Giuseppe Civitarese, MD, PhD

Interviewed by Patricia Marra, MFT

This year’s Visiting Professor is Giuseppe Civitarese, a psychiatrist and Training and Supervising Analyst at the Italian Psychoanalytic Society (SPI) in Pavia, Italy, where he works in private practice.  He is also the past-editor of the Rivisti di Psicoanalisi, the official journal of the SPI.

Emphasizing that psychoanalysis requires a new paradigm in the 21st century, Civitarese approaches psychoanalytic thinking in a post-Bionian framework that goes beyond Freudian metapsychology.  He theoretically and clinically places himself in the Analytic Field, seeing the main objective of psychoanalysis as facilitating transformations through dreaming — in this way, transforming the concept of “the unconscious” into the Italian verb inconsciare — “to unconscious.”

He has published several books, which include: The Intimate Room: Theory and Technique of the Analytic Field (2010); The Violence of Emotions: Bion and Post-Bionian Psychoanalysis (2012); The Necessary Dream: New Theories and Techniques of Interpretation in Psychoanalysis (2014); and Truth and the Unconscious in Psychoanalysis (2016).  He also published The Analytic Field and Its Transformations with Antonino Ferro (2015).  In press to be published later in 2017 are: Sublime Subjects: Aesthetic Experience and Intersubjectivity in Psychoanalysis, London and, with Antonino Ferro, Un invito alla psicoanalisi [An Invitation to Psychoanalysis], Rome.

The conversation that follows occurred by email between Giuseppe Civitarese and Patricia Marra, from their respective cities of Pavia and San Francisco, in September 2017.

PM:
Let’s start with your own development in psychoanalysis.  How did you get interested in psychoanalysis and where and with whom did you study and do your training?
 
GC:
I had a math and science teacher at secondary school (when I was 12-13 years old) who was very charismatic and passionate about culture. He told us about many important authors, including Descartes, Marx, and Freud. I bought The Interpretation of Dreams at that time, which I did not read because it was too difficult. However, I was still interested in psychoanalysis.

Before University, I also became very interested in Psychiatry. These were the years in Italy in which a strong movement for the closure of public psychiatric hospitals was born, and I had the opportunity to meet the leader of that movement, Franco Basaglia, who impressed me very much. From the Centre of Italy, where I was born (Ortona in Abruzzo), I came to study Medicine in Pavia. The University of Pavia is very ancient and famous. It was founded in 1361 and had many famous scholars — for example the Nobel Prize winners, physiologist Camillo Golgi and physicist Carlo Rubbia, as well as polymath Gerolamo Cardano, physicist Alessandro Volta, writer Ugo Foscolo, and semiotician and literary critic Cesare Segre, etc.

All my professors at the School of Psychiatry were IPA psychoanalysts (Dario de Martis, Fausto Petrella, Francesco Barale); therefore, I found an incredibly favourable and stimulating environment in which to develop my interest in psychoanalysis. My formal training as an analyst took place at the Training Institute of the Italian Society of Psychoanalysis (SPI) in Milan. My meeting with Antonino Ferro, who before me had also come to Pavia from Sicily to study Psychiatry, was decisive. I did a training supervision with him, and after a few years we began to collaborate intensively. My second training supervision was with Giuseppe Di Chiara, who also had come to Milan from his native Palermo. Both of them are past-Presidents of the Italian Psychoanalytic Society.
 
PM:
Following up with your early attraction to The Interpretation of Dreams, I think of you as part of the group of psychoanalytic thinkers whom I call “the dreamers,” who have radically re-interpreted what dreams might be — thinkers such as Bion, Grotstein, Ogden, and Ferro.  It seems to me the importance of dreams has been superseded by the importance of dreaming, which you describe as a mind unconsciously creating poetry.  Can you say something more about that?
 
GC:
With Bion the theory of dreaming changes radically. The dream is no longer, as for Freud, a psychic production, all in all spurious, whose only function is to intercept the stimuli that could disturb sleep, and whose value derives above all from being an extraordinary window into the unconscious. And dreamlike work is no longer invariably moved by the first engine of childish desire, which through censorship is disguised in the manifest text. Instead, for Bion dreaming is the way in which the psyche thinks the real (“O”), so it also thinks of itself and builds itself.  For this reason, Grotstein places the dream in column 2 of the Grid, which is that of falsification-fabrication-building of the real (and which, of course, can extend to “lies”).

Dreaming is ultimately the same thing as translating experience, i.e., thinking. The alpha-dream continuously builds the “contact barrier,” the dynamic and semi-permeable threshold, made of alpha elements, which differentiates the unconscious from the conscious and allows balanced psychic functioning. Only if you are able to transform raw emotions and sensations into alpha elements can you both be awake and fall asleep and dream.  If excessive pressure is produced on either side of the contact barrier from either or both the internal and external world — the slash of the Ucs/Cs formula — it can prevent the proper functioning of alpha function and the thought/dream function. The contact barrier is replaced by the beta screen, a non-permeable membrane of beta elements that surgically separates the unconscious from the conscious. We will then have different types of psychic suffering, from the all-unconsciousness of psychosis and hallucination to the all-reality of people who are cut off from their inner life and the vital lymph of their emotions —the latter, a more ego-syntonic form but in some respects no less malignant than "psychosis."

In the eyes of Bion, Freud considers, above all, the "negative" aspects of the dream, the processes of concealment and deformation of contents that otherwise would be immediately understandable, and, therefore, the processes of destruction of meaning. Instead, Bion emphasizes the “positive” aspects of the elaboration and synthesis of the meaning of the experience. To become part of consciousness, there is no perception that is not also “dreamed” beforehand. In other words, perception is not “just” perception, but it is already a complex construction of meaning.  In this sense, perception is dreamed, if we consider dreaming as the activity of the unconscious as the psychoanalytic function of personality aimed at providing us with a sense of reality — in the way that Hegel brought a destructive criticism to the naïve idea of immediacy of perception in his Phenomenology.

