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Giuliani, J. (2009). Psychoanalysis in Italy: “Freud After All” 2007. Psychoanal Q., 78(1):317-340.
Psychoanalytic Electronic Publishing: Psychoanalysis in Italy: “Freud After All” 2007

(2009). Psychoanalytic Quarterly, 78(1):317-340


Psychoanalysis in Italy: “Freud After All” 2007

Abstracted by
Jack Giuliani

The Italian Psychoanalytic Annual, 2007: Freud After All is a collection of essays representing the views and interests of many of today's leading Italian psychoanalysts. Edited by Patrizio Campanile and published in 2007 by Borla Edizioni in Rome, it contains articles selected from those published in the Rivista di Psicoanalisi (the best-known Italian psychoanalytic journal and the official journal of the Società Psicoanalitica Italiana), Volume 52, 2006. Unlike the standard fare for the Rivista di Psicoanalisi, whose topics generally reflect the diverse spectrum of interest in contemporary psychoanalysis, this annual's content is unusual since it is mainly devoted to reflections on Freud's work, in celebration of the sesquicentennial of his birth. The articles have been translated into English and are published here as the inaugural volume of the Italian Psychoanalytic Annual, with subsequent volumes planned for publication each year.

Prior to World War II, there was limited knowledge of Freud or of psychoanalysis in Italy. This is surprising since Italy and Austria are neighbors, and also because Freud traveled to Italy many times. In part this lack of awareness was the result of the opposition that psychoanalysis encountered from Italian Fascism and from the Roman Catholic Church.

A notable exception to this state of affairs was the early enthusiasm for psychoanalysis demonstrated by the psychiatrist Marco Levi Bianchini of Naples. And the most prominent Italian analyst of this period was Edoardo Weiss of Trieste, who was analyzed by Federn and became a member of the Vienna Psychoanalytic Society in 1913.

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The Italian Psychoanalytic Society was founded in 1925, and the Rivista Italiana di Psicoanalisi in 1932. However, with the enactment of racial laws in Italy in 1938, the Italian Psychoanalytic Society was dissolved, and many psychoanalysts—among them Loewald, Arieti, Weiss, Limentani, Servadio, Hirsch, and Kovacs—were forced into exile. Marco Levi Bianchini was marginalized but remained active as a psychiatrist; while others, like Nicola Perrotti and Cesare Musatti, lived underground for the remainder of World War II.

After 1946, when the Rivista di Psicoanalisi resumed publication and psychoanalysis in Italy was revived, many new theoretical influences from within the international psychoanalytic movement contributed to the subsequent development of the field in Italy. The result is an original and diverse blend of several historical and theoretical traditions that can be traced to the professional contact that Italian analysts have had with analytic writers, consultants, and teachers from England and the United States, as well as from France and South America. The result is a unique synthesis and cross-cultural dialogue of theories whose presence characterizes Italian psychoanalysis, meriting our study and greater understanding.

A significant historical milestone that may perhaps illustrate the uniqueness of Italian psychoanalysis concerns the fact that the entire Freudian corpus was not translated and published as one collection until as recently as 1980, by Cesare Musatti. Prior to that time, the divergent translations of Freud, while perhaps contradictory and confusing, may have also cultivated an acceptance of diversity and controversy in Italian psychoanalysis, which markedly differed from a monolithic theoretical tendency elsewhere.

The selection of articles in this annual reflects an interest in several overarching themes. One theme is Freud's discovery of unconscious life and of the laws governing unconscious psychic functioning, such as the discovery of transference, the meaning of transference, transference as a metaphor, and transference as the central illustration of a dynamic and dialectical paradox. A second important focus in these articles is a close examination of Freud's cases, especially as they reflect the development of his method of treatment and

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of his working through an understanding of transference and countertransference. A third prominent theme is an interest in Freud's style of writing as it provides an illustration of the very psychoanalytic method that he invented. A fourth interest of many of the writers is the role of group processes in the history of the psychoanalytic movement, in the development of psychoanalytic theories, and in the continuing presence of unconscious group functioning in contemporary psychoanalytic professional groups.

These essays offer a rich and textured introduction to the unique treasury of Italian psychoanalysis. Although all twelve authors have been widely read in Italian and French Psychoanalytic journals, none has been widely published in English. I was also rather surprised to find that none of these authors made references in their bibliographies to any of the Italian analysts who are better known to English readers. The editor has, therefore, done English-speaking readers a valuable service by publishing these writers, since they provide an important, fresh perspective on the Italian and European psychoanalytic scene, with its own unique mix of theoretical, philosophical, and technical questions, unlike those discussed elsewhere.

One finds evidence in these articles of a greater appreciation for, and contact with, academic perspectives, especially from philosophy, philology, and classical literature. An important factor influencing the development of Italian psychoanalysis, as noted above, is that a complete edition of Freud's collected works, comparable to Strachey et al.'s translation in the Standard Edition, was not available in the Italian language until 1980.1 As mentioned, prior to that time, differing translations available to Italian readers very likely contributed to an interest in the text itself, textual interpretations, and divergent theoretical perspectives, which are all reflected in this collection of articles. Consequently, a close reading of each of these papers will repay the reader well for the effort invested.

