Working through multiple crises: the experience of psychotherapists and psychoanalysts in Lebanon.

INTRODUCTION: This research explores the impact of the COVID-19 pandemic on psychotherapists' practices and their ability to maintain a framework despite a shared reality with their patients. The specific focus in this article is on the Lebanese context, which is characterized by a series of crises including economic collapse, the COVID-19 pandemic, and the Beirut blast. The objective of this study was to examine how the destabilization of the meta-frame due to crises necessitates adaptations in theoretical knowledge, practice, and setting. METHODS: We conducted a qualitative study among a population consisting of mental health professionals, which were recruited in Lebanon through associations and societies of psychologists, psychotherapists, and psychoanalysts. Data was collected using semi-structured individual interviews. The interviews were analyzed using interpretative phenomenological analysis (IPA), which allowed for a dynamic exploration of the participants' experiences. RESULTS: Our study revealed four superordinate themes: (1) The strained frontiers; (2) The cumulative traumatic reality and its impact; (3) A challenged professional identity; (4) The creativity stemming from collective trauma. CONCLUSIONS: Our results highlight the insecurity caused by external reality infiltrating the therapeutic setting. Online therapy allowed for continued work, but uncertainty about the online environment's impact on therapeutic relationships was observed. The study underscores the importance of adaptability, containment, and support for therapists navigating crises, particularly in the online setting.

Case Report: When Does Puberty Become Traumatic?

Puberty provokes physiological upheaval that can be psychologically traumatic and destabilizing for the child. Before the transformations of puberty, the body is a protective vessel that acts as a stable reference for the child. A child's emotional security is derived from a sense of predictability and well-being. However, the nascent sexuality and burgeoning libido experienced during puberty can trigger unsettling changes in the psycho-affective and psycho-dynamic equilibrium of the child as he or she transforms into an adolescent. This article presents puberty as a transformative experience with traumatic impact that needs to be considered in therapy conducted with adolescents. At best, pubescent trauma can cause superficial issues in a child's adaptive abilities; at worse, it can lead to pathological symptoms. This article presents a qualitative study derived from a clinical case of an adolescent girl who expresses her pubescent suffering through social withdrawal and mutism. The study determines several symptomatic and traumatic indicators caused by the sudden physiological transformations of puberty, such as perceived breaches in a child's sense of safety and the child's ability to predict. The study also explores the feelings of helplessness, vulnerability, and aloneness that pubescent adolescents endure, which are then exacerbated by the sensed inability to turn to parents for help or peers for support.