[Symposium 36] Exploring clinical cases on dissociative spectrum disorders: a transcultural psychiatry perspective on family system and implications on cultural background

[SY-36-02] Hidden dissociation in an affluent migration context: a clinical case discussion

*Michele Mattia¹ (1. Milanese Family Therapy Centre (CMTF), Swiss Office, Lugano)

The presentation will focus on a clinical case involving an adult patient from the Romansh-speaking part of Switzerland. Switzerland is composed of four regions, each with its own language and culture: German, French, Italian, and Romansh. The initial diagnoses were schizoid personality disorder, alcohol dependence syndrome, and recurrent depressive syndrome. Throughout the course of weekly personal psychotherapy, it was only after she began to build therapeutic trust that underlying family trauma and significant relational trauma within her current family began to surface. She is married and has two children. Her husband holds a significant role in the Ticino health care system. As therapy progressed, it became evident that the husband exhibited severe narcissism, creating a panopticon-like environment that entrapped the patient. The incorporation of couples' treatment progressively enabled the patient to navigate the delicate complexities of her relationship and family dynamics. The author aims to highlight how numerous cases of dissociation are often concealed within seemingly unsuspecting cultural, family, and societal systems.