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This volume, richly illustrated with clinical examples, explores the curative
power of the intersubjective analytic encounter from the vertex of post-Bionian
field theory. In so doing, it offers psychoanalysts of all levels of experience a
pragmatic, clinical metapsychology of psychic process and the analytic encounter
and demonstrates the centrality of transformations in dreaming and the value of
the oneiric model of the mind.
– Howard B. Levine, MD, Editor-in-Chief, The Routledge
Wilfred Bion Studies Book Series

Antonino Ferro, one of the most brilliant psychoanalytic thinkers of his time
brings us directly into the heart of the psychoanalytic encounter, this time accom-
panied by a stellar list of contributors. Theoretically astute and clinically inspir-
ing, Psychoanalytic Practice offers the reader a vivid and clear understanding of
innovative Italian Psychoanalysis inspired by the later work of Bion on dreaming,
reverie, and affect. This joins the ranks of Ferro’s most important contributions.
– Galit Atlas, Ph.D, NYU Postdoctoral program for Psychotherapy
and Psychoanalysis, Author of The Enigma of Desire:
Sex, Longing and Belonging in Psychoanalysis
Psychoanalytic Practice Today

Psychoanalytic Practice Today offers the reader a good understanding of the

school of thought inspired by the late work of Wilfred R. Bion. The contributors
share a belief in the curative power of the analytic encounter and in the capacity
of the human mind to develop from the encounter with a mind capable of reverie,
dreaming and thinking. The multitude of vignettes presented emphasise the
necessity of the emotional involvement of the analyst with his or her patients for
improvement to take place.
The book is divided in two parts: ‘Psychopathology’ and ‘Emotions and
Feelings’. The first part adapts a more classic description of psychiatric disorders
by diagnostic criteria, from neuroses to psychoses and including depression and
borderline states. The second part of the book takes a closer look at specific
clinical manifestations of basic emotions such as anger, surprise, sadness and
more complex ones such as jealousy, abandonment and betrayal. The common
thread is represented by the central place of dreaming in the psychoanalytic field
as a tool to understand these clinical manifestations, and to allow for their psychic
representation as an emotional experience.
The contributions together offer a varied introduction to current ideas that are
growing increasingly interesting to English speaking readers, with a sufficient
character of originality, irreverence and creativity that bears witness to the
maturity of Italian psychoanalysis. Psychoanalytic Practice Today will offer new
ideas to the practicing psychoanalyst and psychodynamic psychotherapist.

Antonino Ferro is a training analyst in the Italian Psychoanalytic Society, the

American Psychoanalytic Association and the International Psychoanalytical
Association. He is the current president of Pavia’s Psychoanalytic Centre. He
received the Sigourney Award in 2007.
Psychoanalytic
Practice Today

A Post-Bionian Introduction
to Psychopathology, Affect
and Emotions

Edited by Antonino Ferro

First published 2020
by Routledge
2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN
and by Routledge
52 Vanderbilt Avenue, New York, NY 10017
Routledge is an imprint of the Taylor & Francis Group, an informa business
© 2020 selection and editorial matter, Antonino Ferro; individual
chapters, the contributors
The right of Antonino Ferro to be identified as the author of the
editorial material, and of the authors for their individual chapters,
has been asserted in accordance with sections 77 and 78 of the
Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this book may be reprinted or
reproduced or utilised in any form or by any electronic, mechanical,
or other means, now known or hereafter invented, including
photocopying and recording, or in any information storage or
retrieval system, without permission in writing from the publishers.
This book is a translation of a work previously published in Italian by
Carocci Editore as La clinica psicanalitica oggi (2016).
All chapters translated by Adam Elgar except chapter 10 translated by
Giuseppe Civitarese and chapter 13 translated by Gina Atkinson.
Trademark notice: Product or corporate names may be trademarks
or registered trademarks, and are used only for identification and
explanation without intent to infringe.
British Library Cataloguing-in-Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging-in-Publication Data
Names: Ferro, Antonino, 1947– editor.
Title: Psychoanalytic practice today : a post-Bionian introduction to
psychopathology, affect and emotions / edited by Antonino Ferro.
Other titles: Clinica psicanalitica oggi. English.
Description: Abingdon, Oxon ; New York, NY : Routledge, 2019. |
Includes bibliographical references and index.
Identifiers: LCCN 2019011793 (print) | LCCN 2019013015 (ebook) |
ISBN 9780429288616 (Master) | ISBN 9781000021998 (Adobe) |
ISBN 9781000022223 (Mobipocket) | ISBN 9781000022452 (ePub) |
ISBN 9780367137083 (hardback : alk. paper) | ISBN 9780367137090
(pbk. : alk. paper) | ISBN 9780429288616 (ebk)
Subjects: | MESH: Bion, Wilfred R. (Wilfred Ruprecht), 1897–1979. |
Psychoanalytic Therapy | Mental Disorders—therapy | Affective
Symptoms—therapy | Psychoanalytic Theory
Classification: LCC RC454.4 (ebook) | LCC RC454.4 (print) |
NLM WM 460.6 | DDC 616.89—dc23
LC record available at https://lccn.loc.gov/2019011793
ISBN: 978-0-367-13708-3 (hbk)
ISBN: 978-0-367-13709-0 (pbk)
ISBN: 978-0-429-28861-6 (ebk)
Typeset in Times New Roman
by Apex CoVantage, LLC
Contents

