Taking Psychoanalysis off the Couch and Into the World: 2022 Sigourney Award Winner

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The 2022 Sigourney Award winner reflects on her work.

Alessandra Lemma

When I received the news that I was one of the recipients of the 2022 Sigourney Award, to say that I was surprised does not quite capture what I felt—I was, uncharacteristically, lost for words. The Award recognizes outstanding work that advances psychoanalysis around the world in the service of the public good. Receiving an award promotes reflection on one’s work to date and gives fresh impetus to future projects. It is also an opportunity to thank family, friends, colleagues, and mentors who helped shape who we become. I am especially grateful to the colleagues who generously nudged me to apply for the Sigourney Award in the first place. Without their intervention, I would not be writing this piece.

I have worked for over 30 years as a clinician in mental health care with adolescents and adults. My work has always been informed by psychoanalysis. I have practiced it as an intense intervention (up to 5 times weekly) and in its applied form as once or twice weekly psychotherapy. In an international context of cuts to mental health care, the provision of psychoanalytic interventions has been decimated. We have witnessed the systematic erosion of long term intensive analytic work in particular—a form of intervention that can make such a profound difference to people’s lives. However, the application of psychoanalytic principles to briefer, more focused psychological interventions is also important because such interventions make a psychoanalytic model more accessible to more individuals in publicly funded health care contexts. This is a challenge with which I have actively engaged.

An important part of my work over the past 10 years, which has been recognized by the Award, has been the development and manualization of a new approach to brief psychoanalytic psychotherapy for mood disorders—Dynamic Interpersonal Therapy (DIT). This has been adopted as the sole publicly funded brief psychoanalytic approach delivered within the British socialized health care system. A new generation of clinicians are now trained with public funding to offer this evidence-based approach, making psychoanalytically informed treatment available to many patients for free. The trainings are inclusive and accessible to diverse clinicians broadening the range of patients that psychoanalytic treatments reach in primary and secondary public health care settings. DIT has created greater professional awareness of psychoanalytic ideas and is frequently cited as 1 of the main reasons for increase in medically qualified practitioners seeking analytic training. The model is now offered in the Americas, Asia, Australasia, and Europe.

My unrelenting commitment to disseminating psychoanalysis also led me to apply its core principles to understanding pressing social questions and contemporary clinical challenges—this is the other strand of my work recognized by the Award. I passionately believe that as psychoanalysts we have a valuable model of the mind that can and should contribute to key social concerns as classical analysis has historically done. This has been the driver for my work, which embodies Mary Sigourney’s original vision.

Through my work in prisons back in the 1980s in the UK, I developed an interest in the body—work in any forensic setting invariably draws attention to the use made of the body to communicate what cannot yet be verbally articulated and reflected upon. Since those early beginnings, and further reinforced by my subsequent work with individuals who have body image disturbances, with individuals who become addicted to cosmetic surgery or tattooing, and with transgender individuals, I have made theoretical and clinical contributions to understanding what drives the need to modify the appearance of the body. In my own practice, I have prioritized clinical work with adolescents and adults whose point of entry into psychotherapy/analysis is through what they feel about their bodies and what they do with and to their bodies.

My interest in how embodiment shapes mind development naturally led me to explore the impact of new technologies on our embodied selves and to consider, amongst a range of topics, the impact of online pornography on youth sexual development, not least how technology disintermediates the psychic work of desire by delivering what we want without requiring any reflection on the meaning of our desires. My books such as Under the Skin: A Psychoanalytic study of Body Modification (2010), Minding the Body (2014), The Digital Age on the Couch (2017), and Transgender Identities (2022), all reflect the application of psychoanalysis to elucidate further our relationship to our bodies both inside and outside the consulting room. I hope they also serve to highlight the unique contributions that psychoanalysis can make to unravelling the complexities of 21st century life.

I am deeply honored and grateful to the Sigourney Trust for recognizing my work and for the Trust’s passionate support of psychoanalytic thinking worldwide.

Prof Lemma is a Fellow of the British Psychoanalytic Society and Chartered Clinical Psychologist, a visiting professor in the Psychoanalysis Unit at University College London and Consultant, Anna Freud National Centre for Children and Families. For 16 years, she worked at the Tavistock Clinic in London where she was, at different stages, Head of Psychology and Professor of Psychological Therapies in conjunction with Essex University.

To see previous Sigourney Award winners, see the following:

Our Work and What the Award Means to Us: 2021 Sigourney Award Winners

Supporting Our Mission: 2021 Sigourney Award Winner

The Psychoanalyst Hears, the Dermatologist Sees: 2021 Sigourney Award Winner

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