Editorial

As more research reveals the enormity of the negative health-related impacts of the Covid-19 pandemic, many of us in the mental health field have become focused on the devastating damage that the virus can wreak on people’s psychological, as well as physical, health. These pathological effects may be due to the direct action of the virus on the brain, such as inflammation, mini-strokes and an increased risk of developing dementia; less clear psychopathological mechanisms resulting in the exhaustion, ‘brain fog’, anxiety, and depression associated with long Covid; the indirect psychological impact of the virus in people who may not have had the virus but who have lost their loved ones, employment, education and many other aspects of their daily lives; and the more global consequences of poor political decision-making, the economic downturn, and neglect of addressing threats to the environment, the discrimination of people of colour, and violence towards women, all of which have been exacerbated by the pandemic, and have provoked both anxiety and anger.

The three papers in this issue are not about Covid and were written before the pandemic; however, they collectively reveal inter-related themes that are pertinent to the virus and its effects. One such theme is the close relationship that exists between body and mind; another is how to process and mourn trauma and loss without resorting to damaging defensive strategies; and a third is the vicious circle of anger and anxiety in interpersonal relationships which may result in symptoms which paralyse a person’s functioning.

The first paper, ‘Unconscious loss processing in diabetes: associations with medication adherence and quality of care’ by Francesco Marchini and his colleagues, is a study from Italy exploring the links between psychopathological dynamic processes and treatment adherence, quality of care, duration of illness and other variables in people suffering from diabetes. The paper draws on a rich psychoanalytic l