Facing the Traumatic Field in the Clinical and Social Work with Forced Migrants Through a Psychodynamic Perspective: from “Refugee Trauma” to the Clinic of Social Links

This article aims to rethink the clinical and social work with forced migrants through the concept of “field” as it is described in the context of Bionian psychoanalysis. The proposed approach goes beyond the individual trauma of the refugee, to arrive at a clinic of the “traumatic field” that includes, but also overcomes, the dyadic relationship searching for the link between intra-psychic, inter-psychic and social dimensions. The work with mediation “devices”, the dream field, and the group as a social witness will be discussed as operational tools of a clinical social practice of intervention extended to relevant emerging social contexts.

Current social and cultural scenarios related to forced migration and war displacement pose several challenges to the psychological understanding and practice.The present article tries to reflect on these challenges and offer our personal ideas on the contribution that the psychodynamic approach can provide towards the understanding of this urgent humanitarian concern within the clinical and social work in this field.In doing this, we would like to clarify that the field of intervention being considered refers to clinical interventions in social contexts which differ widely from the context of the consulting room, not only due to the different characteristics of the setting but also due to the frequent absence of a request for help from the migrant attributable to a wide range of factors (i.e., defense mechanisms of denial, negation, avoidance or numbing, fear, lack of language proficiency etc.).
Forced migration represents a multidimensional phenomenon in which trauma emerges in its entire complexity intertwining intrapsychic, intersubjective, social, and cultural dimensions (Margherita & Tessitore, 2019).From our point of view, a psychodynamic approach to the experience of forced migration has the ability to offer useful interpretations of such a complex vision of the trauma, allowing all these different levels to stay together.
On the one hand, the repeated and visible violence of which forced migrants are increasingly victims of today (i.e., abuse, violence, persecution, imprisonment), the so called "human-made disasters" (Bohleber, 2007), determines not only a deep wound of identity but also profound changes in their psychic and brain functioning.In this sense, the ongoing contemporary interdisciplinary dialogue between psychoanalysis and the interpersonal neurobiological models (Spinazzola et al., 2021;Bromberg, 2008Bromberg, , 2011;;Shore, 2013Shore, , 2009) ) has largely demonstrated the negative impact of relational trauma on the whole brain/mind/body system and the relationship between interpersonal trauma and dissociation.
On the intrapsychic level, research has shown the existence of an alteration of the inscription of traumatic memories that, recorded mostly in the form of somatosensory elements (images, smells, physical sensations), remain 1 3 dissociated from the rest of the memory, and cannot be organized into a logical and coherent narrative (Herman & Van der Kolk, 2020).There is, therefore, a consequent failure of the capacity for symbolization, representation, and narration (Diamond, 2020).On a relational level, it is the destruction of the empathic dyad and the sense of a profound alienation from oneself, from one's own history, and from the other to prevail, determining the so-called experience of dehumanization (Jović, 2021;Mucci, 2018) in which the experience of feeling separate to the human and social community is included.
On the other hand, the experiences of interpersonal violence only represent the first and more explicit level of trauma of the forced migration experience.A deeper, pervasive, and creeping trauma can also be seen in the identity re-definition process implied by the migratory experience.In fact, migration has been described as an experience of re-birth that re-proposes the infantile condition of child inermity (the Freudian hilflossigkeit) (Grinberg & Grinberg, 1989).In this sense, the challenges faced by the migrant related to learning the language as well as the acculturation processes can be compared to those of the infans and contain a strong traumatic potentiality, which might end up generating a deep fracture of cultural identity (Margherita & Tessitore, 2019;Tessitore et al., 2023aTessitore et al., , 2023b)).