List of contributorsxiii
Acknowledgementsxv

PART I
Psychopathologies1

1 Anorexias and dyschronias 3

A N TO N I N O F E RRO

1.1 Anorexias 5
1.2 Atemporalities (dyschronias) 8

2 Phobia 14
M A U R I Z I O C O LL OVÀ

2.1 Presuppositions for a different nosography 14

2.2 Post-Bionian developments 17
2.3 The weight of thinking thoughts 18
2.4 Avoidance: a very wide-spread practice 19
2.5 In search of a narrative 20
2.5.1 A providential narrative 21
2.5.2 A faulty roundabout: only one exit – to “phobias” 22
2.5.3 How many stories do we need? 24
2.6 On the subject of multiple storylines: The Best Offer 25
2.7 Collaborative or necessary illnesses of the field? Dario
and the magnetic bike 27
2.8 Agoraphobia in the session. “But which piazza were you
telling me about?” 29
2.9 A phobia about birds? Certainly the result of a sexual
trauma! 30
2.10 Conclusions 31
viii Contents

3 Obsessionality. Algorithms, compulsions, rituals, and

obsessions36
G I O VA N N I F ORE S T I AND MAURO MANI CA

3.1 Towards a(n obsessive?) definition of obsessionality 39

3.2 The psychoanalytic tradition 45
3.3 Orienting oneself: obsessionality and the bi-personal
clinical field 50
3.3.1 The metaphor 52
3.4 The ♀/♂ dialectic and the dimensions of the field 54
3.5 Concluding observations 57

4 Depression: geographies and histories 61

E L E N A M O LI NARI

4.1 Holden and Zerocalcare: transforming depression during

adolescence 62
4.1.1 The Catcher in the Rye 63
4.1.2 Zerocalcare’s raft and the nightmare of
non-compliance 64
4.1.3 How to treat non-compliance? 66
4.2 Researches and researchers 68
4.2.1 Elisa 69
4.3 The grip and the journey: two aspects of the same problem 71
4.4 Primary depression and the impossibility of moving 74
4.5 Children 76
4.5.1 Tongue, don’t move 77
4.5.2 Alice and the lost words 78
4.6 Conclusion: building a ladder 82

5 Borderline 85
V I O L E T P I E T RANTONI O

5.1 Radio border: live from border camp, where dreams

appear and disappear, interrupted by mysterious
“intermittences” 85
5.2 Borderline: at the limes of the possible dream? 86
5.3 Border landing: (when a bordercamper knocks on
the door) proto-telluric of the analytic field. Love story
and crystal hell 89
5.4 Border field: psychodynamics of an analytic field in
work with a borderline patient. Morphology, physiology,
and possible syndromes 91
 Contents ix

5.4.1 The border and the “poisoned” setting: eggs of

black widow-nightmares laid in a spiderweb?
Psychosomatics of the analytic field 92
5.4.2 On the borders of analysis: bordercamper strategies 95
5.4.3 Toto and Dorothy on a journey in search of brain,
heart, and courage. Borderline analysis: to the
Bermudas of O 100
5.4.4 End zone 103

