19:00 - 20:30
Opening Lecture With simultaneous interpretation
Lecture by Juliet Mitchell
Ageless art: Louise Bourgeois and psychoanalysis
My talk uses images from Louise Bourgeois’ recent exhibition The Woven Child which displays work from the last fifteen years of her long life. My experience of the living-in-dying / dying-in-living of the exhibition is captured by Lorca’s account of duende.
The framework of my talk is Louise Bourgeois’ re-use of her analyst Henry Lowenfeld, a well-established New York practitioner when she started with him in 1952. My contention is that she had a sense of his radical past and this may have facilitated her own radical work.
I look at this radicalism from two aspects – her own repudiation of ‘conventional’ analysis in favour of creating an psychoanalytical art practice of the emotions and placing at the centre of this a new resolution about the fear and pain of her love for her ‘mad’ brother, Pierre.
9:00 - 11:00
Central Panel With simultaneous interpretation
Psychoanalysis and mental health
Chairperson: Esteban Ferrández (Spain)
Trauma and internal time. Daniela de Robertis (Italy)
Starting from the Freudian idea of trauma in two times (stages), the purpose of this work is to broaden the term and advise a conception of trauma that encompasses four times (stages): the impact of trauma and blow; the attribution of meaning to events; the creation and “invention” of subjective and personal responses; rigidity of responses.
The text continues detailing the patterns of internal time (as opposed to external time), as deepened by philosophical analysis (Aristotle, Augustine, Bergson, etc.) and current phenomenology. In this framework, the author's proposal is that trauma is not a product, but a process that takes its origin and its development in internal time to the subject. The objective is to outline the links between temporal processuality (past, present and future) and trauma, which entails interpreting trauma as a process that occurs in intrapsychic time.
Finally, in the psychotherapeutic framework, the future asserts the time of change: a time in which the subject returns to read the trauma in another way and therefore dissolves the trauma nuclei and the rigidity of the responses adopted.
Identity, anguish and gender. Esteban Ferrández (Spain)
We witnessed an explosion of the classic coordinates that oriented sexuality as regards choice and renunciation, the binomial that safeguards the desire of its multiple impediments: superyoic, drives, principle of reality... New forms of relationship, but especially new forms of nomination and identification, populate the contemporary social map. Is it simply a temporary effect of the crises we are experiencing, or is it a deeper transformation?
In difficult times, marked by enormous uncertainty about the future as well as a constant demand, identity becomes an overvalued reference point, perhaps that is why there is a fragmenting explosion of it, disparate names appearing that draw a map in which identity finds extraordinarily diverse ways of being constituted.
The binomial "desire - guilt" gives way to that of "identity - anguish". Guilt carries the possibility, although always uncertain, of negotiation and symbolic reparation. In contrast, anguish often calls us to impotence, to dangerous action of the subject to preserve it, or to the desubjective pharmacological solution.
Anguish, with its intolerable nature, entails a different approach for the analyst. It has undoubtedly contributed, among other reasons, to the transformation of its positioning in the therapeutic relationship and to the evolution of intervention modes.
Sexual definition gives way to gender identities, sexual polymorphism gives way to the proliferation of gender identities, to the realm of generic nominations. Gender issues, although they began as a feminist claim, difficult to articulate with classical psychoanalysis, are at this time also crossed by these identity elements, especially what is termed transgender people, which opens up to a myriad of definitions.
However there is also emergence of children's, adolescents’ and youth clinical practice around gender identity, which questions us as therapists at the core of the psychoanalytical paradigm of sexuality. A practice that overwhelms the classic symbolic references and confronts us with the limit of our listening, accompaniment and symbolization skills.
The clinic in movement: Francesc Tosquelles and the bordering knowledge. Alessandra Sapoznik (Brazil / Spain)
This paper aims to present the thought and clinical-political practice of the Catalan psychiatrist Francesc Tosquelles. A thought that brings the vital imprint of exile. A man in transit whose knowledge was forged by and on the border, which ended up creating an innovative psychoanalytic institutional practice in a territory as unsuspected as an asylum in which patients, political refugees and artists lived together.
Tosquelles' institutional psychotherapy emphasizes the need to decentralize the function of the hospital space through interventions that contribute to cleaning up the institution by creating networks, branches. The inaugural measure was to put the patients to work for the peasants of the town in order to face the famine that devastated the psychiatric hospitals of France in the year 1940. This experience is representative of a type of psychoanalysis that is interested in thinking strategies and clinical proposals that go through the walls of the consultation to approach certain forms of social vulnerability that cause significant psychological suffering. It is our intention to think about the movements that are required from the analyst when his clinical practice is developed in certain social contexts.
The desire for recognition and the recognition of desire. Pablo J. Juan Maestre (Spain)
There is a need to be looked at with a gaze of recognition of otherness in order to be able to construct one's own desire.
Far from desire arising endogenously and as a product of necessity, desire is constituted on the basis of a recognition of the self as an autonomous subject. In order to discuss this, the case of Donald Winnicott is used as a paradigmatic example of this difficult transition in his case with respect to the father figure. Winnicott's theoretical and clinical production is also taken as a creative way out of this absence of recognition by the significant others.
11:30 - 12:45
Central Panel With simultaneous interpretation
Social presence of psychoanalysis
Chairperson: Pilar Revuelta (Spain)
Passion and tenderness as political forces. Jô Gondar (Brazil)
To understand contemporary forms of social organization it is not enough to know the geopolitics in course; it is also necessary to enter the field of micro-politics and, particularly, the affections and sensibility modes that sustain the construction of social ties. In this field, psychoanalysis provides fundamental contributions to understand both the possibilities of adherence to forms of government and sociability, and as well as the construction of emancipation projects that aim to transform them. Different affections and sensibility modes will differently build social and political life. Hobbes had already shown the importance of fear as an affection that induces the construction of a strong State, capable of preventing the war of all against all, stabilizing society. Hatred and fear are affections that combine in the case of authoritarian governments that, as Carl Schmitt proposed, make the enemy a necessary element for the exercise of power. In the 21st century, individualism and competition, valued by the neoliberal order, erect societies that demand too much from their members without providing them with a support, circulating affections that oscillate between fear and panic.
In distinguishing the language of passion from the language of tenderness, Ferenczi did not intend to have a political discussion, but we can use these notions to think about the current possibilities of political coexistence. Fear and hatred are violent and incisive passions, as Hobbes would have already shown when he said: "The only passion of my life was fear”. Tenderness, on the other hand, constitutes another kind of force, more fluid and porous, opening a more extensive surface of communication with the outside world. It is the child's form of sensitivity, but also that of relationships of solidarity through dispossession. In this sense, the language of tenderness refers to the notion of vulnerability theorized by Judith Butler. It is not about defending a puerility or naivety, but a force of non-violence that, when affirmed, creates the possibility of a less unequal, fairer political coexistence, especially in countries immersed in a culture of hate (right-wing and left-wing) such as Brazil.
The social as an unconscious construction of psychoanalysis. Juan Flores (Chile)
The psychoanalysis, and the psychoanalyst, in investigating the unconscious of the subject, will encounter the totality of the social, political and cultural field, in which he himself is involved. In this way, he also encounters himself, since, as a social being, as well as in his theory and practice, he is part of this field.
The psychoanalyst is involved in the analytic situation as a subject and also as a spokesperson or expression of the social whole. Although these implications are extremely complex, they require a special effort to elucidate their effects on the analytic situation, since they are inevitably present both in the transference and in the countertransference, in which the analyst involved may respond as a representative of social hegemonies, rather than as a function of the analysand's own subjective problematic.
As Freud has shown, these hidden threads are always present, they are part of the scene, even if they are disguised to the point of not being visible. In this sense, in every social practice, as well as in every theoretical, intellectual or cultural elaboration, a part of the plot is hidden, dissimulated, repressed. It is precisely some of these secret and repressed threads that we deal with when we look into the unconscious through psychoanalysis. And in doing so, we must face a great variety of problems that will demand an appreciation of their unfolding in the analytic situation, and a permanent interrogation about from which theoretical-ideological place we listen.
12:45 - 13:45
Keynote Speaker With simultaneous interpretation
Lecture by Alejandro Ávila Espada
With the perspective of the legacy of more than a hundred years of psychotherapy and almost half a century of clinical practice, reflections of a psychotherapist and questions for psychoanalysis.
15:00 - 16:25
Parallel Panel 1 Without simultaneous interpretation
Chairperson: María Fernández Ostolaza (Spain)
2022, sick of acceptance. Narratives of grief in a neoliberal world. José Antonio Pérez Rojo (Spain)
Since the appearance of the canonical text of Kübler-Ross, we are urged to walk the path of mourning every time we suffer a loss: denial, anger, bargaining, depression and acceptance. The world is going faster and faster and you have to do this circle over and over again until you accept, accept and accept.
Still immersed in the coronavirus pandemic, our losses are piling up. The world will never be like before, we have to accept deaths, crises, limitations, the breakdown of public systems and ideals, climate change, extremism, the nuclear threat.
What if getting depressed is no longer just The New Black that Darian Leader told us about? What if becoming depressed is something that we should not avoid and, as Bifo Berardi says, it is the symptom that must be prescribed? Because in order to change something you have to be aware that things are not going well. That is why an avalanche of patients with the same symptoms as always but with profound despair arrive at our offices. Young people want to accept what they are told that they will never live as well as their parents. That is why there are so many who remain outside the wheel and that is why those who ride on it suffer so much. Those who are not so young are looking for something to hold on to but the neoliberal creed alone does not serve them.
It seems that the system wants us to travel the path of mourning until we accept that it is what it is, that it is the end of history, take it or leave it. Our task is to help our patients not to fall into the clutches of Capitalist Realism that Mark Fisher wrote about asking himself: Is there no alternative? We have to go along with them through the Ghosts of My Life, another book by Fisher that was a long suicide letter, so that they don't write theirs or, once written, they tear them up.
Several of my patients have complained that they have received antidepressants for years, which has made them able to put up unhealthy situations for too long. I no longer want antidepressants, I prefer to suffer than forget why I suffer, they say. Because perhaps the solution is not to accept, and much less to accept the unacceptable.
Epilogue: These days, my friend David reminded me that we made a book-album together a few years ago. His interpretation is that I wrote a book of poems to help him go along with his loss. Mine is that I also wrote it to accompany myself with mine because, that is the therapist's job, right?
Effect of the pandemic on adolescents. An institutional vision from resilience. Félix Crespo (Spain)
The concept of "resilience" is introduced by Boris Cyrulnik referring to a capacity that would be transferred to us with the first care of childhood. Nothing to do with the spurious use of the term complementing, as a neoliberal mandate, the other great concept of the time, "self-esteem." The habitual use of resilience would not be related to the defense of desire but to submission to external mandates. The resilient, according to the hegemonic discourse, would be the one who bends effortlessly to external mandates, whatever they may be.
This reflection on the resilience/self-esteem binomial, which I take from Jorge Alemán, would come to explain why the adolescents who would be applauded would be those who adapted to confinement and social distance, despite the especially important effect that these measures had on those who were going through this vital stage, and with the same ease they adapted to the cessation of the measures and the return to the alleged normality.
And yet, the authentic resilience would be revealed, precisely, in the strength for non-acceptance, robotic and uncritical non-adaptation, to external difficulties. The ability to preserve the subject even if, in doing so, symptoms appear.
When local institutions provide a place and time to listen to the discourse of adolescents and young people, when they are the ones who have the floor, we hear obvious and at the same time surprising things, such as the fact that the plastic screens and signs in the floor are not accessible to people with blindness.
Also, going through the diverse discourse of the different young people, we hear mentions of loneliness, estrangement from the group, distancing from others that social networks do not attenuate, and also the difficulty of reunion, the decrease in the desire to be with others , the problematic of the resumed contact that, supposedly, should be festive and only festive. Also from contact with bodies, with a sexuality in which it seems that language would only appear online, dissociated from the physical presence of the other, in a way not very different from the way Lola López Mondejar describes it in her “model Tinder”, more painful for those of us who listen to it, perceiving the reference to the beginnings.
More things appear in their speeches, concern for others, for equals, for those who self-harm, a concern for solidarity and the demand for means to deal with so much discomfort. Demand for psychological care but also social and political measures. The demand for spaces that allow what is being the most problematic, the meeting, outside the bookmakers and the possibility of an interlocutor.
When adolescents are listened to in a public, institutional event, they bring to the table individual cases, actually collective ones, that seem to illustrate what Franco Berardi “Bifo” theorized when he spoke of the depressive exit from the pandemic and the phobic reaction to the bodies.
The complaint, the expressive manifestation of discomfort looking for an interlocutor who listens to us and thinks about us, is an exercise in resilience. That from the institution it is due, it can be heard, it is wanted to do it and spaces and mechanisms are generated that allow it, is, as it happened with some things that appear in the speeches of adolescents, evident and surprising at the same time.
Trauma, Psychic Survival and Integration through psychoanalysis. Hannu Saavala (Finland)
In this presentation I shall discuss the effects of childhood psychic trauma on mental integrity and on the treatment of the disintegrated psychic reality in a psychoanalytic setting. I portray a case-report of a middle-aged man with early traumatization. I describe his psychic collapse, the psychoanalytic process to reintegrate mental functions and the difficulties faced in the psychoanalytic dialogue with him.
In my presentation I shall explore early traumatization and its psychoanalytic treatment through the theoretical notions of Wilfred Bion (1959), Donald Winnicott (1971, 1975), Eugenio Gaddini (1982, 2016), Howard Levine (2014), and Simo Salonen (2018). Based on those notions, I describe the analysand’s incoherent state of mind and his propensity to a dreaming atmosphere. I reflect the analysand’s variable polarised affective tones and colours, which were initially inexplicable both to the analysand and the analyst. I show how the analysand’s urge for survival (Gaddini 1082, 2016) has endowed him with a capacity to control his behaviour but not his disordered and confused mind. I show how only through analyst’s use of his reverie (Bion 1959) there opens an opportunity for the integration of the analysand’s disorganized and at the same time rigid mental functioning.
Winnicott (1971) linked the individual’s psychic survival to the mother’s survival of the infant’s unbound aggression. I elaborate the analytic process showing how the analyst’s obsessive control of aggression is the main challenge in the analysis now. How can this aggression be freed for our mutual disposal so that it can be worked through in the analysis? If it can be freed, there will be healthy aggression at the analysand’s disposal.
Simo Salonen (2016) uses the terms primary identification and affect integration, which are helpful concepts in understanding the analysts history and psychic vulnerability. How is it possible that with such a history of trauma and of psychic rigidity there has been a process of mental representation for him.
Misframes and Missed Frames. Sport and mental health. María Fernández Ostolaza (Spain)
The crisis triggered by the 2019 pandemic reset many frameworks. Some psychoanalysts moved the couch on-line for the very first time; others, having already taken that leap, shifted all their patients to on-screen sessions—and it became clear that Zoom sometimes misframes the psychoanalytic encounter, particularly in cases of psychological or physical mourning.
The pandemic also reframed classical sports, and it did so dramatically. Group training came to an end; facilities became deserted; basements were turned into makeshift gyms. The biggest change, however, occurred in high-performance sports and the four-year cycle that frames the Olympic Games. Not even Japan, the host nation, was able to uphold the established order.