Alongside this already complex vision of migration trauma there must be a consideration of the consequences that the contact with the extraneousness produces on the intersubjective and social systems.Following the Freud (1919), we know that the other-stranger stands as a simulacrum of all the most hidden and subtle parts of the individual and society, and that the contact with it often generates primitive and radical defensive mechanisms.An example, in the case of migration, is the endemic "fear of the stranger" and the socio-political use that it has made of the sovereigntist right in the world.In these terms, we believe that the social and cultural dimensions of the phenomenon do not only describe a socio-political framework in which to frame the migration experience, but also concern aspects related to a symbolic and emotional universe that defines the social bond and the consequent reception policies and care practices of forced migrants in a peculiar way.
Starting from these premises, we believe that the clinical practice with forced migrants needs to be rethought by virtue of the weight that migration trauma assumes on all these levels and precisely assert that the psychodynamic theory could offer a useful frame to do this.
Literature on clinical interventions with those who have suffered repeated and prolonged violence of a social and political nature (i.e., political prisoners, concentration camp survivors, war veterans, women who suffer gender-based violence) has given fundamental insights on some specific adaptations of clinical practices used with this population.
Since the pioneering work of Herman-Lewis (1992), the need for interpersonal and complex trauma treatment to go through specific phases (i.e., the creation of secure conditions, the processing of mourning, the transformation of trauma memory, and the reconstruction of social relationships) has been highlighted.More recently, within the field of dissociative disorders, a phase-oriented trauma treatment for overcoming structural dissociation and complex PTSD has also been developed (Steele et al., 2005;Van der Hart et al., 2017) and standardized by the International Society for the Study of Trauma and Dissociation (2011).The recommended treatment model involves three phases: ensuring the individual's safety, reducing their symptoms, and empowering emotional, social, and psychological competencies (phase 1); processing the individual's memories of traumatic experiences (phase 2); integrating the Self to facilitate the transition from the end of the treatment to greater engagement in relationships, work or education, and community life (phase 3).
Within the process of transformation of traumatic memories, psychoanalysis has highlighted the historicization of trauma and the work of integration between historical and material truth as simultaneously preliminary and fundamental conditions that prelude the work on the symbolization processes.It has been, in fact, highlighted that these operations enhance the process of witnessing (Mucci, 2019), making the clinician able to recognize the traumatic reality, digesting memories, thoughts, and affects and allowing the restoration of the relational and social link as well as permitting the brutal reality to find new forms of representations.All these contributions and the contemporary scientific advances in the field of trauma treatment have given very useful and important suggestions on the recovery process of people who have survived extreme and complex traumatization.
Taking these levels combined, we believe that clinical intervention with forced migrants in social contexts (i.e., migrant welcoming centers as well as third sector associations) puts in place even more complex issues.First, these issues pertain to what therapists, clinical social workers, and cultural mediators can do in their practice since this is unfolded in a context in which the complexity and multidimensionality of trauma, extended from individual to collective and social dimensions, seem to push migrants, as well as professionals, to focus solely on concrete aspects, nourishing the dissociation of affective and emotional aspects, with a consequent flattening on the reality.Secondly, these issues concern how important it is for clinicians and social workers to activate an awareness about the complexity of the levels that this type of trauma entails in the mind-body-social field connections.The contribution of dynamic psychology to the mechanisms of care and support actions is to be sought not so much in the attention to reconstruct and symbolize the 1 3 traumatic experience, but in the continuous attention to the conditions for building a safe, non-intrusive and not potentially traumatic relational environment.This means being able to consider the impact of unconscious affective implications that also cross the socio-cultural systems at multiple levels.We can consider, for example, how some aspects of institutionalized care of forced migrants can represent, at some levels, a kind of re-traumatisation.Indeed, socio-institutional systems, despite seeing and recognizing the impact of trauma, call upon forced migrants, once they arrive in the host country, to recall, retell and narrate their history and traumatic experiences in order to obtain refugee status.
Starting from these premises, we would like to propose a reflection on clinical and social work in this area, attempting to extend the field model, as a wide relational and emotional container as it is described in the field of Bionian psychoanalysis.

