Like a phoenix: the journey toward core-self restoration following paediatric skin-burn injury: a psychoanalytic perspective

ABSTRACT

Severe and sudden injury to the skin during childhood may damage both the child’s outer appearance and mental state. Such a trauma can provoke a complete and utter breakdown of the core-self and regression to an ‘unintegrated’ state. We present the case of 11-year-old Michael, who played with matches, set a fire and sustained severe burn trauma. Michael was treated in our rehabilitation ward over several months and received skin treatment, physical therapy and psychotherapy. Paediatric burn injury is not only a physical struggle but is often accompanied by intense emotional distress of the child and his family. In describing Michael’s therapeutic process, we show how the restoration of the core-self, alongside the healing of the outer skin, provoke issues concerning early infantile skin formation, normative age-related conflicts and vulnerabilities specific to the child. By integrating psychoanalytic thinking into the clinical work of skin rehabilitation, following burn injury, we demonstrate how the significant relationship between the skin and the self manifest in different practice.

KEYWORDS:

• Burn
• injury
• skin
• paediatric-rehabilitation
• child-psychotherapy
• self-restoration

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. This is a retrospective study. Institutional Review Board approval was obtained for using existing patient records. In compliance with the ethical standards, data were de-identified for this study by removing the patient's name and other personal identifiable data.

Additional information

Notes on contributors

Einat Yehene

Einat Yehene, Ph.D, is a Clinical Neuropsychologist and Rehabilitation Psychologist. She is a head psychologist and a clinical instructor at the Paediatric Rehabilitation Department, at the Edmond and Lily Safra Children’s Hospital, Israel. She is also a faculty member at the Academic College of Tel Aviv-Yafo, Israel, where she lectures and clinically supervises students at the graduate programmes on topics related to psychotherapy with various clinical populations in the medical-rehabilitation setting. Her research focuses on the psychological mechanisms underlying loss perception, grief and adjustment following life altering events. Alongside this work, she maintains a private practice.

Edwa Friedlander

Edwa Friedlander is a Ph.D student in the Department of Psychology in the Hebrew University of Jerusalem, investigating prenatal risk factors for cognitive and social-communication impairments among children. Alongside her work in the research field, Edwa is a neuropsychologist and an intern in rehabilitation psychology. Edwa has completed the first half of her internship in the Paediatric Rehabilitation Department at Edmond and Lily Safra Children’s Hospital, and currently works in the Paediatric Hemato-Oncology Department at Dana-Dwek Children’s Hospital, Israel.