Why psychoanalysis is still interesting?
[Position statement discussed by Morris Eagle, Stephen Ellman, Robert Holt and John Muller on June 9, 2001, at the Annual Meeting of the Rapaport-Klein Study Group]
For nearly a century, psychoanalysis was celebrated as a psychological procedure for relieving patients of their crippling neurotic symptoms, and for emancipating them from their self-destructive illusions. It was extolled as a means for deciphering the hidden meanings of the forbidden wishes that subvert our daily actions, rational thoughts and ideological commitments. During its formative years, it was also applied a humanistic instrument for the radical critique and reform of society, and for exploring the psychological motivations for artistic creations and cultural practices (Freud, 1913). Over the same century, psychoanalysis was ridiculed as a lewd prescription for sexual license, and as a lucrative but unproven therapeutic nostrum whose successes could be attributed to persuasion and brainwashing. Scientists mocked its theoretical foundations as fantastic constructions based on irrelevant biological metaphors, circular reasoning, and a Spenglerian word view.
Nevertheless, American psychiatrists, mental health professionals, patients, teachers and social workers embraced psychoanalysis as the preferred technique for treating a wide range of mental illnesses, emotional disturbances and other forms of deviant behavior, once psychoanalysis had established itself in the New World. Child psychiatrists and behavioral pediatricians applied their own revised version of psychoanalysis as a mental health framework for early intervention in child guidance clinics and for the primary prevention of mental Illinois (e.g. Brazelton, 1985; Emde, 1980; Stern-Bruschweiler & Stern, 1989). However, the potentially subversive radicalism of Freud's original proposals was forgotten or dismissed, and psychoanalysis was transformed into a technically pristine method of psychotherapy that was designed to help patients to conform and adjust to existing social realities.
Eventually, the main stream of American psychiatry became disillusioned with the therapeutic possibilities of psychoanalysis, because it was too expensive and time consuming; and because it failed to address the perceived needs of patients who demanded quick fixes for their emotional discontent. Therefore, patients and mental health workers turned to Cheaper, shorter and less demanding, but equally untested, forms of psychotherapy.
At about the same time, the dramatic success of new psychoactive drugs in clearing out the back-wards of mental hospitals inaugurated a new age of scientific psychiatry (or a revival of "organic psychiatry"). Pharmaceutical companies marketed a vast armamentarium of pills, capsules and injections that were designed to treat the major psychoses, emotional disturbances codified in DSM- III, IV, and V and newly "discovered" or invented disorders such as "masochistic personality disorder" that had once been considered normal human variations or everyday miseries. Academic psychiatrists abandoned psychoanalysis in favor of psychopharmacology, neurophysiology, molecular genetics, and functional brain imaging, as the more promising means for discovering the secrets of the disordered mind. The practice of psychoanalysis was confined to psychoanalytic training institutes where its secrets were immunized against public scrutiny. Both friends and foes of psychoanalysis came to the conclusion that psychoanalysis was suffering from a terminal illness of irrelevance.
Yet, the diagnosis may have been premature. Alarmed by their marginal status, psychoanalytic investigators held out the possibility that their discipline would survive and might even flourish if its theoretical propositions were translated into operationally defined hypotheses and tested by accepted methods of the empirical (preferably the experimental) sciences. On the other hand, they disagreed how such a transformation could be realized (Grünbaum, 1984; Holt, 1985; Holzman, 1985; Rubinstein, 1976). The survival of psychoanalysis was also supported from a very different direction. Novelists, literary critics, feminists, philosophers, theologians, and some psychoanalysts continued to wrestle with the enduring enigma that had been made explicit by psychoanalysis - how we can know things about ourselves and about others, without knowing that we know them (see, for example, Barratt, 1985; Kitcher, 1995; Kovel, 1981; Kung, 1979; Ricoeur, 1965).
