколения в поколение. Представлен анализ случая, в котором описан данный процесс и который подчеркивает, каким образом гештальт может способствовать нашему пониманию коллективной тревоги по поводу перемещения и культурной травмы.
Presentado inicialmente en la Conferencia del Journal, titulada ‘Desplazamiento: Experiencia Traumática Contemporánea’ llevada a cabo en Londres, en Noviembre 2019, el presente trabajo amplía - sobre la base de la teoría de la autora sobre la Gestalt de organización psicológica implícita - un patrón asociado de funciones psíquicas, las cuales operan en un modo integrado para estructurar simultáneamente nuestra experiencia de auto-continuidad y auto-cohesión. La Gestalt, la cual implícitamente vincula la formación de la piel psíquica, la imagen corporal, la piel cultural y la identidad personal y cultural, con el lugar, funciona como una presencia permanente, emergente, no-consciente o un ‘constante’ contexto: se desarrolla a través del tiempo y emerge a partir de la experiencia emocional corporizada con la totalidad del medio ambiente - humano y no-humano. La autora argumenta que es la ruptura de esta Gestalt y las consecuencias desorganizadoras de su pérdida, la cual subyace a la experiencia de trauma por desplazamiento. Si las interrupciones en su formación y/o ruptura permanecen sin ser reconocidas y sin representación, entonces la ausencia crea un vacío que puede transmitirse intergeneracionalmente. Se presenta material de un caso que describe y subraya los modos en los cuales la Gestalt puede contribuir a nuestra comprensión sobre la ansiedad por desplazamiento colectivo y trauma cultural.
移置的创伤:个体、集体和代际间破碎的情结状态 这篇文章首先发表在2019年11月, 于伦敦举办的名为:“移置:现代的创伤体验”的一日会议上。这篇文章基于作者提出的“隐含的心理组织格式塔”理论进行了扩展, 这一理论是与心理功能关联的模式, 其运作方式是整合的, 它可以同时组织与建构我们关于自我凝聚和自我连续的经验。这一格式塔内隐地把心理皮肤、身体意象、文化皮肤的建构、个体和文化的身份与场所联系起来, 其作用是涌现的、非意识的、永久存在或是处于背景中的一种“持续性”；它持续发展并从具身的情绪经验中涌现出来, 包含了对人与非人的整体环境的体验。作者认为, 这一格式塔的断裂, 以及由于失去它, 会导致解体的结果, 这构成了移置创伤的经验。假如其结构的毁坏以及/或者后续的破裂不被觉察, 不被表达, 那么就会带来一种可以在代际间传播的空虚感。文章呈现了一些个案材料, 用以对此进行描述, 并强调了这一格式塔如何帮助我们理解集体的移置焦虑和文化创伤。.

