“When we reconstruct [in a patient] a possible lacking object or role or function, we see that if the analyst himself has been able and the patient allowing him to be able to enter to a deep level the objective reality of the internal world of the patient, it can happen that some new function or position can be achieved. This is something that could be rare but it happens. This is one more reason for not blaming the length of some analytic treatments, because time is needed for entering that internal deep area where the analytic relation can create something new. Transformation is also one of the words that in our analytic world became more and more common and utilized because we have achieved the certainty that there can be a transformation. Not only an understanding or a clarification, but also a transformation of the quality of the objective world and of the relation with it.”
Stefano Bolognini, MD
Bologna
Episode Description:
We begin by describing the differences in psychoanalytic approaches today as compared to past generations. This shift has occurred alongside changes in patients’ concerns; currently, individuals are disproportionately preoccupied with how they perceive themselves through others’ eyes, rather than grappling with internal conflicts related to guilt. Stefano posits that this increased narcissistic investment stems from alterations in family structures and premature disruptions in “the physiological fusionality” with the early maternal caretaker. We discuss how this sense of distrust in the availability and reliability of caretakers affects the manner in which one introduces a patient into analysis, as well as the broader cultural emphasis on superficial bodily care – what he terms the aperitif experience. We consider the fundamental importance of the depth of object relations in understanding sexual diversities. Stefano concludes by reading the final paragraph from his book, which acknowledges the invaluable lessons learned from his analyst. We reflect on the enduring presence within him of this profoundly personal connection.
Linked Episode:
Episode 140: Are Patients Different Today? with Stefano Bolognini, MD (Bologna)
https://youtu.be/rjzpA8QZrWk?si=Srf_Tuxt0zTpsKNK
Our Guest:
Stefano Bolognini, MD, is a psychiatrist and training and supervising analyst of the Italian Psychoanalytic Society (SPI), where he served as president (2009-2013). He also was an IPA Board member (2002-2012) and was IPA president from 2013-2017. He was a member of the European Editorial Board of the International Journal of Psychoanalysis and a founder of the IPA Inter-Regional Encyclopedic Dictionary of Psychoanalysis. He has published over 280 psychoanalytic papers, and his books on empathy and on the inter-psychic dimension have been translated into several languages.
Recommended Reading:
Bolognini, Stefano – Secret Passages. The Theory and Technique of the Interpsychic Relations. IPA New Library, Routledge, London, 2010
https://www.amazon.com/Vital-Between-Non-Self-Library-Psychoanalysis/dp/1032132973, Routledge, London, 2022
https://pubmed.ncbi.nlm.nih.gov/21387998/ Psychoanal. Quart., vol. LXXX, 1, 33-54, 2012.
Enchantments and disenchantments in the formation and use of psychoanalytic theories about psychic reality. The Italian Psychoanalytic Annual, 13, 11-24, July 2019.
New forms of psychopathology in a changing world: a challenge for psychoanalysis in the twenty-first century. The Italian Psychoanalytic Annual, 2020.
Reflections on the institutional Family of the Analyst and proposing a “fourth Pillar” for Education. Opportunities and problems of transferal dynamics in the training pathway“. In Living and containing Psychoanalysis in Institutions. Psychoanalysts Working Together, edited by Gabriele Junkers, 89-104, Taylor & Francis, 2022.
From What to How : A Conversational with Stefano Bolognini on Emotional Attunement by Luca Nicoli & Stefano Bolognini. The Psychoanalytic Quarterly, 91 : 3, 443-477, 2022.
The Interpsychic, the Interpersonal, and the Intersubjective: Response to Steven H. Goldberg’s Discussion. The Psychoanalytic Quarterly, 91:3, 489-494, 2022.
Hidden unconscious, buried unconscious, implicit unconscious. The Italian Psychoanalytic Annual, 16, 87-102, 2022.
Thank you so much for this, both Harvey for your great work, now this (second) time with Stefano Bolognini, with all my appreciation.
This talk makes much sense to me, in regard to contemporary psychoanalytical practice (not leaving behind previous or other patients’ approaches).
I look forward to reaching SB’s new book, hopefully at the next IPA congress in Lisbon.
Thank you both, again.
Kindly,
Cláudia Antonelli
Brazil
Dear David H, thank you for your attention and question. And forgive my bad English. The incubator experience is hardly mentalized in the usual sense, it is more imprinted in the whole body/mind unit; and then usually conditions deeply a sense of self and of the life which is much beyond the capacity of the individuals to understand their own interior attitude and perspective.
In my clinical experience I observed several cases of problematic attachment, separation anxiety, extreme need for controlling the object, and other serious issues, in patients who only after some time in analysis spoke about their premature birth and a period in incubator; in some cases they “discovered” that after having asked (not by chance…) some parent or relatives for informations. In other cases, they “knew” such historical data, but in fact they didn’t really know experientially and in an integrated way what they really had passed through. I name this: knowing with the experiential Self, not only with the cognitive Ego. In short, in analysis one experiences the incubator-like sense of lack of contact, of vital sources, of loss of vitality, when the object is not there.
Then, each analysis follows its specific path and potentially re-creates something new: a partial experiential reparation, a recognition of the fragility (which at least becomes more understandable and can be better contained), sometimes in some cases also a change of the interior colours, temperature and capacity for link and for contact, and so on.
However, I can also report how some individuals who experienced the incubator period surprisingly don’t seem affected by the same difficulties of others. In every case, we have to be cautious in establishing immediately an equation “incubator=wasting situation”.
Dear Dr Bolognini,
I thank you for this thoughtful response—your English is wonderfully vivid and clear. What you say rings true.
In the case I’m thinking of there have been dreams of the family home (and surrounding neighborhood) absolutely empty. All houses and streets deserted and in a state of frozen time at dusk. The sun paused at the horizon, mid setting. No family members or neighbors and a sense of being very small, helpless and left behind. This Dream is not factually true in fact there was much engagement and play and music in and around the house. The child was sought after by playmates. But this imprint and feeling of disappeared objects and waiting desperately for them to return and provide solace persists.
I should also say I misread your final sentence as “incubator = waiting situation”
Thank you too for describing the healing that can come from analysis. I do believe that is occurring.
All the best,
David
Dear Drs. Schwartz & Bolognini,
A wonderful discussion, thank you so much. I wrote down the four questions from the end.
I have a somewhat odd question. I thought since you’re both medical doctors and analysts you might have some ideas…
Would a placenta abruption, premature birth, and spending time in an incubator be remembered by a baby or imprinted somehow in the psyche? Or is it so early it’s forgotten?
Thank you!