The Italian Psychoanalytic Annual 2023/17

Starting from the constitutive incompleteness of the human, the pathways of subjectivization and humanisation through the work of culture are analysed, with the associated dehumanising risks that constantly resurface in conditions of historical and cultural crises. Forced migration, pandemics and war are analysed as «traumatic contexts» that configure ‘extreme’ anthropological situations capable of profoundly influencing the construction of subjectivities and processes of cultural transmission. In particular, the psychic and anthropological dimension of risk that emerges in experiences of relations with the foreigner and the enemy is examined, phantasmatic places as well as historical configurations in which the human/inhuman interweaving becomes particularly evident.
KEY WORDS: Border, cultural work, foreigner, human/inhuman, stranger, trauma.

Epidemics arenot only a health problem, they also involve social, cultural, political, financial and even psychological processes, which require complex and multidimensional approaches. After delving into the concept of the «epidemic of fear» and its unconscious roots, the article examines the «vexata quaestio» as to whether this pandemic has caused negative repercussions on the social structure and culture, or whether it has merely unmasked its pre-existing flaws, and considers the need to construct reflective spaces capable of helping  people to orient themselves amidst uncertainty, avoiding the risk of defensive action at the mercy of phantasms and prejudices. In conclusion, the idea is postulated that psychoanalytic thinking, especially in its group-and socio-analytic declinations, can be an effective aid in facing fear and inspiring «good enough» leadership that is capable of governing situations of uncertainty by resorting to «negative capability».
KEYWORDS: Fear epidemic, group, leadership, negative capability, stigmatisation.

Excessive brightness and the resulting light pollution have taken away space from the value of darkness, the meaning that the perception of darkness can have. There are many harms at the psychological, physical, scientific and cultural levels that light pollution can cause. Two clinical vignettes specifically illustrate how significant in emotional and relational terms an excess of ambient brightness or, conversely, the irruption of darkness into the analysis room can be.
KEY WORDS: Darkness, light, lighting, invisible, visual perception and abstention.

In the present work, I attempt to define virtual reality from a psychoanalytic point of view and identify the reasons for its appeal, and why some people become addicted to it. I will therefore seek to differentiate virtual reality from other worlds of imagination, such asplay or the literary tale. I believe virtual reality must be conceived as a special category of psychic reality, distinct from and opposite to the field of creative fantasy. Indeed, creative imagination is in contact with psychic reality, while virtual reality, sensorially constructed and preset by others, contrasts with the relational experience, thereby taking the place of the emotional and affective world.
KEY WORDS: Alternative reality, imagination, make-believe, metaverse, psychic reality, virtual reality.

Starting from the etymology of ‘risk’, unforeseen situations are addressed, making the task of governingtheir consequences difficult. The effect and consequences of the recent pandemic, with its disruptive effect on behaviour and life, reduced to pure survival, in order to defend which a deadly principle has been embraced, that of dissolving the bonds that constitute the essence of life itself. The risks of the digital revolution, which leads to mutual control and surveillance to manipulate and influence behaviour and opinions. And in which otherness disappears, in the name of an inclusion that erases differences. Finally, the borderlines are examined as exemplars of the prevailing psychic condition, with their problems due to the difficulty of establishing boundaries, limits between self and other, with the consequent risk of psychic collapse.
KEY WORDS: Unexpected, ungovernable, survival, otherness, borders, breakdown.

In this paper, risk is dealt with from the viewpoint of dream-work. In certain apparently neurotic clinical conditions, dream-work seems to parcel itself, thus determining two different types of dream: one aimed at elaborating unconscious desires, and another aimed at representing an only seemingly preconscious thought. Here, the oneiric work seems to disjoin, rather than conjoin, preconscious thoughts from repressed unconscious desires. Yet, such disjoining is necessary for maintaining a narcissism, often grandiose and primitive, which would otherwise crumble if linked to hatred towards a parental figure who, through excessive idealisation, had trapped subjectivity into the grandiose Self and its unrealistic demands. The paper also hypothesizes a similarity between the parcelling of social work and the «multi-activity» of individual oneiric work.
KEYWORDS: Grandiose Self, multi-activity, oneiric work, parcelling, psychic work, risk society.

The work deals with the theme of psychological risk factors in childhood, linking it from the outset to the complexity of the processes that support development, processes that are in turn investigated by different research perspectives that, by integrating, enrich our understanding. The author highlights how this broadened scientific outlook makes it possible to focus more and more accurately on how a child’s affective, cognitive and relational competences are built early on through his or her first interactions with the environment, going on to delineate with increasing clarity the close link between intrapsychic and interpsychic. An enlarged view that confirms many of the hypotheses underlying the major models of psychoanalytic theory. In this enlarged framework, the article then examines how the current sociocultural pressures to which the individual and the group are subjected, end up being risk factors for the physiological psychic development of the child, subtracting from the necessary relationality of psychic becoming the space-time necessary for the establishment of  mental growth processes.
KEY WORDS: Diagnostic evaluation,fantasy, precocity, relationality, loneliness, psychic space-time.