The Field Model Applied to Clinical and Social Work with Forced Migrants
The analytical field model was born as a non-linear evolution of relational models in psychoanalysis.Its origins can be traced to the social psychology of Lewin (1951) and in the psychology of man in situation of Merlau Ponty (1945).However, in psychoanalytical terms, it was born from the concept of the bi-personal field of the franco-argentine Baranger analysts (1962) and then developed along a series of studies by contemporary authors that converge in the theory of Bion (Corrao, 1998a(Corrao, , 1998b;;Ferro, 2006;Ferro & Civitarese, 2015;Neri, 2021).
Unlike the concept of "frame" which contains the invariant conditions of the intervention, the field, from our point of view, pertains to the process and is simultaneously container and contained.The field represents a Third element located on the threshold of the dual relationship, but which can simultaneously be part of it and transcend it.In the classical psychoanalytic tradition, the Third refers to the paternal function, harking back to Freudian Oedipus and Lacan's Law of Language, and then being enriched with different meanings at the level of theory and analytic technique.The developmental importance of the Third area (or potential space) is described by Winnicott (1971) through the concept of the transitional area of experience, which allows the child (and later the adult) to hold together the illusory omnipotence of internal psychic reality and external reality.The theme of the Third therefore develops as the theme of identity in the confrontation with difference, a space in which two different visions of reality can coexist without destroying each other by recognizing themselves as similar and different at the same time (Benjamin, 2004).Its operational implications are highlighted by Ogden (1994) through the concept of the "intersubjective analytic third" that emerges from the unconscious of the analytic couple and its reveries.From our point of view, the Third can be defined as the unconscious dialogue of separate individualities, which have generated a Third subjectivity, in continuous tension and evolution.We propose to extend the idea of the "Thirdness" from a psychodynamic private care to the clinical intervention in the field of migration, since we believe that the field, becomes, on the one hand, the depository of the most unrepresentable and traumatic aspects of the migratory experience and at the same time, a container of profound transformative potential.
The complexity of unconscious dimensions seems crucial in the clinical care of forced migrants in which the traumatic experience is configured as a real violence contemporary of the intrapsychic, intersubjective, and social spaces.For this reason, we think that the field model can be useful to embody the aspects that go beyond the relational dimension of psychological and psychotherapeutic intervention with migrants and go across the clinical and social settings in a transversal way.Specifically, we propose that the work on non-symbolic traumatic elements and affective traumatic memories that settle in the field of interaction between clinician and culturally different others can be mobilized by some symbolic "devices" that might promote figurability.Therefore, we propose below the description of three operational tools of intervention, that we will illustrate with the help of some clinical material: • The work with mediation "devices".
• The dream field work to cope with the traumatic field.
• The Group as social witness

The Work with Mediation "Devices"
With the term mediation "devices" we intend some material conditions that allow the establishment of a clinical process, promoting the development of a clinical relationship with the migrant.The mediation "devices" find, therefore, concrete expression in a person or object that acts as a "connector" between the clinician and the migrant.
The mediation activity can be carried out using objectmediators in clinical settings (Vacheret, 2002): for example, plastic objects (toys, puppets), activators of sensory or cultural fields (photographs, as well as stories), that do not require verbal language and therefore overcome language barriers.The use of a mediator object in the field of forced migration that can be used at a first level of intervention can be traced back to the Asylum Seekers Photographic Interview (ASPI) (Tessitore, 2022), a qualitative instrument developed by the second author of this article.The use of this tool based on the combination between visual and narrative stimulators in the encounter with forced migrants has shed light on the multiple functions performed by the photographs as mediator-objects.Firstly, the photographs 1 3 allow the experiences to become visible and representable, since previously, due to their traumatic nature, these could not be imagined and thought about.Secondly, these make the researcher/clinician a witness to the experiences of the migrant themselves; and lastly, the photographs, as concrete symbols, allow the unfolding of traumatic memories and, therefore, of traumatic narratives (Tessitore, 2022).