6 Paranoias 109
F U LV I O M A Z Z ACANE

6.1 Introduction 109

6.2 Normality and paranoia 110
6.2.1 Semantic ambiguity as paranoia’s identity card 110
6.2.2 Paranoid thought as a vicissitude of the human 111
6.2.3 White paranoia 112
6.3 Paranoia and affective trauma 115
6.3.1 The ambiguity of paranoia in psychopathology 115
6.3.2 A case of paranoia 117
6.4 Microparanoias 119
6.4.1 Oedipus, paranoia, and psychoanalysis 119
6.4.2 The first significant move in analysis and the
paranoid rebound 120
6.4.3 The clue-based paradigm: identification of the
selected fact and the paranoid analyst 122
6.4.4 Paranoia as a configuration in therapy: nosography
of the field 123
6.4.5 Paranoid phases 125
6.4.6 Episodic paranoid configurations 127
6.4.7 Paranoia in the psychoanalytic institution 128
6.5 Conclusion: paranoia as a pathology of boundaries 129

7 Psychosis. Listening to psychosis in a state of profound

ignorance132
M A U R O M A N I CA

7.1 To begin a discussion 132

7.2 Intercepting the delusion 147
7.2.1 Primary psychoanalytic preoccupation 147
7.2.2 “By our lady . . .” 151
x Contents

PART II
Emotions and feelings 161

8 Abandonment 163
A N TO N I N O FE RRO

9 On the feeling of exclusion 168

M A U R I Z I O COL L OVÀ

9.1 We are a crossroads of emotions and feelings 168

9.2 What are we being excluded from? 169
9.2.1 Sara and the recovery of a retro-perspective 170
9.2.2 From missing crib syndrome to the “ripped-off” crib 171
9.3 At the origin of the bi-personal 173
9.4 The experience of exclusion in vivo 174
9.4.1 The feeling of exclusion in a session 174
9.5 Opposite declensions of exclusion 176
9.5.1 The Family 177
9.5.2 Fanny and Alexander 178
9.6 The disappearance of the mind 179
9.6.1 Conversation with the mother 179
9.7 Ogden’s napkin. Exclusion as a “collapse of the
dialectic of experience” 180
9.8 Conclusions 182

10 Rage and shame 185

G I U S E P P E C I VI TARE S E

10.1 Characters who express rage 186

10.1.1 The lipless 187
10.1.2 The time of the decision 188
10.1.3 Green with rage 189
10.1.4 The sense of justice 189
10.1.5 The self-feeding effect 190
10.1.6 Full moon 192
10.1.7 Impotence 193
10.1.8 Shame 194
10.1.9 Slow rage and the art of exaggeration 197
10.2 Shame as the photo-like negative of rage 198
10.3 Curing rage 201
 Contents xi

11 Jealousy: the treachery of a forgotten sister 205

V I O L E T P I E T R ANTONI O

11.1 Oedipal jealousy: cryptograms of psychoanalytic riddling 206

11.2 Othello, Oedipus, and Cain at the mouths of the Nile. Field,
jealousy, and plagues in Egypt. When K trembles at the
encounter with O 207
11.3 Looking for Iago: jealousy as clashes between βα noumena?
Sherlock K and O 210
11.3.1 Phase K 210
11.3.2 Phase KO 211
11.4 Possible outcomes of jealousy 211
11.4.1 K retreats before O 212
11.4.2 K⇄O. Jealousy: grieving mother of unexpected oneiric
conceptions. Being able to dream jealousy. When K
succeeds in pausing on the riverbanks or swimming
in the numinous 216

12 Betrayals. Psychoanalytic pathways in the works

of James Joyce 224
F U LV I O M A Z Z ACANE

12.1 Introduction 224

12.2 16 June 1904 226
12.3 Betrayals great and small: language as a source
of betrayal 227
12.4 The Dead: history as a source of betrayals 228
12.5 Dedalus: betrayals by the artist/analyst 230
12.6 Exiles: betrayal as a shadow of the relationship 233
12.7 Ulysses: a day-long analytic session 234
12.8 Negative therapeutic reaction: from betrayal to the
perception of the boundary 236
12.9 Memoir of the Future: Joyce and Bion 237
12.10 Psychoanalytic experiences: betrayal or translation
of the method? 239
12.11 Finnegans Wake: the play of characters in a dream
environment 241
12.12 A brief conclusion 243
xii Contents

13 Surprise 246
E L E N A M O LI NARI
T R A N S L AT I O N BY GI NA AT KI NS ON

13.1 The experience of surprise: to surprise or be surprised? 246

13.2 I’m home! 247
13.3 A lie to tell the truth 249
13.4 The surprise that crouches hidden in the session 250
13.5 Ellipsis points 252
13.6 A touching surprise hidden in an ordinary session 252
13.7 A surprise enclosed within a shell 253
13.8 Surprise as an antidote 254

