Comments by Abstracter/Translator: Although there is no explicitly identified theme for this number of the Rivista, most of the articles deal with symbolization. Vallino describes the importance of ultimately enabling the symbolic representation of pathological transferences in trauma cases. In a sociological/psychoanalytic analysis, Contardi describes the current trend toward emphasizing action at the expense of symbolization and reflection, in both clinic and culture. Zilkha describes psychodrama as complementary to psychoanalytic work in enabling the representation of separateness in a severe narcissistic disorder of adolescence.
Theoretical-Clinical Journeys through Trauma. By Dina Vallino Pp. 5-22.
The familial type of trauma is not necessarily experienced by the subject as a loss that affects him; but it is one that powerfully impacts and subsequently pervades the family environment. Patients who have suffered such traumas often end up in interminable analyses because these traumas bring about the collapse of normal identifications and the formation of pathological identifications, a phenomenon extensively described by Ferenczi. These pathological identifications resist symbolic representation and persist as introjects, persecutors of the Ego; they are not integrated into the developmental process, but are etched into the mind, devitalizing the self.
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The analyst must recognize not merely the trauma as a painful event, but also its disruption of normal development via introjection. To avert interminable analysis, the analyst must create space for the symbolic representation of the original split.
The author describes a patient named Elio, who had had a long analysis years earlier, and now presented himself with a “hesitance to live,” taking refuge in a tormenting hypochondriasis. He evoked in his analyst the need for medication referrals and for extra sessions. Once the analyst had conveyed to Elio that interminable analysis was very much counter to what was needed to benefit either his life or the analyst's own, the analysis was brought to a close, with the patient freed enough to marry, have a child, pursue a responsible professional career, and have a pleasant quality of life.
Nevertheless, the patient returned to see the analyst at several crisis points in his life. In these occasional encounters, the analyst was disappointed to realize how little mental relief the patient experienced after all the analytic work that had been done. The analyst could not forget that when he was eight years old, Elio's immediate and extended family had been exiled from their home in Yugoslavia after the war. That island home had often appeared as a backdrop of the patient's dreams during the analysis proper. Noting his indifference to news reports of current (1990s) strife in the Balkans, his childhood home, the analyst sought to explore the traumatic events of his childhood and to place them in a narrative context.
In postanalytic encounters, Elio reported a recurrent dreamimage of a window frame, which he did not know whether to think of as the opening to a view of a starry sky or the window of a prison cell. The window represented a window in the hold of the boat in which he and his family journeyed into exile. He recalled that he himself was not frightened by the trip and even regarded it as an adventure. But his family went into profound and endless mourning over the loss of their home. His pathological identifications, developing out of familial trauma, impeded the development of a robust self. The dream and its interpretation
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enabled the symbolization of the pathological identification (the prison window), counterposed against the starry sky, and ultimately the recognition of a self differentiated from the trauma and suffering of the patient's family.
Another patient, Giulio, was born with a defect, a cranial stenosis requiring extensive surgery and elaborate psychomotor rehabilitation, both of which were severely traumatizing. He had been in analysis as a child, following the development of a major psychosis. The patient returned to treatment as an adult after developing the symptom of an inability to urinate into any toilet away from home; the symptom was precipitated by a threat made by a work colleague. The threat reawakened terrors of attacks from without. Only as the early traumas became represented in dreams—i.e., symbolized—was it possible to analyze the pathological identifications.
This type of patient is distressing for the analyst because the analytic journey remains forever a journey, with only advances and regressions, and no consistent progress or definitive solution. Even substantial gains are fragile and require the constant presence of the analyst to prevent backsliding. The analyst must maintain awareness of his or her potential rejection of the “interminable analysis,” so as not to turn against the patient, but instead to recognize and analyze the pathological identifications that obstruct symbolization in both patient and analyst.
Psychoanalysis and Culture—with Reference to “The Moses of Michelangelo.” By Roberto Contardi Pp. 69-92.
As conceptualized in The Interpretation of Dreams and exemplified in The Moses of Michelangelo, Freud brought “discontent” and “civilization” together as the focus of psychoanalytic study of the psychic work that the individual accomplishes through symbolization.
Modern culture, with its emphasis on immediate gratification, turns to technical/scientific solutions, e.g., psychotropic medications, to resolve discontent. These “solutions,” denying the cardinal
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role of psychic reality in the formation of all thought and desire, corrupt the soul, insofar as they promote quick fixes instead of soul-searching—that is, exploring and developing symbolic representation. The technical/scientific systems of symbolization are “scientifically” rationalized, even though modern science does not have a scientific basis for assessing the ends to which its discoveries are to be put. Psychoanalysis—through integration of metapsychology, clinical observation, and cultural study, as well as the study of tension between culture and the individual—possesses the scientific basis for the exegesis of symbolization within the individual and within the culture.
The Contribution of Individual Psychoanalytic Psychodrama in the Treatment of Narcissistic Transference in Adolescents. By Nathalie Zilkha Pp. 115-128.
For adolescent patients to take possession of their lives and to better enjoy their later adulthood, they must recognize the Oedipus complex and its associated psychic conflicts. They need help in order to take charge of a potential space of reverie and desire. Individual psychodrama is especially adapted to enabling expression of the polarity joining/separation, particularly in narcissistic transference situations in which the patient lacks the capacity to “use the object.”
