On Psychoanalytical Formation and its Regulation in Italy

“We were Cheetahs, Lions: those who will replace us will be little jackals, hyenas; and all of us, cheetahs, jackals and sheep alike will all keep on believing that they are the salt of the earth.”

G. Tomasi di Lampedusa, The Leopard

I have entitled my paper “On Psychoanalytical Formation and its Regulation in Italy” because I want to give testimony to the law that, in Italy, regulates training in psychotherapy — a law that at the same time also purports to regulate the formation of analysts. Law 56 of 1989 actually not only sets up an order for psychologists but, equally,  it also lays claim to judicially governing the world of psychotherapies at the level of psychotherapists’ training, via university or para-university careers, restricting the practice of psychotherapy solely to physicians and psychologists.

But how does this affect psychoanalysis? How does this juridical act clash with our ethics? How does it hinder the analyst from assuming responsibility for his act? In my view, it does so in several different ways. Let us examine a few of them:         

1.     First, by assimilating, implicitly at least, psychoanalysis into psychotherapy. The law’s article 3 first stated: “the exercise of psychotherapeutic activities, including analytical activities…” After a long debate, that added clause was deleted, leaving the law open to all possible interpretations. With the foreseeable outcome of being immediately interpreted restrictively by the institutions: i.e., psychoanalysis  is  a psychotherapy.

2.   As a result, analytical practice is limited to physicians and psychologists. With an initial paradox: If it is true that analysis is didactic only après-coup, that is, that is has no a priori didactic existence, then, in principle, it is also true that any and every analysis can turn out to be didactic. Hence the paradoxical case whereby it cannot be ruled out that an analyst might be forced to interrupt the “didactic” work of analysis – on the grounds that the analysand is neither a physician nor a psychologist. (And this is so regardless of how many of the protagonists in the history and recent history of psychoanalysis had neither medical nor psychological training nor, in some cases, even university degrees.)

3.   The objections I have just made to this law in turn come out of two essential assertions concerning all analytical formation:

a) All members of the psychoanalytical movement consider a  personal analysis fundamental for the formation of any psychoanalyst.

b) The relation between the analyst and patient demands that the symbolic function between the two not be pre-established by some agency fundamentally extrinsic to that relation, such as a public authority. In fact, the analyst’s responsibility cannot be delegated to any third agency of a legal kind without the entire meaning of analytical practice becoming distorted. If some third party, in this instance the State, incarnates the Other’s Other, the analyst is automatically deprived of any symbolic function, that is, of the very possibility of functioning as an analyst.  There remains then only the possibility of a relation on a purely intersubjective plane, as such open to all sorts of perversions.

But above all, by assimilating psychoanalysis into psychotherapy, this law tends to delegate the essential aspect of psychoanalytical formation to university or para-university procedures – thereby going against Freud who, as we know, always wanted to keep the formation of analysts distinct from university education and who managed,  in an Austria that in 1926 was no longer so felix, to have a law initiative defeated that would have restricted psychoanalytical practice solely to physicians.

Furthermore, if we read the parliamentary debate that arose about Law 56/89, what leaps immediately to our eyes is, as I’ve just stressed, that the legislator himself had trouble fitting psychoanalysis into the class of psychotherapies. How, then, did he extricate himself from this problem? By the nth instance of the cunning of reason, by concretely erasing the word psychoanalysis from the list of psychotherapies and simply leaving everyone the task to guess whether it was included, excluded, or what…. The thorny decision thus falls to the judge (in Italy, where, over the last few years, there have been several trials for professional malpractice).

While waiting for the “verdict,” we have all the time we want to reassert that if psychoanalysis does not figure under the term psychotherapy in the encyclopedia, it is precisely because analysis is always an inextricable intertwining of therapy and subjective formation. Therapy doesn’t occur without formation. Formation advances by prompting therapeutic effects. Wanting to forcibly separate clinic from formation is an old error of psychoanalysts themselves. Indeed, it was an effect of the institutionalization of psychoanalysis when in 1920, for the first time in the history of the psychoanalytical movement, the Teaching Commission of the Berlin Society decided to regulate its activity. This therefore steered psychoanalysis toward becoming a sort of specialization within the medical profession. In practice, in fact, they quite simply assigned the psychoanalytical associations the function of handing out diplomas in psychoanalysis.