Over the last decade, my focus of theoretical interest has been the mourning experience in athletes and non-athletes alike, and the pandemic has provided a unique opportunity for study in both groups. I am interested in how athletes mourn their retirement, which I have approached in my practice using a variety of techniques. With the postponement of the Olympic Games, I found my time divided almost equally between helping a number of athletes deal with retirement—in some instances through complex processes of mourning and identity loss—and providing support to those determined to tackle an extremely protracted fifth Olympic year despite the uncertainty.
Athletic competition is a modern development through which we can observe some salient aspects of our society. It is no coincidence that Tokyo 2020 was regarded as the Olympic Games in mental health. Qualifying rounds were gradually reduced to zero; injuries multiplied, as did traumatic dreams; the ability to persevere in training was replaced by the ability to withstand change and unpredictability.
Athletes, those pretend heroes of our times, openly discussed their mental-health issues, which preceded the pandemic.
Parallel Panel 2 With simultaneous interpretation
New paths, new relationships
Chairperson: Cristina Nunes (Portugal)
The Babel Syndrome. Reflections on the dialogic crisis in the institutions. Carla Weber (Italy)
The current challenge of psychoanalysis is measured in the ability to maintain its grip with reality, a reality that induces the activation of defenses to avoid widespread fears and anxieties. The study of intersubjectivity (Ammaniti, Gallese) and above all that of trans-subjectivity (Bleger, Amati Sas) seem to offer an explanatory contribution useful for understanding psychoanalytically the functioning of the body-brain-mind in the throes of highly anxious experiences and going through continuous traumas in daily life.
Eco-environmental emergencies, pandemics and wars seem to be the iceberg of a crisis of our human coexistence and of our planning, of the institutions that we have founded for this purpose. What seems to be in crisis is the dialogic approximation and necessity to think together, to find forms of reassurance in fear, to plan actions for emancipation and creative change.
I would like to focus my contribution on the dialogical crisis in institutions, which increasingly presents, considering the ancient Greek term lógos - lége (bond), a crisis of the social bond that leaves the subject alone at risk of pathogenic regression and high exposure to mass-emotions (Bion).
The institution was born as a defensive system from primary anxiety, thus saving us from psychosis, and creating in the collective dialogic elaboration a reassuring bond of belonging capable of facing the secondary anxieties that the institution produces with respect to the pursuit of the primary task (Jaques).
When this institutional psychodynamics ceases to function and undermines the primary task, that is, the reason that established it, we witness the emergence of a deeper regression, prior to the defenses that legitimized it. In the institution we stop recognizing the good reasons for the defense of the other, denial of the other and envy take hold. The institution continues to remain in the pre-task, in basic assumptions of attack and flight (Bion), to ensure that no one takes over what remains of the institution. This prevents to enter into work assumption if not in fallback activities and hinders learning from experience.
The Babel syndrome recalls the punishment of the almighty towards those who want to build a tower so high that it reaches up to him. In fact, in the dialogic crisis of the institutions, the deadly obstacle of narcissistic omnipotence often looms.
In the contribution, I intend to make use of the research of English psychoanalysts attentive to the institutional contexts introduced and translated in Italy by Luigi Pagliarani (Bion, Klein, Jaques, Trist, Bowlby, Menzies, Hirschhorn and others), of French sociopsychology and psychoianalysis (Enriquez, Simondon, Stiegler, Kaes) to help analyze some phenomena that hinder and often prevent dialogue in and of institutions.
Is Psychoanalysis struggling with a developmental arrest? New envisions of agency in psychoanalytic theory and practice. Isabel Mesquita (Portugal)
The psychoanalytic field has now a considerable number of schools each one focusing on one dimension of human experience (Harris, A; Kuchuck& Rozmarin, 2021) so, psychoanalysis it is no longer a unified discipline. Psychoanalytic theories must decenter to be more integrative while attending to the different dimensions of human experience such as the instinctual life, the experience of the self, and the vicissitudes of the object and all relational experience, also attending to the development along with life. All these dimensions allow a deep acknowledgment of human psychic life.
We defend that is important to clarify the meaning of agency in psychoanalysis, and its place in the psychic life, because many psychoanalytic theories treat agency with disregard (Fried, 2008) as if the agency will place the psychoanalytic process on/in the superficial domain. Indeed, as human beings, we are creators of meaning and of interpretations, the experience is actively categorized and not merely passively recorded, and we are always constituting the contexts where we participate and exist, in a more or less effective way, in the sense that we can be more active or just passive in our life. We defend that it is the more or less openness to new experiences and new envisions of the self and the self with others that determine that agency will be expanded or constrained.
So, one aim of psychoanalysis should be the expansion of the agency of the self, while enhancing the transcendence of current self representations into novel ones – representations of the self as more secure, cohesive, and with a sense of effectance in the relational world.
Traditionally, in psychoanalysis, there has been a primacy of the inner world compared to the outer world. However, we know that it is impossible to know us well and most deeply without knowing our impact on others' lives and without recognizing the role of others in our psychic life. Indeed, we determine, and, in the meantime, we are constituted by relationships, in the sense that our psychic life is formed in relation with significant others. Our self and our identity are relational- with ourselves and with the others, and it is dynamic, as new relationships can promote changes in representations of the self and the self with others, and the reverse, as new representations of the self, leads to the search of more mature relationships, in an expanding way (Mesquita & Silva, 2021). This is our agency, the capacity to act purposefully and reflexively (Frie, 2008), and the competence to improve relational life while keeping ongoing and creating ourselves in multiple ways and transforming our inner and outer relational life. So, the agency is a capacity that develops over time, it is not only dependent on the cognitive process, but also a result of the interplay between affective, embodied, and relational processing of emotional experience. We can only understand agency if we conceive the connection between personal history, embodiment, affectivity, reflexive competence, and social and cultural context (Frie, 2008).
A third pathway for the social presence of clinical practice and of psychonanalytical culture. Fabio Vanni (Italy)
Psychoanalytic theory and clinical practice were born and evolved, from their origins, in a typically private context, both in the sense that the therapist was a professional who operated in his practice and received patients who could adhere to the type of treatment offered - for cultural, clinical and economic reasons - and because he operated as an individual and not in aggregate or group forms. Even the theoretical representation of the problems was typically private, intimate, almost unfathomable and therefore general in scope precisely because it was decontextualised. Over time and in many parts of the world, the care, health, and welfare systems of various countries have broadened their remit, in parallel with the evolution of the concept of health as indicated by the dedicated international organisations that have sprung up in the meantime. Moving beyond the body, they have included psychic care among their prerogatives; psychoanalysis and psychotherapy have found their place, with difficulty, but also bringing important stimuli to the institutions dedicated to care.
In Italy, psychic treatment has settled on these two poles: the public mental health facilities where psychoanalysis has played an important role but where today it experiences a progressive marginalisation and, in any case, great difficulty in developing its treatment perspective. The second pole is that of the private profession, which has become a possible alternative for the social classes that have greater capacity, and for the less acute and less serious problems that can be treated there.
This paper aims to briefly illustrate the concrete possibility of the existence of a third way that combines economic sustainability, ethical attention to the universalism of psychic care, and attention to the quality of clinical work for both patients and psychotherapists. We will speak of the 'Sum Project' placing it within a network, which has become increasingly wider in Italy, of organisations and projects that place themselves in contiguous positions by declining psychic care in forms not without interesting novelties even for colleagues in other countries.
Is a Pandemic of Psychoanalytic Sensibilities in the XXI Century possible? Ricardo Azevedo Barreto (Brazil)
The pandemic of COVID-19 demanded adaptations of the psychoanalytic approach and its interventions. In other respects, the XXI century has already flagged in its first decades that the biological, ecological, psychological, social, political, economic, digital and humanistic changes will present countless challenges to subjectivities (unconscious subjects), interpersonal relationships, craft works, several knowledge areas and their practices, the health field, the interactions between the human being and the Earth, psychoanalysis and emotional care activities, among other aspects. Barreto (2017, 2018, 2020, 2021) works in some of his publications on “the future of psychoanalysis in the world of things", "the future of the human being in the world of things", “COVID-19 and the sensibility of the human" and "the poetic-analytical care in an objectified pandemic world". Many authors of the psychoanalytical, philosophical and social fields offer contributions to the ways of thinking about humanity and work in the XXI century. The present individual paper will have the goal of discussing the future of psychoanalysis considering potentials and limits from this approach and problematizing the question with which this work is entitled: " Is a Pandemic of Psychoanalytic Sensibilities in the XXI Century Possible?" From a methodological point of view, this paper is an essay based on the contributions of psychoanalytic approach, which is characterized by a plurality of trends, and possible interfaces with other areas of knowledge. Among other aspects, some conceptions of the unconsciousness and the future of the mind and psychoanalysis will be discussed during this essay in a theoretical and reflexive nature. At the end of the presentation, the question of whether the future of psychoanalysis in the XXI century is possible or not will be discussed. Some guiding questions of the discussion will be: what is a psychoanalyst? What is the legacy of Sigmund Freud? How are we to think about the relation between psychoanalysis and the XXI century? What has happened through the objectification of humanity? Is psychoanalysis terminable or endless? By way of "conclusion", this paper will identify some factors that can facilitate a promising future for psychoanalysis in the XXI century as well as signaling aspects that tend to wear away at psychoanalysis in these new times. Undoubtedly, plural and multifaceted challenges are faced by psychoanalytical practices in the XXI century in the avenues, dead end streets and holes of the unconsciousness and the architectures of the civilization and the psychoanalysis to come.
Alternatives to truth in psychoanalysis. Cristina Díaz Erofeeva (Cuba)
This work focuses its attention on what limits psychoanalysis in the double sense of the limit term, I mean, in the weight of the edge; right on the border between what is and what is not psychoanalysis, assuming that “what is” is defined in relation to “what is not”. All what remains outside the intimate and specific space, both transferential and epistemological of psychoanalysis, acts within he, in a particular way, dislocated. What is left out of psychoanalysis is its condition of possibility, and at the same time it becomes the political of psychoanalysis, as long as it is not excluded or denied. When it is excluded or denied, it does not stop producing effects, and in practice and in theories, effects to be revealed in the movement of a critic. The concepts of value and meaning, of which the psychoanalysis is strange at times, they can be placed as an orientation in and to that place of extimacy.
It is in this sense that psychoanalysis as practice and thought, that emerges historically and is instituted in a social-economic reality determined and at the same time increasingly global, the psychoanalysis (and psychoanalysts), cannot be innocent of their internal and external power relations, that is, mutually affected, and allow oneself not to question the own norms that it generates there where it is posited as a-normal, as well as those norms of the ideological consensus that applies. Psychoanalysis is a practice in that one is responsible for what is said and what is not said, not only of the silence that says and allows to say, but of the silencing that silences and It has effects on subjectivity. So it is the statement of silence and of the word and not its statements what matters, of both transfer sides.
Double movement of criticism - in and out - through the concepts of psychoanalysis applied to itself, to radicalize the always double, equivocal character of its concepts themselves, but also and at the same time, in a necessary dialogue with their contemporaneity, with its scenarios of subjectivities, truths and powers, a criticism that is located in that loaded border line that defines the possible and opens to the impossible. Psychoanalysis also leads the mark of mortality that is characteristic of the suffering it welcomes (for that he also terminable and interminable) and perhaps like all we need to assume their mortality, which is not the same as accept his death. But before, now, through our own concerns, our uncertainties, our discomfort, our sense of demand for openness to changing temporality, to through our resistance, take charge of that state of crisis (structural and current) of our practice.
16:30 - 18:30
Central Panel With simultaneous interpretation
One psychoanalysis or two?
Chairperson: Rómulo Aguillaume (Spain)
A psychoanalysis of relationship: the non-presence of the analyst. Juan Rodado (Spain)
Each era has its socio-cultural dimensions that produce a certain form of subjective inscription. The finisicular Vienna, where Freud's work emerged, has nothing to do with the current era. Therefore, for Stephen Mitchel (2004, p.21) it is possible that classical Freudian psychoanalysis is outdated (according to this author, orthodox psychoanalysis is not of our time). Just as the world around psychoanalysis has changed, psychoanalysis itself has changed in terms of the frameworks in which it is applied, the ways in which it is practiced, and the understandings it generates.
It can be said that the current psychoanalytic perspective is complex and marked by multiplicity and diversity (one or two psychoanalyses). Far from being a problem, in my opinion, what it shows is that it is a living discipline, that is constantly questioned.
For Jessica Benjamin (1997, p.38), an American psychoanalyst, Freud's theory should not simply be adopted or discarded. Criticizing and revising that theory, rereading it, even modifying it and letting it influence us, is a prerogative that we have as analysts. As Foucault points out in "What is an author?" psychoanalysis represents a different model of thought than that found in the natural sciences, where one thinker can simply destroy the thoughts of another thinker. Like Marxism, it is rather a discursive field linked to its origins by certain formulations of its creators.
We are in a time, the era of liquid modernity as defined by Bauman (2005) where we find a fragmented, dispersed world, in which uncertainty, unpredictability and chance predominate.
Julio Moreno, Argentine psychoanalyst, describes in his book "Being Human" (2010) two models of psychic functioning. One would be the associative, which he also calls "psychic account" and which would be formed by the mental representations that are chained in association, integrating both the conscious and the preconscious. They are representations subject to repression and phenomena of displacement and condensation. Borrowing Alain Badiou's (1988) concept “account for one”, Moreno also calls this type of process Logics of one. For him there is another type of functioning, which he calls connective and which is represented by the immanent, the immediate and which falls outside the order of representation. These two types of psychic processing coexist and occur at the same time and for Julio Moreno, "the link" supposes the space between one and the other.
For modernity, the unconscious was constituted from the oedipal epic, giving rise to a closed subject. This model is still valid, but as Lea Forster (2020, p. 14) points out, it coexists with heterologous sets of events and functioning (the overstimulation of signals and the accelerated rhythm, the use of the network...) with event effects. What Julio Moreno has described as connective processing. The event, therefore, is unforeseen, it happens by chance, it resists all representation, it does not take place, but must be done.
A world, as Franco Berardi (2019) points out, where the overstimulation of brands and signals imposes such a high rate of inputs that it makes symbolic coding difficult; a world where more and more psychic structures and functionings appear in which the primordial repression and therefore the establishment of representations typical of a neurotic functioning are scarcer to see and where the discomfort falls more on the side of the immediate, the contingent, the connective.
This work intends to explore the linking dimension that an analytic relationship proposes and that is established in each analytic session between the patient-therapist pair.
Taking into account the two types of psychic processing described by Julio Moreno, we can say that in the analytic relationship and in each session, intervening elements of the so-called Logic of the One converge (such as the psychic apparatus of the members of the couple, functioning in a associative) ; factors of the connective functioning (what is produced in being subjects, in the empty space between the analyst-patient couple) and the conditions of the socio-cultural context.
With concepts taken from philosophy, such as Merleau-Ponty's Intercorporality and Francois Julien's Emergency, I would like to foreground the analytic session and what happens in it through a clinical case, to highlight the importance of presence of the analyst, real presence in the sense of what G. Steiner (2022) defines, that is to say that of the non-representable, the ineffable, elusive, immaterial always present, that gives meaning and is in the analytical relationship and that is characteristic of the between link established by patient and analyst.