It remains uncertain whether the abiding interest in psychoanalysis can be attributed to its claims of therapeutic efficacy, its status as a growing natural science, or to something very different that touches a *deep chord in all of us, but that has nothing to with its scientific authenticity or psychotherapeutic efficacy, Yet, it will be impossible to come to any conclusions unless we can reach some agreement as to what exactly we mean when we speak about psychoanalysis. Splits, schisms, and dissident movements that have characterized the history of psychoanalysis from its very beginnings. Further developments in the psychoanalytic movement over the past 50 years have only added to the confusion. Nowadays, "orthodox Freudians", Neo-Freudians, Lacanians, Anti-Freudians, Jungians, Adlerians, and scream therapists all claim that they, and only they, have captured the essence of what psychoanalysis really is. Yet, they all subscribe to different theoretical formulations, and they all probably conduct their clinical work in entirely different ways, although it is usually impossible to determine what goes on behind closed doors. A skeptic might therefore conclude that psychoanalysis is whatever you want it to be (Forrester, 1997).
For better or for worse, I have therefore listed some of the fundamental ideas that, I believe, must be part of any meaningful discussion about psychoanalysis:
1) Historically, by definition, and conceptually, psychoanalysis is first and foremost, an "internalist" theory of psychological meanings. Its epistemological position on the non- reducibility of mental phenomena to physiological or neurological explanations overlaps extensively with that of other psychologies of meaning (Chomsky, 2000). At the same time, it differs from these in important ways. Usually, psychoanalysis does not concern itself with meanings in their conventional sense, but with unconscious ideas whose meanings can only be inferred from otherwise inexplicable thoughts, feelings and actions accessible to observation.
2) Psychoanalysis is at the same time a unique method of discourse that proposes to decipher the meanings of forbidden wishes (unconscious ideas) by interpreting their disguised symbolic expressions.
3) The method applies counter-intuitive canons of interpretation that take their cues from theoretical constructs such as primary process thinking, repression, a dynamic unconscious, and the transference.
4) These constructs serve as a convenient descriptive short hand for organizing a vast collection of mental phenomena, but they have no explanatory status.
5) Therefore, psychoanalysis also introduces a set of abstract metapsychological propositions that are designed to explain the mental phenomena in the "externalist" terms of biological and neurological mechanisms that it borrows from the "hard sciences".
6) The ambiguous relations between the clinical theory and its metapsychological underpinnings remain a topic of enduring and sometimes heated controversy.
My "minimalist" account of psychoanalysis will almost certainly be dismissed by the majority of contemporary psychoanalysts as being reactionary, nostalgic, and out of date. Some will fault me for not acknowledging the enormous scientific advances in psychoanalytic theory and practice that have laid the foundations for a general theory of human psychology by integrating a vast spectrum of diverse findings from the biological, neurological, developmental and social sciences under the developmental and adaptive points of view of metapsychology (psychoanalytic ego psychology). Others may object that it is logically impossible to separate the clinical theory from the metapsychological propositions, because neither has any theoretical standing without the other.
Because my efforts to address these criticisms will be iconoclastic and will satisfy only a tiny minority, it would have been more prudent for me to introduce these remarks by the title "Why I think psychoanalysis is still interesting".
Psychoanalysis as treatment
During the early years of the psychoanalytic movement, Freud and his collaborators took it for granted that their talking cure was an effective method for treating neurotic and psychoneurotic disorders outside the asylum. On the other hand, the extensive writings from that period indicate that the early generations of psychoanalysts were far more interested in the applications of the psychoanalytic project for the radical critique and reform of society, for uncovering the hidden motivations that shape our social conventions, and for exploring the psychological motives that shape artistic and literary creations (Freud, 1913).
Yet these "other" applications were quickly forgotten ("repressed") as soon as psychoanalysis had found a foothold in North America, and became a sophisticated method of psychotherapy. Why only this particular application survived, and why it became the dominant mode of psychotherapy in a country that prided itself on pragmatic optimism, remains a puzzle. For one thing, there was no empirical evidence that the talking cure has any therapeutic benefits (Crews, 1993; Grünbaum, 1984). Even today, there still is no agreement what would constitute the meaningful outcome measures for testing whether it has any beneficial effects. For another thing, Freud already had begun to question the psychotherapeutic efficacy of his talking cure, long before it became established in North America. Disappointing clinical results may have contributed to his skeptical appraisal (Freud, 1937). However, his doubts had much deeper roots in his conjecture that the inherent contradictions between personal desire (pleasure, unconscious wishes) and civilization would inevitably militate against any permanent psychological cure (Freud, 1920, 1930). He still held on to the hope that the talking cure could help some patients to confront their forbidden wishes, so, as to take greater responsibility for their conflicts as well as for their life decisions. Such limited goals were, however, not what most neurotic patients expected from a protracted and expensive talking cure. Why, then, did psychoanalysis find such a ready acceptance in America before the age of psychopharmacology?