That was 1920.  Things haven’t changed much since then, at least in Italy, given that nearly seventy years later, in 1996, the Società Psicoanalitica Italiana declared itself willing to adhere to this law, after numerous hesitations…. And, just to remain within the Lacanian field, how can we not remember that immediately upon declaring their adherence, some went as far as to declare this law– to my mind thoroughly contrary to the spirit of psychoanalysis and a menace to its survival in Italy– to be an enlightened law, representing progress. In this cultural climate, one should not be surprised that on-duty psychiatrists should daily or almost daily recite in our newspapers a De Profundis for psychoanalysis immediately followed by a Gloria for the neurosciences.

To be sure, it is always a matter of the project  to which a substantial part of scientific discourse aspires, the project of achieving a humanism without ethics (take this also to mean “religious”).  Heidegger, Adorno, Marcuse and Althusser, in their differing arguments, already stigmatized this project’s idealist and revisionist bases. Never mind that the arrogant tone in which it is accommodated today is an effect we can largely attribute to the fact that official psychoanalysis abdicates from still exercising its cultural and intellectual role in relation to the discontent of our civilization. A declared withdrawal, a backing down sanctioned as well by the Italian psychoanalytical societies’ compliance with the law concerning psychotherapy.

After nearly twenty years, what effects has the application of this law produced in Italy? How is it possible – if it is possible (Antigone docet) – to reconcile the normative juridical act with the analytical act which remains essentially an ethical act?

From the outset we made a choice: to critically distance ourselves, as an institution (Nodi Freudiani) from Law 56/89, which, in our view, risked putting psychoanalysis into the same basket as the psychotherapies. The reasons for this refusal were widely debated and elaborated over all those years (in numerous debates, texts, books, colloquia, etc.).  I will cite only two that strike me as especially significant.

•                 Although it is born, with Freud, in the context of medical (neurological and psychiatric) discourse, psychoanalysis is the inverse of this logic. For example, its understanding of the concept of symptom and of the exercise of knowledge developed by those discourses is different, if not flat out opposite.

•                 In medical discourse, every symptom, including the psychic symptom, even when it is presented as a resource, nevertheless remains a manifestation to eliminate, stifle or lead to some adaptation more congruent with, more subservient to the ideals of health and well-being that prevail throughout civilization. There is an analogous perception in the domain of the psychotherapies, which largely share this same logic.

As for the use of knowledge (savoir), the medical act and the psychoanalytical act move in diametrically opposed directions. In the framework of technology, technique and strategies of intervention, medicine makes the patient the object of a specialized, remote knowledge. Despite their mutual diversity, the psychotherapies, for their part, answer to the logic of an informative, reparative, and prescriptive knowledge. In any event, the physician and psychotherapist are and remain, throughout the treatment, the unfailing depositories of a knowledge about the other that is demonstrated, recorded, guaranteed.

Things are very different in psychoanalysis.  The symptom is always a resource for the subject: a tyrant perhaps but also an identity. And thus the idea of freeing the subject from his symptom is not only a blunder, but far worse, it is an expropriation.  It is only through its exploration and its articulation that the subject can come to modify his psychic structure (neurotic, psychotic, etc.) that has caused the suffering and discontent he complains of. Consequently, in psychoanalysis, the symptom traces the course that can lead the subject to cure: A cure inasmuch as it is a change that allows giving up the bluntest, dullest aspect of this symptom by way of a sublimation, namely a different formation of the unconscious, in a recomposition of the libidinal economy.

But knowledge, le savoir, in psychoanalysis is neither the property nor the certainty of the analyst; rather, it is a matter of a theoretical experience made act … a failed act. As a result, “cure” or “recovery,” “giving up the symptom” and “sublimation” are no more than the terms of an always critical knowledge, and, by carefully considered choice, one bereft of technique. A knowledge, therefore, to whose weakness and impermanence we bear witnes daily. The irreplaceable mark of psychoanalysis is to be found in all that, and equally so in the peculiar course treatment takes, founded as it is on unconscious listening and the infiniteness of the act. A psychoanalyst does not make promises of health, but rather commits to leaving open an investigative  space, a space that the subject, before, felt was stifled by inhibition, symptom, and anxiety. Moreover, he promises to keep the responsibility for the act he has inaugurated with his analysand vigilant  and active. The work of an analysis can prompt startling effects in knowledge but equally so in solitude and helpless confusion. And here, the analyst has no wish to shirk his own implication: he can no longer withdraw by projection or institutionalization.

