Jornada Ibérica teórico-clínica de psicoanálisis
Se celebra cada año impar el primer sábado de octubre. Es un encuentro entre miembros, candidatos e invitados de las Sociedades de la Península Ibérica, que constituyó la originaria Sociedad Luso-Española de Psicoanálisis.
La Jornada Ibérica viene promovida en estos momentos por la Sociedad Española de Psicoanálisis (SEP), la Asociación Psicoanalítica de Madrid (APM) y la Sociedad Portuguesa de Psicoanálisis (SPP), a las que se ha añadido recientemente un nuevo grupo portugués, el Núcleo Portugués de Psicoanálisis (NPP).
La jornada se organiza alrededor de un tema teórico o clínico sobre el que cada una de las sociedades presenta una ponencia teórica.
Posteriormente, se presentan dos casos clínicos que son discutidos por miembros de las diversas sociedades y después por el público asistente.
La V edición de la Jornada Ibérica teórico-clínica de psicoanálisis se celebrará en Lisboa el día 7 de octubre de 2017.
Llevará por título Modificaciones del cuerpo. Identidad y desorganización.
“Body and Mind in Conflict?” – Entrevista con Riccardo Lombardi
Riccardo Lombardi es psicoanalista Miembro de la Sociedad Psicoanalítica Italiana.
Con base en la filiación las teorías de Bion y de Matte Blanco, para Lombardi el pensamiento psicoanalítico es un “trabajo abierto” en constante evolución – algo para examinar y cuestionar. Central para su pensamiento clínico es la conexión/desconexión cuerpo-mente, que sitúa en un nivel arcaico del psiquismo. Lombardi da mucha importancia al transfer somático, experimentado por el analista y fuente de información que permite un trabajo de elaboración de los niveles arcaicos del psiquismo del paciente.
Riccardo Lombardi, escribe sobre las exigencias físicas y mentales del trabajo clínico y la importancia de la flexibilidad en el trabajo con pacientes psicóticos.
Hay varios artículos publicados y dos libros. En 2015 pública: Infinito sin Forma: Exploración Clínica de Matte Blanco y Bion y en 2016: Disociación Cuerpo-Mente en Psicoanálisis: Desarrollo después de Bion.
CMA : Helplessness is inherent to the human condition. Considering that everything first happens in the body, how we represent it, or do not represent, especially when it has a predominantly traumatic dimension?
RL : Also if it’s true that helplessness is inherent to the human condition, helplessness is not always experienced for its positive and creative implications by our patients, especially if the mind doesn’t meet the body, or, if you like, doesn’t eclipse the body, with the consequence that no true feeling of humanity seems possible.
A healthy maturational development of the human animal implies an intimate interconnection between mind and body. As the Latins said: Mens sana in corpore sano. We must however recognize the existence of severe forms of dissociation between the body and the mind in our current patients.
The role of the maternal reverie is determinant in catalyzing the cooling down of the primitive explosive forms of sensoriality and the activation of the first forms of sensory perceptions, which permit the birth of a containing capability. If it’s true that the maternal reverie is crucial, it is also true that the mental activation of mental containment of the primitive sensoriality is internal to the subject herself.
In this hypothesis, the first forms of traumatism are connected to a scarcity or absence of maternal reverie. Babies can, however, be very different according their bodily constitutions, so the same lack of maternal reverie can be tolerable for some subjects and toxic for others. From the beginning some kind of responsibility seems involved in the subject’s orientation to accept or refuse frustration.
If the baby’s primitive needs do not meet a maternal reverie, the activation of the first forms of mental sensory registration and containment can be hindered. What happens during the primitive stages of development seems however beyond the resources of historic reconstruction.
It is necessary to work in the present for stimulating self-observation and exploring modes and form of internal functioning. In such a way, the psychoanalytic working through can stimulate new forms of self-awareness and mental recognition of the body, of sensations and bodily emotions.
In its most severe form, the tendency to body-mind dissociation cannot be completely resolved by psychoanalysis. In these cases, the analysand who is able to observe his internal way of functioning can pay attention to promote body-mind connection through some inventive strategic modalities, exactly as a blind man can use different forms of sensoriality to integrate the lack of vision. When the body is integrated by the mind during a psychoanalysis, we are often witness to deep feelings of helplessness and confusion. This evolution must be not confused with a worsening of the analytic process, since these feelings signal the new integration of the mind with the body. It is indeed a catastrophe, but a catastrophe that signals the dawn of a new world. When the psychotic area of the personality, combined with lies, struggles against the body-mind integration, the feeling of helplessness inherent to human condition can be impossible or almost impossible to achieve.
CMA : Once you said: psychotic patients teaches us psychoanalysis because they are in a deepest level of the unconscious. What’s the mind for you?