Jacoby's trenchant analysis of the sociological, political, and cultural forces that led to the "medicalization" and radical revision of psychoanalytic theory may shed some light on the question. (Although this medicalization is commonly equated with its "Americanization" because this is where most European psychoanalysts found a refuge after the Nazi debacle, the same trends are equally evident in many other Western countries, with the possible of France). To explore how the major revisions of theory might have influenced the clinical practice, it may be useful to return to some of the basic assumptions of the clinical theory. Even today there is still wide spread consensus that the pleasure principle is a construct that is central to the entire clinical enterprise (Freud, 1911; 191 5a, b). Freud applied the principle as a device for organizing the full spectrum of clinical observations, including the parapraxes, neurotic symptoms, dreams, sexual perversions, and cultural practices. He also used it as a critical bridging term for linking the mental phenomena of primary interest with the theoretical constructs of unconscious (primary) mental processes, repression, displacement and the like. Although the principle was derived primarily from clinical observations, Freud also speculated on its foundations in physical and neurological mechanisms in order to realize his dream of an inter-disciplinary explanatory theory of mental processes (Freud, 1895): "The nervous system is an apparatus having the function of reducing excitation to the lowest possible level: an apparatus which would even, if it were feasible, maintain itself in an altogether unstimulated condition" (Freud 1915 a).
As many commentators have repeatedly pointed out, this model went badly awry because it relied on the thermodynamics for closed systems and outdated reflex models of the central nervous system. The behavioral version of the model in turn portrayed the young infant as an inherently solipsistic, antisocial creature, but there was no empirical evidence to support such model
Over the past 30-40, many investigators starting from very different theoretical assumptions have systematically observed young infants in their natural habitats, and empirically tested hypotheses that follow from these observations. Their findings converge on the conclusion that newborn humans are equipped at birth with an extensive repertoire of spontaneous behavior patterns that allow them to interact appropriately with the physical and social environment. Moreover, their behavior leaves the observer with the impression that they are naturally disposed to search out opportunities for interacting with the social and physical environment, although it is always difficult to decipher what infants "want" (Kessen, Haith & Salapatek, 1970; Piaget, 1952; Wolff, 1966, 1993). In short, empirical observations and experiments have effectively "falsified" Freud's fanciful model of the young infants. In parallel, advances in the physical sciences had earlier demolished Freud's physical-biological model by demonstrating that living things exchange energy freely with the environment, and can therefore not be modeled in terms of the thermodynamics of closed system. Likewise, advances in the neurological sciences had persuasively demonstrated-that the central nervous system is a "self-organizing" system whose operations cannot be modeled like a reflex machine that periodically stores and discharges energy. Had he limited himself to a purely psychological theory of meanings, Freud could therefore have saved himself a lot of grief, although that would have left his project without an explanatory framework (Kitcher, 1995).
Evidently, the developmental and adaptive points of view in psychoanalytic metapsychology needed a qualitatively different depiction of the young infant, and the empirical findings on infants reported by developmental psychologies provided precisely the kind of data needed for such depiction. For purposes of discussion, its main features can be summarized as follows:
Biology has programmed the human newborn to be a pro-social organism that actively seeks contact with the social and physical world. Its behavioral competencies at birth (also known as the primary autonomous apparatuses of the ego) guarantee that the infant is able to interact with the physical and social environment. The new developmental model further assumes that the infant is born with an inherent need or motivation to engage the physical and social world, and that normal personality development and the development of a coherent sense of self require a supportive social environment that will exercise the species-typical social competencies. Pari passu, maternal neglect or abuse, social isolation and the like are causally related to the later emergence of depression, mental illness, and anti-social behavior. Thus, it posits causal relationships between the quality of emotional experiences during infancy and emotional wellbeing during adult life that, although complex, are nevertheless accessible to investigation.
Empirical evidence to support such a causal theory of adult psychopathology is scant and has been repeatedly challenged (Clarke & Clarke, 1976; Wolff, 1996). On the other hand, no one would deny that infants and young children require humane and emotionally stable and supportive environments in order to become psychosocially healthy adults. Therefore, psychoanalytic ego-psychology probably gives us a far more accurate and realistic picture of. the young infant's behavior than Freud's far-fetched model. However, it is by no means self-evident that falsification of Freud's model of the immature nervous system either challenges or has any bearing on the clinical discoveries subsumed by the pleasure principle.
