Raffaello Cortina Editore

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.

Pensando alle nostre istituzioni: lasciti, transiti e depositi Partendo da un sogno che segnala la fine di un’esperienza istituzionale, l’autore riflette su alcuni passaggi della vita istituzionale psicoanalitica e sanitaria, sul lavoro psichico da compiere per diventare soggetto sociale. Centrale diventa pensare al valore della funzione istituzionale per la vita societaria, sulla necessità di osservare la dimensione interstiziale della comunità soprattutto in un periodo di virtualità dovuta all’esperienza del covid. Anche nelle istituzioni sanitarie si riproducono fenomeni simili. Lo sviluppo di piccoli gruppi di soci che coltivano interessi specifici costituisce un potente fattore di elaborazione e favorisce i transiti all’interno della vita istituzionale. Il piccolo gruppo, se ben inserito nella vita societaria, costituisce un’esperienza tra pari; rappresenta una risorsa intermediaria rispetto al tema della trasmissione tra generazioni di analisti per contrastare i fenomeni conformistici tipici delle famiglie analitiche a funzionamento endogamico. Parole chiave: Interstizio nelle istituzioni di cura, istituzione e funzioni intermediarie, piccolo gruppo,trasmissione generazionale nelle famiglie analitiche. Thinking about our institutions: bequests, transits and deposits. Starting from a dream that signals the end of an institutional experience, the author reflects on some passage of psychoanalitical and healthcare institutional life, on the psychic workbe done to become a social subject. It becomes central to think about the value of the institutional function for corporate life, on the need to observe the interstitial life of the community, especially in a period of virtuality due to the experience of the covid. Similar phenomena are also reproduced in health institutions. The development of small groups of members who cultivate specific interests is a powerful processing factor and promotes transits within institutional life. The small group, if well integrated into corporate life, constitutes an experience between equals; it represents an intermediary resource with respect to the issue of transmission between generations of analysts to counter the conformistic phenomena typical of analytic families with endogamous functioning. Key words: Institution and intermediary functions, generational transmission in analytic families, interstice in health care institutions, small group. En réfléchissant sur nos institutions: legs, transits et dépôts. Partant d’un rêve qui signale la fin d’une expérience institutionnelle, l’auteur réfléchit sur quelques passages de la vie institutionnelle psychanalytique et sanitaire, sur le travail psychique à accomplir pour devenir un sujet social. Il devient central de réfléchir sur la valeur de la fonction institutionnelle pour la vie sociétaire, d’observer la dimension interstitielle de la communauté surtout dans une période de virtualité due à l’expérience du Covid. Des phénomènes similaires se reproduisent également dans les institutions de santé. Le développement de petits groupes de membres qui cultivent des intérêts spécifiques constitue un puissant facteur d’élaboration et favorise les transitions au sein de la vie institutionnelle. Le petit groupe, s’il est bien intégré à la vie de la société, constitue une expérience entre égaux; il représente une ressource intermédiaire par rapport à la question de la transmission entre générations d’analystes, pour s’opposeraux phénomènes conformistes typiques des familles analytiques au fonctionnement endogame. Mots-clés: Interstice dans les institutions de santé, Institutions et institutions intermédiaires, petit groupe, transmission générationnelle dans les familles analytiques. Pensando en nuestras instituciones: legados, tránsitos y depósitos. A partir de un sueño que marca el final de una experiencia institucional, el autor reflexiona sobre algunos pasajes de la vida institucional psicoanalítica y asistencial y sobre el trabajo psíquico a realizar para convertirse en sujeto social. Se vuelve central pensar en el valor de la función institucional para la vida corporativa, en la necesidad de observar la dimensión intersticial de la comunidad especialmente en un período de virtualidad por la experiencia del covid. Fenómenos similares se reproducen también en las instituciones de salud. El desarrollo de pequeños grupos de miembros que cultivan intereses específicos constituye un poderoso factor de elaboración y favorece las transiciones dentro de la vida institucional. El pequeño grupo, bien integrado en la vida corporativa, constituye una experiencia entre iguales; representa un recurso intermediario respecto al tema de la transmisión entre generaciones de analistas para contrastar los fenómenos conformistas propios de las familias analíticas con funcionamiento endogámico. Palabras clave: Funciones de institución e intermediación,intersticio en instituciones de salud, pequeño grupo, transmisión generacional en familias analíticas. Nachdenken über unsere Institutionen: Nachlässe, Übergänge und Einlagerungen. Ausgehend von einem Traum, der das Ende einer institutionellen Erfahrung markiert, stellt der Verfasser Überlegungen zu einigen Übergängen des psychoanalytischen und gesundheitlichen institutionellen Lebens an, zur psychischen Arbeit, die zu leisten ist, um ein soziales Subjekt zu werden. Im Mittelpunkt steht das Nachdenken über den Wert der institutionellen Funktion für das gesellschaftliche Leben, über die Notwendigkeit, die interstitielle Dimension der Gemeinschaft zu berücksichtigen, insbesondere in einer Phase der der Covid-Erfahrung geschuldeten Virtualität. Auch in Einrichtungen des Gesundheitswesens finden sich ähnliche Phänomene. Die Entwicklung kleiner Gruppen von Mitgliedern, die spezifische Interessen pflegen, stellt einen wirkmächtigen Faktor der Ausarbeitung dar und fördert die Übergänge innerhalb des institutionellen Lebens. Die kleine Gruppe ist, wenn sie gut in das gesellschaftliche Leben integriert ist, eine Erfahrung unter gleichen; bezüglich des Themas der Übertragung zwischen Generationen von Analytikern ist sie eine intermediäre Ressource, die konformistischen Phänomenen entgegenwirkt, die für analytische Familien mit endogamer Funktionsweise typisch sind. Schlüsselwörter: Generationale Weitergabe in analytischen Familien, Institution und intermediäre Funktionen, kleine Gruppe, Zwischenraum in Pflegeeinrichtungen.