Paradigms in Psychoanalysis – Author's notes — Karnacology



At nearly 80, I thought it could be useful to share with readers my experience of nearly fifty years in the field of psychoanalytic psychotherapy.

In addition to my clinical work, four basic experiences converge in this book.

First, after receiving my medical degree in Milan, I trained in genetics and evolutionary theory in Pavia with Cavalli-Sforza, a specialist in human genetics who later moved to the USA. After this, I turned to the field of psychiatry and trained in New York in 1963-64 with Silvano Arieti, who belonged to the interpersonal-cultural school founded in 1943 by Sullivan and Fromm, and whose books I later translated into Italian.

In New York, I also attended a course in sociology at the New School for Social Research, where Fromm, and before him, Ferenczi, had lectured.In 1982 I started to correspond with John Bowlby; in 1985 I met him in London to discuss a paper on “Attachment Theory as an Alternative Basis for Psychoanalysis”, which I presented in Zürich later that year; I then kept up my correspondence with Bowlby until his death in 1990.

My reading of Fromm confirmed my interest in the social sciences, and my acquaintance with Bowlby renewed my interest in evolutionary theory.

In this book I set forth the paradigms, or scientific theories, that I find relevant in psychoanalysis.  After reviewing the basic sciences of genetics and neurobiology in Chapters One and Two, I turn to Bowlby’s attachment theory in Chapter Three.  Bowlby shows that the infant’s basic drive is towards establishing attachment with the mother, who responds with complementary caregiving behaviour.  Humans have attachment behaviour in common with all mammals and many birds. The time dimension of this inter-class connection is millions of years.  I therefore consider Bowlby’s attachment theory, based on ethology and evolutionary theory, as the most powerful conceptual tool we have at our disposal in psychoanalysis.  In this chapter, I list the multiple binding mechanisms that in our culture often keep a child bound to its family, instead of allowing it to achieve autonomy, in the service of role reversal, whereby the child has to gratify the needs of the parents.

In Chapter Four, I review the field of infant research, which records much more detailed observations of the mother-child dyad as compared to the clinical level of attachment theory. This research reveals that the infant is actively related from birth, and that in development there are no such things as a normal autistic and symbiotic phase.  In Chapter Five, I discuss psychic trauma. 

In his early work Bowlby spoke of “real-life events” in infancy, to differentiate his position from Melanie Klein’s  emphasis on phantasy,  but in a 1983 paper he explicitly spoke of  “Violence in the Family”, thus joining the vast literature on trauma that had grown up in those years, following on Ferenczi’s rediscovery of trauma towards the end of his life. I agree with Bowlby that psychopathology is the result of traumas that arise when the relational environment deviates too widely from that to which we were adapted in the course of evolution (what he calls the EEA, the environment of evolutionary adaptedness).

In Chapter Six, I discuss the relational model, as opposed to the drive model of classical psychoanalysis. I regard Ferenczi as the initiator of this model, and Bowlby and Fromm as two great representatives of the model on the two sides of the Atlantic.  I  discuss the reciprocal relationships of these three authors.  In Chapter Seven I turn to the family, which is the wider relational environment in which an individual is immersed.  This literature reveals the reciprocity between the individual and this wider environment.  Chapter Eight is devoted to a higher systemic level, the socio-cultural one.  Here I discuss Fromm’s analytic social psychology, according to which society, in order to perpetuate itself, creates through the family the appropriate character structure in the individual, which Fromm calls the social character.  In this chapter I also discuss social psychiatry and ethno-psychiatry.



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