Let us assume, for the sake of this discussion, that the ego-psychological rendition of the "competent infant" provides the proper foundations for a revised theory of developmental psychopathology. Do we now conclude that neurotic suffering and irrational behavior in the present are ca used by maternal deprivation, growing up in a less-than-average-expectable social environment, or even by the parents' sexual indiscretions? lf so, what remedy can the talking cure offer adult patients that will emancipate them from their unconscious conflicts? What, in fact do we now mean by unconscious conflicts? Do we now turn the goals of clinical psychoanalysis upside down, and offer patients a corrective emotional experience in order to make up for their real or imagined childhood deprivations?
That is not to deny the possibility that the kind of empathetic treatment that follows from the revised developmental model, may yield much greater therapeutic benefits than a talking cure that requires patients to undergo painful and lengthy confrontations with their forbidden wishes and self-destructive behavior. However, a psychoanalytic psychotherapy based on such domesticated ego-psychological extensions of psychoanalysis does not differ in kind from all other forms of psychotherapy that set out to assist patients to make a harmonious adjustment to existing social-cultural conditions. It offers us no clues why psychoanalysis in particular is still interesting today.
Psychoanalysis as natural science
Over the past 30 years, psychiatrists, neurophysiologists, philosophers of science, and historians of science have demonstrated at great length that psychoanalysis is at best bad science, and at worst, a fraud (Hobson, 1988; Crews, 1993; Masson, 1984; Sulloway, 1991). However, their uncompromising criticisms will probably not enlighten us about those features of psychoanalysis as a scientific enterprise that might still be interesting. Instead, I have therefore limited my remarks to some of the more evenhanded critiques on the natural science status of psychoanalysis.
Freud's numerous, and sometimes contradictory, statements regarding the natural science status of psychoanalysis suggest that he never resolved the issue to his satisfaction. His Project for a Scientific Psychology (Freud, 1895) states in unmistakable terms his hope that psychoanalysis would one day become a comprehensive, scientific, and interdisciplinary theory of mental life (Kitcher, 1995). Later writings suggest, however, that he retreated from such a strong position, perhaps because he realized that the attempt to explain an internalist psychology of idiosyncratic meanings in terms of biological forces and brain mechanisms would ultimately lead him into a position of crass reductionism. Nevertheless, he returned again and again to the question how one might formulate an explanatory theory that would complement his clinical theory.
The same question is reflected in many current discussions on the issue. For the most part, these discussions concur that any coherent discussion must begin by distinguishing conceptually between a clinical theory of meanings and a metapsychology of biological and neurological mechanisms. Rapaport's (1960) incisive and elegant essay on the structure of psychoanalytic theory clearly demonstrates that the metapsychology embodies the essential elements of a coherent explanatory framework. However, that does not resolve the essential question whether any externalist explanations in physical or physiological term, no matter how elegantly stated, could ever shed any light on the problem of meanings that are the lifeblood of the clinical theory of psychoanalysis.
Among those who have addressed the question systematically, some have argued that the clinical theory stands apart from all biological-neurological explanations (Kiein, 1976). Others have pointed out that it is not possible to decide the question until one has sorted out which of the psychoanalytic propositions belong to the clinical theory, which ones to the metapsychology. Yet they, too, assume that the clinical theory will remain relatively unchanged, no matter how drastically the metapsychology might be modified (Gill, 1976; Holt, 1985).
A third position holds that, although the clinical theory can stand alone, it will always be incomplete unless it makes some provisions for transforming circular speculations into hypothesis, and for testing those hypotheses probatively In other words, it calls for an "expanded" clinical theory equipped with operational defined hypotheses that can be tested in terms of physiological processes (Rubinstein, 1976). As currently formulated, this position acknowledges that there is at present no such expanded clinical theory. Moreover, it concedes that it is impossible at present even to suggest what kinds of bridging terms might test the physiological basis of mental phenomena without committing the reductionist errors of the current metapsychological propositions. What form such bridging terms might eventually, take, is of course an issue whose interest extends far beyond the concerns of psychoanalysis.
