Review of Riccardo Lombardi’s essay: Half prisoner, half winged. The dissociation between mind and body in psychoanalysis

In a historical moment in which body transformations are quite common, from body art to plastic surgery, there seems to be a high number of borderline pathologies also known as the “false self”. I believe it to be crucial that mental health specialists give therapy special attention on physical level other than on a mental level, which is typical to clinical practices, especially in psychoanalysis. Giving importance to the somatic aspect during the treatment doesn’t take from the psychological analysis that we carry out as psychotherapists. On the contrary, as Riccardo Lombardi argues in this essay, both the patients and the analyst’s body can be resources for major improvements and can open a large set of possibilities in therapy that had not taken into consideration until now. Lombardi encourages analysts and therapists not to exclude the somatic reality of the clinic scenario also because, to use Lombardi’s words, one of the purposes of psychoanalysis is of “activating new forms of communication between mind and body” [2]. Moreover, using theoretical framework rigidly and without context on the body risks to change the input of the therapist into a useless preconception.

This text isn’t only fascinating and filled with examples from clinical practices, but it’s also a little off-putting for the reader, as Antonio Ferro argues in his introduction, because it removes the analyst from their position of hieratic holiness and it diminishes their role by showing how fundamental physical involvement is, as I said earlier, to get in sync with the patient. This sense of discomfort increases when Lombardi focuses on the mechanism of “transference on the body”, which I will talk about further ahead in the article.

The relation between soma and psyche is excruciating, turmoiled, as the author highlights from the text’s epigraph in Paul Klee’s words: this is the human condition, halfway between its most unrestrained part (the psyche, the winged site, fitted with the ability to fly beyond the limits of the body) and captivity ( the boundary in which we are constrained by the soma). A tumultuous comparison between intrinsic opposites that will obviously never reconcile, a perpetually dramatic and painful conflict that allows us, in moments of balance, to experience the pleasure of pacifying to adjacent but different worlds, “the vertical axe of the internal relationship between body and mind” [3]. This juxtaposition between body and mind doesn’t necessarily have to end in a conflict: mind and body can challenge and fight each other, producing fruitful results that nourish the individual and foster their growth. If it’s true that during the growth of the psyche the body regulates mental operations through this eclipse, Armando B. Ferrari sustains, [4] this doesn’t in any way entail a rupture between the mind and the body; soma and psyche need to interact harmonically, mutually embellishing each other.

Paul Klee, Senecio (1922)

Conversely, when the rupture does take place, we can start talking about psychopathology: in these situations, the conflict between mind and body turns to a mechanism we commonly refer to as “dissociation”, a form of «extreme divergence» [5], a kind of “counterfeit” independence , in which the two opposite poles don’t communicate with each other. It’s very likely that in this condition, soma and psyche have never really communicated with each other. This way, the mind distances itself from the body, and this separation entails a series of consequences. The dialogue between the physical and the psychic level becomes a sequence of pure nonsense, misunderstanding or complete lack of communication [6]. In this case, one of the poles tends to take the upper hand on the other, trying to annihilate its opposite. During these moments, it’s up to the analyst, says Lombardi, to mend psyche and soma back together, and must do so along with the patient on a mental as well as on a physical level.

Artist Marina Abramović during one of her performances

Lombardi enriches his arguments through Freud, Matte Blanco, Bion, Winnicott, Ferrari and his own psychoanalytic experience, and by doing so he helps us to understand what happens when a dissociative mechanism takes place, splitting the individual in two separate parts. An example of this phenomenon can be found in the first clinical case that Lombardi shows us, in which the patient (Antonio), projects his own painful life experience on the analyst’s foot, as he couldn’t find a way to experience it neither inside nor on his own body, and therefore transfers his troubles on a “safer” and more reassuring physicality, the therapist.

The origin of the discomfort that comes from the dissociation between body and mind are very ancient; thanks to Freud’s findings and to the research of post-Freudian authors (the most relevant in this clinical area being Bion and Spitz), we know that a gravely disturbed caregiving relationship in the first years of life tends to compromise the frail balance between body and mind, which in that moment is still in the making. This produces distortions and deformations during the growing process, and it can lead to a sharp separation between these two worlds during their adult life. When this situation is compromised so early on in life, the individual functions according to an unevolved psychic model, and it’s for this reason that the body takes on an extremely important role: Because in these cases the individual has not reached a symbolic level, the body functions as a vector for psychological distress.

Going back to the “discomfort” and “annoyance” Lombardi’s essay produces for therapists – I obviously say this with irony – let’s try to approach the original concept of “transference on the patient’s body” that Lombardi talks about [7]. In psychoanalysis, the analyst is traditionally expected to interpret the patient’s transference in terms of projecting their life experiences on the analyst: However, according to Lombardi, often on top of this type of transference, there is another one, namely the “bodily transference”, where the patient transfers their experience on their own body. This type of transference, which the patient carries out on themselves, partially excludes the analyst’s participation. This is therefore a mechanism that allocates more emphasis on the relationship that the patient builds with themselves, a mechanism of self-observation and conscience. This works to the disadvantage of the therapist’s function, which results decentralized, desacralized, and partly marginalized in the therapeutic process.