 It also happens more and more frequently that after looking elsewhere for clues and answers, people in great distress, who feel that their quest may end there, ask to start an analysis.

B) The a/historical position that psychoanalytical discourse occupies with respect to its era and the discourses it intersects is nourished on the Freudian intuition that the unconscious is atemporal.  Over its hundred years of existence, psychoanalysis has almost always occupied a special, asymptotic position in relation to the dominant discourses with which it is confronted.

Furthermore, – let us finally take account of this and if possible draw the consequences from it – psychoanalysis has had a semblance, a glimmer of “success,” of undeserved and equivocal popularity, only during a few brief historical periods in which particular, transitory contingencies seemed to have thrown into crisis the very foundations of the era’s dominant discourse. Or rather, when it has itself subscribed acritically to the triumphant ideology.

But today more than ever, in an era in which we witness the triumph of technique, of “technological monotheism,” psychoanalysis can only find itself cast aside.  In particular, subjective malaise can no longer be tolerated, except as illness, in a civilization – present-day, technological and technocratic civilization – that has an exacerbated ideology of “well-being” as its purpose and end. The suffering that, on the contrary, inevitably continues to emerge, must therefore be eliminated or at least neutralized –  even if this proves useless, indeed harmful, to the psychic development of the individual (as I have pointed out above).

But it cannot be otherwise, for the action of technique sets as its horizon precisely exact understanding as a capacity to dominate (Heidegger).  It is a matter, in sum, of a new discourse of the Master. And in its discoveries it finds, ever more effective at the therapeutic level (psycholeptics, psychotherapies) the tools with which to silence the agencies of desire underlying psychic suffering, which the subject – the subject of the unconscious, structurally neither comprehensible nor circumscribable in the logic of a dominant discourse – keeps stirring up in agitating himself symptomatically.

Who, then, – now more than ever – still listens to this malaise and the questions it implies if not the psychoanalyst?  On one condition, however: that analytic discourse remain the inverse of the discourse of the Master, and that, on the contrary  it tries, therefore, to bear the weight of an unprecedented subjective subversion, in accepting the unforeseen consequences of the act it engenders.

From an ethical point of view, it must, moreover, manage to recognize the formative and tragic meaning of the exile that structurally pertains to it. The exile it itself traces, in asserting and continually making present the existence of the unconscious, at the heart of every civilization and in the malaise which derives from it. It is a matter, then, of learning to belong to the exile that belongs to us, in an exile not solitary or merely endured, but active and shared critically with various others.

We must, then, stress at least two of the reasons that have prevented us  from following and adapting ourselves to a law of the State that risks, in its execution, confusing psychoanalysis with psychotherapy. But let us, however, recognize in it, the merit of having managed  – if we really want to read this law– to restored psychoanalysis, paradoxically, to a rightfully unheimlich, foreign position.  It is here, however, that another question arises. If a psychoanalytic association deems itself unable to adapt to the parameters of this law, what function can it fulfill? And further: starting from the preamble that in any event, to date, no psychoanalytical association and no mechanism set in motion by these same associations can guarantee an analyst’s formation betraying the principles governing the logic of psychoanalaysis, how then are we to manage still today to work together on psychoanalytical theory? In other words, there’s no school of psychotherapy, no institute for an improbable guarantee for an analyst’s “formation.” So what’s to be done?

It’s necessary, for instance, to realize that it’s not possible to propose direct, university-like teaching of psychoanalytical knowledge. What can exist most authentically in psychoanalysis, is, rather, its transmission.  Transmission of a desire acted upon and transmission of the style in which it is carried out.  Namely, what is implied by the passage from the work of transference (personal analysis or psychoanalytical clinic in which an analyst “is authorized solely by himself”) to the transference of work (in which an analyst is authorized to develop a personal theoretical elaboration solely in engaging with various other people). Taking stock, in that way, and publicly too, of the theory that supports and sustains his clinical work.

