Luc Ciompi

Luc Ciompi

(Biography written at time of nomination.)

Luc Ciompi is one of the most representative and innovative Honorary Members of the ISPS and he has influenced the history of our society and its Symposiums since its beginnings up to the present date.

He was born in Florence, Italy on October 10th, 1929, the son of an Italian medical doctor and a Swiss mother. He studied medicine in Bern, Geneva and Switzerland and specialised in psychiatry and psychotherapy in Bern, Lausanne and Geneva. Along with Christian Müller, one of our founders, he conducted an extensive research program on the long-term course of severe mental illnesses from 1963 to 1972 at the Hospital de Cery in Lausanne. This unique research project, known as the "Enquête of Lausanne," still represents one of the longest and largest psychiatric follow-up studies in the world.

They were surprised to observe that the long-term course of former schizophrenics who were re-examined 36.8 years on average after their first admission was both considerably more favorable and more variable than believed up to now. Even though most patients had never, or only minimally, been treated with neuroleptic drugs or other therapeutic methods, more than half of them had completely recovered or were substantially improved. It is of special interest to observe that the long-term outcome seemed to depend more on biographic and environmental factors than on heredity, thus providing new hope in an illness so-far believed to be almost incurable.

On these bases, Ciompi questioned the traditional understanding of schizophrenia and proposed an alternative model of the evolution of the psychosis, focused on a revised version of the stress-vulnerability concept and the importance of an unfavorable environment, with a crucial role being attributed to pathogenic interactions between emotions and cognitions and  critical life-events which, provoking excessive emotional tensions, may lead to a change from normal mental functioning to psychosis in vulnerable persons.

This multifactorial understanding of schizophrenia provided new opportunities for prevention, therapy and rehabilitation which were systematically examined in Ciompi's consecutive research. Practical consequences included the reorganization of local community-based psychiatric services for crisis intervention and rehabilitation, and the creation of the open therapeutic community Soteria Berne in 1984, of which Ciompi was Director until 1998. This was the first European Soteria house which continues to function successfully after more than 20 years.  The term "Soteria" is of Greek origin and means protection and relaxation, in the present context. It was chosen in 1971 by Loren Mosher and his collaborators in San Francisco/USA as the name for a pilot project focused on a no-drug or low-drug treatment of acute schizophrenia.

Soteria Berne is a small therapeutic community where patients suffering from acute schizophrenic psychoses are treated by an innovative milieu-therapeutic and psychotherapeutic low-drug approach. This approach which induces a sustained emotional relaxation therefore became a main therapeutic approach that was not primarily achieved with neuroleptic drugs, but rather with continually and emphatically "being with" the tension-overwhelmed psychotic patient, in as normal an open, family-like, protecting and relaxing setting as possible. Evaluative research has proved that objectively, and at least equally and subjectively partially better, 2-year outcomes were achieved with much fewer drugs at Soteria Berne as compared to conventional approaches. In addition, treatment of acute schizophrenia at Soteria Berne has been continuing 10%-20% cheaper than in comparable local psychiatric institutions. Costs have been lowered by the fact that all housework (cooking, shopping, cleaning, gardening etc.) is part of the therapeutic program and thus performed by the members of the therapeutic community themselves.

The concept of affect-logic is an innovative theory of Ciompi on ubiquitous interactions between feeling and thinking, or affectivity and logic which are overtly or covertly present in all mental activities. The concept was first introduced in 1982 and has been steadily developing since them, according to the ongoing scientific progress. It represents a theoretically and practically useful synthesis of current neurobiological, psychological, psychoanalytical, socio-dynamical and evolutionary notions, revisited under the perspective of a general systems theory.

The notion of affect is understood as a broad "umbrella-notion" which covers all kinds of emotion-like phenomena. Cognition is also is understood in a broad sense which includes different functions such as perception, attention, memory and combinatory thought. Simultaneously experienced emotions, cognitions and behaviors are functionally linked and conjointly memorized. Such links are reinforced by repetition and can be further modulated by experience. There is a circular interaction between emotion and cognition, which are continually interacting in all mental activities: Specific cognitions trigger specific emotions, and specific emotions modulate and change the related cognitive functions. The evolutionary function of the affects and their operator-effects on cognition is the situation-appropriate reduction of the complexity of the surrounding cognitive world, in the service of survival. Comprehensive thought and logic are, hence, strongly dependent on the prevailing affective state. Different types of logic prevail in different affective states, e.g., a "logic of fear," a "logic of hate," a "logic of love," or, on the collective level, a "logic of war" or a "logic of peace."

The theory of affect-logic also postulates that affective-cognitive interactions are basically similar on different levels of complexity. In other words, they show a so-called fractal structure, a largely similar basic structure on the individual, interpersonal, inter-group and even international level. Prevailing affects such as, e.g., fear or anger, selectively mobilize or inhibit emotion-specific attention, memory, combinatory thought and logic in similar ways both individually and collectively. Intra-individual self-similarities over time furnish, e.g., the basis for projective personality tests which examine the fact that a small fragment of mental activity may contain significant information on life-long personality traits. Psychoanalytic transference reactions, artistic style and personality formation, are also typically self-similar phenomena of lower and higher levels of complexity. The notion of fractality permits a methodologically correct and theoretically economic transfer of small-scale (e.g. individual or interpersonal) observations on large-scale (e.g. inter-group or international) processes, and-vice versa.

The implications of affect-logic are particularly important for the technique of communication on all levels, from interpersonal to international. A particularly interesting psychotherapeutic application of affect-logic is the therapeutic community where patients suffering from acute schizophrenia are treated by a special therapeutic approach and milieu entirely focused on the overall aim of inducing a sustained emotional relaxation. Other psychiatric applications are related to general psychopathologic and psychosomatic problems, violence-prevention, crisis intervention, and body-centered psychotherapies.

Originally focused on psychiatric problems only, its basic assumptions proved eventually to be of general value. Consequently, the concept gradually developed into an interdisciplinary meta-theory with implications in all fields where affective-cognitive interactions are of importance, especially in psychology, psychiatry, psychotherapy, pedagogy, advertising, politics, micro- and macro-sociological dynamics.

Luc Ciompi's book “The psyche and schizophrenia: The Bond between Affect and Logic” Harvard University Press, Cambridge/Mass. 1988, is probably his most representative work  among  more of  250 scientific publications, including 14 books and more than 50 book contributions.

Luc Ciompi is Emeritus Professor, former Medical Director of Sociopsychiatric University Clinic and President of Swiss Society for Social Psychiatry. He has recently received the title of Doctor Honoris Causa of Lausanne University and has numerous scientific honors and awards. We have the honor to have him among our ISPS Honorary Members.

More information: www.ciompi.com

 

 

 

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