Another concrete example of mediation "devices" is the cultural mediation carried out by cultural mediators within clinical intervention with forced migrants.The cultural mediator is not only an interpreter, translator, and referent of the culture of origin of the migrant but also a bridge between different languages and cultural identities.In dynamic terms, the aspects that the figure of the mediator collects in the field refers to the psychic function of testimony: witnessing and incubating (De Micco, 2017) the horror, intended as the process of hosting, in their own psychic apparatus, the inhuman.We believe, in fact, that it is precisely on the figure of the mediator, even before the clinician, that the unrepresentable and unspeakable traumatic dimensions of the migratory trauma converge and are manifested through actions or real acting out that, if contained, welcomed, and symbolized can give representation to previously unrepresentable elements.In this sense, the mediator represents a witness of the inhuman but at the same time, they contain in themselves the potential of what Kaës (2002) describes in groups with the term word bearer or spokesman.The mediator thus becomes, from our point of view, not only part of the clinical field but its founding element, a sensory-perceptual probe that orients the clinician and sometimes guides them on the path of symbolization.The gaze to the mediator, therefore, allows us to grasp aspects that are not yet representable to neither the mind of the clinician or to that of the migrant.These aspects, however, find in the mediator the ability to start being expressed, most often through body language: This example is taken from the project "MIA: Modelling of Integration and Reception pathways for refugee women victims of violence". 1The project was born from the idea of sharing a series of skills in the field of immigration and gender violence with the aim of modelling specific intervention and management paths for female asylum seekers and refugees who suffer violence.
As part of the project, an individual reception and consultation counter was set up for women asylum seekers and refugees.The counter was organized as a reception space for anyone who felt the desire to take part in the activities of the project, and directly or indirectly make a request for help.Mercy, a 21-year-old Nigerian, was one of the users of the counter.She initially approached it upon the direction of the operators of the reception center in which she resided who had developed the fear that Mercy was entangled in the circuit of sex trafficking.In view of the conversation with the Territorial Committee, the institution that evaluates the requests for international protection of migrants in Italy, the operators asked to "accompany" Mercy during the waiting time of the Committee, attempting to clarify to her the nature of the interview and the implications it would have for her future.The clinical space was composed as follows: a psychologist with psychoanalytic training, Mercy, and Susan, a Nigerian cultural mediator, present from the first interview.During the clinical interviews, Mercy's narration, as often happens in forced migrants who survived traumas of an interpersonal nature, even more in the absence of a spontaneous request for help, was completely screwed onto the migration experience, on the more visible and explicit traumatic aspects connected to it (i.e., the experience of detention in Libya, crossing the desert, etc.), and on the concrete aspects of everyday life (i.e., the lack of documents, the inadequacies of the reception center, etc.).Only after a long time did Mercy feel that the interview space was a truly safe space in which the previously unspeakable violences of her past could be deposited.In a particularly significant junction of this work, in which, for the first time, Mercy was about to tell the story of the sexual abuse suffered at the hands of her uncle since adolescence, Susan, sensing the scope of Mercy's story even before she began to speak, jumped up and positioned herself behind Mercy with her hands resting on her shoulders, accompanying Mercy's story.It seemed that Susan, with her body, powerful and protective, had felt the need to protect Mercy and to "shield" the blows of the traumatic story for her, to "cover her shoulders" allowing the narrative to unfold in a safe zone.An action, which allowed, as a dream does, to stage, dramatize, and allow all those present to feel the affective elements that were unfolding throughout the field, destabilizing the scenario of the setting.