The introduction to this annual describes Italian psychoanalysis as “polyphonic,” with a “variety of tones” (p. 5), emerging from ten


1 Freud, S. (1980). Opere [in twelve volumes], ed. C. Musatti. Torino, Italy: Boringhieri.

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psychoanalytic centers in Italy, each with its own history and culture, and having contact with diverse psychoanalytic traditions from outside the country. Regrettably, however, only five of the ten centers are represented among the contributions to this annual. The introduction also promises an emphasis on a discussion of Freud's cases, yet this, too, was reflected in only four of the papers.

However, I was most aware of how many articles, perhaps owing to the selected group of authors, seem to be virtually carrying on a conversation with one another, without making specific reference to that fact. For example, the topics of transference, paradox, ambiguity, dialectical literary, and dialectical psychoanalytic style, and group processes, are all discussed by several writers in this volume, as I will elaborate below. There was also a significant interest in a discussion of the history of the psychoanalytic movement, especially as it has unfolded at the international psychoanalytic congresses, and with particular interest in the theoretical and political positions taken by American Psychoanalysis at these congresses (cf. especially Rossi, chapter 5, and Campanile, chapter 6, described below).

In the volume's lead article, “Transference: Notes on the History of a Paradox,” Francesco Napolitano begins by marking out the territory to be explored as he quotes Freud's emblematic and paradoxical remarks about transference (in “The Dynamics of Transference,” 1912), as follows: “Actually, I have to admit that transference is not an excuse at all; it is a basic demand which is honestly opposed to our effort, and because it is honest, we must encourage it” (Napolitano, p. 7). Napolitano is eager to illustrate how Freud laboriously came to realize, over many years of clinical and theoretical work, the important dual and paradoxical nature of transference as embodying both a psychic truth and a lie, i.e., a distortion of external reality, and, further, that transference revealed both intrapsychic and inter-psychic phenomena.

Napolitano first traces the protohistory of transference as it was understood by classical and continental philosophers. He then carefully

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demonstrates how the concept of transference was further developed by early neurologists who anticipated the birth of psychoanalysis and who most influenced Freud, viz. Charcot and Bernheim. Napolitano demonstrates that, throughout Freud's first 10-year period of research into transference—described in Studies on Hysteria (1895), “Project for a Scientific Psychology” (1895), The Interpretation of Dreams (1900), and “Fragment of an Analysis of a Case of Hysteria” (1905)—his theory of transference as both internal and as a false link remained unchanged. Napolitano declares that:

Transference … becomes the prototype of psychodynamics in general, in the form of the displacement of cathexis from the unconscious to the preconscious. It is this displacement that first triggers the desire/censor dialectic and then promotes the deformation of representation. [p. 13]

Placing Napolitano's essay first in this collection serves to underscore what will follow, which is a reassessment of Freud's contributions from a predominantly, though by no means exclusively, contemporary relational lens. Like many contemporary analysts, Napolitano approaches the transference empathically, i.e., from the perspective of its subjective truth, as experienced within the psychic reality of the patient.

Transference is also the central topic of the second article in this annual, entitled “Transference and Unconscious Communication: Countertransference, Theories, and Analysts' Narcissism,” by Antonio Alberto Semi. This author begins by discussing the problems that Freud encountered in developing transference, since he was simultaneously burdened by the discovery of the phenomenon, its clinical comprehension, and its further theorization. Like Napolitano, Semi recognizes that:

The process of psychical transferability is a fundamental process for Freud. … This idea of mobility and transferability gradually becomes more and more specific and detailed, so in turn it can explain the origins of hysterical symptoms, the

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creation of a phobia, or the appearance of an anxiety attack … and the ideal of possible mobility is obviously at the basis of the free association method. [pp. 31-32]

In referring to the Dora case, Semi quotes Freud's comment on transference as

… by far the hardest part of the task … the one thing the presence of which has to be detected almost without assistance and with only the slightest of clues to go upon, while at the same time the risk of making arbitrary inferences has to be avoided … if one manages to guess it each time [Freud (1905) quoted by Semi, p. 33]

It is this experience, in which the analyst is “possessed” by the patient, becomes “the patient's prey” (p. 33), and has to “guess” about the circumstances, that seems most intriguing to Semi. He wonders how Dora's transference to Freud worked “inside Freud. The very same Freud who then wrote an essay on the case study of Dora … one could say the person inspiring this writing is Dora” (p. 35, italics in original).

To underscore the presence of the patient's unconscious in the unconscious of the analyst, Semi refers to a statement in “Recommendations to Physicians Practicing Psycho-Analysis” (1912), where Freud writes that the analyst

… must adjust himself to the patient as a telephone receiver is adjusted to the transmitting microphone … so the doctor's unconscious is able, from the derivatives of the unconscious which are communicated to him, to reconstruct that unconscious, which has determined the patient's free association. [Freud 1912, pp. 115-116, italics added]

Semi suggests that this would seem to result, however improbably, in the peculiar circumstance of the analyst “hosting someone who is making him think, and at the same time, realizing he ‘is being thought of’ and of having to observe his own unconscious as expressing someone else's thought” (p. 36). Semi continues following Freud, who further admonishes his readers that if the analyst is unable to disentangle

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the patient's unconscious from his own, then he is likely to project unresolved unconscious conflicts into theories having universal validity (Freud 1912, p. 117).

Thus, theorizing, Semi suggests, may be the analyst's narcissistic attempt at self-reintegration, following the experience of having been colonized by the patient's mind. At this point, the reader feels led to the inevitable question, which subsequently Semi explicitly poses: “How much transference and countertransference are there in theories?”