Bion is interested in the "way in which the necessary dream isbuilt.”  The images of the dream are no longer to be deciphered, but are already the more or less successful product of the symbolic-poietic — or mind-and-meaning-making — operation of the individual. As Ferro says, dreams are the psychic elements that absolutely need to be interpreted less. Of course, if the unconscious becomes a psychoanalytic function of the personality, an apparatus for symbolization, and is no longer seen as the cellar where the repressed ideas are hidden, then cure means to expand this ability to give full meaning to the experience of life.
 
PM:
So, for Bion and you, dreaming is “mind-making” — serving primarily to expand the capacity for more dreaming. In a chapter in your latest book, Truth and the Unconscious in Psychoanalysis,1 you elaborate on this capacity for dreaming as the capacity “to unconscious” — what you term in Italian as the verb, inconsci-are.  Here, the unconscious becomes not a disappeared or hidden place, or any kind of place at all, but instead an action of creating and expanding the mind’s capacity for symbolic signification — for giving meaning, and for dreaming our emotional experience.
 
GC:
Let us remember that Freud's theory of repression is based on a strong etiopathogenetic hypothesis in which a specific repressed representation, or a group of representations, is the cause of a specific symptom that symbolically enacts the forbidden desire. The radicalization of the oneiric paradigm in Bion's theory, and then later in those theories inspired by Bion — specifically, Meltzer, Ogden, Ferro, derives from the rejection of a clear dividing line between primary process and secondary process, which now are seen to have a continuity between them.

Put aside that dreaming activity is a mystery still awaiting elucidation, the main difference between dream-thinking (even while being awake, as in reverie) and focused thinking seems to reside in the function of attention,2 which enlarges or restricts the field of consciousness while awake, thus producing the oscillation of primary<—>secondary process in mental functioning.

As a matter of fact it is almost impossible to look at Bion’s thinking on dreaming as a development of mainstream psychoanalytic theory if we do not do our homework with Klein. On the contrary, in the light of Klein’s ideas, Bion becomes quite easy to understand. His new theories of dreaming, of the unconscious, and of affects directly stem out of Klein’s equation of:

“dreaming = play = activity-of-symbolization”

— arising from her view of the mind as the never-closing theatre where the meaning is constantly shaped by the interplay of unconscious phantasies, from her emphasis about the key role of the emergent anxieties in the here and now of the session, and from her original and very fertile concept of projective identification — indeed a concept that kick-started the concepts of container/ contained, “normal” projective identification, and, above all, represented the seed of a proto-intersubjective model of psychoanalysis.

I think that it is decisive to understand, and theorize, that we “dream” also in our body, i.e., we construct the meaning of our experience also in ways that are not representational. As Merleau-Ponty teaches us, the body knows the world: “The movements of one’s own body are naturally invested with a certain perceptual signification, they form a system with external phenomena so tightly woven that external perception 'takes account' of the movement of the perceptual organs, and it finds in them, if not the explicit explanation, then at least the motive for the intervening changes in the spectacle and can thereby understand these changes” (1945, p. 49).3
PM:
Staying with the body — in your latest book, Truth and the Unconscious in Psychoanalysis, you talk about “giving body to the mind.”4 How do your ideas compare with Freud’s when he talks of the individual as grounded in his/her instinctual body, driving toward gratification? Or with Lombardi, who says that the body cannot contain, only the mind can contain, but “if there is no emotion, there is no thought, either.”5
 
GC:
There is a critique of the idea that the psyche can be explained directly with neuroscience, and, therefore, the confusion between the anatomical body and the body lived. Then, there is a critique of the concept of the drive, which, in my opinion, originated with Freud precisely by his push in the beginning to explain the psyche neurologically, a wish that he abandoned but perhaps it went underground. Whoever does not accept these critiques says that then you want to deny the body. This, to me, is wrong. Psychoanalysis does not deal with the anatomical body but, rather, the body lived, that is, the body imbued with meaning. In fact, Bion uses the concept of emotion precisely to deal with the meaning produced in and out of the body, and not only as Freud does, principally, through representations. Meltzer says, in fact, that Freud does not have a true theory of affects.
 
 
PM:
Well, why don’t we stop here, right in the thick of it, and continue this conversation when you come to San Francisco this November as Visiting Professor. We are all looking forward to a “week lived” during your time here. Giuseppe, grazie mille for answering my questions so fully and so thoughtfully. Non vediamo l’ora di vederti! A presto!
 

  1. Civitarese, G. (2016). “The un/conscious as a psychoanalytic function of the personality.” In Truth and the Unconscious in Psychoanalysis (pp. 84—110). London: Routledge.
  2. Vygotskij, L.S. and  Lurija, A.R. (1984) say that the main function of language may not be communicative, but rather a medium to control attention. In fact, they distinguish natural attention driven by stimuli from attention driven by language, which they call “artificial” attention. (Strumento e segno nello sviluppo del bambino. Laterza, Bari, 1997.)

  3. Merleau-Ponty, M. (1945). Phenomenology of Perception (D. Landes, Trans.). New York: Routledge, 2012.

  4. Civitarese, G. (2016). Giving body to the mind:  A comparison between Freud’s and Bion’s metapsychologies.  In Truth and the Unconscious in Psychoanalysis (pp. 121—148).  The New Library of Psychoanalysis.  London:  Routledge.

  5. Lombardi, R. (2017). Body-Mind Dissociation in Psychoanalysis—Development after Bion (K. Christenfeld & G. Atkinson, Trans.). London: Routledge, The Relational Perspectives Book Series, (p. 8).