14 Contempt in clinical practice 255

LUCA NICOLI

14.1 Introduction 255

14.2 The myth of the good (and blind) analyst 257
14.3 Transformations: the eternal problem of the Roma 259
14.4 Apology for the banal, the abnormal, the infantile,
and for me-tooism 261
14.5 Nothingness 264
14.6 Friday self-analysis 267

15 Sadness. Sadness between phenomenology and psychoanalysis:

from nameless sadness to sadness in O269
M A U R O M A N I CA

15.1 A phenomenological premise 269

15.2 A psychoanalytic perspective 272
15.3 Sadness is not (only) D 274
15.4 AC↔PS 276
15.5 PS↔D 277
15.6 D↔TP 278
15.7 AC↔TP 279

Index 283
Contributors

Giuseppe Civitarese is a training and supervising analyst in the Italian Psycho-

analytic Society and the International Psychoanalytical Association. He is a
member of the American Psychoanalytic Association and a past Editor of the
Rivista di Psicoanalisi.
Maurizio Collovà is a full member of the Italian Psychoanalytic Society and the
International Psychoanalytical Association. He is the Scientific Secretary of
the Pavia Psychoanalytic Centre.
Antonino Ferro is a training and supervising analyst in the Italian Psychoana-
lytic Society, the American psychoanalytic Association and the International
Psychoanalytic Association. He received the Sigourney Award in 2007 and is
a former President of the Italian Psychoanalytic Society. He is the President of
the Pavia Psychoanalytic Centre.
Giovanni Foresti is a training and supervising analyst in the Italian Psychoana-
lytic Society and the International Psychoanalytical Association. He is a mem-
ber of the Scientific Committee for the NODO Group (Torino) and for OPUS
(London).
Mauro Manica, psychiatrist and psychoanalyst, is a full member of the Italian
Psychoanalytic Society and the International Psychoanalytic Association. He
was the recipient of the Tycho Award.
Fulvio Mazzacane is a training and supervising analyst in the Italian Psychoana-
lytic Society and full member of the International Psychoanalytic Association.
Elena Molinari is a psychoanalyst of the Italian Psychoanalytic Society and
an International Psychoanalytic Association member. She began her profes-
sional life working as a pediatrician. Since 2000, she has been in private
analytic practice, treating both adults and children. She also teaches child
neuropsychiatry for the undergraduate course in art therapy at the Academy
of Fine Arts of Brera, Milan. She is a past Editor of the SPI journal Rivista
di Psicoanalisi.
xiv Contributors

Luca Nicoli, psychologist and psychoanalyst, is a member of the Italian Soci-

ety of Psychoanalysis and International Psychoanalytic Association. He is co-
author of the book The New Analyst’s Guide to the Galaxy.
Violet Pietrantonio is a clinical psychologist and member of the Italian Psycho-
analytic Society and International Psychoanalytic Association.
Acknowledgements

The editor wishes to thank the contributors for their thoughtful and creative con-
tributions, Adam Elgar for his sensitive translation, and Gillian Jarvis for her
excellent work on this project.
Part I

Psychopathologies
Chapter 1

Anorexias and dyschronias

Antonino Ferro

We know that there are a variety of defence mechanisms against very primitive
anxieties.
For purely illustrative purposes, we can list the following:

1 Modes of elimination:
a repression;
b splitting;
c evacuations.
The last of these can occur
• in the body: psychosomatic illnesses;
• by inverting the functioning of sense organs: hallucinations;
• in the body social: transformations in hallucinosis, characteropathies,
and criminal behaviour.
2 Modes of “staunching and management” without large-scale evacuation
(immediately perceptible):
a Hibernation: that mode in which the field is put to sleep, sedated: by
boredom, for example. It is like a circus in which the lion-tamers and ani-
mals, especially the fierce ones, have been put to sleep. This comes about
through particular communicative strategies: for example, a discourse
based on a predominance of coordinate clauses (which form a kind of
open plain that tends to grow misty in the absence of any alternation with
the landscape of subordinate clauses) or through hypnagogic projective
identifications. In these modes, emotions end up in hibernation.
b Bonsaification: this consists in the miniaturising of emotions, transform-
ing them into mini-emotions with no force; it would be like turning
an oak tree into a series of bonsai oaks. In this way, worlds of micro-
emotions are created which find narrative voice in worn-out, cut-price
stories where everything is made saccharine, free from conflict, and free
from any kind of passion.
4 Antonino Ferro

c Computerisation: this mode is not very different. Violent emotions are

turned into computer games and role plays. It is not unlike the technique
used by Quentin Tarantino in Kill Bill: whenever the emotions at work
are too violent, the scenes with actors are turned into animated cartoons,
losing their overwhelming, bloody violence.
d Glaciation: this is a mode in which freezing or petrification are used
to extinguish emotions that are feared because of their indigestibility.
When the bulls are running in Pamplona, if we lower the temperature to
many tens of degrees below zero, or if the bulls are turned into statues,
the problem of the uncontainability of these emotions is (apparently)
solved.
3 Predominantly spatial modes:
a quashing;
b two-dimensionalising;
c linearisation.