The author discusses some reflections arising from clinical work, on the subject of risk as a pathological potentiality or, on the contrary, as an opportunity for growth. She presents an evolutionary point of view in the evaluation of the patient that also takes into account risk indices and transformative possibilities, in consideration of environmental stimuli. She emphasises in conclusion the need not to move away from an ethical vision that privileges the need for patient care as the first objective that does not preclude, but rather favours the expansion of the patient’s mind and of the analytic couple at work.
KEY WORDS: Developmental potential, ethics, psychotic potential, risk.

After preliminary remarks about the risks of merging with the mother for the infantile psyche, the author underlines the need to adapt the setting to reach the mother-child unit, and work toward stable transformations of internal and external reality. The case of Davide and his mother exemplifies some technical aspects and developmental moments of mother-infant psychotherapy, shedding light on the child’s role in the mother’s transformations. The clinical process shows the gradual creation of a ‘third space’, later occupied by the father with an increasingly active participation in the analytic process, and how this led to a further adaptation of the setting.
KEY WORDS: Developmental risk, mother-child merging, mother-infant psychotherapy, setting adaptation, the father’s space.

In order to shed light on the complex form of contemporary analytical experience, in the present article I shall attempt to trace in parallel the evolution of theatre towards the composite form we know today – made of action, narration and intersubjective dialogue – and that of psychoanalysis which, starting from narration, has come to discover and include dramatic,  dialogic and action elements, all typical features of the theatrical form, finally achieving what is not possible in theatre: going beyond the predefined plot and creating a form of real life  on the analytical scene. This might allow us to glimpse intersubjective risk as peculiar to contemporary psychoanalysis.
KEYWORDS: Chamber theatre, crazy dance, dialogue, evolutionary transference, intersubjective dialogue, intersubjective risk, peekaboo game, primary conversation, repetition transference, self-object transference.

The author follows the pathways of violence within the setting in a therapeutic situation underlying a constant, not better defined, state of alarm (of elimination?). She hypothesizes encystments of destructiveness in parts of the patient’s body as an attempt to avoid total suicide. She questions whether a sort of countertransferential «not understanding» of the  intensity of the violence might have contributed, more or less protectively, to the continuation of the therapeutic relationship, and to the staying alive of the relationship itself, as well as of the protagonists.
KEY WORDS: Countertransferential «not understanding», body, destructiveness, psychosis, suicide.

The clinical vignettes show the risk for the analyst resonating with the severely ill patient to contract a similar illness. In one case, from within the patient-psychoanalyst relationship and in a moment of crisis, a series of communicative exchanges through bodies come to the fore: the anguished body of the patient and the aching body of the analyst. In the crisis of the relationship a health risk becomes apparent for both, patient and analyst. At the same time, both experience a new primary object in the transference: the jammed therapeutic process resumes with renewed impetus. Some theoretical considerations on non-verbal exchanges in the psychoanalytic relationship follow.
KEY WORDS: Body language, psychoanalytic process, transference, transformations, unison.

It is proposed to differentiate suicide from suicide attempts (or even communications). On a dynamic level, the former represents the net loss of all investment in/on the Self, while the latter represents an extreme and powerful investment in it. Suicide attempts are not the search for death, but the attempt to adapt the body’s potentialities to the potentialities of the  Self. The body, therefore, is summoned to a buffer function of uncontainable anxieties on an affective or symbolic level. Finally, the containment of suicide attempts may be possible  through modifications of the setting that, in the logic of the Enactment Process, are transferentially solicited by the patient. The analyst modulates and cares for a setting in which the patient can trace specific elements that tell of his presence and that the analyst introduces as a concrete signal of his capacity for intimate listening.
KEY WORDS: Body-buffer, deformed self, enactment, setting, suicide attempts.

Proven effective and widely practiced during the COVID-19 pandemic, online psychotherapy is today a fundamental tool in the toolbox of the psychoanalyst and the psychotherapist: to be studied in depth in its possible indications and counter-indications and to be included in the training programs of our training schools. Our thesis is that it does not represent a risk, but rather the stimulus to progress for our discipline.
KEY WORDS: Online psychotherapy, online setting, risk.

In response to the request of Editor-in-Chief of the Rivista di Psicoanalisi, Lombardozzi, the author provides a comprehensive account of his professional journey spanning over forty years. Throughout this trajectory, he grappled with the tension between social intense needs that manifest as psychic suffering and the helping dimension within the prism of the  potential use of psychoanalysis. The repeated scientific verification of high efficacy coefficients of psychoanalytically-oriented supporting methods favoured their development and  expansion over time. In Baldini’s journey, the pivotal role played by the Italian Psychoanalytic Society is emphasised, as the Society actively engaged with public institutions and private  social organisations, universities, the cultural realm, journalism, and local and central administrations. Throughout the author’s account, the theme of risk looms large, intricately linked  to the concept of prevention. It emerges as the back drop, permeating every facet of institutional and personal helping professions.
KEYWORDS: Applied psychoanalysis, institutions, prevention, private social life, risk, social.