In the third chapter, entitled “‘All Dreams Are Wish Fulfillments': Is This Still a Tenable Thesis Today?,” Francesco Conrotto explores the role of dreams, and of dream interpretation in psychoanalytic theory and practice, following the advent of Freud's structural theory. Conrotto highlights Freud's (1932, p. 59) discovery of the earlier splits present in the ego as illustrated in the “‘crystallographic metaphor’ in Lecture 31 of the New Introductory Lectures on Psycho-Analysis” (p. 50).

Conrotto wonders how contemporary psychoanalysis has responded to the role of dream analysis in the treatment of borderline and psychotic states, which he calls “group-type personalities” (p. 50). In Conrotto's view, these patients’ lack of an integrated subjective experience, as the result of a chronic split or of fragmented states, means that the most useful psychoanalytic model is one that pays closer attention to this “group” functioning of the individual personality, as opposed to the dream model of Freud's first topography, which was based on conflict arising between repressed wish and censorship.

Conrotto considers that the psychoanalytic setting and the analyst's countertransference are two factors that assume far greater importance in the treatment of such cases. Although traditionally regarded solely as a technical device, the setting, according to Conrotto, becomes the locus of primitive psychic functioning in the treatment of primitive borderline and psychotic states. However, it is the analyst's countertransference, utilized as a means of gathering up and analyzing the patient's unrepresentable affects and states, that plays an even more important role for Conrotto:

Because the patient is sometimes, owing to the absence of the dimension of subjecthood, incapable of “thinking,”

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dreaming,” or associating—that is, of expressing a wishful subjectivity … to perform his function, the analyst must then rely on his countertransference. [p. 53]

Conrotto means that the analyst must come to identify and differentiate, through careful self-analytic work, his own feelings during the analytic session as “the intersection between the patient's (unconscious) transference and his own—equally unconsciouscounter-transference response” (p. 53), together with the analyst's own personal transference to the patient. Since all these dynamic interactions are occurring unconsciously, a great deal of difficult and complex psychological work is required of the analyst—a task unimaginable without the help of consultation.

However, Conrotto sees this as a creative and fruitful process, especially when the analyst's conscious derivatives can eventually lead to the formation of a “representation,” a “double,” or a “screen” (upon which can be projected and depicted these “inter-transference processes,” p. 53). Conrotto concedes that his description of this process is reminiscent of Bion's conception of maternal reverie, and that the analyst's aim is to help the patient develop the capacity for thinking, playing, and dreaming through introjection of the analyst's capacity to perform these functions in the patient's stead.

We notice a consistent interest and an abiding perspective among the essays reviewed thus far. Each of these three authors has given considerable attention to a reexamination and a reinterpretation of drive theory, especially within the context of Freud's structural theory, the so-called second topography, and of object relations, especially through the prism of transference and countertransference.

By contrast, Fernando Riolo, in the fifth chapter on “Freud and Lichtenberg's Knife,” while pursuing some of these same points, adds somewhat of a corrective to the tendency to valorize the psychoanalytic relationship. Riolo begins his essay by revitalizing some of Freud's pioneering discoveries, starting with Freud's assertion that psychic reality does not coincide with consciousness, but rather that psychic processes are essentially unconscious, bodily based processes, with consciousness being an incomplete sense organ of their perception

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(p. 60). Riolo adds that Freud did not claim to have discovered the unconscious, since it had already been known to poets and philosophers; instead, Freud's original discovery lay in the exploration and in the organization of the laws underlying its functioning.

Riolo tells us that, by clarifying and systematizing dream thought —the rules by which dreams transform unconscious content into something capable of being represented to consciousness—Freud believed that he had discovered a “primary” mode of psychic functioning. In fact, it is this discovery that Riolo believes constitutes Freud's paramount achievement, the very method of dream interpretation:

The fundamental rules of analytic technique—breaking down into component parts, free association and evenly suspended attention—are indeed isomorphic with the rules of the dream work … the equivalence of the part with the whole; the violation of the principle of non-contradiction; and logical and temporal bidirectionality. … The rules of the method consist in the mutual exercise of the type of thought intrinsic to dreams. … The dream work assumes the character of a paradigm. [p. 61]

Riolo identifies two paradigms in contemporary psychoanalysis that are competing for dominance: a vertical one comprised of drive theory, psychosexuality, transference analysis, and interpretation; and a horizontal one, which places primary importance on the mutual construction of meaning within the object relationship as located in the continuously evolving intersubjective field. Riolo ends his essay by making a passionate appeal for the scientific paradigm, arguing that psychoanalysis cannot be reduced to hermeneutics alone, since it must account for the body, history, drive, and affect, for which neither representation, narration, nor signification are sufficient. His plea for an embodied drive theory serves to retain a preeminent role for sexuality as “indispensable” to a psychoanalytic view of psychic life (p. 68).

Although by no means limited to this area of analytic treatment alone, nowhere is Riolo's appeal more compellingly illustrated than in the analysis of children and adolescents. The sheer physicality and

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driven qualities that an overstimulated child or troubled adolescent can add to the analytic mix forcefully assert the role of body and drive, history and development that Riolo seeks to affirm.

