Alessandra Lemma

• University of Essex

Die Autor*innen arbeiten in Band 19 der Internationalen Psychoanalyse einen Schwerpunkt auf das Sein und die Bedingungen des Lebendig-Werdens heraus und bringen eine Vielfalt an Themen zusammen, die unter einem ontologischen Gesichtspunkt neu gedacht werden können. In Arbeiten zu Winnicotts Konzeption des Leibseelischen und der Bedeutung von »Unint...

Death and mourning are being shaped by posthumous opportunities for the dead to affect current life in ways not possible in pre-digital generations. The psychological and sociological impact of the dead "online" and of "grief tech" is only beginning to be understood. It has not yet been explored psychoanalytically until this paper that examines one...

Death and mourning are being shaped by posthumous opportunities for the dead to affect current life in ways not possible in pre-digital generations. The psychological and sociological impact of the dead “online” and of “grief tech” is only beginning to be understood. It has not yet been explored psychoanalytically until this paper that examines one...

This paper focuses on how for some young people who identify as transgender, the anticipation, and/or the actual process, of transitioning represents a movement away from something in themselves that feels wrong, painful, or traumatic and that has not yet been consciously recognised as such. This becomes a 'missing' part of the self's experience, l...

Background: Short-term psychodynamic psychotherapy (STPP) is frequently used to treat depression, but it is unclear which patients might benefit specifically. Individual participant data (IPD) meta-analyses can provide more precise effect estimates than conventional meta-analyses and identify patient-level moderators. This IPD meta-analysis examin...

La capacité des transgenres à intégrer toutes les différences entre les sexes et les préférences sexuelles est devenue un puissant moyen d’activisme et d’identification personnelle. Moins qu’un indice de marginalité, le « trans » est devenu un marqueur culturel central. Dans cet article, je soutiendrai que cette étiquette d’identité englobe une gam...

Originally published as a special issue of Psychoanalytic Psychotherapy, this collection was timed to coincide with the publication of the new NICE guideline for the treatment of depression, which will shape the context of NHS talking therapy services for the next decade. In 2005, Professor Lord Layard demonstrated for the first time that mental h...

The paper describes the development of Dynamic Interpersonal Therapy for use with complex depression (DITCC), and a pilot study testing DITCC’s effectiveness. The pilot found large pre-post improvements in well-being and distress; moderate rates of reliable improvement and clinically significant change; and curvilinear declines in depression and an...

Background Improving Access to Psychological Therapies (IAPT) services treat most patients in England who present to primary care with major depression. Psychodynamic psychotherapy is one of the psychotherapies offered. Dynamic Interpersonal Therapy (DIT) is a psychodynamic and mentalization-based treatment for depression. 16 sessions are delivered...

Background Women affected by gynaecological cancer are often unaware of the sexual consequences of both the cancer and its treatment. Most do not receive appropriate advice or help to recover sexual function, and the effect on their sexuality may be profound, both physically and emotionally. However, several potential therapies can be effective in...

The capacity of transgender to incorporate all gender variance and sexual preferences has become a powerful tool of activism and personal identification. Rather than being an index of marginality “trans” has become a central cultural site. In this paper, I will argue that this identity label encompasses a complex range of internal psychic positions...

The current article focuses on client’s perspectives of the mechanisms of change in Dynamic Interpersonal Therapy (DIT), a brief psychodynamic therapy developed for the treatment of depression. Five participants were interviewed and the transcripts were analysed using Interpretative Phenomenological Analysis (IPA). The results point out four subthe...

Cosmetic surgery and minimally invasive techniques have recently become popular. Noting the compulsive way in which many people approach these procedures, psychoanalytic scholars have conducted several studies to evaluate the possible presence of mental disorders. In this regard, Alessandra Lemma (2009, 2010a, 2010b) argued that the craving for bea...

In this article, I examine the impact of extensive modification of the body on the temporal link, which is an important feature of human identity, as it provides continuity between different representations of the self over time. I illustrate this with a case of a young boy who underwent sex reassignment surgery in late adolescence after the artifi...

Dynamic interpersonal therapy (DIT) is a brief manualised psychodynamic intervention for depression. This is a first study exploring clients’ experiences of DIT specifically and brief, manualised psychodynamic psychotherapy (PP) in general. Interpretative phenomenological analysis was the methodology employed. Five participants completed a semi-str...

In this paper the author gives an overview of some of the challenges facing psychoanalytic clinicians working in times of techno-culture. More specifically she argues that in our clinical work we can observe how technological advances and the dominant values of contemporary culture make it possible and acceptable to alter and extend the body and it...

In this paper the author questions whether the body of the analyst may be helpfully conceptualized as an embodied feature of the setting and suggests that this may be especially helpful for understanding patients who develop a symbiotic transference and for whom any variance in the analyst's body is felt to be profoundly destabilizing. In such case...

The analyst's consulting room toilet lends itself to myriad uses in the context of the analytic relationship. It is a place where "dirty" secrets may be excitedly deposited and where perverse fantasies can be fueled and acted out, as illustrated in the analysis of Mr. D. This perverse use of the analyst's toilet is contrasted with the case of Ms. C...

This article outlines the development of a manualized, brief (16 session) psychodynamic intervention—Dynamic Interpersonal Therapy (DIT)1—for the treatment of depression. DIT is based on a distillation of the evidence-based brief psychoanalytic/psychodynamic treatments pooled together from manualized approaches that were reviewed as part of the com...

Dynamic Interpersonal Therapy (DIT) was originally developed as a brief psychodynamic intervention for the treatment of depression and anxiety. More recently it has become the psychodynamic protocol for depression specifically within Improving Access to Psychological Therapies services across the U.K. The aim of the present study was to pilot and e...