The Cartesian mind in psychoanalysis. Carlos Rodríguez Sutil (Spain)
The egocentric perspective, that is, the idea that our minds are isolated in an inner space, inside our heads, is very ingrained in our culture. This Cartesian mind is a social 'construct', somewhat conventional, but one that cannot be easily modified. From the relational perspective in psychoanalysis, we maintain, instead, that the mind is not something innate or internal, but rather is a product of human interaction, within a particular way of life. The confusion between mind and brain stems from a 'category mistake, as Ryle suggests, which consists in endowing the mind with a space and with a material causality. The mind of the other can be inferred, somehow it is phosphorescent. Ours, instead, is constantly "verified", as Wittgenstein denounced, thanks to the private experience of sensations, ideas, images, etc. It is tempting to speak of the eye looking at the "outside" world and providing us with a picture in the mind, but that picture should be seen by another eye in the mind, and so on ad infinitum. Originally, I learned my language of sensations and emotions, and even the very idea of "mind", through interaction with the other, who taught me to identify them.
The metaphysical counterpart of the egocentric perspective is the problem of other minds - how can I be sure of the existence of minds other than my own? This problem is apparently "solved" by the argument per analogiam: I infer that other have mind by the similarity of their actions with respect to mine. Freud can be accused of this "mistake", as shown in theory and in practice, but it is quite widespread mistake. Other examples can be found in Meltzoff - with his "like me" hypothesis - and in some approaches by Fonagy's mentalization theory, which suggests that the ability to make sense of psychological experiences with others evolves because of our discovery of the mind behind them, their actions and thrives in a relatively safe and secure social context.
We should urgently review the concept of “internal representation”, and its derivatives, such as the “internal object”, probably also the “self-object”, internalization and many others. The psychoanalysis that we propose, the relational psychoanalysis, within the great variety of existing proposals, puts the origin of the psyche in the group, beginning with the family group, it rejects metapsychological energetism but does not accept an exclusively hermeneutic version either, but rather lends a special attention to the evolutionary trauma and to the family attributions and myths in the origin of the pathology. We refer to the myths of Narcissus, Oedipus, Ulysses and Telemachus, and Orestes and Elektra.
Psychoanalytic practices. Rómulo Aguillaume (Spain)
If, in its day, it was difficult to mark a theoretical border between the two possible psychoanalytic models, today doing the same with the practice of psychoanalysis seems more cumbersome.
The practice of psychoanalysis goes first of all through the framework in which it is carried out, which in turn is determined by the theoretical model on which it is based and the conception of cure that it advocates. Three sufficiently complex referents that force us to differentiate this practice as much as possible.
The setting still marks, for some, the difference between psychoanalysis and psychotherapy. It would seem that psychoanalysis rests on transference and psychotherapy on suggestion, or psychoanalysis on transference and psychoanalysis on suggestion.
This work aims to show that beyond the theoretical complexity with which certain models are presented, their practice does not exempt them from a foundation in suggestion.
Likewise, it is intended to differentiate a therapeutic process model marked by suggestion from another marked by transference.
18:45 - 20:15
Parallel Panel 1 Without simultaneous interpretation
The beginning of the impossible profession: experiences of young therapists
Chairperson: Daniela De Robertis (Italy)
Psychoanalytic Psychotherapy Training in the SPP School. Simone Maschietto (Italy)
Choosing the profession of psychoanalytic psychotherapist in Italy implies a very detailed complex path. This is both because the four year training course is very demanding and because each student must carry out 500 training hours per year. These hours are divided into 150 of internship, 285 of lessons, at least 50 hours of personal analysis and 15 hours of individual supervision. This is also for the subsequence insertion into the world of work with the acquired title which is becoming an almost heroic enterprise. There are very few competitions and psychotherapeutic treatments at the level of recruitment in the public health structures for the administration of psychotherapy to adults. These contexts are entrusted, under the supervision of a very few tenured psychologists, to crowds of students enrolled in the various specialization schools in psychotherapy.
Yet the object of study of psychoanalysis, the human unconscious that which makes us so deeply human, is so desired in the university years and in the faculty of psychology at the quadrennial course in psychoanalytic psychotherapy, that it helps to overcome the many difficulties encountered in doing the analysts job. The search for meaning, which analytically recalls the search for the relationship with the object, is so pregnant in the human psyche that those who decide to deepen it’s study on a professional level can remain intensely involved in it throughout their life.
Furthermore, the young psychoanalyst therapist, in order to do the job of the analyst well, must have put himself on the line in his own personal analysis. He must have deepened how starting from his childhood, relating to the object has become characterized and how it developed. And above all, he must have repaired the wounds that occurred in this relationship with the object. The young therapist, in order to work well, must stay fully involved in the relationship with the patient. This patient, in turn, will project his ancient object on the therapist to repeat them in the transference process with the hope of changing them through analytic work. The therapist needs to study a lot, because in this profession one must know psychoanalytic theory very well. He must then forget it when he is with the patient and make it refer surface in his mind in an intuitive and immediate way, listening to the patients associations and his own.
The centre of the session always remains the patient, but it can be observed how the analytic therapist, whose active role in determining what happens in the analysis room, is now widely recognized by all the different psychoanalytic currents. He is constantly questioning himself in the first person (countertransference process), in order to make the analysand's transformative process evolve.
Supervision in the Psychoanalytic Psychotherapy School. Anna Sordelli (Italy)
The author reports some reflections of her own experience as a supervisor in the SPP School of Psychoanalytic Psychotherapy.
She underlines the importance of supervision as a meeting point between the institutional training demand characterized by the need for an increase in clinical skills. The more private and individual request of the students who have to deal with their own theoretical uncertainties and intense emotions are calculated by the clinical experience. The alliance dimension within the supervision is important, for a lucrative joint work. This requires adequate continuity and frequency, which must be structured in a setting shared by the participants.
Setting is characterized by concrete aspects, made up of places, times, but also internal space shared by the supervisor and students. However, the well defined external framework must allow fluidity of reflections and thoughts inside their minds.
The supervisions act as a moment of theoretical and clinical reflection to help the student understand what is happening in the therapeutic relationship. One of the objectives of supervision can be to teach the student how to think using theoretical references; thus listening to his own ideas in relation to that specific patient.
Supervision work is a tool to improve the diagnostic capacity and student centered on understanding the patients intrapsychic functioning, without blocking the dimension of the relationship. It tries to promote a non defensive clinical capacity that allows good management. It tries to do this without incurring in technical errors that could compromise the work, or in extreme cases harm the patient. Supervision also performs an important containment function by helping the young therapist recognize and regulate his emotions. It improves the students capacity for understanding and emotional attunement with himself and the therapeutic relationship.
The importance of reflection on more strictly transference and countertrasference dynamics activated in the patient is also emphasized. This accompanies the student in grasping the unconscious dimension that is always present as a subject of the conscience dimension of the relationship. This way of working will also allow for a shared reflection on the possibilities of promoting an evolutionary dimension in the transference. That is, the possibility of activating new modalities in the patient through experimenting in the relationship with ‘a new object’ therapist who allows a different acceptance than with the objects of the past.
The supervision work, in this context, will be useful to elaborate the risk for the student to act as a therapist / a totally good object in an attempt to differentiate himself from the bad objects of the patients past. Doing this, he unknowingly activates an idealized relationship, that would not allow analysis and integration of aggressive elements.
The challenges faced when undertaking the psychoanalytic profession. Donatella Rattini (Italy)
The young psychologists, who wish to become psychoanalysts end up learning from a kind of experience that is incomparable to any other formative practice. That is the meeting point between their own unconscious and that of their patients. They begin their formative training lacking the mastery of the tools required to perform their profession and upon which the therapeutic effect of their action relies. This translates into a day-to-day approach in which both therapist and patient face uncharted and dangerous waters and nobody is safe from seasickness. Being exposed to the greatest variety of difficulties, whether technical or of other nature, is precisely what offers the training analyst the opportunity to learn how to use the tools of their profession.
One of the most critical moments happens when, during the therapeutical process, erotic transference and countertransference manifest themselves: the dimensions of the care relationship in which transference love – thought to be an unavoidable and necessary element of the psychoanalytic treatment due to its highly subjective nature – takes on a considerable intensity and a particular weave. If in a therapeutic setting, this phenomenon develops in too strong a fashion, young psychologists in their formative period may find themselves in the dangerous situation of being overwhelmed or scotomising it. This is because they feel they do not have the necessary tools to contain, elaborate and furnish it with meaning.
The clinical situations described in the chapter ‘The explosion of love in the psychoanalytic room’ clarify this concept by taking the readers inside the room and make them partake of the moments in which the author experienced the challenges of clinical practice, with all the thoughts, doubts and resulting countertrasferational and personal responses.
To bypass these challenges, the therapist is often brought to experience, defensively, an excess of psychoanalytic theory. That is embraced as a defensive shield as well as a working tool in his own place.
The fil rouge that clearly emerges from the reports of former pupils of the SPP - School of Individual Psychoanalytic Psychotherapy of Adults of Milan, both recent graduates and those who graduated a few years ago, is the crucial role of the relationship with the tutor/supervisor. The supervisor, with his being, knowledge and experience, both psychoanalytic and personal, is capable of assisting the training psychotherapist with a psychoanalytic focus in the art of taking care of the patient.
At this point, one may wonder: what does one learn and discover when the training process is successful? Or in other words: what personal tool does the training psychologist seek in the supervisor?
Discussant: Davide Fiocchi (Italy)
Parallel Panel 2 Without simultaneous interpretation
Groups and family
Chairperson: Javier Naranjo (Spain)
Multifamily psychoanalysis. Broadening the spectrum of psychoanalyzability. Fernando Burguillo (Spain)
For Juan David Nassio, saying that someone was or was not psychoanalyzable was like saying whether or not they were "aspirinable". An aspirin can undoubtedly be very harmful to, for example, people with gastric problems. However, we understand that it is part of good health work to find a way for the patient with gastric problems to somehow get the maximum possible benefit from aspirin, while minimising its undesirable consequences.
It is very likely that there is a threshold of fragility in the mental structuring of individuals, which discriminates against their ability to withstand psychoanalytic practice. It is also very likely that the analyst who pretends that everyone can be psychoanalysed pose as omnipotent. However, considering the alternative, I believe that the illusion of transcending the limits of psychoanalyzability should be a horizon towards which we walk, even if this almost always implies tolerating important uncertainties.
My experience as a psychiatrist, and also as a psychoanalyst, has been marked by the desire to go further, to get out of the prevailing pessimism according to which we have to accept that certain diagnoses will be practically immovable and, therefore, their chronic course and their treatment - usually more psychiatric than psychoanalytic - practically for life.
About fifteen years ago I approached and began to delve deeper into Multifamily Psychoanalysis. The discoveries made by Jorge García Badaracco 50 years ago changed my way of understanding and, above all, of facing the difficulties of psychiatric and psychoanalytic practice and, perhaps especially, of improving the articulation between both disciplines. What I would like to share with you in this space is a brief approach to this practice based on my professional experience.
The group technique of "social dreaming". E. Martin Walker (United States)
Ferenczi's "Confusion of Tongues between Adults and Children" (1933) reformulated Freud's idea of symbolic material, or phantasies. Similarly, Gordon Lawrence (1999) helps us to reframe the dream as a social experience. Ferenczi challenged the idea that memories of sexual abuse were fantasies symbolically expressing a repetition of childhood and childhood conflicts. (Zaslow, 1988) Ferenczi insisted that they were based on actual events experienced in the past. He dismissed Freud's seduction theory by insisting on his earlier theory that memories of sexual abuse were based on actual experiences, and also proposed that psychoanalytic transference included a commentary on the analyst's actual character. In the end, Ferenczi insisted that the exploration of sexual abuse and transference in psychoanalysis revealed neglected links between self and other both inside and outside the consulting room. Ferenczi's interest in what happened between himself and his patients took him beyond the standard transference interpretations of the time in a way that ultimately led to a break with Freud. Ultimately, by suggesting that actual events revealed neglected links between himself and his patients, Ferenczi planted the seed that has become the interpersonal/relational turn.
The group technique of "social dreaming," proposed by Lawrence (1999) for dreams, defines their meaning beyond the exclusively individual, intrapsychic domains of interpretation, examining the operation of dreams in terms of systems, and not just in individualistic symbolic terms. Based on the idea that dreams reflect elements of shared experiences of the world, he proposes that the dreams of a social aggregate also reveal neglected links and interconnections between individuals and society, extending beyond the dyadic realms of which Paul Lippmann has written (2001).
In my presentation to the conference, I will explain in brief how Lawrence, drawing on historical and anthropological knowledge of dreams, hypothesised that it was possible to dream socially (to consider dreaming as a manifestation of the social environment in which we live), and that dreams could illuminate unknown aspects of the shared social context. In essence, this allows for the strengthening of socio-centric characteristics threatened by the egocentric materialism of a nascent modernity of cultures that overestimate individualism in its extreme. "Social dreaming introduces a methodology that enhances creative social forces by suspending systems of personal repression born of archaic cultural values. By setting aside over-dependence on external authorities, it gives us access to the universal function of dreams and their wisdom.
Motherhood and Fatherhood as psychoanalytical essentials along the way life span of psychoanalysis. Terttu Mäkinen (Finland)
A Room of One’s Own (Virginia Woolf’s classical book) is classical text about women. The role of the woman in the society under the shelter or the shadow of the man is the main question of the original book. Bela Bartok composed an opera of the Duke of Blue Beard, and composer Outi Tarkiainen’s opera has integrated these two, the castle of Duke Blue Beard and the female room of one’s own. The castle is dreamy like psychological drama to the subconscious. Judith, the newest wife of the Duke Blue Beard asks her husband to open all the seven closed rooms of the castle to look at the inside secrets. Also, Mexican artist Frida Kahlo, wanted the room of her own in the house with her husband, artist Diego Rivera, room, where anyone could enter without, she let. The mothers for ever have allowed voluntarily, ambivalently, with desire, as sexually abused, or raped, or many other situations, to come in and make space for new life in them. Peaceful times, wars, decades have changed, but individual lives have been beginning under different kinds of situations and relations. The Finnish writer, Anni Swan, was talking in her stories about the womb of the mythical forest, when the development of the child is symbolically transforming individually more subjective and the separation from the mother is necessary.
Sigmund Freud did create the origin of the psychoanalysis with many other important creators as Jung, Ferenczi, Lacan, Klein, Winnicott, Bowlby, and others. It happened historically under hard times in Europe, where tensions between nationalities and people did not end beautifully. The motherly wombs and motherhood could not give shelter for lives of the victims. The fatherhood did discriminate and choose between life and death. Today again we meet the same discrepancies in Europe and in the whole world. Can psychoanalysis in history, today, and tomorrow, to solve or to help the problem of unsymbolized bad and good in humankind or even individually?