In the sixth chapter, entitled “Travels Around the Wolf Man: A Diary,” Pier Luigi Rossi comments on Freud's use of the case history as a literary genre. Rossi argues that Freud seems to use this less as a means to illustrate a particular point of clinical theory (as he does with case vignettes in other works) and more as a device aimed at demonstrating his clinical technique by replicating a psychoanalytic experience in writing. Freud thereby illustrates psychoanalytic theory “in the process of its constitution” (according to Rossi, p. 71), with the reader virtually participating as a co-creator. In fact, Rossi asserts, the persuasive effect on the reader can be described as similar to the persuasive effect that Freud's interpretations might have had on his patients. What we witness is the psychoanalytic experience both from the side of the analyst, as he is thinking out loud, creating his theory and forming his interpretations, and from the side of the patient who is the object of those interpretations.

Rossi explains that, though following in the footsteps of his teacher Charcot, Freud could be even more compellingly persuasive in his five case histories with his tableaux cliniques. In the Wolf Man's case history, Rossi states, Freud sets himself the task of showing the case's complexity, as well as of demonstrating the clinical relevance of infantile sexuality in the analysis of adults (p. 73). Furthermore, Freud wants to illustrate ways in which memories from a period of early childhood (eighteen months of age)—a time for which memories are typically unavailable or unclear—can “subsequently” be “understood and interpreted” (p. 73). Rossi also shows us that Freud—paralleling his patient's subsequent and revised understanding (Rossi declares this case and the wolf dream “the paradigm of ‘deferred revision,’” p. 78)—is himself in a continuous process of revising. This process results in the progressive augmentation of Freud's clinical understanding and of his own theories, as well as of his patient, subsequent to various unforeseen crises in the analysis.

This process of working in a state of theoretical ambiguity, and with continuous development and dialectical revision, is another important

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feature of the psychoanalytic method underscored by Rossi. He believes that this process is well demonstrated in the genre of the psychoanalytic case history as it was developed by Freud: “Anything that was truly his [Freud's] is never simply dropped, but put away for possible reuse. As already noted, this approach is similar to how analysis proceeds in the form of a spiral” (p. 74).

The author carefully takes us through a detailed summary of Freud's analysis of this patient, making every effort to link the case with the theory explicated in 1905′s Three Essays on the Theory of Sexuality (which, Rossi reminds us, Freud had recently revised). Rossi's critique of Freud's treatment is limited to two areas of countertransference: first, in Freud's reconstruction of the Wolf Man's history in accordance with Freud's own theoretical prejudices, and second, Freud's “injunction to terminate the analysis by a fixed date” (p. 79). More importantly, Rossi believes that the effectiveness of this “technical error” (p. 79) by Freud lay in the fact that it constituted an enactment, a second traumatic scene within the treatment, “to which such a revision will then be applied” (p. 79).

In this way, Rossi declares, the anamnestic model of psychoanalysis, along the lines of “Remembering, Repeating, and Working-Through” (1914), is reaffirmed by the rediscovery in the Wolf Man case of “how remembering actually takes place, partly by way of evocation of ‘a piece of real life’ in repetition” (p. 81). Here Rossi uses a contemporary understanding of the centrality of enactments in the treatment. Many other contemporary analysts—and not only Italian ones (e.g., Renik 19932; Smith 19973)—come to mind as representing a contemporary perspective on the apparently inevitable necessity of enactments, and of the need to examine them through the lens of transference and countertransference. One of the unique merits of Rossi's chapter, however, is his skill in finding and elucidating what appears to be a contemporary perspective in Freud's early work in the case of the Wolf Man.


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In the chapter that follows, “The Witch of ha-ish Mosheh: Some Considerations (and Conjectures) on “‘Analysis Terminable and Interminable,’” Patrizio Campanile, this annual's editor, discusses this paper of Freud's as forming one part of a triptych that includes An Outline of Psycho-Analysis (1940) and Moses and Monotheism (1939). Campanile pays particular attention to the fact that this paper took shape from within the vicissitudes of the psychoanalytic movement at that time. Campanile reads Freud in this essay as more remote, skeptical, and wise, and juxtaposes this particular sensibility with the political, scientific, and personal developments occurring around him.

Freud's pessimism in “Analysis Terminable and Interminable” (1937), according to Campanile, must be considered in light of the following staggering sequence of events: at eighty years of age, Freud had already had thirty-three mouth surgeries over the previous fourteen years; he had lost several significant psychoanalytic colleagues (Abraham in 1925, Ferenczi in 1933) and family members (most recently, his mother in 1930). With the Nazis in power after 1933, there followed the burning of Freud's books, the appointment of Jung to preside over the state-controlled psychotherapy association, the appointment of Goring's cousin as director of the Berlin and Vienna Psychological Association in 1936 and 1937, and the closing of the Verlag publishing house. Campanile describes how uncertain Freud must have felt about the future of the psychoanalytic movement, noting that he was particularly “tormented” by the situation of psychoanalysis in America (p. 91).

Campanile understands Freud's “torment” as related to the recent attempts (especially by Otto Rank) to shorten the duration of analyses—a movement seen by Freud as a “child of its time, conceived under the stress of the contrast between the post-war misery of Europe and the ‘prosperity’ of America, and designed to adapt the tempo of analytic therapy to the haste of American life” (“Analysis Terminable and Interminable,” 1937, p. 216). Campanile's illumination of the background events in Freud's life may make the case for viewing “Analysis Terminable and Interminable” as an extended elegy to Ferenczi, and as a continued effort to mourn the loss of his friendship,

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especially given its unresolved state at the time of his death. This idea may also be supported by the fact that other authors in this annual seem interested in Ferenczi (cf. Mangini in chapter 8), someone who is regarded as a psychoanalytic maverick, and therefore integral to the questions that Campanile suggests were a concern to Freud at this time.