In sum, while respecting the reasons of the associations that organize a teaching of psychoanalytic theory, we continue to prefer (as we have for these last fifteen years) our theoretical practice in psychoanalysis. The practice implies simply an encounter among analysts, even with non-analysts interested in the discoveries of the theory of the unconscious.  This was the case, moreover, with Freud in our day, yet only when the best psychoanalytical tradition has managed to be appreciated and given its due. It follows, then, that the work of investigation, to be carried out, one hopes, outside of any scholastic setting and left entirely to the possible invention of each of us, imposes on us a theoretical reflection free of bureaucratic impediments and of forced transferential impediments (that is to say, altered by suggestion).

Such is the critical tension that animates us; such are the desire and the ethics that engage us. In short, we would like to remain analysts solely by choice, that is, by desire to carry out the analytical act in which the heart of our subjective adventure is situated.

To return to a few incomplete points:  our error,  our error as analysts, resides in the fact that after a hundred years of various associational paths – that is, of shared solitudes – we still, too often, consider, that associating ourselves should, strictly and necessarily, have as its sole purpose the formation of the analyst. And, at the most, we call “lay” the formation that wants to preserve our “cult object” from the dissolution of the present era and from laws for psychotherapy.  Concerning the anxiety over the “dissolution” of our current age, it will suffice, perhaps, to recall, by way of consolation, Borges’s words on Oscar Wilde: “he was a genius; what a pity he lived in a terrible age … like everyone else, of course.” Concerning the “cult object,” I admit, things are more complicated.

In short, the “formation of the psychoanalyst,” and its formalization, has always been the mirage – later the nightmare – of every analytical institute. And it must be said, on this point, that in what is called the formation of the analyst, the “sadly famous” 56/89 Law – if one takes it literally – finally does justice: the only institutional formation possible in the psych world is that of the psychotherapist!

The juridical discourse tends to intervene to make up for the ethical lack of the other discourses and thus, the consequently wobbly social bond. In the Italian example: “clean hands ” in absentia of an ethics of political discourse, or the law of the psychotherapies in absentia of an ethics of analytic discourse. One might even add that the psychotherapy law was motivated equally by the repeated insistence with which the psychoanalytical Societies exhibited the fetish of the “formation of the analyst.”  But in Italy, the reaction to the State law on the part of psychoanalytic institutions has quite simply been to reject the truth born out of juridical discourse, either by acritically subscribing to it or by denying it factually. I will not dwell on this, as it is too recent a history, and  well known.

Let us listen again, though, to their insistent complaint: if our fetish (the analyst’s formation) – the sole object that in our eyes justifies our existence as associations – should it disappear, how are we to tolerate our continued living together?  That is, how are we to tolerate founding our desire on absence .. the absence of a fetish?!  Doesn’t that strike you as a sort of sniveling that is, to say the least, curious for psychoanalysts to indulge? Why can’t the analysts support that desire – and their own desire – necessarily stems from the lack?

Well then, why not summon up the courage to say, perhaps with too much sancta simplicitas, that associating among psychoanalysts, that working together in psychoanalysis, has above all as a goal to look continually for a discovery: the discovery of everyone’s talent and antinomy. It certainly is not to have as a goal the recruiting of analysts. It is no doubt desirable, although never to be taken for granted, that finally, over the course of things, effects of formation are produced.

In fact, to dialecticize the question of knowledge and its transmission in psychoanalysis and to be able to speak of the bond among analysts, one term at least must be introduced: truth. If a psychoanalyst, or a psychoanalytical association, does not continue to question itself, as Freud and Lacan have taught us, on the relation between the subject and truth – namely, on what must happen to the being of the subject for it to be able to accede to a part of truth and, in return, that the subject can transform into itself to have access to a morsel of truth – he inevitably risks relapsing into some form of positivism, of psychologism.  Furthermore, as Foucault reminds us, if psychoanalysis abandons the three ancient questions of epimeleia heautou, that is, of spirituality  as a form of access to the truth, it risks no longer considering the analyst’s formation to be one of the conditions of the subject’s formation as an effect of truth.

