ECM – Scuola medica ospedaliera – Somatic Aspects, Alexithymia, and the Phenomenology of Corporeality in Dual Pathology. Clinical Practice and Treatment

The term dual pathology refers to a range of psychopathological manifestations resulting from relational, environmental, and neurofunctional factors which, taken together, lead to substance-related and non–substance-related addictive behaviors. These include pathological gambling, gaming disorder, and food addiction associated with uncontrolled eating behaviors.

The somatic aspects present in every diagnostic framework related to dual pathology have prompted the development and further exploration of a line of research that began in the 1960s. This research consistently identified characteristics in individuals with heroin dependence that closely resemble those observed in patients with psychosomatic disorders.

These characteristics converge in the definition of the construct of alexithymia, as proposed by Nemiah and Sifneos in 1970, which is now widely recognized in international scientific literature as a transdiagnostic construct.

Building on these premises, the course will explore the transnosographic aspects of alexithymia, with the aim of highlighting similarities and differences between psychosomatic conditions and dual pathology.

The course will also present ongoing research examining the relationship between alexithymia and altered sensory body awareness in dual pathology, through the presentation and discussion of longitudinal clinical studies.

Subsequently, similarities and differences in somatic features observed in heroin dependence, gambling disorder, and obesity related to eating and feeding disorders will be presented and analyzed.

Finally, the course will outline and discuss the key elements that characterize clinical intervention in dual pathology according to different levels of severity, ranging from inpatient treatment to the development of a structured therapeutic pathway, and ultimately to psychotherapeutic intervention proper.