In the clinical realm, it’s precisely through the “body transference” that therapy is able to work: in these conditions, communication takes place on a somatic level and the analyst or psychotherapist has the task to listen to the patient’s physicality, even through body language (somatic countertransference), thus returning to the patient the elaboration of their somatic experiences in a more acceptable and verbalized form, through the process of ‘rêverie’ [8]. According to Bion [9], thanks to psychological analysis, the patient improves their «physical and anatomical toolkit» [10], because it sharpens the ability to control a new sort of sense organ: consequently, it’s crucial that the psychotherapist is aligned in this direction, so that they can function as a guide in connecting the patient to the somatic roots of the human psyche. In order for the analyst to get in touch with the deeper layers of their patient’s psyche, it’s necessary that they tune with them on a somatic level (preverbal and presymbolic), which in some cases govern the functioning of their minds. In numerous clinical cases, it’s essential that the therapist works on the patient’s physical sensations, guiding them in the acceptance process of such sensations and in the «perceptive recognition of their own body» [11]. Indeed, we must remember that the body is «the concrete object the psyche evolves from and with which it relates itself» [12].

Austrian psychoanalist René Spitz with a young patient

The physical communications that the analyst receives from the patient can take place during a therapy session, but they can also continue after the session is over. As Lombardi notes, after particularly turbulent sessions, one might feel weary or fatigued, like after a long run, and in fact they may feel all the physiological traits of intense physical activity such as accelerated heart rate and short breath. Even before receiving a patient, often, our bodies give us important indications on our emotional state, be it of a patient we already know or a patient who is about to have their first session with us. It’s a good idea for the therapist to pay attention to these physical experiences: We therapists know how emotional metabolization can be more strenuous than understanding the mind. The considerations on the soma that Lombardi makes in this text prove to be original and inventive compared to the theoretical framework of classical psychoanalysis. However, if one looks closely, he never deviates from the main path of psychoanalytic discipline, and in fact he starts from the first works of the leader Sigmund Freud [13]. More specifically, the way Lombardi uses his references pushes towards pioneering studies that the Freud has accomplished starting from his patient’s bodies. He found how sensitive the body was to the psyche’s movements, enabling the patients to convey their impalpable disquiet that was typical of patients affected with hysteria, which at the time interested many scientists. Today, the body still provides many points of reflection because it’s capable to convey the numerous and mysterious aspects of the extraordinary kaleidoscope of the human psyche.

WORKS CITED

[1] Cfr. Winnicott D. W. (1954), L’intelletto ed il suo rapporto con lo psiche-soma, 1958 e Winnicott D. W. (1960) Le distorsioni dell’Io nei termini di vero e falso Sé, 1965.
[2] Lombardi R. (2016) Metà prigioniero, metà alato. La dissociazione corpo-mente in psicoanalisi, Bollati Boringhieri Torino, p. 59.
[3] Ivi, p. 89.
[4] Cfr. su ciò Ferrari A. B. (1992) L’eclissi del corpo. Una ipotesi psicoanalitica, Borla Roma.
[5] Lombardi R. (2016) op. cit., p. 25.
[6] Cfr. su ciò Tustin F. (1981) Stati autistici nei bambini, Armando, Roma e Meltzer D. (1982) Implicazioni psicosomatiche nel pensiero di Bion, «Quaderni di Psicoterapia Infantile», 7, pp. 199-222.
[7] Cfr. su ciò Lombardi R. (2005) On the Psychoanalytic Treatment of a Psychotic Breakdown, «The Psychoanalytic Quarterly», 74, pp. 1069-99 e Lombardi R. (2010) The Body Emerging from ‘Neverland’ of Nothingness, «The Psychoanalitic Quarterly», 79, pp. 879-909.
[8] Cfr. su ciò Bion W. R. (1962) Apprendere dall’esperienza, Armando, Roma 1972.
[9] Cfr. su ciò Bion W. R. (1979) Gemello Immaginario, in Id., Analisi degli schizofrenici e metodo psicoanalitico. Saggi e considerazioni, Armando, Roma 1979.
[10] Lombardi R. (2016) op. cit. p. 44.
[11] Ivi, p. 101.5
[12] Ivi, op. cit. p. 100.
[13] Cfr. su ciò Freud S. (1895) «Studi sull’isteria», in OSF, vol. I, Boringhieri, Torino 1983 e Freud S. (1905) «Tre saggi sulla teoria sessuale», in OSF, vol. IV, Boringhieri, Torino 1983.