Case Reports
Vol. 37 No. 1 (2026)
https://doi.org/10.4081/rp.2026.1167

When escape is no longer possible: the collapse of defense mechanisms and emotional rebirth in an alexithymic young adult

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Published: 30 April 2026
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Cognitive behavioral therapy, body, trauma, relational trauma

Authors

Enrico Scappatura
enrico.scappatura@gmail.com
Italian Society of Cognitive and Behavioral Therapy; Italian Association for the Study of Trauma and Dissociation/European Society for Trauma and Dissociation, Italy.

Luca, 30 years old, a sales consultant, came to my attention in the autumn of 2022, referred by a colleague. He presented in a severe state of decompensation: persistent depersonalization for five months, disabling anxiety, profound emotional disconnection, intrusive thoughts of death, and a fear of going insane. He spoke rapidly, and his narrative was confused. However, his facial expression was rigid and minimally expressive. In the initial sessions, this dichotomy between the suffering described verbally and the limited expressiveness led me to consider various diagnostic hypotheses, ranging from the autism spectrum to personality disorder presentations, including schizoid or schizophreniform conditions, which were gradually ruled out.

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How to Cite



When escape is no longer possible: the collapse of defense mechanisms and emotional rebirth in an alexithymic young adult. (2026). Ricerca Psicoanalitica, 37(1). https://doi.org/10.4081/rp.2026.1167
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