A cursory look at recent advances in the reformulations of psychoanalytic theory suggest that, despite cautions to the contrary, forward-looking psychoanalysts with a commitment to research seem to be rushing head-on into precisely such a reductionist trap. In their haste to transform psychoanalysis into a natural science, they are assimilating the latest discoveries in developmental psychology, the brain sciences, genetics, neo-Darwinism, .pharmacology, parallel processing and general systems theory to fashion an all encompassing interdisciplinary theory (exemplified, for example, in the new subspecialty of "neuro-psychoanalysis" sic). Yet, it is physically impossible to assimilate the vast corpus of discrete findings in these diverse fields. Since there are no independent objective criteria for deciding which data are relevant, which one are irrelevant, they are therefore obliged to fall back on a strategy of "enumerative induction", picking and choosing fragments from many of the "hard sciences" that best illuminate a particular (already stated) psychoanalytic proposition (Holzman, 1985; Wolff, 1996).
Despite their scientific veneer, these gerrymandered bio-psycho-social theories will almost certainly not provide us with the kinds of bridging terms for establishing even the most tenuous link between the clinical and explanatory frames of reference in psychoanalysis. Certainly, they will shed no light on problems of meaning that are at the core of the clinical theory. In short, they offer us no compelling reason to assume that current efforts to transform psychoanalysis into a natural science are of any abiding interest.
The controlled setting of the clinical discourse might nevertheless afford investigators who start from a different frame of reference the opportunity to order and systematize the "rich" but bewildering array of mental phenomena that emerge during the discourse. For example, investigators who are not burdened by the theoretical preconceptions of psychoanalysis might find it interesting to document objectively what actually transpires during the psychoanalytic dialogue. The transactional characteristics of the talking cure are undoubtedly of general interest but they are all too often obscured during the preparation of formal reports and clinical publications. At the same time, it is important to keep in mind that the results of these and similar "socio-linguisitic" studies would have no bearing on the search for internalist meanings that are the proper business of the clinical theory. Finally, the form in which current discussions on the relation between clinical and metapsychological theory raise the enduring philosophical question whether externalist explanations of any sort can ever enrich our understanding of internalist meaning in a particular form will remain a topic of abiding interest.
The politics of psychoanalysis
Many of the early psychoanalysts came to psychoanalysis from a background of social activism, and were therefore naturally motivated to discuss the political implications of their project. For example, they debated the usefulness of psychoanalysis as an instrument for the radical critique of society, for exposing the hypocrisy of social institutions, and for promoting social reform. Even Freud addressed the problem of social reform when he exposed the hypocrisy of the prevailing sexual morality and “ts devastating effect that on the erotic well-being of women.
Their proposals to turn psychoanalysis into an instrument for social reform, implied a critique of Freud's position on the' importance of economic, political and cultural factors as determinants of mental illness. Freud however, took a dim view of radical politics, and rejected the idea of a "Marxist psychoanalysis" on the grounds that explicit political ideologies simply replaced neurotic illusions with social delusions (see, for example, Jacoby, 1983 for a detailed and scholarly account). The Freudian Left did, in fact, place greater emphasis on economic, political and cultural factors than Freud may have appreciated, although he had almost always encouraged dissent (Jacoby, 1983). Yet, it remained steadfastly critical of the Neo-Freudian domestication ("Americanization"?) of psychoanalysis, on the grounds that the latter would transform the talking cure into an affable method of treatment that encourages conformity and adjustment rather than critique and dissent (Bernfeld, 1929; Kovel, 1981; Reich, 1929).
A brief survey of contemporary papers, keynote addresses and panels presented at official psychoanalytic congresses, suggests that the politically subversive implications of psychoanalysis are now judged to be out of date and irrelevant, socially inappropriate, or divisive and therefore best forgotten. Yet, I believe that, given the far reaching theoretical and clinical consequences of today's sanitized psychoanalysis, many of the questions once raised by the Freudian Left are even more pertinent today. For example, it may an interesting, and perhaps even a bracing undertaking, to systematically explore the following kinds of questions:
1) Is the practice of psychoanalysis as politically neutral and ethically pristine as most contemporary practitioners insist?
2) Does the claim of neutrality cover up the reactionary intent of clinical practice to explain away the social basis of human miseries by reducing them to "intrapsychic conflicts" and discouraging dissent?
3) Is the practice of psychoanalysis instead a politically subversive procedure for emancipating patients from the crippling bonds of social hypocrisy, and an instrument political liberation?