The hypothesis supported here through this material is that the cultural mediators, gathering on themselves a series of traumatic and pre-symbolic dimensions, condense and express in their behaviors what is deposited within the field and has not yet found or cannot find a way of symbolization.Therefore, through the gestures and actions of cultural mediators (the way of being in the interview, but also the delays, forgetfulness, changes in tone of voice etc…), expression, sometimes, of acting out, the clinician can find what, through the mediator, has found a first path of access to the symbolic.In this sense, going back to the example, the traumatic elements of Mercy's past which until then had remained dissociated and which Susan seems to contact emotionally, find in her body a first form of representation 1 3 through an action, a movement of the body which aims to protect Mercy, to cover her back.From that moment, a greater deployment of symbolization processes in the field became visible through a greater fluidity of narrations and memories able to move more freely along the different psychic temporalities (past, present, and future), but also to the acquisition of a more properly subjective vertex of the narration of one's own story, from which one can start to set up a field of transformative and imaginative operations.

The Dream Field Work
We believe that where one meets primary meanings and codes not yet expressible through symbols and cultural representations, a dreamlike knowledge of the world can be helpful.Therefore, the second element of the field which we intend to describe connotes a particular mental state: the dream field work.
An important derivation of the field model is the attention to the oneiric as a specific category of the analytical encounters (Corrao, 1998b;Ferro, 1992;Ogden, 2007).This concept arises from Bion's idea of dreamlike waking thought, which describes a function of the mind that is always active, that builds on unconscious emotional thoughts-a process that takes place throughout the day as well as during the night.The mind, in fact, through the activity of alpha function, continuously transforms what comes from sensory impressions (beta elements) into visual images and elements of experience (alpha elements).Similarly, the mother's dreaming capacity, reverie, provides the possibility to process emotional experiences by returning them to the child, once transformed into alpha elements, who internalizes them with the same transformative capacity.In this scenario, psychic suffering derives from the difficulty in converting emotional experiences into thinkable alpha elements.
Following these insights, the focus of clinical and psychoanalytical practice is increasingly shifting from the content and meaning of dreams to the conditions that make the process of dreaming possible, from the dream as a psychic act to be interpreted in the psychoanalytical session to the whole session as a dream (Ferro, 2009).With respect to trauma, we can imagine dreams and trauma along a continuum of mental experience.In psychodynamic terms, what is not susceptible to representation by the psyche will be "traumatic".The trauma and dreams investigated in the Traumdeutung (1900) have the same etymology: trauma, in fact, refers to the wound, but also to the hole.
Dreaming can assume a traumatolytic function, providing a solution for the traumatic event (Ferenczi, 1932, Hartmann, 2010) with a para-therapeutic role, highlighting a mental activity that regulates, integrates, and repairs psychic processes (Margherita & Caffieri, 2022;Margherita et al., 2020Margherita et al., , 2021Margherita et al., , 2022)).If trauma disorganizes mental functioning by threatening the continuity of the Self that resorts to dissociation as a defense, the work on dreaming allows a flexible relationship with different Self-states (Bromberg, 2006).
We now present a proposal for work on trauma in forced migration that implies the attention of practitioners to a mental and intersubjective field that can be traced back to dreaming, as an area of mental functioning in which the processing of emotion generally occurs.But how do these transformations take place within the field?When is the transition from a "traumatic field" to a "dream field" possible?

Dreaming of Wounds
We would like to report another glimpse into the MIA project.This was a particularly delicate moment in the Project which began during one of the meetings of one of the planned activities: the Body Awareness Laboratory, led by a psychologist and a gynecologist on the issues of female sexuality/affectivity, health, and psychophysical well-being, offered to female asylum seekers and refugees of various origins.During the meeting in question, in introducing women to the knowledge of issues relating to sexuality and reproductive health, the gynecologist began with a series of images projected on a screen that represented the female sexual organ to illustrate its anatomical structure and functioning, images which turned out not to be neutral at all.It was a very strong moment.Nigerian women began to tell their lived experience of genital mutilation.The pain of those who had lived this experience first on their own body and then, later, as a mother, was touched.Someone spoke of the violence of these practices, some women took sides in defense of cultural traditions, other women wondered if there was a relationship between the lack of infibulation and betrayal by their own men.The group split apart.Meanwhile, the image of the slide permeated the field, like an "out of place" primitive emotional element, for all the women participants and operators.The psychologist felt obliged to point out that at times the medical vision risked fragmenting the totality of the person.The gynecologist abruptly left the meeting before its closure.