Poetics in the creation of a space for adolescents. Looking and being looked at in the public institution. María José Rodado (Spain)
In adolescence, the boundaries between the normal and the pathological become closer, blurred and confused. This confusion is as much for the professional who must recognise the pathological as for the adolescent himself, assailed by anguished doubts about what is happening in his mind, his body and in his relationships. Both adolescents and professionals need criteria - limits - that differentiate normality and pathology. However, adolescents feel the need to transgress these limits and put the adult to the test. Therefore, working with adolescents requires great plasticity and flexibility from the professional. Flexibility that contrasts with the protocolisation and the establishment of rigid rules that public institutions demand and that put subjective singularity at risk. In a period in which the discourse of science permeates all psychiatric practice, the elimination of the symptom becomes a preponderant objective. It is the psychoanalyst's responsibility to include in clinical practice a model that allows us to understand the structuring of the psychic apparatus and interventions that contrast with the prevailing health policies in public health.
Knowing these particularities of working with adolescents and the demands of the institution, this text contributes a reflection on the challenge of opening a unit for adolescents in a public hospital. This unit is conceived as a psychotherapeutic space, both for adolescents and their families, and incorporates psychoanalytic listening. In the development of the project, difficulties will appear, determined both by the complexity and seriousness of the pathology and by the characteristics of the institution itself. These characteristics imply contradictions with the psychoanalytic way of doing things.
In order to overcome these difficulties, a theoretical working model is necessary to validate clinical practice. I propose, accept and work with what Winnicott describes as paradox and which Lacruz (2011) points out as the epicentre of Winnicott's thought. Paradox is a figure of thought whose expression involves a contradiction, in that it confronts two opposing elements whose tension must be accepted: "Paradox must be accepted, not resolved", says Winnicott. When paradox is tolerated and respected, thought is given a dialectical, dynamic character that flees from single truths. Phenomena are thus understood on a continuum between the normal and the pathological. With this approach, both the treatment and diagnosis of adolescents are seen as dynamic, subject to reformulation.
The text will also be accompanied by clinical vignettes to exemplify the specificity of each of the symptoms and interventions carried out during the period that the adolescents remain in hospital. I will articulate this clinical approach with theoretical concepts.
I will conclude, taking into account Morin's (1990) developments on complex thinking, by highlighting the need to approach mental health problems from the perspective of complexity and to incorporate the differences related to each of the individuals who consult us in the public system. And I will raise the question of whether certain clinical practices are health-generating or can become pathologising.
Being creatively in the therapeutic relationship. The child without a smile. Paolo Arru (Italy)
The child in psychotherapy often needs help to interpret the world. In situations in which very disturbed essential functions of growth are highlighted, the greatest difficulty is that of transforming the despair of the children of parents into hope. When these children use words they do so in a concrete way. It is therefore up to the therapist to use their language by adding something more. In these cases it is important to weave a web of words in which a shapeless malaise sharpened by a bombardment of disordered and automatic sensations is collected and shared by the therapist (Vallino, 2005). It is not a question of reflecting, but not even of giving a verbalized psychoanalytic interpretation, but rather of containing, replacing and transforming by telling them what they do without being able to narrate it, waiting for shared stories to emerge. It is a constant, tenacious, devoted patient work that a psychoanalytic psychotherapy involves over time.
This work presents a psychoanalytic psychotherapeutic treatment of an 11-year-old child Maximilian, suffering from Moebius syndrome, a rare disease whose main feature is a permanent facial paresis which prevents, among other things, smiling and closing his eyes. or move them sideways. Maximilian also has a linguistic delay and hand malformations.
Individual psychotherapy was made necessary because the child's difficulties were accentuated both at home and at school: stereotyped attitudes, aggression, hyperactivity.
From the initial consultation meetings Massimiliano shows a strong anti-aging, his gaze is unstable he does not verbalize desires, choices, the language does not seem to have a communicative value; the child tends to ask insistent repetitive questions. Words are spoken quickly and expulsively. When faced with requests, he shows anxious reactions. Refuse to draw. When there is tension it tends to isolate itself and manifest motor tics.
In the game he does not appear capable of accessing a symbolic dimension, he merely explores some toys and appears very interested in their electrical and mechanical functioning. A poor integration of the Self emerges and Maximilian's experience of being a "broken object" and "not working".
From the first interviews with the mother there is a difficulty in the woman to resonate with the child by sharing emotional states with him and a difficulty in reading the signals and meeting his emotional needs. He has an inhibitory attitude towards his son, he blocks him on all his initiatives that do not fit into his pre-established scheme.
It is hypothesized that the birth of Maximilian, suffering from a rare genetic syndrome, had a profound impact on the mother and influenced her ability to be for her child what Bion called alpha function. Thanks to this function, the overwhelming impact of the first childhood experiences becomes tolerable and the sensations are identified and endowed with meaning.
An infant who is denied the opportunity to "explore his feelings in a personality strong enough to contain them" will later manifest a severe curiosity impulse disorder on which all learning depends.
Maximilian's relationship with his mother seems to be fraught with suffering with problems that have been transmitted for three generations due to the difficult and painful personal story of the mother and maternal grandmother without being able to be elaborated and would need to be welcomed and supported.
The fragmentation of experience and sense of self can be a consequence of splitting (Klein, 1946; Bion, 1967), of a lack of integration, resulting from a lack of care (Bick, 1984) or of segmentation processes described by Meltzer (1977).
Although Maximilian had suffered from a primary affective deficiency, the therapist sensed that he had an intact ability to keep the innate expectation of being a thinking person, a child who could "turn on", if welcomed by an attentive look and listened to in a silent reverie. This made it possible to start the journey with Massimiliano and his parents by sharing the effort and suffering to support the small uncertain steps towards growth.
In the analytic field generated by the patient and analyst, every communication can be understood as a narrative derivative of the dream thought of waking generated at that particular moment.
The therapist prefers unsaturated interventions while maintaining a mental attitude capable of grasping the elements linked to the transference / countertransference dynamics to expand the patient's ability to stay and build as a couple by activating a process of co-narrative transformation or transformative co-narration. (Ferro, 2002)
The theoretical discussions are illustrated by clinical vignettes in which the narrated symbolic journey has allowed the access and work of the patient's inner world, allowing to start producing symbolic representations.
Verbal communication with this child was not meaningful to him. Then a pre-verbal communication was adopted using, intuitively, mirroring and imitation as tools; in this way it was possible to involve Massimiliano in the relationship.
During psychotherapy process, having completed the fragmented words expressed by the child, composing them in a meaningful chant motivated Massimiliano to invest in language.
In a psychotherapy session, synchronously grasping the meaning of a rudimentary game produced by the child, of the patient's "psychological birth", has acquired a very intense emotional meaning. This exchange allowed the child, through introjective identification, to begin to learn a capacity to think from the therapist.
9:00 - 11:00
Central Panel With simultaneous interpretation
Chairperson: Silvia Amarilla (Spain)
Does it still taste like psychoanalysis? Experiences of collaborating with universities in psychoanalytic training. Jan Johansson (Finland)
Psychoanalytic training has been a subject of discussion from the start of the first formalized efforts to train psychoanalysts at the Berlin Institute a hundred years ago. The most common way of training is the Eitingon model, developed at the Berlin Institute, consisting of three elements: theoretical seminars, personal analysis and supervised clinical practice. The model has been criticized by many. Otto Kernberg has likened the training in the psychoanalytic institutes to a cross-breed of a monastery and a technical institute. In his view, the atmosphere of scientific inquiry is mostly lacking.
There has been a striking lack of interest in reforming the training and creating new forms of transmitting the essential knowledge required to function as a psychoanalyst. Yet, as many acknowledge, this is something that is sorely needed. This paper aims to present, and to some extent evaluate, a model for training psychotherapists in use in Finland.
The training of psychotherapists, of all persuasions, is confined to universities. In the model, privately kept institutes offer the training in collaboration with the universities. The role of the university is to assess and approve the training program, take part in the work of the supervisory board of the training and, upon completed training, write a certificate. The institute provides for the creation of the program, assessment of the suitability of the applicants, teaching the theoretical seminars and supervision of the clinical practice.
The paper aims to discuss the implications of this mixed-model training. What does happen, when a third-party becomes involved in the training process? Is it possible to maintain a psychoanalytic curriculum of studies in such a context? What does the relative loss of autonomy signify? What are the implications for the psychoanalytic institutes? As such, the model doesn’t solve or address in a sufficient manner the problems inherent in the traditional model of psychoanalytic training. It still offers some change; it has compelled the institutes to modernize the literature in use. Another advantage is that there are elements incorporated that prepare the trainees to make use of and assess psychotherapy-research and conducting minor research-projects themselves.
Training in Psychoanalysis, the Norwegian model. Arne Døske (Norway)
The Institute for psychotherapy in Norway has 350 member and is by far the greatest in number of the member institute of IPFS.
At any time we have 73 students enrolled in our training. We have 23 qualified teachers and around 147 training analyst and supervisors.
In Norway there is a plethora of institute to choose from, many of them offer extensive education within their method. Still we continue to have many applicants.
Why has our institute flourished?
In this presentation I will focus on the historical and strategical elements made by the founders of our Institute. I will try to show how their vision on training made it possible for psychologists and psychiatrist all over the country to train in psychoanalysis and intensive psychotherapy.
Secondly the presentation will address the challenge of identification as psychoanalyst and how in my view this has somewhat weakened over the years.
Thirdly I will discuss how particularly within the current health political arena the psychoanalytic thinking and practice may become rigid or stultified because of fear of retaliation from the state or colleagues, and how that might be a hinderance to breaking new grounds within the field.
Fourthly I will discuss some possible ways forward to increase the sense of personal and institutional identification within IFPS.
Transmission of listening. Raquel del Amo (Spain)
Within the training in psychoanalysis, it has always seemed to me that the most complicated thing is to transmit not the theory, which, although complex and multiple, can be apprehended, but listening.
During my presentation, we will try to see the difficulties to be able to be in a position of floating attention, to practice the rule of abstinence and to be able to ask ourselves about what is listened to for example in border pathologies where the act often precedes the word.
The psychoanalyst's listening is the cornerstone of his work, which is, as Leonard Cohen says, that "there is a crack - a crack - in everything. That's how the light gets in". The light that reveals what is the desire behind the imaginary vicissitudes of any person.
11:30 - 12:45
Central Panel With simultaneous interpretation
Psychoanalysis in times of covid
Chairperson: Fernando Soriano (Spain)
Psychoanalysis in the Time of Coronavirus. Anna Maria Loiacono (Italy)
Love in the Time of Cholera (1985) is a novel about waiting for the fulfillment of a promise of love. Taking inspiration from this famous novel by G. García Márquez, the Author recounts her experience as an analyst, from the point at which the lockdown was triggered up until today, when unfortunately the nightmare of contagion is not over, even if the awful fear seems to have abated.
The Author will highlight not only the relationship between colleagues, which in periods like this proves to be more supportive than ever, but also the influence that the move towards an online working procedure has had on the therapeutic process and on the setting.
The issue rekindles those themes having to do with the body and sensoriality in psychoanalysis (Russell, 2015; Turkle, 2015; Parsons, 2007, 2014), ones which involve the possibility of reaching and integrating, through the analytical relationship, traumatic experiences that are embodied, non-verbalized, and not able to be verbalized (Mancia, 2004; Correale, 2022). In this sense, the “promise of love” in the analytical relationship has undergone powerful shocks in the transition to the online format.
As the pilots of the psychoanalytic ship, we have had to face waters never encountered before, ones that are upsetting our habitual mode of working with the other, and challenging our ability to adapt.
The Author brings her contribution to this debate by means of a clinical case, in which the contingency strategy, based on working remotely, continued to guarantee that sense of security necessary to enable the possibility of dreaming together and freely exploring, introducing however, within the relationship, aspects of “active technique” (Ferenczi & Rank, 1923), which would not have occurred in person, and which certainly influenced the process in a different way than the in-person modality would have.
Today more than ever: the centrality of attempting a metapsychology of tele-copresence. Lucio Gutiérrez (Chile)
A particular consequence that the COVID19 pandemic left us was that psychoanalysts were inclined (whether by desire or necessity) to de facto legitimize telematics as a modality to continue their psychoanalytic work.
The massive and vertiginous nature of the adoption of the tele-analytic setting was such that in a certain sense it blocked the polyphony of the discussion -once a niche one- about the possibility and determinants of a genuine tele-psychoanalytic process. Although the exchanges of experiences abounded, the substantive question became a kind of “stone guest” that to this day accompanies our tele-psychoanalytic practice. The theoretical references from which to think about this radical technical modification still seem scarce.
In this paper we will make some metapsychological proposals about the psychic processes behind tele-co-presence and tele-linkage; and we will explore some of its consequences both for tele-psychoanalysis as well as for other digitally mediated human activities.
12:45 - 13:45
Keynote Speaker With simultaneous interpretation
Lecture by Darian Leader
There seems to be little psychoanalytic interest today in research that deals with infantile and childhood sexuality prior to questions of gender. This talk will explore early childhood anxieties and preoccupations with the body, and their possible impact on later sexual practices. How is sex actually possible, and what are the risks and dangers that may be involved?
15:00 - 16:25
Parallel Panel 1 Without simultaneous interpretation
Chairperson: Alessandra Sapoznik (Brazil / Spain)
Functions of the voice in the session: implications for analytic listening. Eleni Filippachi (Greece)
In 1905 Freud famously wrote that “words are the essential tool of mental treatment” and have their own “magic” effect (Freud, 1905). Psychoanalysis still remains a fundamentally “talking cure” in the sense that language is the primary vehicle of interaction. Yet theoretical and clinical developments since Freud (especially under the influence of later psychoanalysts, notably D. Winnicott and W. Bion) have gradually paid attention to the importance of non-discursive, non-linguistic aspects of communication in the analytic room. Recently, analytic receptivity has been re-described to include attention not just to semantics but also other aspects of communication: the musicality of analytic prose, the communicative qualities of the voice, the varied meanings of silence, analytic reveries, body language, sensory experiences and various forms of enactments express the complexity of the transferential and counter-transferential responses to the analytic condition and are considered integral parts of the therapeutic process.
Drawing on the analysis of Mrs A., I propose three distinct functions of the voice in the analytic session: semantic, expressive and performative. Considering the voice not just as a vehicle of language and semantic content, but particularly in what I call its expressive and performative functions opens up an imaginative space for un-(or pre-)preconscious, pre-discursive mental content to emerge in the analytic context in a very distinctive way. Technical implications are discussed on the basis of the clinical material. Is the analyst’s listening of the patient consonant or dissonant with the patient’s own listening of the analyst and herself? Is the communication of affect aligned with cognitive understanding in each member of the pair? Do words capture the experience of the body? Does the analyst’s own body become the receiver/instrument (Breen, 2019) of unsymbolized material requiring further psychic work? Analytic listening is suggested as a creative way of being-in-the session that cannot be reduced to hermeneutics and conceptual understanding. Receptive at once to amorphous psychic content, proto-symbolic representations and second-order thought processes, the analyst listens at different registers, which sometimes orientate and sometimes disorientate her understanding of the patient.
Tuning psychoanalytic listening. Isabella Lemos Novello (Brazil)
As a magnifying glass, the pandemic mirrored what had already been announced: a new malaise.
The psychoanalysis room is no longer, for a long time, a space dominated only by the intrapsychic dynamics, being also taken by elements of society’s deep and constant transformation.