RL: When an acute psychosis intervenes, the patient experiences very directly, together with the catastrophe, the most primitive anxieties. The analyst working in these contexts must be at-one-ment with the patient’s experience. The urgent need of facing disorganized emotions stimulates the patient to collaborate with the analyst, especially when the patient, after some psychoanalytic sessions, realizes that he can be understood by the analyst and feel better. Also, in confusional states, the psychotic patient generally speaks of his internal condition and is unable to lie, differently from what happens with more evolved patients with psychotic functioning.
The patient in acute crisis, also in deeply confused states, can make sense of the analyst’s interventions, provided that the analyst’s interventions are precise enough. When these interventions are not sufficiently precise, they will be inevitably refused by the patient. So the psychotic patient can offer the analyst an important compass on how to reach the most primitive levels. Since this patient will refuse everything that is not in line with his internal experience, the analyst meets an important field of experience for his professional development. If the analyst is able to have open ears, he can adjust his analytic propositions step by step until he can become able reach the patient, using in a determinant way, the patient’s own suggestions as his primary guide.
CC : In your articles you speak about dissociation body-mind. What’s the difference between dissociation and splitting?
RL : Splitting is connected to more evolved dynamics, such as those connected to splitting between hatred and love as well as the splitting connected to projective identification. These levels are clearly described in Melanie Klein’s works. Dissociation is related to more primitive dynamics in which the body is unreachable by the mind.
GC : Considering your deep interest in both, the body-mind link and psychotic dimension of the personality, how do you look to the issue of body modification and how they can be understood within a psychoanalytic framework, such as the large use of tattoos, piercings, plastic surgeries, etc.
RL : Tattoos and piercings have a different anthropological meaning according to cultures. In analytic patients the role of body modifications should be explored in every single case. What I see more often in analysis is that the tattoos, piercings, and plastic surgeries offer a way of reinforcing the perception of the bodily self and self confidence, also when the body cannot still be integrated in a harmonious way. In some cases, tattoos can offer testimony of a provisional sense of existence, especially if the patient feels herself entrapped in an imaginative ‘bubble’ external to the body self.
GC: Do you consider that this might reflect a change in psychopathology? Is it the body gaining another presence in communication?
RL : According the psychoanalytic vertex, I would not speak of pathology in medical terms, but of internal disharmony between two different subsystems: those of the body and the mind within the personality. Our patients change as time and cultures change. The clinical cases of body-mind dissociations are, in my view, a new challenge for the analysts: they require new conceptual hypotheses that could help us in approaching the most difficult cases.
GC: One other issue that we will try to reflect upon is the body transformation related to psychosexuality. Could you share your thoughts on the subject?
RL : The role of sex and gender are significantly influenced by the differences of culture, too, so they change in relation to time and different environments. The exploration of the patient’s modes and forms of internal functioning, introduced by Bion in psychoanalysis, offer the possibility of exploring the different meanings and values that psychosexuality, as well as masculinity and femininity, have in each subject. Masculinity and femininity are also influenced by the personal way in which the subject organizes his/her Oedipal area.
Sometimes the body transformations can correspond to an effort, more or less realistic, of re-arranging a failure in the body-mind relation or, at more evolved levels, within the Oedipal internal theater, offering new resources when the personal survival is in danger. It is also true that people who had experienced a personal psychoanalysis often show a more realistic appreciation of the body and show good resources of rearranging their personality through mental and imaginative instruments, protecting themselves from seeking an omnipotent solution in potentially dangerous surgeries.
CMA : Can you speak about body transference and countertransference? How useful as an instrument with those patients that symbolize life in the body as a canvas?
RL : The transference onto the body can help the patient to give concrete substance to a body whose existence is systematically denied. This happens also in those psychotic conditions which deny the body, becoming dangerously wounded by external gazes or transparent to external recognition. The personality growth involves not only minding the body but also to become able to maintain the concreteness of the body and the weight of bodily sensations.
Working with these patients, clinical experience shows how the analysts are often called to experience very directly their own physicality. In other words, this level of working through fosters the body-mind conflict within the analyst. If the analyst is too literally identified with her mind, the analyst risks considering perverse and regressive every sign connected to the body, so the analytic process can suffer from dangerous impasses. Only when the analyst is able to recognize more realistically the pressure and existence of his body, the patient can be helped to find the way to discover and meet his own body.
The most frequent misunderstanding is the tendency to consider the patient perverse when some bodily issues come to the foreground in analysis. The so called ‘bodily countertransference’ should however be considered a normal component of the analytic process when this primitive level of functioning is involved.
CMA – Conceição Melo Almeida; CC – Carla Cruz; GC – Guilherme Canta
Carla Cruz, Eugenia Soares y Rita Gameiro investigaron el pensamiento de Riccardo Lombardi