Case Report: From somatic pain to shared narrative-mentalization and intergenerational trauma in a transcultural group consultation.

INTRODUCTION

Somatic symptoms in migrant and trauma-affected young people often resist a strictly biomedical reading. Trauma, forced migration and family silences may disrupt the parental reflective function, leaving experience unsymbolized and the body as the primary site of expression. Group-based transcultural consultation (TC) has been proposed as a setting able to temporarily sustain mentalization.

METHODS

We report the case of Gloria, a young Kinyarwanda-speaking Congolese woman (Banyamulenge) followed since late adolescence after hospitalization for chronic disabling pain with somatoform features alongside ongoing investigation of possible autoimmune findings. Seven TC sessions were conducted between December 2024 and November 2025 at the Maison de Solenn (Cochin Hospital, Paris). The integral verbatim of each session and of the post-session team debriefings was analyzed by the first author under senior-author supervision, using the transcultural analytical framework developed by Maherzi et al. (2024) to identify therapeutic levers. The presentation follows the CARE guidelines.

RESULTS

Gloria's clinical picture had been shaped by pre-existing somatic and school-related difficulties since childhood, subsequently compounded by a traumatic rupture at age 13-abrupt separation from her mother and three siblings during the South-Kivu conflict-followed by forced migration and 6 years of family separation before reunification in 2023. Three therapeutic processes became visible across the sessions: a movement from a frozen body-bound symptom toward a shared narrative; a movement from mother-daughter affective indifferentiation toward incipient symbolic separation, mediated by the cultural image of the pagne (a wax-print cloth of West and Central African tradition carrying meanings of feminine identity and maternal transmission); and the emergence of culturally meaningful representations (Addolorata, Ubuntu, the "pages paires et impaires"-the even and odd pages of a shared family history).

DISCUSSION: The group dispositif may be read as a temporary mentalizing envelope in which intergenerational suffering can be progressively named, differentiated and inscribed in a shared cultural and family narrative.