Historically, we are now moving from a repressive and patriarchal, modern society towards neoliberalism that brought with it a false idea of autonomy and freedom, suggesting that the subject is a free manager of himself and solely responsible for his success or failure. This is, of course, a decoy because every human action brings within it an unlimited set of causes. In a country marked by deep inequalities and structural racism, as is Brazil, this socioeconomic organization becomes even more toxic.
The work arises from concerns about the clinic and its connection with the world around us and raises the importance of psychoanalysis to preserve its freshness and continue being the 'plague' as Freud suggested. For this, we need to recognize what is new in the diversity of patients who currently come to us, their sufferings and their symptoms, without rushing to seek shelter and comfort in the theoretical patrimony already established.
In line with Ferenczi, we look forward through the presentation of a clinical vignette to reflect on the importance of recognizing, in the analytical scene, the abusive and pathologizing aspect of the contemporary sociocultural environment, especially for certain groups - people of Color, the LGBTQIA+ population, the economically disadvantaged - among other minorities or minoritised majorities. Denying the toxicity of this enlarged circle of the environment, beyond the nuclear family, could put the analyst in the place of Ferencziano's discreditation.
It is in clinical practice - our sovereign field of investigation and performance - where the cross-over of this infiltrated collective suffering is found out in the individual psychic sphere.
This paper aims at questioning how the process of fine-tuning our listening skills to easy the patient to deal with the constant risk of colonization of their subjectivity. We consider as fundamental the act of perceiving the symptoms, formations of the unconscious which inform us about the psychic suffering of each individual, also as the expression of the collective suffering considering the power of such symptoms as a denunciation, as a weapon, as a reaction to a deeply oppressive system.
The womb that grows two: The therapist’s pregnancy and psychic change in the “new relationship”. Carolina Franco da Silva (Portugal)
El embarazo de una terapeuta es una innegable interrupción del entorno terapéutico de la paciente. A pesar de ser un evento ordinario para la mayoría de las mujeres, no deja de tener consecuencias significativas para las terapeutas, dado que se supone que el entorno terapéutico debe permanecer lo más estable posible durante el tratamiento. Sin embargo, no hay muchos artículos que se centren en el efecto de tal evento en el proceso terapéutico, y los que están disponibles generalmente destacan cuán perturbadora puede ser esta situación. Argumento que el resultado no siempre es necesariamente malo: es posible que el embarazo de una terapeuta represente una nueva oportunidad de cambio, siempre que la relación terapéutica entregue a la paciente una “nueva relación”, concepto acuñado por el psicoanalista portugués António Coimbra de Matos. Este destacado autor planteó que en el psicoanálisis hay dos sujetos, el paciente y el analista, y que la relación que se establece entre ellos ofrece la oportunidad de que ambos se transformen y sean transformados. El terapeuta y el paciente pueden construir una relación terapéutica saludable, diferente a la que el paciente podría haber tenido tanto con sus objetos internos como con los sujetos reales. Una vez interiorizada esta relación, el paciente accede a un nuevo modelo relacional de sí mismo y del mundo, a partir del cual puede construir fuertes lazos afectivos. De acuerdo con los enfoques relacionales contemporáneos del psicoanálisis, la dimensión biológica/pulsional ya no es la parte más central del proceso, ya que los aspectos relacionales del encuadre han pasado al centro del escenario. El terapeuta, aunque sigue siendo un individuo neutral, ya no se ve como ausente del entorno emocional del entorno: como dice Coimbra de Matos, el vínculo precede al apego, de manera similar a lo que ocurre en las relaciones maternas: el terapeuta debe, ante todo, invertir emocionalmente en sus pacientes antes de que pueda esperar que los pacientes se dediquen a su proceso terapéutico cooconstruido. Coimbra de Matos vio la transferencia como un vórtice reductor, mientras que describió esta “nueva relación” como una espiral expansiva: el terapeuta puede pasar no solo como un objeto de transferencia donde se pueden proyectar representaciones pasadas, sino también como un modelo de identificación presente con quien un paciente puede experimentar una relación transformadora, desarrollando aún más las fortalezas recién descubiertas. Implacable defensora de la complementariedad y la creatividad no saturadas, Coimbra de Matos nos ayudó a muchos de nosotros a hacerlo mejor y, lo más importante, a ser mejores. «Si me implico, me transformo» – la relación, el otro y yo. Se discutirá un ejemplo clínico de cambio psíquico durante el embarazo de la terapeuta, centrándonos en una paciente para quien mi embarazo condujo a mejoras en su capacidad para elaborar e integrar aspectos dolorosos de su relación con su madre. Una situación quizás poco ortodoxa, teniendo en cuenta que la paciente tenía un cierto grado de conocimiento sobre mi vida personal, le permitió sentirse cómoda para finalmente pasar de las sesiones presenciales al sofá, a pesar de temer que este cambio de escenario pudiera traerle más dolor. Hubo un crecimiento emocional positivo significativo, basado en nuestra "nueva relación": una que aceptaba, no juzgaba y no era resistente. También se pondera mi propia experiencia, atendiendo a la contratransferencia y otros aspectos relevantes.
Listening to the body: fragments of a clinical case. Marcia Costa Barbosa (Brazil)
Over time, the psychoanalytic practice has demanded attention from analysts, which often goes beyond floating attention and interpretation. In contemporary times, we increasingly observe in our clinic, analysands who present an empty speech, which evokes our sensations, giving rise to an experience that goes beyond the use and apprehension of the word itself.
Through the Freudian concepts of thing representation and word representation (Freud, 1923), post-Freudian authors expanded metapsychology, responding to a process of evolution of Kultur, increasingly marked by consumerism, the fugacity of temporal experience and the availability of licit and ilicit drugs. The so-called School of Paris, represented by Pierre Marty and M'Uzan, from the 60's decade, developed the concept of operative thinking (Marty and M'Uzan, 1983), which would be a very peculiar psychic structure, where the description of emotions and even feelings by the subject would be harmed. Sifneos (1973), along the same lines, created the term alexithymia, which would consist of the absence of words capable of describing emotions, reflected in an empty speech of affections. Mc Dougall (2000) extended the study of psychosomatics a little further: what would be at stake in these patients, would be the concept of disaffection, resulting from the difficulty of distinguishing one from the other. This psychic disarticulation would end up causing, in the face of stressful situations, such as the loss of a job, a loved one or an accident, an instinctual discharge in the body of an unrepresented psychic pain.
Through the presentation of fragments of a clinical case about a 26-year-old men, who started a year before the beginning of the pandemic, in March 2022 and who went through this phase, through online service, I intend to demonstrate how the subject's body gave voice to his psychic suffering not subject to elaboration. Experiencing in the analytic relationship a flexible and welcoming environment (Ferenczi,1934), even in the virtual setting, he was managing to promote the integration of his Self.
Corporal imagination and political creativity in Cornelius Castoriadis’ work. Alexander Masca Ovejero (Belgium)
Although the question of imagination is absolutely central to Castoriadis' thought, the expression "bodily imagination" - used by Castoriadis to describe the process of socialization of the psychic monad - is a hapax in his work. However, I will try to show that the context in which this expression appears and the demands proper to what Castoriadis called "the project of autonomy" justify giving it a conceptual value. I will try to show that the theme of the bodily imagination influences Castoriadis' later work, and that it opens up possibilities both for thinking about the status of the body in his philosophical work and for developing a Castoriadis-inspired sociology that takes into consideration elements such as gender, sexuality, or social class.
The hypothesis from which I will start is that the theme of the bodily imagination can serve as a transition between Castoriadis' psychoanalytic thought and his theory of socialization at the macro-social level (i.e. at the social-historical level). On the basis of this hypothesis, I will try to discern how the imposition of otherness - resulting from the rupture of the original psychic monad in socialization - is realized in various ways according to the type of social individual that such socialization seeks to produce. The bodily imagination will then appear as the key that allows us to think about the way in which social individuals perennialize the institution by reproducing it in their behaviors -for example, a man reproduces the imaginary signification "man" by adopting behaviors that correspond to what society considers "masculine"-.
However, contrary to the structuralist tradition, our hypothesis places the question of creativity and imagination at the heart of this social reproduction. On the other hand, the creative element, and the spectrum of possibilities that this creativity has to express itself socially, condition the mode of relationship that different individuals may have with the autonomy project. In other words, it is a question of thinking about how "sectoral" struggles such as feminism or non-discrimination of LGBTQIA+ people can be combined with the global project of autonomy, without this implying a hierarchization of the legitimacy or value of these struggles.
Parallel Panel 2 With simultaneous interpretation
About our concepts
Chairperson: Jan Johansson (Finland)
The keyrole of emotions for dreams and dreaminterpretation. Uta Jaenicke (Switzerland)
In connection with the subject matter of our congress that focusses on differences between different psychoanalytic schools, I want to discuss this question in respect to dreaminterpretation.
In my talk I want to present a new view on dreams that is based on the daseinsanalytic concept of Alice Holzhey, where psychanalytic insights are combined with existential-philosophical insights. The method is hermeneutic- phenomenological. This means that, although the manifest dream has to be observed strictly, it is not to be taken concretely. Hemeneutic-daseinsanalytic dreaminterpretation shares Sigmund Freuds groundbreaking insight that the manifest dreamphenomena conceal and reveal a hidden meaning.
But in dasaeinsanalysis this hidden meaning has a wider and deeper sense: In difference to Freud the latent core of dreams is not only seen in formative childhood reminiscences bothering us when dreaming, but in our concern with our own existence and its relentless conditions, like our being mortal, vulnerable, insecure, unsure, faulty. The philosophical base for this thesis is Martin Heidegger's existential-philosophical insight that as human beings we are latently always concerned with our own existence. This occurs emotionally - moods confront us with our own being. The same is true for dreams. It is a generally acknowledged finding that emotions play a highly important role for our dreaming. This is especially so in daseinsanalysis; here dreams are understood as embodied emotional experiences, as crystallized emotions so to say. Emotional conflicts, fears and wishes concerning our own existence are the deepest core of all our dreams.
Dreams deal with problems regarding our own life in manifold dimensions and references, but all these concrete problematic issues root in conditions of human existence difficult to endure.. They all hint at a most fundamental “philosophical” mood which Kierkegaard named Angst - I use the German word so as not to confound it with anxiety. Angst confronts us with the mysterious phenomenon of our very being as such. It is the usually hidden core of our dreams. Usually Angst remains concealed, clad in more well-known quotidian moods. In my hermeneutic-phenomenological view though, all emotions that become subject of a dream are existentially meaningful, hinting at certain fundamental concerns. With the example of a short nightmare I hope to show how far and deep reaching the meaning of dreams is when seen in this view.
The endless pain of trauma. Between the need for compensation (impossible?) and reconciliation. Beyond the concept of forgiveness. Giovanna Tatti (Italy)
Whoever has experience in working with victims of handmade trauma, especially when they occur precociously, or with people who lived in environments with highly traumatic atmospheres knows that such patients bring into analysis their feeling to be entitled to compensation'. At some point, once part of the guilt has been processed, or perhaps because of the inability to process it fully and therefore to deny or project it, the analyses clash with this theme of justice, which clearly refers to the injustice suffered, to the world that loses the meaning and order that it was expected to have.
The impossibility of mourning what happened, has to do with the impossibility of mourning something that has never really been internalized, because of the plus (what was there and should not have been, the abuse) and the minus (what was not there and should have been, the protection and recognition) of the trauma. As Ferenczi masterfully teaches us, what makes the trauma pathogenic is the denial of what happened, the denial by those who should have recognized it and done something. And if this is missing, how can the process of mourning go on?
Therefore, some patients move on the narcissistic claim of the right: “Since this has happened to me, life must do me justice, compensate, refund”.
In order to reconcile with one's own story and to be able to write a new one free from the repetition of trauma, someone must recognize the role of victim.
The Truth and Reconciliation Commission of South Africa (and also the restorative justice derived from it) required the guilty to acknowledge his own 'faults' -or crimes- in front of the entire community, the truth has to be told. We can hypothesize returning to our psy rooms, that if the fault is really and deeply recognized by the various parties involved, the patient can stop being the living proof of the crime with his own suffering.
How can this happen in analysis whether there’s no a concrete guilt who plays this fundamental role, in the real life? In the consulting room our patients and we re-build the plot of their own lives, which sometimes were really tremendously raped by unthinkable trauma and that has twisted on it without the possibility of pulling a single thread out of the skein. The analysis and the analyst become witnesses both of the crime and the liberation.
The role of therapy as a testimony is, in my opinion, fundamental and central in working with such patients.
Whether they are patients who are victims of traumatic abuse, or from a different point of view, whether when they are perpetrators of crimes that have made others victims of their actions.
The Mental State of Atonement in the Taming of the Superego. Aili von Schulman (Finland)
Working through anxiety and hatred with patients stretches the analyst's capacity to handle distress and helplessness. Rachel Blass (2017) states that an extraordinary desire is needed to allow us to be subject to the patients' unconscious forces, understand their process and suffer with them without submitting to those forces. According to Melanie Klein, the most crucial part of the setting is the psychoanalytic attitude, and love at its core is a prerequisite for reparation. Freud discovered a connection between unconscious guilt and the primitive superego. Klein continued researching the structure and change of the superego and its impact on personality. She noticed that the superego was initially harsh, and its humanisation was essential for reparation. The nature of the patient's superego determines how they use defences while protecting themselves from psychic pain and anxiety. Similarly, the nature of the analyst's superego defines the analytical relationship's atmosphere. Not only does the defensiveness affect the patient, but the analysts also tend to protect themselves, which, if excessive, can damage the analytical relationship. (Klein, 2017). Irwin Rosen (2009) describes the mental state of atonement as a dyadic connection and identification with patients’ experiences.
Klein divided the structure of the mind based on anxiety and defences into a paranoid-schizoid position (Ps) and a depressive position (D). She (1940) outlined a division of the D by talking about "the pre-depressive position". Henry Rey (1986/1994, 216) encouraged elaborating on the pre- depressive position, distinguishing between normal defences serving growth and development and pathological defences that prevent psychic change. John Steiner (1987) divides the D into the fear of losing an object when the pressure caused by mental development cannot be tolerated, naming it as the pathological organisation (PO), and working through the loss. Ron Britton (2001) divides the PO into two: Ps (path), when defences have omnipotent and manic qualities and D (path), when inflexibility, masochistic guilt, and moral principles dominate. Internally, we are in constant movement; growth never stops, but integration must disintegrate and then reintegrate repeatedly. To evolve, we must dare to leave the safety of the D and face the disruptive uncertainty again.
In my writing, I describe the division of working through loss into two parts: D(n), trust and care and D (n+∞) where forgiveness and atonement are needed as multi-level anxieties co-occur. Infinity (∞) refers to a repeated oscillation between positions. The case material will clarify the need to use transference interpretations and countertransference as essential tools and a stable psychoanalytic attitude to protect a collaborative relationship while working through anger and a harsh superego.
Sublimation, a reassembly in the architecture of the drives. Alberto Arntz (Chile)
Sublimation is a concept present throughout Freud's work and occupies a significant place in drive theory. For Freud, scientific and artistic sublimatory phenomena are phenomenologically distant from the clinical manifestations of normal and pathological sexuality. To explain this distance, he posits sublimation as a special process of desexualization by changing the libido's goal, which, by not investing an object, would remain available as energy and power at the service of cultural production.