Campanile points out that at the 1934 International Psychoanalytical Association Congress in Marienbad, which Freud did not attend, a day-long symposium was dedicated to the therapeutic results of psychoanalysis. Various contributors to the congress, such as Edmund Bergler, Edward Bibring, Herman Nunberg, James Strachey, Otto Fenichel, and Edward Glover expressed varying opinions. Freud's pessimistic attitude toward this topic, according to Campanile, “ran counter to the trend at the Marienbad symposium” (p. 93). Campanile expands his discussion of Freud's conservative view of the therapeutic effects of psychoanalysis, by citing contemporary writers as well, notably Arlow and Cooper.

Campanile ends his contribution by returning to “Analysis Terminable and Interminable,” and by stressing his belief that the resistances within each analyst, and within psychoanalytic institutions, are what Freud most wanted to address in that essay: “These are the mechanisms involved between generations and between analysts as well, and they are not extraneous to the development of theories and positions we hold in the psychoanalytic movement” (p. 104). Here we can perhaps hear allusion to the current controversies over training and standards of psychoanalysis that seem to be, Campanile might say, unavoidably repeating themselves and continuing earlier conflicts in the history and literature of our field.

Fausto Petrella, in chapter 7, “Freud's Style: Terminology, Metaphor and Textual Strategies,” resumes discussion of a topic of great interest to many of the writers of this annual, and especially to Napolitano in chapter 1 and to Rossi in chapter 5—i.e., Freud's style of writing and the objectives that he sought to achieve in developing that style. Petrella emphasizes the richness in metaphor and simile of Freud's writing—a richness drawn from many fields, but particularly employing

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similes of “space and energy” (p. 111). The need for such similes and metaphors reflects the fact that no vocabulary or language had previously existed for the phenomena and concepts that Freud discovered, and so he was required to struggle with the creation of an original lexicon. This development reflected two different fields of discourse, requiring two different genres of writing. The first field of discourse sought to describe a clinical experience, an individual history, and a course of analytic treatment, while the second discourse attempted to provide an explanatory model of psychic processes, i.e., a metapsychology.

Petrella is concerned about the split that can develop between these two realms of discourse when analytic writers and their readers lose sight of the personal—sometimes irrational but always experiential—foundation of those metapsycholgical concepts, and of the struggle Freud and his early collaborators underwent in developing them. In addition, Petrella is concerned with the banalization and meaningless, “textbook” feeling of certain metapsychological concepts when they become detached from the lived experiences of analytic practice.

Petrella argues for a continuous appreciation of the Freudian dialectical method, which maintains a tension between both poles, between a not too “hasty reaching for meaning” and a “turning one's back on meaning … precisely because the analyst has got hold of it but has rejected it as intolerable” (p. 120). Petrella compares this Freudian balance to Bion's idea of negative capability, wherein a space for psychoanalytic ideas is always maintained as provisional, open to correction and to greater refinement and precision drawn from additional observational evidence and experience. This dialectical tension, Petrella asserts, is the foundation for a unique Freudian style, both in his writing and in his clinical practice, tantamount to a “third topography”:

It means taking style as a generative principle which makes movement between the various points of view possible; which allows shifts between the clinical and the theoretical, thus permitting the adventure of conferring meaning to unfold within the play of analysis. [p. 121]

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Petrella remains convinced that Freud was born with a gift to create metaphors. Petrella's agenda is not solely to praise Freud's literary style, however; he also means to emphasize the benefit to psychoanalytic progress afforded by Freud's capacity to depict and represent, since this enabled him to create a mental space for thinking about the theory, giving form and shape to the objects that it contained. This third Freudian topography, Petrella maintains, serves to “mediate” and to act as the flexible and provisional “connective tissue” between clinical practice and theory, thereby facilitating future growth and development by other analytic contributors.

The following chapter, by Enrico Mangini on “The Schreber Case: The Discreet Charm of the Paranoid Solution,” is the first of three chapters devoted to Freud's other case studies. Mangini places Freud's conception of and composition of the Schreber case squarely within the context of Freud's relationship with Ferenczi, and specifically as it unfolded during their tense two-week holiday in Sicily during the summer of 1910. A study of the Schreber case within the context of this conflicted relationship enables Mangini to convincingly flesh out the homosexual dynamics that underlie Freud's theory of paranoia in his analysis of Schreber's memoirs.

Regrettably, Mangini passes over an opportunity in the paper to offer a critique and to suggest a reassessment of the linkage that Freud established between mourning, conflicted homosexual desire, and paranoia along more contemporary psychoanalytic lines. It has been proposed by other analytic writers (e.g., Frosch 19814) that the unconscious homosexual features within paranoid dynamics are “secondary” and “pseudophenomena” (p. 587). Still other writers (Butler 19975; Corbett 20016) view paranoia and homosexuality in radically different and deconstructed terms, when compared to Freud's in the Schreber case. Contemporary views of gender theory and gender


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development (Harris 2005;7 Stryker and Whittle 20068) might also have offered an enriched perspective to Mangini's discussion.

