Psychoanalysis On and Off the Couch

Reflections on Our Changing Field with Stefano Bolognini, MD (Bologna)

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Apr 6, 2025
Stefano Bolognini, a prominent psychiatrist and former IPA president, shares insights on the evolving landscape of psychoanalysis. He discusses the shift from internal conflicts to contemporary issues of self-perception driven by societal pressures. Bolognini emphasizes the importance of long-term therapeutic relationships, highlighting how transformation in a patient can emerge from deep engagement with their internal world. The conversation touches on the impact of modern family dynamics and the need for personalized care in navigating the complexities of identity.
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INSIGHT

Early Fusional Breaks Affect Development

  • Reduced extended family and early maternal return to work may shorten a crucial fusional period for infants.
  • Early rupture can prompt defensive narcissistic withdrawal and weaker object investments later.
INSIGHT

Contemporary Mistrust Of Dependence

  • Many patients resist intensive analysis because dependence feels devaluing or terrifying.
  • Rotating caregivers and absent grandparents encourage mistrust and guarded relational investment.
ADVICE

Introduce Analysis Gradually

  • Start some patients gradually and accept reduced frequency to build trust and later increase sessions.
  • Avoid rigid insistence on intensive scheduling that may alienate patients who need stepwise engagement.
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