Under the Skin : A Psychoanalytic Study of Body Modification book cover
1st Edition

Under the Skin
A Psychoanalytic Study of Body Modification

ISBN 9780415485708
Published March 22, 2010 by Routledge
216 Pages

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Book Description

Alessandra Lemma - Winner of the Levy-Goldfarb Award for Child Psychoanalysis!

Under the Skin considers the motivation behind why people pierce, tattoo, cosmetically enhance, or otherwise modify their body, from a psychoanalytic perspective. It discusses how the therapist can understand and help individuals for whom the manipulation of the body is felt to be psychically necessary, regardless of whether the process of modification causes pain.

In this book, psychoanalyst Alessandra Lemma draws on her work in the consulting room, as well as films, fiction, art and clinical research to suggest that the motivation for extensively modifying the surface of the body, and being excessively preoccupied with its appearance, comes from the person’s internal world – under their skin. Topics covered include:

  • body image disturbance
  • appearance anxiety
  • body dysmorphic disorder
  • the psychological function of cosmetic surgery, tattooing, piercing, and scarification.

Under the Skin provides a detailed study of the challenges posed by our embodied nature through an exploration of the unconscious phantasies that underlie the need for body modification, making it essential reading for all clinicians working with those who are preoccupied with their appearance and modify their bodies including psychotherapists, counsellors, psychiatrists and psychologists.

Table of Contents

The Body as Canvas. As You Desire Me. The Symptom of Ugliness Mirrors. Being Seen or Being Watched. Occupied Territories and Foreign Parts: Reclaiming the Body. Copies Without Originals: Envy and the Maternal Body. The Botoxing of Experience. Ink, Holes and Scars. An Order of Pure Decision.

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Alessandra Lemma is a psychoanalyst and a clinical and counselling psychologist. She is a Member of the British Psychoanalytic Society, a Senior Member of the British Association of Psychotherapists, and Associate Fellow of the British Psychological Society. She is the Trust-wide Head of Psychology at The Tavistock and Portman NHS Foundation Trust and Honorary Professor of Psychological Therapies at the School of Health and Human Sciences, Essex University. She has published widely on psychotherapy and psychoanalysis.


"It is high time for clinicians to recognise that the body matters. This book is a brilliant illustration of how psychoanalytic therapy can illuminate our struggles with the physicality of our being and suggests effective solutions for the clinical management of these. With this book, Alessandra Lemma has established herself as one of the most original and creative contributors to psychoanalytic psychotherapy. The book is replete with arresting clinical insights and provides innovative theoretical integration that the field concerned with the mind in the body has lacked for a generation." - Peter Fonagy, Freud Memorial Professor of Psychoanalysis, University College London

"Beautifully written, this book is easily approachable by a large spectrum of readers while also addressing some deeply psychoanalytic and clinical issues. By discussing specific unconscious phantasies and the hatred of reality at work in the compelling need to modify the surface of the body, the book introduces an important psychoanalytic perspective on the complex and delicate role of early maternal responsiveness in development." - Dana Birksted-Breen, Training Psychoanalyst; Joint Editor-in-Chief International Journal of Psychoanalysis

"Under the Skin, is unique as an in depth psychoanalytic study of body modification, and needs to be recognized and commended for its insightfulness and the comprehensive integration of psychoanalysis with cultural studies, literature, art, and film. It is a powerful, well written treatise in the growing field of body modification....Lemma's mind, like the bodies she investigates, is worthy of exploring as she takes us on this journey through fascinating terrain. - Melanie Suchet, Ph.D., DIVISION/Review Vol.1., No. 1