Mangini instead calls attention to Freud's development of a theory of narcissism—to complement his theory of psychosexuality, trauma, and repression—as thereby opening up the possibility of the psychoanalytic treatment of the psychoses. Mangini adds an additional important group dimension to this theoretical development in psychoanalysis, noting that consideration of the Schreber case came precisely at a time when Freud was expanding his psychoanalytic movement outside Vienna, to include Jung, Abraham, and Ferenczi, and was laying the groundwork for the establishment of a psychoanalytic institution with an organized form and structure. “It is known how group and institutional functioning is always at risk of paranoid rigidities, composed around phantasies concerning survival and transmission” (p. 135), notes Mangini. The author goes on to explain how these dynamics operate within our own contemporary psychoanalytic groups, as well as in groups undergoing crises or transitions. In discussing the projective functioning in Schreber's paranoia, Mangini notes that Freud described the phenomenon by observing that what was abolished internally returns from without.

Might this pathological development have been altered, Mangini wonders, had Schreber had access to an object's capacity for maternal reverie? The object's availability would then have provided a container into which the projections could have been directed—as may also be the case in hypochondria, when the body attempts to contain primary anxiety, a process often called “‘paranoia of the body’” (p. 137).

Mangini concludes by noting Freud's concern about descendants, transmission, and safeguarding psychoanalysis. Like Campanile, Mangini refers to disputes over lay analysis and analytic training.

In the following chapter, Diomira Petrelli's essay on “A Case of Female Homosexuality: Notes and Comments on a Case with No


8 Stryker, S. & Whittle, S. (2006). The Transgender Studies Reader. New York: Taylor & Francis.

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Name,” begins by drawing interesting comparisons between this case and Freud's other and better-known 18-year-old, Dora. Petrelli notices traces—conspicuous, she thinks, by an absence of explicit acknowledgment—of Dora in much of the background of this case. Petrelli finds Dora in Freud's “unease,” “like a traumatic ‘residue’” (p. 152). Freud describes both girls as intelligent, good-looking, from proper families, and rebellious.

This particular girl's rebellion takes the form of an openly homosexual love affair, whereas in Dora it was disguised in hysterical symptoms. Both girls would not have sought treatment without parental insistence. This girl seemed more compliant, but frankly admitted no need to be rid of her homosexuality. Although both girls came to analysis at the insistence of their fathers, with this case, Petrelli writes, Freud was nearly twenty years older and therefore wiser— “more attentive … skeptical … disillusioned … ironic, and self-mocking” (p. 154).

Petrelli praises Freud for his modernity in his initial evaluation of this case. Unlike with Dora, Freud met the patient's mother in person, and found her to be subtly pleased by her daughter's choice of lovers, since in this way, Freud thought, she would be neutralized as a rival. In fact, Freud suspected both parents to be unconsciously colluding with their daughter's arrangement, despite their conscious objections, since it mollified the mother's hostility. Petrelli is also struck by Freud's contemporary view of adolescence, which he regarded as a developmental phase marked by new and critical psychic rearrangements, and which could become traumatically disrupted by life events such as occurred in this case with the birth of a brother. In addition, Petrelli praises Freud for not regarding her object choice as pathological, and for declining to view her as a case of “‘physical hermaphrodism’” (p. 157).

Nevertheless, Petrelli notices that something is awry in the treatment. She states that throughout the analysis, Freud seems distracted by the recent traumatic birth of the patient's brother, as well as by the continual conflict with the father—to the exclusion of giving serious consideration to the abundant evidence for mutually hostile

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feelings between mother and daughter, likely beginning in early childhood. As with Dora, the positive oedipal conflict gains prominence in Freud's clinical evaluations, overshadowing conflicts with and envy toward the mother.

The fateful unconscious comparison that Freud makes between this case and the Dora case is responsible, Petrelli believes, for his misgivings and eventual discontinuation of treatment. Unlike with Dora, who took the initiative and broke off the analysis, in this case, it is Freud who catches a glimpse “of that ‘cruel’ desire for revenge which had brought about the end of analysis in Dora's case” (p. 157). Petrelli believes that it was Freud's “traumatic residue” from Dora that “‘demolished’ all his hopes of taking therapy through to a good end” (p. 157).

Petrelli then makes the point—emphasized earlier by Rossi—that Freud's literary style sought to draw the reader into this case study as a co-creator and co-discoverer, akin to the style of his teacher Charcot. Petrelli writes that Freud achieves this by juxtaposing two events from different time periods, combining and interweaving the two different narratives, one of the patient's history and the other of the history of the analysis. Petrelli says that Freud thereby “aims to re construct in writing the course [that] analysis takes and to bring about in the reader the effect of actively participating in the process” (p. 159).

Petrelli also wants to show that Freud includes in his understanding of this case—and in his interpretations to his patient—ideas about masochism and perversion that he had been developing after completing “Mourning and Melancholia” (1917) and Beyond the Pleasure Principle (1920), as well as during the contemporaneous writing of “A Child is Being Beaten.” One such central notion that Freud develops is the idea that “the ego can identify itself with an intensely hated object” (p. 160).

In the remainder of this essay, it is Freud's unconscious countertransference enactment that most occupies Petrelli's attention. While recognizing that Freud's narcissism was wounded by his patient's indifference to his interpretations, Petrelli believes that a “deep pessimism” (p. 164) also influenced Freud to dismiss her from analysis, because he had “a deep unconscious understanding … of the patient's

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central problems. There was something that enabled him to feel, and probably come into contact with, the destructive range of the patient's unconscious behavior” (p. 163).

A shortcoming of this essay, I believe, is Petrelli's relatively shallow interest in, and appreciation for, a developmental perspective when considering this case. The fact that both this patient and Dora are adolescents is treated more as a peripheral issue than as a central factor around which discussion could be organized. Absent is any serious consideration of the nonsequential, developmental sea change, often experienced traumatically, to the adolescent body, self and object concepts, identifications, fantasy life, and behavior that occur at that time of life. Many contemporary adolescent researchers have focused upon these major issues in discussing both their own adolescent cases and the Dora case in particular.