4) Or is the psychoanalytic dialogue none of the above, but a far more radical procedure that challenges not only personal, but also political, ideological, theoretical and scientific preconceptions that we are inclined to accept as self- evident truths?
Psychoanalysis as method
In the preceding paragraphs I have summarized what I believe psychoanalysis is and is not; and which of its many dimensions are no longer interesting:
1) Psychoanalysis is first and foremost a psychology of meanings whose legitimacy does not depend on objective evidence from any empirical science.
2) Psychoanalysis is therefore not a natural science like any other science.
3) Nor is it a psychotherapeutic procedure for the removal of neurotic symptoms, restoring the fractured self, or facilitating a harmonious adjustment to the status quo.
4) It is not a political enterprise in any conventional sense. On the contrary, when either partner in the clinical discourse endorses any specific ideology or program of social action, it ultimately perverts its own goals, no matter how egalitarian and implicit these programs might be.
What then remain in this iconoclastic version of psychoanalysis that might still be interesting? In earlier passages I suggested that contemporary psychoanalysis has lost sight of its unique position among all-psychological formulations and theories as the only coherent and systematic procedure for unraveling the hidden meanings of our desires and passions. By the same token, contemporary psychoanalysis may have lost sight of its principle clinical goal of confronting us with our unacceptable wishes, so that we may be emancipated from our neurotic shackles and illusions. These, it seems to me, are two of the fundamental signatures that confer an abiding interest on psychoanalysis.
Even the most recondite among us sometimes make false statements about others and ourselves. When we make false statements deliberately (consciously), we call it lying. When we make false statements unknowingly (as we probably do more often than we realize), common sense allows us to dismiss them as flukes or momentary lapses of attention. By contrast, psychoanalysis, and only psychoanalysis, takes such errors of speech, thought and action seriously, treats them as symbolic expressions of hidden motives and wishes, and sets itself the task of discovering their hidden meaning. The strategies by which the method hopes to achieve this goal and the personal discoveries that follow from the discourse, are additional signatures that confer enduring interest on psychoanalysis.
Most generally, I suggest that psychoanalysis is grounded in an "epistemology of suspicion". lt accepts no thing at face value. Instead, it assumes that behind every apparently rational statement, behind every reasonable action, behind every innocuous mistake (parapraxes), behind every irrational action, and behind most cultural conventions, there lurks a hidden wish or unacceptable motivation. In order to emancipate us from our illusions, the method therefore exposes the hidden meanings not only of our personal secrets, but also the hidden meanings of our theoretical preconceptions, whether they held by the psychoanalysts, the patient or extant social institutions. Therefore, it must also suspect the ideological commitments of institutionalized psychoanalysis and the asymmetric social relations that all too often characterize the clinical situation. Construed in this way, the talking cure is a tough road to travel. It will surely discourage all but a few courageous souls willing to risk the journey of "self-discovery", but such difficulties do not detract from its inherent interest.
In conclusion we can say that psychoanalysis confronts us with five basic antinomies that succinctly capture why it is still interesting:
1) Psychoanalysis is not a technique of psychotherapy in any conventional sense. Yet, it leads those who are willing to make the journey on a path towards greater responsibility for their own miseries and self-destructive behavior and on a path towards emancipation from their personal and social-cultural illusions.
2) Psychoanalysis encourages us to search for personal truthfulness, but it rejects the notion of Truth or scientific certainty.
3) Psychoanalysis focuses specifically on the irrational dimensions of our mental life, but it applies rational procedures to achieve its goals.
4) The talking cure implies a radical and subversive stance towards personal and social reality. Yet, it suspects all formal political programs and ideologies as potential sources of self-deception.
5) The psychoanalytic method emerges from within a theoretical superstructure that gives it substance. Yet, the method suspects, and if necessary, rejects the theoretical structure and its hidden assumptions.
What remains of psychoanalysis is therefore a unique method of discovery that distances itself from any theoretical superstructure; and that unearths uniquely personal meanings without exploiting and distorting these as raw material for new conceptual schemes or theories (Barratt, 1985).
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[Note: This essay is a revised and expanded version of a paper previously published under the title "Perché la psicoanalisi è ancora interessante?" in the Italian journal Psicoterapia e Scienze Umane, 1998, XXXII, 1: 7-20]
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