We will try to retrace with the help of the clinical case what we mean by traumatic field and dream field, and how we understand the transition from one to the other.We have recalled how in the analytic relationship the field is an entity that emerges from the encounter, going beyond the subjects at the same time, therefore tracing its origin becomes impossible.Within the clinical work that we present, we have described one of the moments in which the consequences of the trauma and wounds of migrant women came into close contact with the operators, who contributed to configuring what could not be thought of: we can define this as a common traumatic field.A common space for migrant women and female workers in which mostly undifferentiated ideas, 1 3 feelings and emotions converged.Contents related to the body, identity, female suffering, gender conflict, gender differences.The described episode marked a critical moment in the project.The bonds seemed to waver, as did the spaces of thought.The operators who experienced the extent of the emotional impact, as often happens in these clinical contexts with a high degree of complexity, a real vicarious trauma (Margherita et al., 2020;Tessitore et al., 2022Tessitore et al., , 2023aTessitore et al., , 2023b;;Troisi et al., 2021) felt the difficulty in maintaining an identity continuity of the project.In a subsequent group meeting, which brought together all the institutional operators, we returned to this moment, through a different state of mind.The group wondered with which words to address the delicate issue of FGM (female genital mutilation) in respect of human rights and in respect of relationships between cultures.The risk and inappropriateness of a stigmatizing "Western" attitude, which can cause, for those who have suffered such practices, the weight of judgment and eventual possible reactions of cultural resistance, began to be assessed.
The contact with the emotional experience and its transformation occurred when the awareness of having acted upon a part of cultural violence, through the proposal of the image-slide that seemed to be the result of an enactment (Stern, 2004), put into action traumatic emotional somatic memories, linked to unrepresentable experiences inscribed in the female body, fragmented, and wounded.Such difficult to contact primary affective experiences were present in "disintegrated" areas of the camp and had taken the path of a relational episode containing interpersonal and cultural aspects.
Before being able to name violence, a pre-symbolic thought for images was born in the group of female operators.The group began to associate stories, images, fragments of all-female stories, personal stories and read stories, stories steeped in emotional memories that linked images to other images and new narratives, in a kaleidoscopic vision of being a woman and of feminine wounds, which through a visionary thought made it possible to dream and integrate the previously dissociated mental state connected to the traumatic element.We can understand this as the creation of a dream field, identifying a peculiar shared mental state.
We do not intend to refer to the emergence of a "dream" as psychic content to interpret, but we think about the experience of dreaming as an active mental functioning that can be precluded by trauma but recovered through the reverie, in this case the ability of the operators to have a dream thought.
The affective expansion of the event allowed for a different narrative, showing the transformation of the trauma from a "foreign body" into a fluid representation, where unthinkable emotions become sufferings linked to a relational responsibility that can be reintegrated into the experience of the group and the individual.From that moment on, a better integration of the traumatic elements began to be possible at all levels, not only from the perspective of the operators who found a more open position in the encounter with emotionality.A transformation in terms of the "field" went beyond the conscious and intentional aspects of the subjects or systems (operators, migrant women, the project itself) and concerned the evolving elements of the containment situation and its conditions.A moment of creativity began which saw the emergence of new meanings and the birth of spaces designed from scratch: "third" spaces, containing different points of view that had been unpredictable until then.These aspects manifested themselves through the expression of greater autonomy and contact with their own needs: the operators requested spaces for supervision, and shortly after the women focused on the desire to be able to consider, through the project, the creation of accompanying interviews to the Territorial Committee.