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.
Cet article est une étude de cas détaillée d’un homme péruvien de 60 ans, réfugié. L’étude met l’accent sur l’importance de construire en espagnol une résilience émotionnelle, afin de créer un espace pour que le patient apprenne l’anglais - le patient ne parle pas l’anglais après 20 ans de vie en Grande Bretagne. Le travail s’est fait avec la participation d’un interprète, et une partie des écrits concernant le travail avec interprète est examinée. L’article s’appuie aussi brièvement sur d’autre cas cliniques, et aborde de manière générale le voyage du réfugié: un voyage allant du culturellement connu au culturellement inconnu. L’article soulève la question de comment les travaux sur la résilience, qui s’inscrivent clairement dans une perspective développementale occidentale, peuvent s’appliquer aux réfugiés, dont la plupart viennent de cultures de groupe et de cultures familiales dominées par l’idée d’honneur et de honte. L’article aborde brièvement l’impact important de l’attitude du pays d’accueil, selon qu’il offre ou non un espace transitionnel pour les réfugiés qui ont perdu leur « chez eux » (home) et qui recherchent un havre de sécurité dans une culture qui ne leur est pas familière.
Dieser Artikel gibt ausführlich die Fallstudie eines 60-jährigen peruanischen Flüchtlings wieder. Der Fokus liegt auf der hohen Bedeutung die es hat, die emotionale Resilienz eines Patienten auf Spanisch zu verbessern, um einen Raum für das Erlernen der englischen Sprache zu schaffen - der Patient sprach kein Englisch nach 20 Jahren in Großbritannien. Die Arbeit wurde mit einem Dolmetscher durchgeführt. Ein Teil der verfügbaren Literatur zur Arbeit mit Dolmetschern wird hier besprochen. Das Text greift auch kurz auf andere Fallstudien zurück und erörtert auch die Flucht selbst in groben Zügen, die eine Reise vom kulturell Bekannten zum kulturell Unbekannten ist. Die Frage wird diskutiert, wie gut sich die Literatur zur Resilienz, die fest in der westlichen Entwicklungsperspektive verankert ist, auf Flüchtlinge übertragen läßt, von denen die meisten aus Gruppen- und Familienkulturen stammen, die von Ideen der Ehre und Schande geprägt sind. Das Artikel geht auch auf die Bedeutung des Aufnahmelandes ein, das Flüchtlingen, die ihre Heimat verloren haben und in einer fremden Kultur einen sicheren Hafen suchen, einen Übergangsraum ermöglicht oder nicht.
Questo articolo descrive nel dettaglio il caso di un rifugiato peruviano di 60 anni, concentrandosi sull’importanza del costruire la resilienza emotiva nel paziente in spagnolo, in modo da creare uno spazio per l’apprendimento della lingua inglese - il paziente non parlava inglese dopo 20 anni di vita in Inghilterra. Il lavoro è stato svolto con un interprete e viene discussa parte della letteratura sul lavorare con gli interpreti. L’articolo inoltre attinge brevemente da altri casi, oltre a discutere il viaggio dei rifugiati in termini generali, un viaggio da una cultura conosciuta verso una cultura sconosciuta. Viene discussa la questione di quanto la letteratura sulla resilienza, che si colloca saldamente all’interno di una prospettiva di sviluppo occidentale, possa essere applicata ai rifugiati, la maggior parte dei quali provengono da culture basate sulla famiglia e dominate da idee di onore e vergogna. L’articolo tratta inoltre dell’importanza per il paese di accoglienza di concedere o no, a seconda delle circostanze, uno spazio di transizione per i rifugiati che hanno perso la loro casa e sono alla ricerca di un rifugio sicuro in una cultura a loro estranea.
В этой статье подробно описывается анализ случая 60-летнего перуанского беженца, в котором особое внимание уделяется важности создания эмоциональной устойчивости пациента на испанском языке, которое впоследсвтии поможет создать пространство для изучения английского языка. Пациент не говорил по-английски после 20 лет жизни в Британии. Работа проводилась с переводчиком. В статье дан небольшой обзор литературы по работе с переводчиками, кратко рассмотрены другие случаи, а также в общих чертах обсуждается путешествие беженцев, которое представляет собой путешествие от культурно известного к культурно неизвестному. Обсуждается вопрос о том, насколько хорошо исследования устойчивости, которая прочно укрепилась в западной перспективе развития, может быть применена к беженцам, большинство из которых принадлежат групповым и семейным культурам, в которых доминируют идеи чести и стыда. В статье также затрагивается важная тема: принимающая страна помогает или нет, в зависимости от обстоятельств, создать переходное пространство для беженцев, которые потеряли свой дом и стремятся найти безопасное убежище в чужой культуре.
El presente trabajo describe en detalle, un estudio de caso de un refugiado Peruano de 60 años, haciendo foco en la importancia de construir resiliencia emocional en el paciente, en idioma Español, para poder crear un espacio para el aprendizaje del idioma Inglés - el paciente no hablaba inglés luego de 20 años de vivir en Gran Bretaña. El trabajo fue llevado a cabo con un intérprete y se discute cierta literatura sobre el trabajar con intérpretes. El artículo se basa también en otros estudios de caso, así como también en la discusión del viaje del refugiado en sentido amplio, el cual es un viaje desde lo conocido cultural hacia lo desconocido cultural. Se discute el modo en que la literatura sobre resiliencia, basada en una perspectiva desarrollista Occidental, puede aplicarse a refugiados, la mayoría de quienes provienen de familias y grupos culturales dominados por ideas de honor y vergüenza. El trabajo también plantea la importancia de que el país receptor posibilite o no, como puede ser el presente caso, un espacio transicional para refugiados que han perdido sus hogares y buscan un refugio seguro en una cultura extraña.
语言、政治和梦:难民建立弹性的挑战 这篇文章描述了一个60岁秘鲁难民的案例, 其工作重点在于病人如何在西班牙建构情感的弹性, 从而创建了一个学习英语的空间--病人在英国生活20年却不会说英文。工作是通过和一位翻译一起进行的, 文章也讨论了一些翻译用语的工作。文章还简要地讨论了另外一些个案研究, 同时在更广泛的层面上讨论了一些与难民之旅有关的话题。文章认为难民之旅程是从一个熟悉的文化向未知的文化的旅程。文章讨论了一个问题, 即根植于西方发展视角的那些关于弹性的话语, 如何应用于难民群体, 这些难民通常来源于群体与家庭为基础的文化, 其主导的关键词是忠诚和羞耻。文章还谈及接收国能否为难民提供一个过渡空间的重要性, 这些难民失去了家园, 并期待在一个陌生的文化中寻找安全的天堂。.

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.

This paper looks at systems of gender within the context of analysis. It explores the unique challenges of individuation faced by transsexual, transgender, gender queer, gender non-conforming, cross-dressing and intersex patients. To receive patients generously we need to learn how a binary culture produces profound and chronic trauma. These patients wrestle with being who they are whilst simultaneously receiving negative projections and feeling invisible. While often presenting with the struggles of gender conforming individuals, understanding the specifically gendered aspect of their identity is imperative. An analyst\'s unconscious bias may lead to iatrogenic shaming. The author argues that rigorous, humble inquiry into the analyst\'s transphobia can be transformative for patient, analyst, and the work itself. Analysis may, then, provide gender-variant patients with their first remembered and numinous experience of authentic connection to self. Conjuring the image of a hinge, securely placed in the neutral region of a third space, creates a transpositive analytic temenos. Invoking the spirit of the Trickster in the construction of this matrix supports the full inclusion of gender-variant patients. Nuanced attunement scaffolds mirroring and the possibility of play. Being mindful that gender is sturdy and delicate as well as mercurial and defined enriches the analyst\'s listening.