Phd in DYNAMIC AND CLINICAL PSYCHOLOGY

Thesis title: Dalla ferita relazionale alla vulnerabilità del corpo: il ruolo delle esperienze traumatiche precoci nell’epilessia e nell’insonnia

The present work integrates two empirical studies aimed at investigating the role of relational traumatic experiences during the first 18 years of life in two clinical conditions – epilepsy and insomnia – traditionally considered within the exclusive domain of neurology and medicine. With this objective, the studies explored the relationship between early traumatic experiences, emotional regulation processes (in the context of epilepsy), and defensive mechanisms (in the context of insomnia), to highlight the complex constellation of psychodynamic factors that contribute, respectively for the two disorders, to the impairment of quality of life and the worsening of symptomatology. Study 1 examined the role of emotional dysregulation as a potential mediator between childhood traumatic experiences and quality of life in individuals with epilepsy. The sample, consisting of 174 participants (89 with epilepsy and 85 controls), showed that patients with epilepsy exhibited higher levels of alexithymia and greater difficulties in emotional regulation. Within the clinical group, emotional dysregulation mediated the relationship between early trauma and seizure-related worries, indicating that emotional vulnerabilities significantly contribute to the subjective experience of the illness and to reduced quality of life. Study 2 investigated the association among childhood emotional neglect, depression, defensive mechanisms, and insomnia in a sample of 146 participants (80 with insomnia and 66 controls). Patients with insomnia reported a greater number of traumatic experiences – particularly emotional neglect – higher levels of depressive symptoms, and a greater use of neurotic and hysterical defenses. Analyses conducted within the insomnia group revealed that depression mediated the relationship between traumatic experiences and insomnia severity. Furthermore, specific dysfunctional defensive mechanisms (namely, neurotic and hysterical defenses) moderated this association, suggesting an interdependence between affect regulation, defensive functioning, and somatic symptomatology. Keywords: early traumatic relational experiences; epilepsy; insomnia; emotional dysregulation; defensive mechanisms.