ISG Segments 2026-2027: Making Contact: Skin, Containment, and the Somatic in Psychic Life

 

32 Weeks | September 18, 2026 – May 21, 2027
Fridays | 10:00 am – 12:00 pm

On Skin: The Development of Psychological Skin and the Psychopathology of Being 
Kristian Kemtrup, LMFT, Ph.D.
September 18, 25; October 2, 9, 16, 23, 30; November 6, 2026

This eight week seminar introduces and explores the metaphor of “psychological skin,” a membrane that surrounds and protects the most inner, private parts of the psyche, that also allows what is “underneath the skin” to still come into meaningful contact with others and the world, ie the capacity to emotionally touch and be touched. We will begin by exploring how psychological “skin” is developed in ordinary, healthy psychological development and how skin can fail to develop, or can be destroyed, especially in cases of severe trauma or neglect. We will then examine two different ways a personality can be organized that are best seen as alternatives to the sort of healthy “skin” described earlier: fascistic character organizations and “false self bodies.” Finally, we will explore how and why our literal skin is a source of projection for anxieties, hates, and most primal feelings, and we will discuss dehumanization and racism as involving projections onto skin itself.
 

Psychic Skin-Psychic Space: Barriers to Contact at the Interface Between Mind, Body, and World 
David Gatta, Psy.D.
November 13, 20; December 4, 11, 18, 2026; January 8, 15, 22, 2027

“The ego is first and foremost a bodily ego; it is not merely a surface entity but is itself the projection of a surface.”

― Sigmund Freud, The Ego and the Id

The skin describes the integumentary system which is the largest organ system of the human body. It is a boundary demarcating inside and outside; it is a frontier of sensual experiences; it is a surface level signifier of identity; but most importantly it is a selectively permeable membrane or interface that facilitates communication through the exchange of information. And just as the body needs skin for protection and communication so to does the mind need a skin. The human being is born twice. Our body is born first and that birth we have no control over. The mind is second born and the labor that brings about that birth is protracted and not necessarily carried to term. Subjectivity is a state of perpetual gestation. 

Phrases like ‘the social fabric’, ‘psychic space, and ‘psychic skin’ are not mere metaphors but rather they point inward to a set of intra-psychically determined functions that represent and re-create the world from the inside out and the outside in, long before an awareness of self, other and world were fully possible. When Donald Winnicott spoke of the mother “bringing the world” he was emphasizing the idea that the good enough mother introduces external reality in manageable doses which meet the child’s drives thus giving rise to phantasies of response. This was our first interface. 

In this short course we will explore the problematic need to cling to surfaces at the expense of vitality which then creates the cultural sequelae tearing societies apart. From the artificiality of the digital age to reductive categories of limitation to the ontological hysteria that frames it all we will use psychoanalytic theories and our clinical experience to turn the surface outside in and inside out. Using the ideas of Didier Anzieu’s concept of the skin ego, Meltzer’s adhesive identification, Houzel’s psychic envelopes, the Barrangers' bastion, Steiner’s psychic retreats, O’Shaughnessy’s enclaves, Gatta’s oubliette, and Goldberg’s pseudo-vitality we will frame the problematics associated with the movement between contact and non-contact, interior space as refugee, and the surface as a rejection of the mind. The clinical manifestations of violent and dissociative action both individual and collective will be examined and the use of the body in these actions will be emphasized.

Touch and the Skin-Ego: Containment and Disintegration
Maiga Berzins, Psy.D. 
January 29; February 5, 12, 19; March 5, 12, 19, 26, 2027 

This course will utilize Anzieu’s concept of the skin-ego as a basis to explore concepts of touch and skin within clinical practice, with a primary focus on inpatient settings. We will explore the links between the skin-ego and the psychotic experience in an attempt to understand experiences of disintegration, permeability, and containment. Clinical material and relational theory related to issues with the skin-ego and psychosis will be discussed in an effort to develop a lens for understanding behavior and ways to treat challenging patients both in private practice and inpatient settings.

Listening 
Alice Jones, MD 
April 2, 9, 16, 23, 2027

This section will consider the sonic envelope/skin within which we live and express ourselves. Thinking about the sensations created within the clinical environment will add to our levels of listening. We will read from writers who think about the clinical hour musically, and those who link prenatal and infant experience in the sound bath to developing forms of bonding and communication. We will also listen to some poems together to notice how nuances of sound affect us.

Skin: Connections and Boundaries of Mind and Body in the Clinical Encounter 
Mary Margaret McClure, D.M.H.  
April 30; May 7, 14, 21, 2027

This section will focus on skin as a complex foundation, psychically and bodily, from earliest development throughout life, and in clinical work. We will consider the meanings of skin regarding relationship to identity, race/ethnicity and skin color, gender, youth/old age, “beauty”/“ugliness”, desires to change inner and outer and limiting forces.