These modes bring into play the defence mechanisms associated with the autistic
spectrum, including those of Asperger’s syndrome. One example is Chekhov’s
extraordinary story The Exclamation Mark. The story tells of an employee who
has spent years writing or transcribing dossiers, always carrying out his work
conscientiously. One day, at a social event, he is taxed with the inadequacy of
his academic qualifications, given that all he does is edit or copy documents.
On his return home, he cannot sleep because all the thousands, or tens of thou-
sands, of immaculately written documents are running through his mind, and he
remembers all the possible rules for commas, full stops, semicolons, even ques-
tion marks.
But his tossing and turning stops dead when he is confronted by the exclama-
tion mark.
He has no recollection of ever having used it. How does it work? He wakes his
wife, who went all the way through college, and she proudly tells him she knows
the whole grammar book by heart, explaining that the exclamation mark is used
when you want to emphasise something or indicate an emotion: anger, joy, good
fortune; any emotion, in short.
It seems clear enough to him how it should be used in a letter, but how would you
do so in an official document? Once again he runs through the thousands of docu-
ments he’s written with not one exclamation mark in any of them, he’s sure of it.
The story highlights how a routine, factual existence is possible with every-
thing just as it should be, with every i dotted and every t crossed, without ever
feeling any emotion; anger, joy, jealousy, or anything else.
At this point, after his sleepless night, the story’s protagonist decides to see his
head of department, and when he comes to sign the admissions book, after writ-
ing his name, Yefim Perekladin, he adds three exclamation marks. As Chekhov
concludes, “as he wrote those three marks, he felt delight and indignation, he was
 Anorexias and dyschronias 5

joyful and he seethed with rage. ‘Take that, take that!’ he muttered, pressing down
hard on the pen.”
Sometimes, if they become firmly established in the long term, these
defence mechanisms (and sometimes others) take the form of a thorough-
going pathology. In this connection, I would like to address the subject of
anorexia and the difficulty of taking on the ephemeral nature of our existence:
in other words, the difficulty or impossibility of accepting the linearity of
time, thereby putting an incredible multiplicity of defences into play: atempo-
ralities or dyschronias.
I put these two modes together because one predominantly concerns space, the
other time.

1.1 Anorexias
Anorexia is often considered in terms of misperception: patients see themselves
as fat, swollen, overweight, not the way they really are: thin, underweight,
emaciated.
I think we should reverse the viewpoint and accept that the anorexic uses
ultrasound to view her or himself. That is, they see gigantic emotions which
they try to compress, attempting to starve them so as not to feel overwhelmed
by them.
There is no end to the possible metaphors: it is as if they looked like chihuahuas
and instead saw an enormous pit-bull lurking behind them with its fangs at the
ready. In other words, they know they are dealing with a tangle of emotions which
they are afraid will savage them and tear them apart.
The illusion is that by denying the pit-bull food, they can “dachshundify” or
“chihuahuaise” it; that it might be possible to make violent passions containable
and manageable.
An anorexic girl dreamed that, by taking some bricks out of a wall, she arrived
at the start of the French Revolution just as the Bastille was being stormed.
She smelled burning and felt a sense of guilt. A seemingly good girl, on the
other side of the wall she had access to this revolutionary world full of fire where
everything was burning to ashes, which made her feel guilty.
Then she saw a “terrible dragon” in a Rorschach blot.
So here is the pit-bull I was talking about: the problem is how to alphabetise
this mass of undifferentiated proto-emotions and transform them into their com-
ponents so that the “proto-emotional lava” can become tolerable emotions.
The “dragon”, this magmatic proto-emotional nucleus, would have to find other
ways of being managed.
But let’s go back to anorexia, where the strategy in operation was described
by another patient who expressed her hatred for hot places like Naples and
her love of cold places like Germany where every one queues obediently,
maybe because the cold makes them calmer: there is also the idea that a gla-
ciation of Vesuvian emotions could be helpful to those who are hungrier than
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