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Aim: A cancer diagnosis—and in particular a Malignant Mesothelioma (MM) one—breaks the somatopsychic balance of the individual, compromising the quality of residual life and giving rise to many negative emotions difficult to integrate and to elaborate (such as depression, fears, anxieties, hopelessness, guilt, shame, and rage). Several national and international guidelines acknowledged the importance of evaluating psychological and socio-relational features in MM patients and their caregiver. However, only few studies have investigated the subjective experience of MM patients and even less research has focused on the caregivers' experience. Thus, the aim of the present study is to investigate the lived experience of both MM patients and their caregivers, providing an in-depth comprehension of the psychological sequelae of the disease.Materials and Methods: Within a psychoanalytically-informed conceptual framework, open-ended interviews were conducted with 10 MM patients and 9 caregivers. Thematic analysis was employed: interviews were audio-recorded, transcribed verbatim, and coded in order to identify the main recurring themes across the narratives.Results: We detected four different themes: (1) bodily symptoms and embodied emotions; (2) living in or near a National Priority Contaminated Site (NCPS); (3) “nothing is like it was” (that is, the impact of the diagnosis on everyday life, the changes it causes in the family relationships, the things that are still possible to do, the mourning process); (4) “what will become of us?” (that is, worries about the impact of the diagnosis on the beloved ones, death and legacy).Discussion: MM patients and caregivers seem to be stuck in a concrete mental functioning focused on symptoms and they find it difficult to openly think and talk about the affective and emotional consequences of the diagnosis. Alongside this, they express the need to find new and less conflictual ways to stay together and talk to each other during the period of active treatments for the illness (i.e., chemotherapy, radiotherapy, etc) and the end-of-life. The results of this study have important implications for the clinical management of MM and can help develop multi-professional specialist interventions addressed to both patients and caregivers.

Aim: Research has extensively examined the relationship between defense mechanisms (DM) and personality traits. However, no study to date has explored if specific defenses (alone or in combination) are able to predict dysfunctional variants of personality domains, as conceived in the alternative DSM-5 model for personality disorders. This study aimed to investigate the relationship between DMs and DSM-5 maladaptive personality domains among adults.Materials and Methods: Three hundred and twenty-eight adults aged between 18 and 64 years old completed measures on DMs and maladapive personality domains. Regression analyses were performed to determine which DMs predicted the maladaptive personality domains of negative affectivity, detachment, antagonism, disinhibition, and psychoticism.Results: According to psychoanalytic literature, results showed that immature defenses positively predicted maladaptive personality domain scores, whereas mature defenses were generally related with better personality functioning. Moreover, different defense patterns emerged as significant predictors of the maladaptive personality domains comprised in the alternative DSM-5 model for personality disorder.Discussion: Our findings support the view that defense patterns represent core components of personality and its disorders, and suggest that an increased use of immature defenses and a reduced use of mature defenses have a negative impact on the development of personality.

This paper highlights the paucity of studies on the psychological distress and care needs of mesothelioma patients and asbestos-exposed subjects. It confirms that malignant mesothelioma is associated with the physical, emotional, and social functioning of patients, while also suggesting that the risk of developing asbestos-related diseases among asbestos-exposed subjects is associated with high levels of psychological distress, despair, and mental health difficulties.

Psychoanalytic literature on extreme traumatization usually distinguishes between natural catastrophes and man-made catastrophes. While the first ones are usually sensed as nature’s ferocity, fate, or God’s will, the second ones are experienced as a volountary and violent attack aimed at disrupting other human beings. In this paper we focus on man-made disasters caused by a profit-driven logic. When traumatization is due to irresponsible actions perpetrated by the owners of the major economic resource of a community, it deeply affects the identity of the group, entailing the loss of basic trust and lively parts of the Self. In such a situation, where the whole community is severely traumatized, psychoanalytic group therapy seems to be the most suitable setting: it allows to place the historization of the event and the creation of multiple narratives of somato-psychic suffering. Trust and faith are two crucial factors in the encounter with patients lacking a sense of vitality. The working through of each one through the group field is an essential forerunner to the construction of a recovered sense of faith and reliability that precedes the onset of a true new-beginning.

In the community of Casale Monferrato, exposure to asbestos has been an extremely traumatic event that has caused cancer and death and that has affected a variety of social and environmental aspects of the people and community. When an entire community is severely traumatized, psychoanalytic group therapy seems to be the most suitable therapeutic setting: It allows for the historization of the event and the creation of multiple narratives of somatopsychic suffering, producing a transformative effect on non-mentalized emotional aggregates. Making reference to clinical material, I will show how the possibility of sharing, with other minds, the meaning of the trauma has also brought into the field the vital aspects of each participant, which are possibly not very intense in each individual, but consistently present in the functioning of the mind of the group. I will also illustrate how this led to the development of a new and more mature psychic asset, where painful and deadly experiences connected to the trauma could be faced.

Background: Extensive research has demonstrated the positive associations among the exposure to traumatic experiences, the levels of dissociation, and the severity of psychiatric symptoms in adults. However, it has been hypothesized in clinical literature that an excessive activation of the dissociative processes following multiple traumatic experiences may jeopardize the psychological and behavioral functioning of the individuals, fostering higher levels of maladaptive personality functioning.Methods: The study involved 322 adult volunteers from Italy. Participants completed measures on traumatic experiences, dissociation, and maladaptive personality traits.Results: The number of traumatic experiences reported by participants were positively associated with dissociation scores and maladaptive personality scores. Mediation analyses showed that dissociation acted as a partial mediator in the relationship between traumatic experiences and overall maladaptive personality functioning. Regression curve analyses showed that the positive association between maladaptive personality functioning and dissociation was stronger among participants with higher exposure to traumatic experiences.Conclusion: Exposure to multiple traumatic experiences may increase the risk for an excessive activation of the dissociative processes, which in turn may generate severe impairments in multiple domains of personality functioning.

Background: Patients of malignant mesothelioma (MM) and their caregivers face significant physical and psychological challenges. The purpose of the present study is to examine the emotional impact after the diagnosis of MM in a group of patients and familial caregivers in a National Priority Contaminated Site (NPCS). Methods: A sample of 108 patients and 94 caregivers received a sociodemographic/clinical questionnaire, the Beck Depression Inventory II, the Davidson Trauma Scale, the Coping Orientation to the Problems Experienced—New Italian Version, and the Defense style questionnaire. The risk of depressive and post-traumatic stress disorder (PTSD) symptoms in relation to the strategies of coping and defense mechanisms was estimated in patients and caregivers separately by logistic regression models. Results: For patients, a high risk of depression was associated with high usage of Defense Style Questionnaire (DSQ) Isolation (OR: 53.33; 95% CI: 3.22–882.30; p = 0.01) and DSQ Somatization (OR: 16.97; 95% CI: 1.04–275.90; p = 0.05). Other significant risks emerged for some coping strategies and some defenses regarding both depression and trauma in patients and caregivers. Conclusions: This research suggests that for both patients and caregivers unconscious adaptive processes have a central role in dealing with overwhelming feelings related to the disease.