If the analyst’s formation, continues Foucault, is viewed almost exclusively in social terms, in terms of organization or on the level of mere questions of belonging (to a group, a school, etc.) the price paid is to reduce the formation itself to the forgetting of the questions related to the relation between truth and the subject–which is what has actually happened most of the time in the history of psychoanalytic institutions.  Foucault concludes by saying that what makes Lacan’s analysis so interesting and important depends, precisely, on the fact that after Freud, he was the only one who wanted to re-center the question of psychoanalysis precisely around the problem between the subject and truth. How, indeed, to found the association among analysts, how to found their social bond, or worse, their formation in a knowledge, which either is not or else if it is, is different from unconscious knowledge: is it already connaissance, book-learning?  A book-learning that, if it becomes analytical theory, can only pursue other truths,  and which, on the other hand, if it is not constituted as vanishing point, horizon line, rapidly becomes university knowledge.

Let us not forget that, for psychoanalysis, every object of desire – being the necessarily lost primary object – can be constituted only as an object of loss.

Each knowledge, including our theoretical knowledge – can only be a loss (a non-connaissance) that discharges a residue: a point of subjective truth. Around these points (Freud dixit), the analyst  constructs his theory … and the psychotic his deliriums.  So why not accept the impossible challenge that being an analyst imposes: to found the social bond among psychoanalysts, our association having as a goal not the formation of the analyst – enunciated by a knowledge – but precisely the formation of the unconscious – the emergence of partial and transitory truths – and thus our theoretical confrontation with those truths by way of a non-connaissance, that is, by way of the suspension of already acquired knowledge?

 Let us return then, among other questions, in order to reach a partial conclusion,  to the question of the choice posed at the start of my text. The choice, each of our choices, is definable as the subject’s encounter with the castration that relates to him. In the act of choosing, something is lost… and lost irremediably, perhaps. In this sense, for instance, hysteria avoids choosing by its often ill-or unconsidered passage to the act; whereas obsessional neurosis remains painfully suspended in doubt, often in a time that subject hopes will be infinite. The choice, then, is the putting into action, the implementing of an act, of an ethical decision on the part of the subject. And this involves – in its effect of signifying retroaction– the taking of responsibility for his act.  “Wo Es war, soll Ich werden,” the ethic of psychoanalysis may be understood equally as the incessant attempt to re-find oneself as subject in the act, and in the choice or decision that that act has entailed.

And today more than ever, in an era in which our modernity (define it any way you wish: postmodern, liquid society, perverse, fatherless, etc.) seems to have as its main effect precisely an ethical impossibility of choosing. Now, if that is the sphere in which the clinical settings of our analysands are inscribed, one must perhaps decisively restate the difference between psychoanalysis and the various psychotherapies, that is to say, underscore the fact that psychoanalysis is above all a practice of listening and of taking care not so much of the pain of a subject but rather of the very subject of a pain.

The question, then, becomes the following: how, in our modernity, can the analyst remain a symptom and not let himself be integrated or expelled (as already sometimes seems to be the case)?  Beyond resistance to psychoanalysis, might it not be time to begin to speak of the resistances of psychoanalysis?  In other words: perhaps we might deduce that precisely just today, in the era of its exile, it is permitted psychoanalysis to be reappropriated by the force of its identity,  that is, to revitalize the ethical and clinical meaning of Freud’s work. In this sense, I must reinforce what is essential:  psychoanalysis is not a psychotherapy because it is not a technique to apply: an analyst’s “technique” is his style.  All in all, psychoanalysis is an experience, not an experiment. It is an experience of discourse that takes place in a practice of the singular word.

 Now, it is clear that in the era of technique, psychoanalysis can only take back, even  reclaim, its “elite” function of the cure of the subject–even if it means reaffirming, with Freud, that no psychotherapy produces as many therapeutic effects as the experience of an analysis conducted up to a desirable subjective change. To cure or recovery, then, which proceeds, as I already wrote, by rectifications of the libidinal economy of the subject. It seems evident to me, then, that we cannot keep pursuing “modernity” in pursuing signifiers that don’t belong to the logic of our discourse. A discourse, let us not forget, which is, and must remain, the inverse of the Master’s dominant discourse at a certain historical period.

As one example among many others: if the subject of our era, of “technological monotheism,” is the consumer – the potential consumer of the (pseudo) infinity of the objects of desire that technique produces – it follows that the signifier “guarantee” immediately becomes a master signifier (one must, in effect, “guarantee” the consumer precisely to guarantee oneself his loyalty). A master signifier to which, obviously, psychoanalysis cannot and must not adapt.