Patients with functional somatic disorders (FSD) are markedly heterogeneous with regard to the factors contributing to their illness, their symptoms, and treatment response. In this article, we present a contemporary psychodynamic approach to the conceptualization and treatment of these patients based on attachment and mentalization theory. Extant...

The transsexual individual confronts the analyst with a disturbing otherness. How this otherness is understood, that is, how the analyst 'looks' at the patient through her distinctive theoretical lens impacts, in turn, on the patient's experience and what transpires between them. In this paper the author outlines a developmental model rooted in att...

Maternal hyperinvestment of the child's bodily self sometimes results in the child's terror of the feminine body, which manifests as sexual excitation in association with necrophiliac fantasies. Such a dynamic constellation is observed in people who express psychic discomfort through the body. The necrophiliac fantasy gains a stronghold in order to...

Alessandra Lemma - Winner of the Levy-Goldfarb Award for Child Psychoanalysis!.

This paper outlines the findings of a qualitative study involving interviews with eight transsexual individuals who had volunteered to take part in a television (TV) documentary about transsexuality. The participants were interviewed before taking part in the documentary and after its screening on national TV. The author proposes that for either bi...

abstract In this paper the author argues that psychoanalytic education is enhanced when (a) it attends seriously to the affective, relational and social processes that frame the experience of teaching and of learning, fostering a critical engagement with both, and (b) it engages candidates in exploring what they do (technique) in the context of the...

Patients with functional somatic disorders (FSD) represent a sizeable group in our health care system. FSD are associated with high health care use and considerable personal and economic costs. Evidence-based treatments for FSD are only modestly effective in a large subgroup of patients, particularly in the long run, which emphasizes the need to de...

Peter Fonagy and Alessandra Lemma say that the psychoanalytical approach can provide a useful and unique contribution to modern healthcare, but Paul Salkovskis and Lewis Wolpert argue that it may have no place there at all (doi:10.1136/bmj.e1188)

Dynamic Interpersonal Therapy (DIT) is a brief psychodynamic psychotherapy developed for the treatment of mood disorders. It is being rolled out as part of the Improving Access to Psychological Therapies (IAPT) initiative as the psychodynamic model for the treatment of depression. This book is a practical guide for the implementation of a brief psy...

This paper describes a protocol for a brief psychodynamic intervention (Dynamic Interpersonal Therapy; DIT) for use with depressed patients and a pilot study set out to test its acceptability and compatibility with session-by-session monitoring as a prelude to a future randomized controlled trial. Sixteen consecutively referred, depressed patients...

This paper explores the role of the key working relationship in helping traumatised and characteristically hard-to-reach young people. A grounded theory approach was used to analyse data from 18 semi-structured interviews carried out with both key workers and young users in a community-based, innovative project in Inner London, Kids Company. The fo...

This paper outlines the development of a manualized, brief (16-session) psychodynamic intervention – Dynamic Interpersonal Therapy (DIT) – for the treatment of depression. DIT is based on a distillation of the evidence-based brief psychoanalytic/psychodynamic treatments pooled together from manualized approaches that were reviewed as part of the co...

Technological advances and the dominant values of contemporary culture make it possible and acceptable to alter, extend, or altogether bypass the body and its functions in actuality and in virtual space. This has contributed to a split between the body and the self, leading to a disembodied subjectivity that may encourage a neglect of the body's un...

The use of cosmetic surgery and procedures has sharply increased in recent years. This paper outlines an object-relational framework for understanding the unconscious fantasies that may drive the pursuit of body modification and proposes three categories of such fantasies. For some individuals, the pursuit of "beauty" through cosmetic surgery provi...

The focus of this paper is on individuals who present as excessively preoccupied with their body, perceiving some aspect(s) to be 'ugly' such that they feel compelled to alter and/or conceal this 'ugly' body part. These difficulties are understood as symptoms of an underlying narcissistic disturbance. The author suggests that the relative pervasive...

A clear and thorough introduction to techniques and practice issues, as well as basic theoretical frameworks, for beginners. Psychoanalysis is not so much skill-based, as dependent upon the development of the analytic attitude, guided by principles of technique that are used in the clinical situation. Alessandra Lemma's accessible guide has been ba...

Assessment in the age of Evidene-Based PracticeThe Aims of AssessmentIntroductions: Setting the Boundaries for the AssessmentHistory Taking verus History MakingSuitability Criteria and Contraindications for Psychoanalytic TherapyWhat Should an Assessment cover?The Trial InterpretationConcluding AssessmentsSetting the ContratPsychodynamic Formulatio...

In this paper the author explores the psychic functions of lying and draws on Glasser's (1979) notions of self-preservative and sadistic violence to identify three selfobject configurations. Each of these is associated with specific anxieties to which the lie offers an apparent solution. The first configuration is sadistic lying. Here the intent is...

Thesis (PsycholD)--University of Surrey, 2000. A portfolio of study, practice and research.

This paper outlines the author's personal experience of contributing to the development of the first ever training in clinical psychology in Bangladesh. This was part of a link project between University College London and Dhaka University. It examines the challenges posed by such an enterprise through the author's experience of teaching and assess...

A traumatic event is not simply understood as an external experience, a random life incident superimposed on an individual. Instead it is reinterpreted in the mind in terms of a relationship with an internal object. A catastrophic event does not exist objectively, in its pure form, but is taken inside the mind and 'worked on' in a way that makes th...

UCL 1 What is psychodynamic therapy? Psychodynamic psychotherapy is a psychological treatment that can help people with emotional and relationship problems. It is also referred to as 'psychoanalytic psychotherapy', but for practical purposes both terms mean the same thing. One of the main ideas in psychodynamic therapy is that when something is ver...

Thesis (M.A.)--Antioch University, 1990. Includes bibliographical references (leaves 116-122).