“It was the intuition about that Then of the patient’s dream that led me to think that ‘beforehand’ there must have been a structuring identification, which was then lost. Then, when? – writes the author of Death Instinct and Knowledge at the end of the first chapter where he details the treatment of a clinical case diagnosed with schizophrenic disorder, known as ‘A case history’ (Fagioli, 1972).
The therapeutic intervention carried out is based on the development of a new theoretical formulation, based on the disappearance fantasy. It will be better understood by the reader throughout the following chapters, where a revolutionary idea of death instinct is outlined. It is radically separated from the one described by psychoanalysis. Moreover, the author proposes a new vision of both the Unconscious and the newborn, which are characterized by vitality.
A “newborn, by his birth, is researcher and scientist – Fagioli writes in his Introduction to Spitz’ No and Yes (Fagioli, 1975). He is in complete opposition to the child as traditionally conceived ‘perverse polymorph’ and ‘autoerotic’ (Freud, 1905).
The evolutionary and fulfillment possibilities of the child from birth opens the way to know the movement which has been present since the beginning of human life. Moreover, the movement is not only considered as a biological and physical movement, but also as the formation of the mind and its progressive development throughout time, which is a specific human feature. Furthermore, in opposition to the previous psychodynamic convictions, the child, as well as the Unconscious, is recognized as having the capability for knowledge and refusal during his/her relationship with reality. In Fagioli’s theoretical formulation, there is not the traditional conception that originally condemns the human being to closure and impotence, which would make humans to be mentally violent and ill.
Listening to the words of the patient, in ‘A case history’, the small preposition made up of only three letters Then resounds in Fagioli’s mind. ‘Then, when? – he asks himself. This preposition provokes an image, a new idea: the unconscious has moved over the time. Thus, the author opens up to the understanding of the pathophysiological process, at the psychodynamic level, of the unconscious itself. The small temporal preposition Then in the patient’s language goes beyond the narration of the dream and his personal history, revealing a universal mental dynamic.
The psychotherapist intuits, sees and understands a non-conscious human thinking, being in turn ‘by his birth, researcher and scientist’ himself. Going into the details of the interpretation, in the context of the psychotherapeutic relationship, the existence of a ‘structuring identification, which was then lost’ leads him to know of patient’s previous psychic existence, which has been made to disappear. These considerations open up to a discovery that is based on a vision of the human being and his unconscious as in motion over time. Human origin is not an unchangeable structure, which is closed and chaotic. On the contrary, it is characterized by an initial ego of birth, with qualities that will develop during life. This healthy condition can then be lost, and these qualities can disappear, if something happens during the early life relationships.
The psychoanalytic unconscious is timeless. For instance, its basic characteristic is space. The psychopathological dynamic is characterized by repression, still considered plausible today, that is an unconscious subjected to displacement. For instance, memories and conscious experiences go to another place, the unconscious. Fagioli’s vision is instead temporally dynamic, in contrast to the Freudian definition, which appears granitic and unchangeable.
Furthermore, we find a fundamental interpretation in psychodynamic psychotherapy, about the meaning of then, in the patient’s dream. It concerns the identification with the father (the ‘structuring identification’) and the search for a valid unconscious image of the relationship with him, the “base platform”, on which a therapeutic path is built by the therapist. Remarkably, this can be possible in psychodynamic psychotherapy, even in the most serious clinical cases, as in ‘A case history’. It is a first movement, over time, a new beginning from which a work is born with deep and complex interpretations to return to the original healthy condition, to the ‘inner child’, who was present ‘beforehand’.
This allows us to conceptualize and realize internal transformation in psychotherapy as a real human possibility and as the cornerstone of therapeutic work. The red thread of a medical methodology that discovers the cure through the knowledge of physiology and how it is lost, has led Fagioli to give effectiveness to psychodynamic psychotherapy. The idea of an unconscious that becomes ill gives patients the possibility of becoming healthy, giving them hope.
This work aims to carry out research, in connection with clinical cases of daily psychotherapeutic practice, starting from the then hidden in the patient’s words and dreams.
Then seems to have stimulated a reaction in the author’s mind in which a new verbal thought has appeared: the patient becomes ill over time and can recover the ego of birth over time in psychotherapy. It is from then that the knowledge and verbalization of the disappearance fantasy seems to have derived. This is an interpretation which appears necessary in psychotherapy, so that a transformation of the patient’s inner reality and an actual cure of mental illness can take place.
Bibliography
- Fagioli, M. (2019). Death Instinct and knowledge. Rome: L’Asino d’Oro.
- Fagioli, M. (2012). Teoria della nascita e castrazione umana. Roma: L’Asino d’Oro.
- Fagioli, M. (2002) Ideologia, scienza e storia. Introduzione a Il No e Il Sì di Spitz, gennaio 1975. Il sogno della Farfalla. 3, 5-18.
- Fagioli, M. (2015). L’idea della nascita umana: Lezioni 2010. Roma: L’Asino d’Oro.
- Freud, S. (1996). Three Essays on the Theory of Sexuality. New York: Basic Books.
- Spitz, R. (1957). No and Yes On the genesis of human communication. New York: International University Press.