The author describes a patient named Catherine, who, through an idealizing narcissistic transference, had made progress in her psychoanalysis in the middle years of her adolescence. Following a return from vacation, however, she suffered a severe regressive breakdown, provoked by departure from her home. Notwithstanding that it was Catherine who chose to leave, she suffered from an inability to symbolically represent her mother in her psyche, and subsequently from a sense that she had been “invaded” by a mother who became persecutory. In the omnipotent maternal transference, she implicitly attributed to the analyst the power to give and take her life. Her psychic apparatus was melting away, and there was a risk of suicide, which she had already
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attempted the year before when her dog died. Slight symptomatic reduction during brief hospitalizations vanished upon discharges, each experienced as another abandonment. Hatred of her mother for all that she had not given Catherine was all that persisted—but that hatred was what kept the patient alive.
Sensing the psychotherapy to be at an impasse, Catherine accepted the recommendation for psychodrama. The reassuring affirmation of her self by the psychodrama group notwithstanding, Catherine found it very difficult to engage in the scenes.
The psychodrama scenes immediately enabled the analyst to better understand the psychic functioning of this adolescent patient and the meaning of the therapeutic impasse. In psychodrama, Catherine attacked the idealized imago that was missing in herself, but in so doing, she lost all possibility of identification. She maintained that nothing was anyone's fault, while everything was the fault of her mother, and it was therefore necessary that her mother fix everything. At the beginning, Catherine proposed scenes revolving around mother—daughter symbiosis and an omnipotent mother—e.g., a nightmare in which she was hanging from a roof, while on the ground lay pickaxes. In the nightmare, the mother encouraged her to jump. A co-therapist then entered the psychodrama in the role of a doctor responding to an emergency call, confronting her about the omnipotence of her mother even in the moment of death.
In time, as the psychodrama spaces became more defined, “absence” became imaginable. For example, one scene represented the analyst sleeping in her own apartment; then Catherine entered the room, forbidding the analyst to dare to sleep while she herself was suffering so.
At first, it was uncertain whether the patient would turn toward a different psychic space capable of resolution, or whether she was presenting an endless drama about the futility of life. The treatment alternated between the space of psychodrama and the session of psychoanalysis, thus opening a pleasure in play—
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the prelude to pleasure in thought, and above all, to a pleasure in living.
Hysteria: The Sacred Known Secret. By Maurizio Guarneri, Serena Indovina, Rosa Lo Baldo, Laura Nastri, Gabriella Russo, and Marina Terrana Pp. 23-39.
The authors identify bisexuality, corporeity, multiple identifications, and dissociation as starting points for characterizing the structural invariants of hysteria. They hypothesize that within the oedipal structure alone, it is impossible to completely reveal the infantile, polymorphous sexuality that characterizes hysteria and to then reintegrate it into a differentiated adult identity.
They propose the integration of the oedipal model with a multinuclear and multifocal model, characterized by the mobility and interchangeability of representations, taking into account that hysteria is a complex configuration comprising both vertical and horizontal splits.
The myth of Dionysius provides the means to identify several regulatory principles that pertain to the areas of trauma, false connections, and transference.
Section Entitled “Beyond the Couch”
Freud and India: A Hermeneutic Discourse on a Missing Journey. By Livio Boni Pp. 131-159.
A series of signs and indicators present in the works as well as in the biography of Freud dispels the idea that Freud was interested only in the Judeo-Christian culture. This hermeneutic pursuit through a series of symptoms and “omitted acts” ranges from the dialogue with Romain Rolland on the nature of religious experience (which developed into Rolland's interest in Indian mysticism) to Indian and Indian-type pieces in Freud's archeological collection; from the Nirvana Principle, with its Buddhist resonance and the myth of Androgenes—-revisited in Beyond
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the Pleasure Principle—to Hindu mythology; from the little-noted encounter between Freud and Rabindranath Tagore in Vienna in October 1923, to the testimony of the Swiss poet Goetz on his conversations with Freud regarding his Vedic philosophy.
The Unconscious and Psychoanalytic Theories in Present Day Russia: The Return of the Repressed. By Alberto Angelini Pp. 161-177.
The concept of the unconscious was already present in the Russian philosophic traditions of the nineteenth century and, in a limited way, in Pavlov's School of Objective Psychology. For about twenty years after 1909, the major works of Freud were translated into Russian. The first psychoanalytic society was founded in Moscow in 1911. In the 1920s, Alexander Luria attempted a synthesis of psychoanalysis and Marxism. In that same period, Dmitri M. Uznadze, founder of the Georgian School, advanced the concept of Set, a new theory of the unconscious based upon cybernetics. Set is an unconscious psychic configuration that forms during the growth of the individual, determined by interactions between the organism and the environment. Psychoanalysis itself, from the end of the 1920s, met with sharp criticism; not until the Rome Congress in 1989 were Russian scholars in attendance.
The story of contemporary Russian psychoanalysis will be elucidated by further research, once the limits of a mere chronicling of events can be set aside.
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Lauro, L. (2003). Rivista Di Psicoanalisi. Psychoanal. Q., 72(4):1089-1095