The following chapter, by Giovanna Regazzoni Goretti, entitled “A Girl of Intelligent and Engaging Looks,” is a riveting and illuminating discussion of the Dora case, the so-called companion case to the homosexual girl from the previous chapter. Goretti approaches this case full of a sense of mystery and puzzlement. She begins by pointing out the many inconsistencies and questions raised both by Freud's behavior in treating this case and by his writing. She notes that he worked on it immediately after the treatment was interrupted, finishing it in less than a month, perhaps as a salve to a painful interruption of the analysis. At first entitled “Dreams and Hysteria,” it was immediately accepted for publication, but Freud held it back, initially for several rounds of editorial changes and then by requesting return of the manuscript. Four years later, with the new title of “Fragment of an Analysis of a Case of Hysteria” (1905), he resubmitted it for publication.

Goretti notes that Freud's reactions to the piece were thoroughly mixed. He wrote to Fliess that he thought it the most “subtle” thing he had written, yet he feared that it might “horrify” his readers. Goretti suggests that the case felt incomplete to Freud, as reflected in the title (“Fragment”). His word choice also reflects his conviction that every analysis must terminate with both patient and analyst facing

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the inevitable limitation of what they can accomplish. Goretti reviews Freud's doubt over which “‘unknown quantity’” he might have missed, and wondering whether the case would be persuasive (p. 170). Goretti points out how Freud's anxiety, many inconsistencies, and his fragmented and nonlinear writing style make the case seem more like a modern novel, and that it also appears to approximate “hysterical speech” (p. 171).

Having established Freud's disclaimers over the painful incompleteness of this case, Goretti then finds considerable evidence that, to the contrary, he is striving to achieve a complete understanding of this patient, her dreams, her symptoms, and her transference to him. Goretti seems to regard this as some sort of split working within Freud, noting that the strangeness of the case report is “perhaps because of the strange way in which the ego works, which is subsequently described by Freud, that is, one part of it knows while the other part behaves as if it did not know” (p. 172). Goretti wants to emphasize that since Freud's conscious goal was to explore “Dreams and Hysteria” (the first title of this paper), interpreting the transference was assigned a much lower priority, and in fact split off as well. Yet, Goretti recalls to our attention that, as early as Studies on Hysteria (1895, p. 300), Freud had been aware that one of the analyst's tasks is to intervene in order to put into words what had never before been said or thought. Goretti imagines it likely that one of the unthought knowns of this adolescent girl, anxious about being trapped with Freud, with whom one might lose control somatopsychically, was flight, in order to safeguard a fragile adolescent self.

Goretti explores, from a feminist and Lacanian perspective, what some of the theoretical clutter may have been that prevented Freud from being more open to his patient, and from finding a way to identify with her dilemma. Goretti suggests that this would have required Freud to think creatively while “under fire” (p. 179), especially in the final session before the unexpected breaking off of treatment, and to challenge her decision to terminate, rather than indifferently saying to her, “‘You are free to stop treatment at any time,’” which defended the analyst against a painful insult (p. 180).

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The significant coda to the Dora case that Goretti highlights is that she returned to see Freud after one year. Goretti seizes upon Freud's pessimism, and is very interested in trying to grasp his unwillingness to again accept Dora into analysis. Goretti proposes that “the blind spot in that clinical case, both during treatment and during successive additions and reflections, is femininity—Dora's, but also Freud's” (p. 182). But it is not only Freud's difficulty with femininity that concerns Goretti; it is also his difficulty with talking about maternal longings and longing for mothers, and Dora's deeply buried homosexual love for Frau K. “This tendency to uncover and then lose Dora's homosexuality as well as the difficulty of integrating it into the text, seems to exist alongside a forgetfulness which covers a broad range of theory concerning transference” (p. 183). Integrating both aspects into the treatment of Dora would have required Freud to see himself as the object of Dora's female homosexual love in the transference, which, Goretti thinks, Freud seemed incapable of doing.

“Isomorphism: A Transitional Area in Psychoanalysis,” by Alessandra Ginzburg, is a chapter unlike any of the others in this annual since it deals with a topic that is not very well known by many psychoanalysts, at least in North America: Ignacio Matte Blanco's rather challenging idea that “an isomorphic function highlights the intrinsically classificatory component in the working of the mind” (p. 191).9 Ginzburg helps the reader considerably by clarifying what she wants to discuss very gradually, at first via a brief case vignette and then by using concepts already familiar to analysts, such as correspondences, parallels, transference, similitudes, displacement, projection, and condensation, as well as by clarifying how all these processes, found in dreams, films, and fiction, can illustrate how the mind intrinsically makes links represented in each of these “isomorphic” processes.

Ginzburg then makes explicit what is to be “the theme of this paper: the inappropriate extension of identity to all isomorphic structures as a characteristic trait of the Unconscious and of emotions” (p. 191). Ginzburg continues her explication of the importance for


9 Editor's Note: For more about Matte Blanco's thinking, the reader may wish to refer to Riccardo Lombardi's article in this issue, pp. 123-160.