From our point of view, this new growth of the field became possible from the moment in which the traumatic affective experience was crossed in shared terms, first in an unthinkable way, then slowly dreamable, and finally narratable.

The Group as Social Witness
The last instance that we would like to underline to discuss the field model is the use of the group device, which also becomes a third element in the space of the encounterclash between different cultures.
The clinical use of the concept of field has been accompanied using the group oriented in psychodynamic terms as proposed by the work of Bion who saw the basic assumptions, the group mentality, and other affective-emotional phenomena originating in the community.In describing the field, post-Bionian authors (Corrao, 1998b;Neri, 2021) reintroduced a model giving importance to proto-mental phenomena and emotional perturbations and described the field simultaneously as a shared mental state like the climate, and as an unsaturated relational and emotional container, which goes beyond people and their relationships.
Within the group device, the psychic level and the social level, the mind and the relationship find space.The group as a "whole" is a presence in people's minds which produces new relational configurations and some group-specific therapeutic factors, such as interpersonal learning, the universality of human experience, altruism, the infusion of hope, socialization and especially cohesiveness (Yalom, 1970).The cohesiveness describes, precisely, the group bonding underlying the affective experience of the relationship.
After experiences of extreme traumatization, the group can represent a privileged device for welcoming suffering, starting from the possibility of reinforcing the interrupted social bond.The group becomes, therefore, a social 1 3 microcosm that can offer a different relational experience; a place for transformation of one's own emotional background thanks to the sharing and mirroring with the others (Foulkes, 1964;Pines, 1983) and where is possible to transform what traumatic suffering has inflicted on the intersubjective bond (Margherita, 2021).Thanks to the plurality of viewpoints and the position that allows participants to experience relationships without power imbalances, one can forget or remember a community of testimony differently in the presence of a social witness (Laub, 2005).Regarding the treatment of trauma through the group, it must be emphasized that the objectives of the intervention differ from those of a classic group psychotherapy by following specific phases (Baird & Alaggia, 2021).In the early stages it focuses on the promotion of safety, support, acceptance, connection, while in the post-trauma period, on the facilitation, reintegration, and recovery.In intercultural contexts the group device shows its potential not only in the treatment and elaboration of trauma but also in the training of practitioners, through team supervision.A particular case is, for example, the ethnopsychoanalytic consultation in which the impact of migratory trauma on the psyche is elaborated with a peculiar composition of the group that sees the participation of patients, families, and operators from different services and in which everyone speaks their own language.The therapeutic factor is, precisely, a new contact with Otherness (Moro, 2004) that supports, through new modes of dialogue, a process of métissage (Moro, 2005) in which different cultural and thought systems can coexist in a mutually enriching field.When the languages are different, the group device favors the possibility of expressing oneself through a plurality of languages, overcoming cultural barriers.We might think, for example, to the use of primitive languages that do not use "words", such as the language of images.In our second example, the image of the female organ presented as an element without connections, in a slide, acted as an enactment and at the same time as a mediating object allowing for a movement in the field: something that was unrepresentable from that moment on became representable and witnessed in the presence of a social container.In relation to this episode, we can see two moments of the project with two different group devices where at first a traumatic area was contacted: the repeated violence suffered by refugee women, the torture, the traumatic result of the inhuman, as an unthinkable element has made its way in an unexpected way.The origin of such primitive elements, however, was not to be traced back only to the operators' dissociated awareness, which made the migrant women's traumatic memory present, but it was generated in a common ground, a cultural and social field that hosts dissociative processes.After this initial movement that brought the affects onto the scene, the process of elaboration became possible in the group when, starting from the awareness of the interpersonal involvement, the practitioners contacted a broader oneiric state of mind, ready to moderate the dysregulated affects that emerged by the enactment of "complex" emotional traumatic memories.

