Psychoanalysis 2020: Clinical and research aspects

The year 2020 will go down in human history as the year of the Coronavirus, whose multiple, severe, tragic, and revolutionary (hopefully not all bad) consequences we are not yet able – as I write this at the beginning of April – to evaluate. Through this issue of the journal, I want to propose to the reader a series of papers dealing with both our clinical work and the research work going on in psychoanalysis at the beginning of this new decade. As we will see, it is important for both dimensions to be at the same time pursued separately yet influence and enrich each other.

A good demonstration of how our clinical work has to be constantly revisited and enriched through new points of view is represented by the article written by Isabelle Boulze-Launey and Alain Rigaud (Montpellier, France), “Alcohol and loneliness: In my solitude.” The authors revisit the psychopathology of alcoholic patients in the light of the clinical research work done by Jean Rainaut (1919–2009), which allowed him to catch these patients’ sense of isolation, and their early feeling of insecurity, close to that experienced in psychosis. This is the basis of the authors’ new psychotherapeutic approach to such a difficult category of patients, based on an attempt to help them establish a new relationship with themselves, along the line of what Donald Winnicott has called “the capacity to be alone.” What the authors call “the solitude of the alcoholic subject” and the “psychopathology of isolation” from which these patients suffer was for many decades a very hard challenge to address for any psychiatrist and any psychiatric institution, and it is a great relief to know that they can benefit from this new analytically oriented approach, based upon “a reactivation of the paternal function.”

The second paper in this issue, “A psychoanalytic interpretation of bipolar disorder,” by Giancarlo Ventimiglia (Pisa, Italy), is also the result of a systematic work of clinical research whose previous stages have been well documented in our journal (see Ventimiglia, 2016). From this point of view, it is noteworthy that no new important contributions to the metapsychology of manic states have appeared since the 1970s. After having revisited the points of view of Freud, Klein, and a series of post-Freudian authors, Ventimiglia proposes his own metapsychological definition of mania as “a form of defense against the state of depression resulting from the narcissistic overidentification with a depressive object,” and documents it through the presentation of a detailed clinical case of his own. At variance with Klein, for whom mania represents a defense against the difficulties of reparation of the lost object, for Ventimiglia mania is a defense against the dissolution of the identificatory bond with it. As we all know, bipolar patients are very hard to treat psychoanalytically, and it is of crucial importance to find effective ways to understand them and work with them.

A former editor-in-chief of the Journal of the American Psychoanalytic Association and former executive director of the Sigmund Freud Archives, Harold Blum (New York, USA) has dedicated most of his professional life to clinical research in psychoanalysis (Blum, 2016). This is well documented in his paper “Developmental and dynamic dimensions of hate, rage and violence,” in which he approaches the metapsychology of hate in the light of the very challenging clinical case of a mother whose severe childhood trauma resurfaced in a very dramatic way in connection with the birth of her first child, in the form of self-hate and a highly disruptive hatred for her baby. Since the Freud Symposium held in Pribor in August 2013, and through his collaboration with Eva Papiasvili, Harold Blum has become a good friend of our journal, and we are happy to publish his work.

The same is true for the work of Siegfried Zepf (Saarbrücken, Germany), whose 2010 article “Consumerism and identity: Some psychoanalytic considerations” has been one of the most downloaded papers of our journal. The cultivation of a socially critical psychoanalysis in only one of his interests, as documented by his papers on Freudian metapsychology (see, for example, Zepf, 2015) and epistemology (Zepf, 2016). In the paper published in this issue, “Psychoanalytic treatments and empirical research on their efficacy: A commentary,” the author further develops the considerations formulated in this regard in his 2008 article “Naturalistic studies of psychoanalytic treatments: Some epistemological and methodological remarks.” According to Zepf, nomologically oriented research operates with assumptions lacking empirical foundations, merely giving an impression of the effectiveness of analytic therapy, while overlooking the specificity of the analytic method. In his view, it is not the treatments themselves, but the treatment theory, that can be usefully subjected to testing. Even if this would, for example, allow us to compare individual treatments on the basis of the related treatment theory, what we still lack of – as an analytic community – is of course a common understanding and usage of the treatment concepts. From this point of view, a huge amount of work is still ahead of us.

Very interesting from the point of view of revisiting the history of the consolidated methodology of infant observation (IO), and of its critical appraisal in the light of our latest concepts of child development, is the following article in this issue, “And who thinks on the baby? Thoughts on the method of infant observation,” by Christiane Ludwig-Körner” (Berlin, Germany), the English translation of an article originally published in the German journal Psyche – Zeitschrift für Psychoanalyse in 2015. A German pioneer in the field of parent–infant therapy, and a professor at the Berlin International Psychoanalytic University (IPU), the author shows how the missing interaction between the infant observer and the infant, on which the methodology of IO is based, runs against today’s widely validated and shared concept of the interactive nature of child development. This allows her to propose what she calls “video-analytic IO” as scientifically acceptable and a technologically possible way to keep making use of the widely used methodology originally proposed by the Viennese-British analyst Esther Bick (née Wander; 1902–1983).

With the publication of the sixth and last article of this issue, “The unconscious and consciousness of memory: A contribution from neuroscience,” by Antonio Imbasciati (Milan, Italy), we want to give space in our journal not only to the way in which the latest research work in the field of neuroscience deserves and needs to be taken seriously by all of us working in the field of psychoanalysis, but also to the important contribution made in this regard by our Italian colleague. An emeritus professor of clinical psychology at the University of Brescia, and a training analyst of the Italian Psychoanalytic Society, Antonio Imbasciati has dedicated his whole very prolific professional life (starting in the early 1960s at the Catholic University of Milan) to working on the interdisciplinary border between psychoanalysis and psychology, having to struggle hard on both fronts in order for the institutions of the university and the Psychoanalytic Society to listen to, talk, and – now and then – collaborate with each other. The fruits of his work are not only very many articles and books in Italian, but also the English-language books Constructing a mind (2005) and Mindbrain, psychoanalytic institutions and psychoanalysts (2017). His latest book – Una vita “con” la psicoanalisi: la costruzione del cervello e il futuro dell’umanità – a good synthesis of his work, centers around what Imbasciati considers his most important legacy, that is, perinatal clinical psychology, based on an integration of the data deriving from infant observation, attachment theory, and affective neuroscience.

The issue closes with my own “Report on the XXIst IFPS Forum, ‘Psychoanalytic encounter: Conflict and change’, Lisbon, February 5–8, 2020,” chaired by Cristina Nunes, the first IFPS event ever organized in Portugal, thanks to the Portuguese Association of Psychoanalysis and Psychoanalytic Psychotherapy. No IFPS event had previously taken place during the European winter, and we had our doubts about such a timing, but, as it turned out, it represented one of the last international events to take place in our field in the first semester of 2020 – because of the Coronavirus. The next IFPS Forum should take place in Madrid in October 2022.