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Matte Blanco of the two modes of being and the two forms of logic: one is asymmetrical, seeing reality as divisible and heterogeneous, and the other is symmetrical, viewing reality as one and indivisible (p. 192). Matte Blanco considered the first to be typical of thought, and the second typical of emotion and of the unconscious. Ginzburg adds that Matte Blanco argued that people usually function in a bilogical, mixed fashion. When we function exclusively in symmetrical logic, then, “the part becomes identical to the whole; space and time disappear; there is no contradiction and everything becomes compatible” (p. 192).

Ginzburg gives four extended case examples to further describe what she has in mind. One case illustrates how all objects belonging to a particular class, i.e., men, were regarded by her female patient as identical. Gradually, Ginzburg shows us, the men in her patient's life become more differentiated and less interchangeable as the patient became more capable of articulating increasingly specific qualities of the object. Ginzburg believes that “in traumatic situations, the mind remains trapped in the abstract dimension of the class—or … it withdraws to that dimension, losing all capacity for an individualized relation” (p. 194).

I found the placement of this otherwise interesting article in this particular collection of essays puzzling. It is difficult to see how this article and its topic fit with the others in this annual. With the possible exception of similar questions raised in regard to the analysis of psychosis, contained in the chapter on Schreber, I did not find much common ground with the overall topic of this collection of essays, that is, Freud's 150th anniversary, or with any of the other writers or their topics. Perhaps this seemingly misplaced article simply serves to highlight how remarkably interrelated are the remaining articles, making it appear to the reader as though the authors are seamlessly carrying on a clinical and theoretical dialogue with each other.

The final chapter, by Valeria Egidi Morpurgo, entitled “Why Does Moses and Monotheism Still Make Us Uneasy?,” seems appropriately placed at the end of this collection of essays, since it is a commentary on Freud's own final contribution. Morpurgo begins her discussion

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by characterizing Freud's ideas in Moses and Monotheism (1939) as a demonstration of “the originality and validity of psychoanalytic thinking, by showing us ‘a revival of the ancient fight for interiority, to bring exteriority into interiority’” (p. 203, italics in original). Morpurgo shows how Freud brings this about by a careful review of his writings that discuss large and small group development and dynamics. She clarifies the interactive role that these group and individual dynamics have with one another by discussing oedipal dynamics in the formation of limits, religion, and group ethics.

According to Morpurgo, Freud remained concerned, throughout his writings on individuals and groups, with the conflict that exists between the fulfillment of individual desire and the limits to that fulfillment. Morpurgo traces this theme through Freud's earlier writings, such as Totem and Taboo (1912-1913), Beyond the Pleasure Principle (1920), Group Psychology and the Analysis of the Ego (1921), and Civilization and Its Discontents (1930), all of which lead up to the conjunction of oedipal dynamics and group dynamics in his comprehensive explanation for the persistence of anti-Semitism in Moses and Monotheism.

Morpurgo summarizes Freud's formulation for anti-Semitism as follows: “Those who carry the higher intellectual and spiritual values are repeatedly attacked, so that their much coveted and envied characteristics can be incorporated” (p. 205). Morpurgo does excellent work in summarizing all the main points in Freud's thesis about Moses as the Primal Father, murdered by his children, who continue to endure centuries of fratricidal and rivalrous struggles over who is favored by the dreaded father. Morpurgo, however, wishes to underscore that for Freud—and also for its relevance to a contemporary psychoanalytic perspective—“faithfulness to Mosaic legacy … implies the capacity to accept the limits of individual needs and the acceptance of oedipal norms and prohibitions” (p. 209). To Freud, “what seems so grandiose about ethics … owes these characteristics to its connection with religion, its origin from the will of the father” (p. 209).

Morpurgo takes up similarities between Jewish identity and flexibility, and the paradoxical capacity to maintain a bridge between oneself

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and the other, that is, between individual and group identities (p. 214). She believes, referring to Janckelevitch (1964), that:

The capacity to keep different truths or positions open within oneself, and to mediate without necessarily meaning a meeting point has to be found … this capacity “to be in the middle” arouses both admiration and envy and involves a strenuous oscillation, difficult to bear, but fruitful. [p. 215]

This volume of essays has been a pleasure to read and rewarding to study. It constitutes a virtual minicourse in a psychoanalytic tradition from another culture and with another lexicon, a tradition that seems more sensitive to its own history, language, and text than is typically seen in psychoanalytic writing in the United States. As a group, these writers reflect often and deeply on the parts that they play as clinicians in the individual analyses that they conduct, and as teachers and colleagues in the analytic groups to which they belong. They take seriously the Freudian and Bionian ideas concerning primitive group processes that are ubiquitous in all group functioning. They seem to realize that analysts themselves can place psychoanalytic thinking and psychoanalytic practice in jeopardy as frequently as non-analysts can.

Furthermore, I was repeatedly struck by the intimacy of the dialogue in this annual. It seemed as though nearly every writer had read nearly every other writer's article and was responding with these others in mind. While this may reflect a certain parochialism, and perhaps even an exclusion of writers from diverse perspectives outside the roster of those who contribute to the Rivista di Psicoanalisi, it nevertheless reflects a literary and theoretical integration that is impressive and compelling.

Finally and most importantly, I was moved by the novel insights that these authors bring to many of Freud's writings—perspectives that are fresh and innovative. I look forward to next year's volume with the expectation that, no doubt, new and equally vital contributors will add their voices to the 2008 Annual of Italian Psychoanalysis.

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Article Citation [Who Cited This?]

Giuliani, J. (2009). Psychoanalysis in Italy: “Freud After All” 2007. Psychoanal. Q., 78(1):317-340

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