Empirical References

  • Alvarez, A. (2021). The Therapist’s Voice: Discussion of “Expressivity and Transformation through Language in Work with Serious Disorder. Psychoanalytic Dialogs. 31: 664-667.
  • Jones, A. (2024). Listening: Poetry as Depth Perception. Psychoanalytic Perspectives. 17:2. 189-204. DOI: 10.1080/1551806X.2020.1748445
  • Kramer, L. (2018). The Hum of the World: A philosophy of Listening. University of California Press. pages 1-14 and 29-40.
  • Ogden, T. H. (2025). Like the belly of a bird breathing: On Winnicott’s “Mind and its relation to the psyche-soma.” In What Alive Means (1st ed., pp. 67–83). Routledge. https://doi.org/10.4324/9781003528821-7
  • Quatman, T. (2020). Mind and its relation to the psyche-soma: (1949) 1. In Accessing the Clinical Genius of Winnicott (1st ed., Vol. 1, pp. 1–23). Routledge. https://doi.org/10.4324/9781003015819-1
  • Smith, David Livingstone (2021). Making Monsters: The Uncanny Power of Dehumanization. Cambridge, MA and London, England: Harvard University Press.
  • Williams, P. (2021). The authority of tenderness : dignity and the true self in psychoanalysis / Paul Williams. (1st ed.). Routledge.
  • Williams, P. (2019). Isolation. Psychoanalytic Dialogues, 29(1), 1–12. https://doi.org/10.1080/10481885.2018.1560873

Learning Objectives

Kristian Kemptrup:

  1. Be able to define the clinical importance of the concept of “psychological skin” (Bick and Anzieu) and give two examples of patients where their current symptoms can best be explained as arising from a failure to have developed this barrier.
  2. Be able to describe Winnicott’s model of the development of psychopathology and give two examples of patients who show such pathology.
  3. Be able to define Ogden’s concept of “ontological” psychotherapy as opposed to “epistemological” psychotherapy and give three examples of clinical interventions that fit the definition of “ontological.”
  4. Be able to define the psychological “isolate” (Williams) and give two examples of patients who have suffered trauma as a result of having the isolate exposed.
  5. Be able to explain the concept of a “somatic false self” (Goldberg) and state three characteristic features that patients with a somatic false self display.
  6. Be able to explain a “fascist personality organization” (Bollas) and three characteristic features that patients with such a personality display.
  7. Be able to describe the psychotherapeutic attitude of “the authority of tenderness” (Williams,) and give two clinical examples of interventions that follow from such an attitude.
  8. Be able to state two of Smith’s criteria for what counts as “dehumanization” and give two examples of how patients of color experience dehumanization

David Gatta:

  1. Participants will be able to define and apply the concept of the skin ego to clinical formulation.
  2. Participants will be able to identify and describe the clinical manifestation of ‘surface as defense’.
  3. Participants will discuss and apply the socio-cultural and socio-political interplay between mind, body and world.
  4. Participants will be able to identify how failures in post-uterine development create the conditions for psychopathologies associated with a ‘un-formed’ ego at both the individual and cultural level.
  5. Participants will be able to identify clinical examples of dissociative phenomena associated with psychic skin defenses and apply this to clinical technique.
  6. Participants will analyze countertransference and reverie experiences associated with psychic skin defenses and apply these observations to clinical case formulation and intervention planning.
  7. Participants will evaluate psychoanalytic techniques associated with the analytic frame through consideration of both surface and underlying dimensions of experience and apply at least two such techniques to clinical case material.
  8. Participants will be better able to identify and analyze clinical examples of identity evolution, regression, and diffusion and compare these phenomena in the context of surface communications versus interior communications.

Maiga Berzins:

  1. Describe the skin-ego theory and its application to clinical practice.
  2. Explain how the skin-ego theory connects to the experience of disintegration and containment in psychosis.
  3. Discuss three ways that trauma impacts patients’ experiences of touch and skin.
  4. Identify and differentiate five responses patients have to experiences of permeability or lack of containment.
  5. Describe how aggressive behaviors can be connected to the experiences of touch and skin.
  6. Discuss two to three different methods for working with psychotic patients utilizing an understanding of touch and the skin-ego.
  7. Assess and discuss the ways in which the inpatient environment can be oppressive and ways it can be containing.
  8. Identify and evaluate at least three ways touch and skin emerge in private practice settings and discuss their clinical significance.

Alice Jones:

  1. Participants will be able to analyze and describe the elemental experience of sound and discuss at least two ways in which it forms an envelope or skin of experience.
  2. Participants will examine the theories of Alvarez and Maiello and be able to compare their uses of the sound envelope.
  3. Participants will analyze the concept of “the audible,” assess how this philosophical concept relates to sensory experience, and discuss its significance for clinical practice.
  4. Participants will demonstrate an understanding of the clinical dynamics of sound, assess the significance of this concept for psychoanalytic practice, and identify five applications of course readings on the subject to clinical practice.

Mary Margaret McClure:

  1. Participants will be able to identify and explain three psychodynamic functions of the skin in early development, including containment, boundary formation, and early object relations, and apply these concepts to two clinical examples drawn from psychotherapy practice.
  2. Participants will be able to analyze three ways bodily appearance and cosmetic modification may express unconscious conflict, identity formation, or defensive functioning, and formulate one psychodynamically informed intervention relevant to clinical work with patients concerned with body image or cosmetic change.
  3. Participants will be able to evaluate three ways skin color, race, and ethnicity influence transference, countertransference, and therapeutic alliance, and apply these concepts to two scenarios involving cross-racial or cross-cultural clinical encounters.
  4. Participants will be able to distinguish three psychodynamic meanings attached to skin and appearance across gender, aging, beauty, and ugliness, and integrate these ideas into one written or verbal case formulation addressing identity, desire, and relational experience across the lifespan.