The present work tries to substantiate, from a metapsychological point of view, the hypothesis that the phenomenology attributed to the sublimation process is the manifestation of quantitative and not qualitative differences in the development of infantile sexuality and assembly of drive architecture.
The sublimatory deobjectification and desexualization are explained by the process of displacement of cathexes, similar to that postulated in repression itself (nachdrängung), but by virtue of a greater pre-conscious "thickness" and a hyper-intense libidinal amount, the libido it can move to representations that are increasingly abstract and away from autoerotic part-objects, without compromise formations, counter-investments, or impoverishment of the ego.
We find a specific moment in the psychic constitution in which the sublimation process is inaugurated, that is, at the beginning of latency, where the renunciation of autoeroticism and the constitution of the ego ideal come together.
In sublimation, the course of discharge is modified in the representational framework towards representations very distant from censorship, through the attraction exerted by the ideal of the self, but that the self manages to execute action according to the end, and not because of a new choice. of object, but by the construction of a new object. Creative action that maintains the sexual property of the drive and that drives primary satisfaction towards culture and human community.
It is observed in the sublimated production a defining human element and practically without comparison among living beings: the essential adaptive strategy of the human being is not the condition of adapting to the environment, but the ability to adapt to the environment itself, the essentially transforming capacity of the environment, "in his image and likeness".
If identification constitutes the introjection of the loved object and its establishment as an ideal, sublimation constitutes the projection of the idealized object into reality, which will become lovable for others. Idealization fantasizes the object, sublimation builds the object.
Psychoanalytic work is not a "learning" of the sublimatory capacity, but as much as possible, through work with neurotic resistances, to have greater amounts of libido available for the ego, and also through associative work, to build a greater preconscious representational framework. , an increase in the creative and productive capacity of the subject would be expected in relation to his constitutional predisposition and character.
Anti-narcissus or the un-signifier. A hypothesis on existence without being. Manuel Moreira da Silva (Brazil)
This paper aims to introduce Anti-narcissus and primary drive in psychoanalysis, respectively as psychopathological and metapsychological hypothesis. The paper intents to contribute for clarification of the problem of personal identity fracture and quaestio of object-relations versus drive, specifically for the question of primary love and primary narcissism. So, the principal objective of this paper is to show existence of a basic platform earlier to primary love and primary narcissism. This basic platform represents a third limit in psychic apparatus, before to Green’s double limit and Lacanian barre, in short, the un-signifier earlier the signifier and the double signifier. This paper discusses emergency of Anti-narcissus as phenomenon and structure in psychoanalytic clinic from clinical work of author with Anti-narcissus patients since 2020. Anti-narcissus differs from antinarcissism or negative narcissism because: 1) the subject perceives himself emptied of himself in front of the other, 2) their ego exists only in function of recognition of the other and 3) it not intents self-destruction of oneself. In this sense, 4) ego lets himself be carried away by the sea of events initiated by the other, as if in a certain way it fused with him. This is because, in himself, 5) the subject has ego and oneself split within themselves. So, if anti-narcissism is a phenomenon of ego splitting, Anti-narcissus is a phenomenon of oneself splitting. Finally, if anti-narcissism is under death drive, Anti-narcissus is under primary drive, the drive of being-one. So, what’s primary drive? This is the second topic of this paper.
If Lacanian barre represents subject cleavage and Green’s double limit a cleavage of unconscious in general, the third limit of psychic apparatus shows its originary and specific cleavage, namely, the cleavage of the oneself or more properly id. This cleavage has three moments: a real, an imaginary and a symbolic moment, both of them represented in infant a) in birth moment, b) in weaning and c) language acquisition. Id splitting was supposed by Freud when he showed ego emergence, when ego becomes an envelope of that split and, therefore, Lacan forces himself to speak of a subject of the unconscious. The problem is that subject of the unconscious also presents itself as an envelope, in this case, as an envelope of the id’s originary splitting or real itself. This is a split between being and existence when latter empties itself from former, what implies loss of the first object of satisfaction earlier it becomes an object, so before its separation from subject. That is why the drive presented here as the search for such lost object can just be the primary drive as called in this work.
Anti-narcissus lives an existence without being. He is the un-signifier for itself, the signifier that nothing represents for another signifier. Consequently, he runs from his own image because remains in conflict with affective permanence himself and his drift into the other. This is the scope of present paper.
16:30 - 18:30
Central Panel With simultaneous interpretation
Research in psychoanalysis
Chairperson: Reyes García Miura (Spain)
Epidemiological study on the clinical practice of psychoanalytic psychotherapy in Spain: patients and therapists. Eduardo Reguera (Spain) y Ricardo Gallego (Spain)
We do not know much about mental health care centers that treat through psychoanalytic psychotherapy in Spain. We present the results of an epidemiological study that collects the information provided by 97 psychoanalytic-oriented psychotherapists belonging to the Spanish Federation of Psychotherapist Associations (FEAP). Therapists’ profiles are described, as well as the patients attended (n=1862) and their treatments. The results are discussed in the light of other studies and represent 7% of the psychoanalytic activity of FEAP.
The role of research in psychoanalysis today. Rafael Arroyo (Spain)
Any discipline that claims a minimum of seriousness and intellectual rigor must go through a constant process of extension and renewal in order not to fall into mysticism, dogma or indoctrination. However, current psychoanalysis is neither expanding nor progressing; aspires to maintain its essence by eternally returning to its original premises. Alternatives are necessary that contribute to its development as an intellectual field.
The objective of this work is to analyze the role of research in current psychoanalysis. It is based on two hypotheses: 1) the lack of a research program in psychoanalytic institutions contributes to the scientific backwardness of psychoanalysis. 2) The exchange with other scientific disciplines is essential for its expansion and progress.
The epistemic approach of contemporary psychoanalysis is reviewed in light of the difference between transmission and research. And some concepts of linguistics, mathematics, philosophy and epistemology are applied to those areas that classically have been considered essential for the training of the psychoanalyst: theoretical study, personal analysis and supervised patient care. Finally, an alternative training model based on research is proposed.
Psychoanalytic cure and social recognition. Reyes García Miura (Spain)
That the social recognition of Psychoanalysis depends on therapeutic successes, that is, on the cure, is not entirely accurate. There are at least two dimensions to take into account: the one that affects the culture and the one that is present at the clinical level.
In the social sphere, psychoanalytic references are incorporated both at the level of language in general, and in the field of culture in all its expressions. At the clinical level, psychoanalysis is at the origin of most psychotherapies, with the exception of some others such as the cognitive behavioral model, so present in the official psychology of our country.
In this work we reflect on these two dimensions and the paradox of their difference.
18:45 - 20:15
Parallel Panel 1 Without simultaneous interpretation
Chairperson: María Luisa Martín Luengo (Spain)
Changes in the technique of psychoanalytic psychotherapy in a time of pandemic. María Sofía Pedrayes Gosain (Mexico)
At the beginning of 2020, we had to make radical changes in the way we work. We leave the office behind and see our patients in person to use a screen or just a phone and continue with our work. This change faced us with very unusual situations, we had to leave that intimate space where patients felt comfortable and safe.
The privacy of therapy was broken (including space security) and became public. Resistances that hindered the work were also provoked. On many occasions a concern was created about whether the analyst was alone and no one else could listen to them and on the other hand that the patient did not find a place where nobody could listen to, or interrupt him.
Sometimes we become walking companions in the park since you could talk there.
The frame, which could not be kept constanIt, so we may say that one of the things that changed the most within this new way of working.
As Etchegoyen says in his book "The Fundamentals of Psychoanalytic Theory," the term analytic situation is used for all the phenomena included in the therapeutic relationship between the analyst and the patient. This situation encompasses phenomena that constitute a process, we analyze and interpret; but it also includes a frame, that is, a "non-process" in the sense that they are the constants where the process takes place.
And the same author tells us that a process can only be investigated when the same constants are maintained ( the frame). Thus, within the psychoanalytic framework we include the role of the analyst, the set of temporal space factors and part of the technique.
Frame is maintained and tends to be maintained (actively by the psychoanalyst) as unchanged and, while it exists as such, it seems non-existent or does not enter into account; and this is what has had to be modified the most in these times.
So in this work I will try to summarize how we had to be more flexible, in order to be able to adapt and make patients adapt to these changes and to be able to continue building the therapeutic process.
Empathy and clinic - psychoanalysts and their feelings during tragic times. Michell Alves (Brazil)
This essay aims to reflect on empathy as a path to clinical work today. The Covid-19 pandemy can be considered a tragedy: something that breaks reality in an abrupt, overwhelming, terrible way. When we were out of our individual routine, there was no place or space for a catharsis or a purge of affections provoked by the impacts, changes and losses. Family, friends, colleagues, patients - someone died.
A mourning that seems to be lived collectively - in which we are all, under the shadow of the same tragic reality, but in distinct subjective realities. Empathy as a tuning of affections between analyst and patient allows the therapist to elaborate both the transference relationship and a possibility of existence. For that, it is necessary, whether in the tragedy of infantile Oedipus or in the tragedy of the pandemic, that there is no "confusion of tongues", as Ferenczi's text points out. "Something had been left unsaid in the relation between physician and patient, something insincere, and its frank discussion freed, so to speak, the tongue-tied patient" (FERENCZI, 1933).
The language of the child and of tenderness is the language of the patient. Empathy as an expression of this language demands this tenderness so that the child/patient could be welcomed. This dialectical meeting, which is characteristic of empathy and formed in the analyst-patient relationship, is a flowing drive.
The analyst should elaborate this flow of the drive in the transference relationship, in order to maintain his/her existence as an analyst, that is, the analyst's health. An analyst could lead his clinic both in the internal direction of the analytic relationship itself and in the external direction through personal analysis and supervision or through exchanges between peers. More than returning to the couch, it is a return to the tripod of the psychoanalytic training - perhaps this is the language of analysts' tenderness.
Demonstrating affection. Patricia González Duarte (Mexico)
Under the focus of contemporary psychoanalysis, this work aims to review and reflect on some psychoanalytic paradigms about technique, in relation to neutrality, subjectivity, transfer-countertransference, bond, mutuality and others related to the figure of the therapist, etc. The great debates on this topic will be taken into account; what happens in the analyst-patient relational space.
This arises as a necessary response to mitigate the characteristics of the current era marked by social inequalities, fanaticism, a tendency to perpetuate narcissistic traits and that also surprisingly went across a global confinement that exponentially favored the use of technology.
In the circumstances already described, I propose as a hypothesis: Would be possible for the psychoanalyst to be able to give priority to be affectionate to certain people and circumstances within a therapeutic process? Can the analyst - sharpening his clinical eye, observing himself, evaluating his own experiences, among other actions, put them at the service of the therapeutic relationship?
Such selective affect interventions, at a very special time, can be given as a response when people are going through an acute crisis of any type of loss and/or too much anxiety that may be going beyond the line of serious emotional breakdown.
I think it is possible for the analyst to jump and bury his traditional role so as not to remain, motionless, cold and distant, moved from within, but as an external observer and self-excluded from a relationship model of inevitable mutual influence. In that sense, paraphrasing D. Stern (2000) I agree that not only is the interpretation sufficient to produce a therapeutic change but also a "something else."
I believe that giving a timely conventional physical response of kindness, protect, support and accompaniment, turns the psychoanalytic space into a place of refuge, in situations of extreme stress.
This means that the analyst, courageously, continues to remain alert to the influences that such action may have on the therapeutic process, and on the ethical implications of the encounter with the patient, by recognizing empathically his acute suffering and that on the other hand the patient can record the person-to-person connection as legitimate.
In my experience, an observed advantage has been that this response fosters the confidence and security necessary so that the patient can continue to open up without resistance and acquire emotional response skills modeled by the therapist, but above all to be able to talk in a situation of horizontality about the meaning for both of this response, with which the patient is located at the present time, thus strengthening the bond, he is treated as an adult and the situation is not considered as a regression or a maternal response to his demand.
By way of conclusion: perhaps it is necessary to make a qualitative leap in theory and technique, like others that have happened within psychoanalysis adapting to socio-historical moments.
Nostalgia for the future. Reflections about psychotherapy with young adult patients during pandemic. Rossella Bo (Italy)
This contribution aims to reflect on some of the negative effects of the pandemic on the psyche of young adults, involved as they were in the difficult task of the so called third birth (Lancini, M., Giovane adulto, la terza nascita, Raffaello cortina, Milano 2014).
Much has been written about adolescents and their sufferings, while relatively little has been said about the conditions of young adults (19-29 years old), except to emphasise the worsening precariousness of their existence in economic terms: many European and non-European studies point to the serious decrease in job opportunities, the almost total absence of any form of economic protection, the abandonment of university studies for many of them, and the impending deterioration of general living conditions, which risks having a heavy impact on the quality of life of their generation.
Already before the end of 2020, a survey conducted by Eurofond (April 2020, Living, working and Covid-19, by D Ahrendt, et al.) reported that the under-35 population was the most exposed to the risk of post-Covid depression, which is why it is not surprising that mental health professionals have seen a dramatic increase in requests for help from this segment of the population compared to the previous period.
Meeting, in a private context, a decidedly increasing number of young adult patients since the beginning of the pandemic, I wondered about the possible specificity of the suffering they are carrying. The young people I am working with appear to be afflicted by a sort of mental long-covid, the effects of which range from a paralysis of the will (a sort of dangerous and entangling oblomovism) to the manifestation of extremely relevant and often disabling levels of anxiety (mainly expressed through panic attacks and somatic symptoms) to the adoption of more distinctly psychopathological behaviour (e.g. related to eating disorders, self-harm, drug use). The difficulty in facing and mentalising emotions is worsened by an experience of nostalgia for the future, which makes it very hard to progress in the work of psychotherapy, and for which it is often necessary to consider supportive pharmacological therapy.
Starting from an analysis of the recent literature on the subject (Rosci, Lancini, Giacobbi, Arnett, Horst) and with the support of some clinical vignettes, I aim to focus on a) some of the specific aspects of the psychoanalytic work with young adults and b) the suffering experienced by these patients, which, apart from evident individual differences, presents common traits to reflect on.
Covid: Shock, resistance and adaptation. Gila Jiménez Rosas (Mexico)
When we talk about the impact of COVID on our lives, we speak at the beginning about the shock created as a result of the disease presents worldwide, an unknown disease. In the face of shock came denial and fear. Even health professionals were unaware of this disease, and in them, there was also fear and uncertainty of what would be the effects of COVID: as an immediate consequence, death. This type of event leads us to see, in addition to the fragility in which we find ourselves, how aware we are of the world in which we live. As Erich Fromm says, would it be an "awakening of the unconscious,"? Or is it the result of "the alienation in which one lives"? Within the analytical process, the framing had to change as it was necessary to adapt the working conditions and the patient care so that the analytical process wouldn't be interrupted. This article shows how the analytical work was carried out in a psychoanalyst's office and how patients responded to COVID consequences. It reflects how these external events can stop the process of emotional development or contribute to a person's growth in our society.
Parallel Panel 2 Without simultaneous interpretation
Researching on the analytical process
Chairperson: Giovanna Tatti (Italy)
The psychoanalyst between reality, transference and subjectivity. Davide Corradetti (Italy)
This paper aims to deepen and investigate the role and possible effect treatment of certain nonspecific factors in psychoanalytic therapy.