Conclusion
Through a reflection on the experience of forced migration as a multidimensional phenomenon (Margherita & Tessitore, 2019), in which the complexity of trauma emerges from the constant intertwining of intrapsychic, intersubjective, social, and cultural dimensions, the present work proposed to rethink clinical work in this field as a situation in which the category of trauma needs to be extended from the individual to the collective.In this sense, we proposed to rethink the clinical and social work in this area through the concept of the "field".We believe that it is precisely in the field, as a Third element which simultaneously contains and overcomes the dual relationship, that the most unrepresentable and traumatic aspects of the migratory experience can be deposited, and, at the same time, the deepest transformative potentialities of clinical intervention unfold.In summary, we believe that the potential to use the concept of the field lies in recognizing a space of unexpected encounter with the other, which simultaneously involves the concrete and material plane of the historical reality of trauma and the psychic-emotional plane in an un-organized "common" traumatic form.The attention to a "third space" goes beyond the shared relational experience and generates something new that has its core in the responsibility of the relationship itself, seems to contain some useful prerequisites for the taking on and healing of the individual and social trauma.
Considering the relationship as a central factor in clinical intervention with people who lived extreme traumatic experiences, we have shown some operational tools that we consider as potential "activators" of the complex work of figurability of traumatic elements that cannot be symbolized, as well as "promoters" of the sharing of dissociated traumatic memories that settle in the field of intervention.The first tool refers to the setting construction through the support of mediation devices, meaning here the setting of an "external setting" that includes some material conditions that allow the establishment of a clinical process with the migrant.The second tool, which we called the dream field work, refers to a peculiar mental state, an "internal setting", which, starting from the clinical position, extends to the entire field.In our understanding of dream work we think of a specific primitive mental functioning, a precursor of the symbolic elements, necessary to welcome and integrate the dissociative elements of the trauma.The last tool, which we have named Group as social witness, has to do with the function that the group assumes by extending the witnessing function in a relational as well as in a wider social key.

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Even the clinical work itself, in the triad formed by clinician, migrant and cultural mediator, represents, in our opinion, the prototype of a small group.
We believe our work proposed some important operational implications in terms of research, intervention, and policies, that can be partly extended from the field of forced migration to other contexts related to collective trauma.A first aspect concerns the impact of emotional aspects for social workers and, particularly, for clinical social workers working in the field of forced migration.For practitioners, clinicians, and cultural mediators a specific training centered not only on the theoretical aspects but also on the lived relational experience becomes crucial.This is both to prevent vicarious trauma and secondary traumatic stress as well as to avoid producing an environment that inadvertently reminds forced migrants of their traumatic experiences.Supporting reflecting supervision also seems necessary with devices such as groups where knowledge is built up from the collective relational experiences.In terms of policies, it would be necessary to invest in training and educational policies, as in care systems, collaborating in the development of a trauma-compliant institutional referral network.In terms of research, the investigation of the factors that promote health and well-being, taking charge of the discomfort and identity positions of which refugees and asylum seekers are bearers should go beyond an individual conception of the "refugee's trauma", aiming to take care of the trauma positioned in the link between the subject and their relations with others.This would imply the need to extend the category of trauma to relational, social, and cultural "traumatic field".We believe that the possibility of treating the impact of trauma, and eventually transforming it, can only occur to the same extent that cultural systems are able to symbolize emotions rather than dissociate them, creating a space of evolutionary transformation in which new meanings can be born, and in which strengthening the social bond and reconstituting the dimension of truthfulness of the self-other becomes possible.
It seems to us that today more than ever, amid different conflicts that are forcing millions of people to flee, these instances are becoming urgent.Now more than ever it is becoming increasingly necessary to show the important contribution that the psychodynamic approach can and must make to setting up interventions aimed at taking into consideration the complexity and understanding of individual, relational, and collective suffering.
Funding Open access funding provided by Università degli Studi di Napoli Federico II within the CRUI-CARE Agreement.