In other words: how is it possible to think of “guarantee” or “taking account of results” of an experience as subjective psychoanalytic experience without irremediably sullying it and making it quite simply unworkable? Unfortunately, and one must take account of this, this is already what is occurring, with the complicity of numerous analysts. The least one can say of them is that they don’t know what they’re doing. For an analyst who has the ethical and theoretical responsibility to respond with his own act, this seems  surprising. 

I would like now, by way of concluding, to sum up and quickly articulate again the two central points of my elaboration:

An analyst’s formation is solely an effect – when it is produced (though it can only be apperceived après-coup) – of his analysis. If this effect is produced, someone may come to authorize himself as an analyst solely as an effect of this particular subjective formation. This subjective (or unconscious) formation will lead him to desire to listen to another’s unconscious in his clinical practice and to be in conditions to do so. But it will also have prepared him to “read” in a logic of the structure of a particular discourse – the antinomies, the discordances, the resistances, the transferential effects, etc.: in short, the bizarreries that the unconscious creates unbeknownst to him. And to desire to bear witness to it through his theoretical practice, which demands encounter with certain others. Only in this sense can an analysis said to have been “didactic.”

 Consequently, one can deduce from this that the ethical task of a psychoanalytical  institution cannot and certainly must not consist in “forming” or in “guaranteeing” an analyst’s formation. But only in favoring the conditions of freedom in which his theoretical practice can be exercised,  facilitating, in this way, every one’s inventions, by respecting the each person’s tempos, rhythm, pace, and thus looking for the idiorrythmia of which Roland  Barthes speaks, since : “Power – the subtlety of power – moves by way of dysrythmia, heterorythmia.” 

 I realize – since, among other things, it has already happened – that all this (to speak of the exile of psychoanalysis, of the impossibility of guaranteeing anything that can be on the side of psychoanalytical institutions, etc.) may seem irritating and utopically subversive: I have offed a reflection on what results from the teaching of our masters in psychoanalysis and our personal clinical and associative experience.  Or else my reflection can seem an arbitrary deduction mixed up with a useless “romantic pessimism.”  As for pessimism, it is enough to think of the prattle surrounding the unfortunately famous “Freudian pessimism.” However one might more carefully reflect on what Lacan said at a conference in Rome in 1974 : namely, that, for our civilization, psychoanalysis is above all a symptom and that, sooner or later, they will come to eliminate this bothersome “illness” too.   Furthermore, as Freud writes in a famous letter to pastor Pfister: “… my pessimism thus seems to me a result, the optimism of my adversaries, a hypothesis.”

Finally, I think that, concerning the results psychoanalyst achieves, it is more correct to speak of a certain disenchantment rather than of pessimism.  A certain disenchantment (actually one of the most desirable “positive collateral effects” that an analysis can contribute) which Claudio Magris, in his inaugural speech for the 76th Salzburg Music Festival, defined in these terms: “Disenchantment is an oxymoron, a contradiction that the intellect can’t resolve and that only poetry can express and watch over.  It says that enchantment is not there, but at the same time, it suggests by the tone in which it says so that, despite everything, enchantment exists and that it may reappear when one least expects it.”

In other words, I think that, ultimately what can best sum up my position is the response that Moustafa Safouan gave someone who’d asked him: “How do you view the future of psychoanalysis?” Safouan replied (and even today, I can’t think of a better response):

“One can examine the question in a broader perspective: what today is the place of psychoanalysis in civilization? I would say, then, that the idea of psychoanalysis as a weapon against the discontent in civilization – which constituted the hope of the first generation of analysts and perhaps of Freud himself– currently, in the face of the irresistible rise of technology in social life, has pretty well come to an end for analysts themselves. And besides, what can a psychoanalytic society do against this malaise except, at the most, what, for instance, certain artists, and in particular certain writers who are men of truth have always done, – those who also  know very well that the struggle is an unequal one? Yet the fact of knowing it doesn’t stop them from writing. That is the lesson that they transmit: Why does a subject exist? It exists to serve its desire. Our desire persists even if the cause is lost. So, what do I care then! I defend it precisely because that’s where my desire is. And thus to say that psychoanalysis has nothing great to do isn’t a good reason for psychoanalysts to stop defending their cause. Even if they consider it lost.”