Reference is made to those aspects pertaining to the human relationship between patient and therapist that surround the psychoanalytic technique in the strict sense. In particular, the role of the analyst's spontaneity will be taken into consideration within the therapeutic setting and in the interaction with the patient, trying to show the importance of this element for the effectiveness of psychotherapy.
Then we will discuss some issues such as anonymity and neutrality of the analyst to light of the changes and evolutions that have occurred in psychoanalytic theory in an attempt to understand how feasible they really are in clinical practice.
Through some clinical cases of Freud it will be possible to observe how the father of the psychoanalysis adopted a spontaneous and self-revealing attitude during the psychoanalytic sessions that seems to contradict what is very often found in the indications on the psychoanalytic technique.
In this direction, starting with Freud, the positions of some authors, including E. Fromm, H. S. Sullivan, I. Hoffman, S. Mitchell, with the objective of highlighting how the human and relational quality of the analyst has always been an essential element of psychoanalytic therapy and patient care.
This work intends to emphasize the importance and the therapeutic meanings that the real relationship between analyst and patient, and how this affects the transference, the possibility of considering psychoanalysis primarily as a human encounter between two people each with their own peculiarities and where each one influences and is in turn influenced by the other.
This speech implies having to rethink and probably question some aspects related to the theory of the technique, in particular considering the more recent perspectives that are emerging in this discipline.
In the work, as support for what has been said, clinical vignettes extracted from the author's personal experience.
The Digital Age and Psychoanalysis: New Frontiers of setting and Therapeutic Challenges. Previdi Serena and Buzzi Anna (Italy)
In this work we reflect on the concept of frame in psychoanalysis and how this has changed over time to the present, contemplating the impact of the Sars-Cov-19 pandemic on human interactions. The way of conducting a therapy has encountered some challenges in the transition from the face-to-face consultation to the online consultation.
Distance therapy is not a novelty, despite the universal impact of the pandemic has activated some questions again. Fear of contagion has led many analysts (and patients) choose to avoid the social interaction typical of presence, leading to a modification in the therapeutic setting and its traditional way of operating.
Although the concept of framing has its origins in the foundations of the method Classical Freudian, in reality Freud did not devote significant effort to its development conceptual. It is not until the 1960s and 1970s that it becomes the subject of research psychoanalytic. The International Psychoanalytic Association (IPA), for example, defines the framing as the presence of those working conditions (internal and external) that are they need to carry out a psychoanalytic process.
From psychoanalysis the psyche is considered as an entity present in space psychic and physical, in such a way that the present work elaborates its reflections around the following aspects: First, the concepts of space and time are addressed (external frame) and secondly, regarding the mental states of both the patient as of the analyst (interior setting). Next, we address some questions related to the use of technological tools and their impact on these concepts that encompass the notion of frame.
What is it that changes, then, at the perceptual level in the analyst and the patient? What are the considerations regarding the presence/absence of the other's body? Finally, what is meant when we talk about framing variations?
From these questions, the existing literature was explored regarding the concept of framing, with the aim of reflecting on the role of what is constant and what is variable when the frame changes. Through some clinical examples we intend to describe whether exist and what are the differences between a face-to-face analysis and an online analysis.
The water diviner and the devote pilgrim. A methodological purpose for the clinical supervision as a research and change process. Daniela Maggioni (Italy)
I think we all, as clinicians and teachers of young colleagues, too often attempt to manage our fear to throw the Freudian legacy out with the bathwater of its epistemological and clinical gaps almost 150 years after the Project. But to not a sol.
We need revisiting, updating and if possible making more “true” some crucial Freudian concepts, such as Unconscious, Insight, Change, Representation, negative transference, analytical neutrality, gender identity in the light of what we know after Freud’s theoretical foundations of Psychoanalysis. That, Thank to Freud’s masterpieces but also to over a century of psychoanalytic clinics and a deeper understanding of his thought and doubts, and to Neuroscience and Infant Research too.
"What we actually know and Sigmund Freud should have liked to know, particularly when he fluctuated and swung writing the Project consista of a stronger conceptualization of the analytical relationship and of its efficacy. As P. Bromberg in Standing in the spaces (pag. 16/20):
The existence and the effectiveness of the therapeutical relationship is based on its not exclusively professional nature … clone to everyday’s intimate relationships”, which the patient knows very well (and better than the therapist) and suffer for.
We need a new Clinical Theory that can explain the therapeutical change in terme of progressive (interminable) integration of pieces of Self-rooted but up to here obscure affective-cognitional configurations, The become pieces of a more integrated and unitary and unique but always potentially changeable “me-ness” only through the specific, dual, intimate relationship with a specific, not naturally and historically involved but analytically and therefore also personally involved analyst.
Nowdays, we know (and A.Schore, particularly, strongly and scientifically showed) that the changes in the patient’s and therapist’s unconscious , session by session, beneath and beyond the verbal narratives and insught – interpretation “gold” trajectory, is embodied and revealed by their relationship itself.
Waiting and contributing to a new psychoanalytic Theory of Mind and Clinical Theory psychoanalytically bridging neuroscience, the individual mind and human relatedness, in the conceptual frame we summarized above, we are proposing a methodological process for Clinical supervisiona that we are studying in ASP’s research Group “Kairòs” and i am preliminary applying as teacher of SPP, Individual Psychoanalytic psychotherapy School (Milan) and in my private practice as a supervisor.
The method consists of repeated sequences of phases:
Phases A (2 supervision hours)
A brief (vical or written) report about life-hystory, motives of request of psychotherapy, date of its beginning, frequency of sessions, and so on. Discussion of PDM-2 and/or SWAP-200 protocol filled in by the therapist after the preliminary encounters/first 1-4 sessions).
Phase B (1 hour)
Clinical conjuncted discussion about one session verbatim transcript from audio-recording or as the most faithfully possible from the analyst’s notes after the session (not more than 1 or 2 hours), including analyst’s thoughts, phantasies, emotional reactions and so on and patient’s gestures, voice tongue, facial expressions, silence and its duration and so on).
Phase C. (2-4 hours)
Application or confrontation of the two shared Jones’ Q-sort of the relationship patient/analyst protocols (the supervisor’s and the analyst’s one) about the session of the Phase B.
Phase C bis. (facuktative- 2 hours)
As in the Phase C, but based on Boston Change Process Study Group protocol oneuroscientific theory and right-brain clinical practice.
Phase D. (2 hours)
Crossing and eventually matching the proticols of the preview phases and fixing (hopefully graphically representing) the value and the repetions or changes of patient/therapist, therapist’s and patient’s relational moves and items during the session.
Phase E. (2-4 hours)
As in phases Band C but on a new session, 6-12 months after the beginning relaxed to the frequency of session or the analyst’s need).
Phase F. (2-3 hours)
Discussion of PDM-2 and/or SWAP-200 protocol filled in by the therapyst after 9-12 months and at the end or Interruption of the treatment.
This cycle of phases can be regularly repeated and their results compared and discussed along the therapeutic process. We are now searching fir an operational instrument to match/dismatch the patient’s and analyst’s relational process of changes, the patient’s structural change (measured by independent instruments i.e. PDM and SWAP) and the clinical reasoning.
We hope to contribute to refound our clinical results and training in the scientific and psychianalytic community, walking together as pilgrims on one ground rather than diviners proud of each own’s “clinical nose”.
Researching the truth beyond and inside praxis, between ethics and science. Mattia Maggioni (Italy)
Always researching (and failing) the one patient’s truth and the one best outcome of our treatments, we risk to undervalue the co-lived and shared truth and process of the analytical encounter between one patient and one analyst.
For decades so many Authors and approaches of the psychoanalytical streaming have been stressing the interactive and “tailored” scientific essence of our work, and admonishing us that the future of the Freud’s dream of già “PROJECT” is nowadays achievable.
Despite that, we think that the “liturgical” and so called (and comfortable) “gold psychoanalysis” just fascinate us with their promises of truth, shared trust and security and formal adherence to Freud’s legacy and to the “sacred” Institutions that clam to be his only legitimate sons.
And the increasing numbers of quotations of the above crucial topics seem to reduce them to obvious, interesting, clinically experience or heuristically useful elements.
We think that our duty is a shared, powerfully and scientifically founded Psychoanalysis: an ethical and methodological work of refundation we hope that our Societies and IFPS can contribute.
Our presentation would like to be considered a little contribution to this effort, based on our clinical experience and on the stimuli that our Society, the ASP of Milan, has always given us in riga direction since its foundation 35 years ago.
We are setting to apply our seminal effort on the clarification of the following main Items.
I. Theoretical-clinical issues:
- Analytical time-space coordinate (beyond and under the time-space, frequency, duration consecrated rules of sessions but without individual and not founded chances).
- Working through the transference-countertransference and patient/analyst relationship as a body-mind, fleshy and “here and now” texture.
- Credibility and trust and not only legitimation as ethical and scientific basic request of our work and contract with our patients and psychoanalytic Societies.
- Consistency of our praxis with the theory of process, change and outcome we state.
- Definition of which “Unconscious” we replay on when we analyse and are involved in the live, always changing series of synchronizations, ruptures and reparations of the analytical dialogue and when we write/speak about outcomes, change and results.
II. Specific issues of the process:
- Supremacy of words and “classical” interpretations versus non verbal instruments such as voice, gesture, tone, irony, paradox and so on.
- Consciousness and revealing of our own and patient’s “semantic area” (A.Semi) and worldview as shared ground and root sta the clinical-technical level.
- Metallization versus consciousness in the change process and outcome.
Some clinical vignettes will illustrate the above issues.
9:00 - 11:00
Central Panel With simultaneous interpretation
History and future of the IFPS
Chairperson: Miguel Ángel González Torres (Spain)
60 years of building an oasis for mental health - will we continue to sow in the desert? Time in pandemic (small jewels in the chaos) Rebeca Aramoni (Mexico)
We were able to transform a lot of rules, to be able to survive and help ourselves and others, our patients.
In unprecedented conditions. Without a couch, today the patient's bed, without rocking chairs, sometimes soft armchairs and sometimes the pavement or a sidewalk, a rooftop or a park. Sometimes without eye contact, sometimes with situations we would never have seen before, magnified by the screen, in the presence of the disarray, the depression, the mania, the madness brewing on the screen. Theirs and ours, behind the screen.
The IFPS is a vital energy that unites us wherever we are. The pandemic, as Rosa Montero says, brought madness out of the closet, the fear of death, without knowing how or when, vulnerable and exposed. For the first time it is something that happens with a democratic…mind.
50 Years Institute for Psychoanalysis Zurich-Kreuzlingen (IfP) (1972-2022). Klaus Hoffmann (Switzerland)
Fifty years ago, in 1972, Norman Elrod founded a psychoanalytic working group which became a training institute (Institute of Psychoanalysis Zürich-Kreuzlingen IfP) in 1979. In 1998, it became a member of the International Federation of Psychoanalytic Societies (IFPS) at the Forum here in Madrid. In addition to the psychoanalytic work in private practices, many members worked in institutions like mental hospitals and halfway houses. In the IfP program, not only clinical psychoanalysis, but also philosophical, political and cultural issues play an important role. In the 1980s and 1990s, the cooperation with the Democratic Psychiatry in Italy was quite close, a multiprofessional regional group in Northern Switzerland discussed for quite some years these issues („Grosser Kreis“). In Herisau (Switzerland) Halfway House for example, psychoanalysis, especially psychoanalytic social work, was for many years the central attitude of the staff. In Schaffhausen (CH) mental hospital, in the departments of Psychotherapy in Wil (CH) and of Psychosomatics and Forensics in Reichenau (D) mental hospital multiprofessional approaches including indidivual and group analysis, special nursing care and milieutherpay were and are central aspects of their orientation and identification. In IfP’s understnding of psychoanalysis, the different interests of the patients, the staff, the therapists and of the society should be realized and formulated in a transparent way. There are many conflicts between these parties as well as in the psyche of the individuals. Before interpretations are given, the phenenomena on all levels should be investigated. At present especially in Central Europe, psychoanalysis looses ground in the universitites because the results of treatment studies do not convince many participants in the scientific community. The fact how important psychoanalytic analyses are for teams and milieus is neglected – and it is to be hoped that young generations of nurses and psychologists will realize these contracitions and contribute to more patient- and milieu-centered approaches.
The role of the Germans and the German language for the founding of the IFPS. Andrea Huppke (Germany)
This Panel contribution wants to tell about the German roots of the IFPS.
At the beginning of the IFPS 1962 all psychoanalysts who met to found this new international organisation were German speaking. It was the German speaking founder of the Netherlands Psychoanalytical Society Anton Westerman-Holstijn and the german psychoanalyst and chairman of the German Psychoanalytical Society Werner Schwidder who first gave the impulse to gather the psychoanalytic societies that did not belong to the International Psychoanalytical Association, IPA. Erich Fromm, Igor Caruso and Gerard Chrzanowski joined them and all the three were also German speaking. Either the participants of the new group were Germans who stayed in Germany during the Nazi period or they were German jewish emigrants or they had their psychoanalytic training in German speaking countries. Most of the correspondence of the IFPS in its first years was in German and also the first version of its statutes. This is not very astonishing on the one hand because psychoanalysis developed out of the German language. But on the other hand it was a aftermath of the isolation of the German psychoanalysts during the Nazi period since they lost touch with international psychoanalysis.
11:30 - 12:45
Central Panel With simultaneous interpretation
Dialogue between psychoanalytic models: their relevance to the treatment of non-neurotic disorders
Chairperson: Valerie Angel (United States)
- Theoretical pluralism in the work with patients with pathological narcissism. Marco Conci (Italy)
- The question of pleasure in the psychoanalytic treatment of borderline patients. Grigoris Mariadakis (Greece)
Discussant: Gabriele Cassullo (Italy)
The panel summary
The four colleagues involved in the Panel agree on how important it is for us today to have a variety of analytic theories and concepts at out disposal. In fact, we have to deal with such a variety of patients and of clinical aspects connected with their problems that no single author or theory would be enough to treat them. The first step in this direction was represented by Robert Wallerstein’s 1987 acceptance of a “pluralistic psychoanalysis”, which was followed by an increase of exchange and dialogue on the international level, and by the priority given to the clinical - as opposed to the theoretical – aspects of our work. This is how, for example, Stefano Bolognini (2011) speaks of the many authors and colleagues he consults in his mind while working with his patients.
In the first paper, “Theoretical pluralism in the work with patients with pathological narcissism”, Marco Conci will show how crucial it is to look at these patients and to work with them, not only from the points of view of Otto Kernberg and Heinz Kohut, but also from the points of view of Herbert Rosenfeld, on the one hand, and of Stephen Mitchell, on the other hand. With these patients, it is crucial to both give them genetic interpretations and to come to a good psychodynamic reconstruction of their problems, as well as to become for them the “new object” they need for their psychic development. Their common denominator is represented by the fact of not being in contact with themselves – as it was the case with Ovid’s Narcissus, who was not able to recognize himself in the image reflected back to him.
In his paper “The question of pleasure in the psychoanalytic treatment of borderline patients”, Grigoris Maniadakis will look at borderline states as structures functioning to a large extent “beyond the pleasure principle”, as an aftermath of the traumatic relation with the primary object. In his paper, he will try to approach facets of the above issue at the level of the technical aspects of the analytic treatment of borderline patients, as well as in terms of the particularities of the containing function and the countertransferential experience of the analyst.
12:45 - 13:45
Keynote Speaker With simultaneous interpretation
Lecture by Jay Greenberg
Ephemera, Loss, and Otherness
Many of our patients, plagued by their histories of painful losses, are unable to enjoy the pleasures that are available to them or to make use of the help that we offer. In this paper, inspired by Freud's ideas in his poetic essay On Transience, I explore some of the difficulties involved in treating these people who, I suggest, are unable to bear the comings and goings of others, whose presence is irreducibly ephemeral.
Using clinical material, and recognizing the limitations of Freud's conceptualization of the problem he describes so beautifully, I offer a way of thinking about and working with patients who are engaged in what he called a "revolt against mourning".
15:00 - 16:25
Parallel Panel 1 Without simultaneous interpretation
An adolescent area in IFPS: first steps
Chairperson: Fabio Vanni (Italy)
- Encounters with totalitarian objects in super-ego development of adolescents. Darius Leskauskas (Lithuania)
- Kindness Violence, and Hypocrisy in the education of adolescents. Neil Altman (United States)
The panel summary
The kick-off of this project will be a time for all colleagues who are interested in adolescence from a theoretical, clinical and research point of view to come together.
Discussant: Fabio Vanni (Italy)
Parallel Panel 2 With simultaneous interpretation
Death and psychoanalysis
Chairperson: José Antonio Pérez Rojo (Spain)
Mourning Becomes Elektra: Expanding the excluded middle. Frances V. Dillon (United States)
When Aristotle classified all living things, he developed the law of the excluded middle; a binary approach to logic which has come to dominate much of how we think about ourselves and our world. Following a global pandemic, where people faced the dualism of life and death more than ever, time collapsed and mourning was stalled because there was little access to a reflective dying process. Is there a space to occupy between our worldview of being alive or dead for people who are grieving? As in a Greek chorus, we witness violent emotional states, the unconscious and inner spiritual forces and the actions and suffering of a protagonist in a moment-to-moment drama. Can the intersubjective re-connection between patient and analyst be the antidote for the missing and lost object?
This paper identifies a clinical phenomenon, which the author calls lamentation disruption in the clinical force field; a cavity or hollow in which the patient and analyst are pulled into a mutually dissociated split-off dynamic, whereby both members lose contact with the full multiplicity of their own selves and of the other and engage in interlocking defenses. The author is specifically interested in the countertransference problems with sudden death and how the analyst loses hold of a symbolic space internally as she struggles to separate herself from her patient’s concrete and non-symbolic negative transferences of revenge and passion. The backdrop of the inquiry is the current repressive socio-political climate where there is a confusion of moral and political rules of behavior contributing to a disorientation to mourn, feel contained, feel nurtured and protected from racism, poverty, disease, natural catastrophes, social turmoil, economic crisis, violence and war.
Building on Freud’s Mourning and Melancholia and Erich Fromm and other authors’ writing on death and love, the author is interested in distinguishing between generative and destructive forms of mourning in the dyad. As a guide to the Tibetan tradition and its insights into life and death, the author refers to The Tibetan Book of Living and Dying to illustrate a dyadic process that seeks to transform the patient’s alienation into a sense of becoming together; a middleness where there is an acceptance of the disorder and unpredictability of life and loss of control and an intensification of love and enduring depth of connection with her partner and her creativity through the therapeutic relationship.
Around the end. Roberta Resega (Italy) and Marco Riva (Italy)
During the presentation we will watch a video made in 2008, a time in which one of the authors was going through difficult personal experiences "Around the end" related to the end of some, not only professional, experiences. What had the Fathers of psychoanalysis uttered on the subject of the end? The video arises from this search for a ‘horizon of meaning’. A search for comparison, perhaps for comfort.
Freud, Jung, Lacan, and Bion orient themselves with their theoretical approach but, above all, they show themselves "in the first person", with their humanity in the face of the issue of the limit of existence.
They are all at an advanced time in their career, and this cannot fail to affect their words and their experiences.
The construction of the video is at the same time parallel to the annual experiences of the authors in the Oncology department of the Fatebenefratelli Hospital in Milan. The encounter with death, with the anguish of the death of dying patients, inevitably aroused in the authors an encounter with themselves and their anxieties. How to approach this border? How to manage the encounter with the death of the other and the fantasy of one's own?
Freud, in London in ‘38, after escaping from Austria, tells himself to the BBC trying in a few sentences to summarize his life, his research, his discovery of the unconscious, and now his perception of being at the end.
Jung, in 1959, from his home in Bollingen, reinvigorates the idea of not dying before his time, and in the meantime, we can see images of him keeping himself alive by cultivating the vegetable garden.
Lacan, imperious and volcanic, during one of his seminars, expressed with determination, the value of life starting from the non-immortality of man. If everything were to repeat itself over and over again, 'we would go crazy'. The true fear is not to be sure of dying forever.
And finally, Bion, who, with his British calmness, questions the meaning of 'terminal'. He invites psychoanalysts not to always go in search of what is not working, but to find what is still alive, even when in hell.
In conclusion, we can say that the video allows us to understand that death can only be said sideways, or around it.
The social work of the psychoanalyst facing cyberspace. Were we ready for the pandemic? Víctor Hidmann López (Mexico)
Living a virtual life is quite usual nowadays, thus we need to adapt our ways. Adapt the way we do many of the things we do in order to fit this virtual living. For example, as psychologists, we have had to adapt the way we teach, but also the way we practice our profession.
In “S’s” case, the virtual world was as real and present as the physical world. Except that, after the lockdown of the COVID19 pandemic, his world in front of a screen gave way to a new space where his demons could be unleashed without the limits that the physical world sets to such fantasies.
What are we doing, as analysts, in order to face the influence and transformation that virtuality imposes? What is our posture amid a world crisis? Are we prepared to welcome all the adaptations that globalization and collectiveness require, and the challenges that they bring? What are we giving to the cyberspace?
These are some of the reflections around the way in which “S” lived the lockdown during the pandemic, and the processes with which he alternated between the cyberspace and the physical world.
16:30 - 18:30
Central Panel With simultaneous interpretation
Psychoanalysis and the group approach
Chairperson: Ana Gutiérrez (Spain)
From Homo clausus to Homines aperti. José Miguel Sunyer (Spain)
Based on the defense mechanisms, the author raises the possibility of conceiving them as communicative mechanisms between people: through them we inform those around us of the levels of anxiety that are activated by a fact or an idea or emotion. By doing so, we are connected to each other. It is through this information, most of the time unconscious or involuntary, that we establish the bonds of interdependence with others. It is precisely through these links that we can conceive of ourselves intertwined with each other, abandoning the position of homo clausus to be homines aperti. If this is our reality, psychotherapeutic interventions involve their actors, turning the work into a process of constant co-construction of meanings.
Psychoanalytic psychodrama: from spoken to acted emotion. Enrique Saracho (Spain)
Psychodrama and psychoanalysis were born very close, in Vienna and almost at the same time. Freud and Moreno were contemporaries. Much work has been done since then in the field of both disciplines. However, for some strange reason that we will try to find out, these disciplines took a long time to meet, they have followed parallel paths and their relationship has never been easy. Psychoanalysis always gave priority to the verbal while psychodrama always prioritised action.
Moreno's psychodrama provides us with a powerful method of group intervention that, through spontaneous action, allows rapid access to the emotional world and its conflicts, but his theory has limitations in explaining psychopathology.
Psychoanalysis provides us with a powerful theoretical frame of reference that explains the construction of the emotional world and its conflicts, but its classic method of intervention has limitations to respond to the complexity of current clinical practice.
The present presentation aims to explain how Psychoanalytic Psychodrama is a powerful instrument that, being faithful to both disciplines, can respond to the challenges posed by psychopathology and the complex psycho-social problems of clinical intervention in Mental Health today. It gives us tools to move from "acting-out" to "acting-in".
Large groups politics, psychoanalysis and identity. Miguel Ángel González Torres (Spain)
Since Sigmund Freud's first contributions, psychoanalysis has devoted attention to group phenomena in the field of politics. Among contemporary authors, Volkan and Kernberg stand out for providing concepts that constitute tools for analysing current political reality. While since ancient times the work of politicians has included a share of group manipulation, today a general trend towards populism can be seen, emerging from both the right and the left. This offers a unique opportunity to examine in detail how leaders promote group functionings similar in character to borderline personality organisations. The war in Ukraine and its terrible consequences offer an opportunity to reflect on unconscious dynamics that psychoanalysis can bring to light. Individual aspects of some leaders can offer clues, as well as group movements that express the need to protect a valuable identity, based more on being than doing. The current situation has generated an identity crisis in Europe and beyond. Autocratic tendencies have become stronger and we have lost leaders who sustained a more adult, less primitive European identity. The possible solutions lie in the abandonment of childish maximalist positions and the adoption of a painful, frustrating, slow...and healthy integrative attitude, perceiving nuances, shades of grey, gradations, both in our own group and in that which we consider Other. Psychoanalysis has the responsibility to put its knowledge at the service of society.
18:45 - 20:15
Parallel Panel 1 Without simultaneous interpretation
When the body speaks: psychoanalytic explorations of somatization reactions to early trauma
Chairperson: Emilija Georgievska Nanevska (Macedonia)
- Case 1: A resonating body and dream: An intersubjective unconscious interchange between patient and therapist. June Her (South Korea)
- Case 2: Breathing with a patient: Intersubjective exploration on the meaning of nonverbal and bodily expressions. Hyun Ah Lee (South Korea)
- Case 3: Covid as the persecutory body of the father. Ernesto Mujica (United States)
The panel summary
Psychophysiological experiences represent a resistance to treatment as well as an avenue for exploration of traumatic memory and affect. This panel explores etiological and therapeutic aspects of the analytic dyad’s psychophysiological experiences within the analytic encounter. Case material from three psychoanalytic psychotherapy treatments will explore transference and countertransference experiences from both classical as well as current relational psychoanalytic perspectives.
Case 1: A resonating body and dream: An intersubjective unconscious interchange between patient and therapist.
A married woman in her mid-thirties reports that she finds bruises on her children that have been caused by herself during dissociative episodes. This elicits feelings of fear and guilt in her. During the third year of treatment her analyst experiences intense tension throughout his body; he feels immobile and suffocated. As the sensations of immobility subside he gradually experiences intense fear. In the next session the patient reports a dream of a man with a soothing voice. The dream reveals that the man is hurt and the patient helps to cure him. Both patient and analyst mutually explore their contributions to the analyst’s countertransference experience and to the patient’s dream. This led to a working through of traumatic memories for the patient as well as of the analyst’s countertransference.
Case 2: Breathing with a patient: Intersubjective exploration on the meaning of nonverbal and bodily expressions.
Implicit dimensions of non-verbal communication are explored by a female analyst with a 30 year old male patient that reports a a five year period of separation from his mother as a toddler. He presents a lifelong preoccupation with chest tightening and shortness of breath. During most of his seven years of twice-per-week psychoanalytic psychotherapy he focuses on his analyst’s quality of voice as the main source of relational connection. The mutual awareness of their breathing enhances their attunement and modulation of affect as it increases the patient’s awareness of the mutual presence and safety between them. The increasing intersubjective awareness of breath between patient and analyst becomes a central theme for promoting mutuality of understanding and trust that begins to unblock the patient’s emotional access to his early trauma of interrupted mourning and loss of his mother.
Case 3: Covid as the persecutory body of the father.
The third case concerns a gay man in his mid-thirties who has been in psychoanalytic psychotherapy during the past fourteen years. Feelings of alienation with suicidal fantasies and gestures began during his grammar school years. He reported incestuous family experiences and was also being bullied at school. His long-term feelings of helplessness and impending demise were expressed through physical illnesses and somatizations that were severely exacerbated during the covid pandemic. We also explored his attempts to empower himself through defensive enactments culminating in an identification with the aggressor. Our exploration of the meaning of his symptoms, including our working through of transference and countertransference dynamics, led to a marked reduction of somatization and suicidality.
Parallel Panel 2 With simultaneous interpretation
Poetics and psychoanalysis
Chairperson: Lola López Mondéjar (Spain)
- Poetry for Psychoanalysts. Sandra Buechler (United States)
- The poetics of the symptom. Anna Maria Loiacono (Italy)
The panel summary
Like the analyst and the analysand, the poet and the reader engage in the exploration of previously unrecognized associations and images. Poetics have the power to stimulate the imagination and the soul.
Poetry, like music, like art in general, offers us a sensory experience that is also psychic and emotional. The art of poetry has much to teach the analyst about the art of creating meaningful interpretations that connect bodily experience with psychic and emotional experience. Poetry can bring depth to our understanding of the relationship between our own body and psyche, and our relationships with the bodies and psyches of others. Poetry can enable the analyst to become more aware of these depths, and more comfortable with metaphor, without which the relationship with the other can remain superficial, intellectualized, and concretely geared toward instrumental goals.
The panel will consist of two presentations:
Poetry for Psychoanalysts. Sandra Buechler (United States)
This presentation explores what makes it vital for psychoanalysts to study poetry. Poetry lives on many thresholds-between ideas and feelings, known and unknown, poet and reader, poet and other poets, poet and other observers of human beings. By studying poetry, the analyst learns to live on these thresholds as well. Poetry does not owe its total allegiance to reason, or rules, or pure emotions, or any one realm. It straddles them all. Just as an outsider (to a culture, or a family, or a profession) can sometimes see what insiders fail to register, poetry notices what others miss. It sees the stars in ways that might not occur to astronomers, and it sees human beings in ways that might not occur to the clinician, without becoming comfortable with the metaphoric language of poetry.
The poetics of the symptom. Anna Maria Loiacono (Italy)
The body is a recurring theme in all fields, from art to poetry to philosophy. It is one of the great interlocutors of our existence. The absolute centrality that the body has makes possible a dimension of intimacy with the other. Giving greater significance to the implicit sensorial element, and not just to the emotional one, is vital. Emotions and sensorial data are embedded inside ourselves from the beginning of our history, becoming a kind of soundtrack that accompanies us throughout our lives (Mancia, 2004; Correale, 2021).
The speaker will demonstrate, by means of a clinical case, how emotional-sensorial, confused, embedded, and condensed states can, through the relationship with the analyst, become readable once again. From this perspective, an insect phobia of a woman having entered into analysis because of morbid jealousy, can come to represent the best modality through which this person has contained and carried her own traumatic themes inside herself—a sort of poetics that has allowed her to stay in contact with the traumatic figures, without being submerged within the sensoriality of the traumatic experiences. Just as poetry is a sensoriality that speaks, so, too, the symptom can become a poetics that encompasses a non-linguisticized sensorial concentrate of traumatic experiences.
Benedetti - Conci Award
The Benedetti-Conci prize of USD 1,000 is awarded to the best paper by a candidate from an IFPS society. The paper will be published in the IFPS journal.
The award will be presented by Mr. Marco Conci on Saturday 22nd, at 20:15h. Aula Jiménez Díaz. With simultaneous translation.