In the later 1990s, in the midst of the high-tech boom, I spent a lot of time in a coffee shop in the theater district in San Francisco [âŠ] and I observed a scene play out there time and time again. Mom is nursing her mocha. The kids are picking at their muffins, feet dangling from their chairs. And thereâs dad, pulled back slightly from the table, talking into his cell-phone [âŠ]. It was supposed to be a âcommunications revolutionâ, and yet here, in the technological epicenter, the members of this family avoid one anotherâs eyes.(Jonathan Rowe, âReach out and Annoy Someoneâ, Washington Monthly, November 2000)
Individuals. Families. Society . We are faced with an image drenched in Zygmunt Baumanâs âliquidityâ and ârisksâ, which is much under discussion today.
Precisely because of the many social changes currently under way, contemporary (hyper-modern?) psychoanalysis has become increasingly interested in the new scenarios embracing the subject, family, society and their mutual relations; increasing attention is given to topics such as: âparental roleâ , âmaternal and paternal love â, âmarital fidelityâ , âstepfamilyâ and âcaring for childrenâ . All this speaks of âfamilyâ: we are increasingly asked to get to the heart ofâhyper-modernâfamily bonds .
To contextualize, today we frequently speak of a social environment full of widespread individualism and of how family and subject are set in this context. This starting point is important because man is essentially a ârelationalâ and âculturalâ being: he cannot be conceived as abstracted from relationship and culture, outside connections, entirely alone.
Psychoanalysis , as we shall see, has nourished these awarenesses for some time, and today is particularly called upon to make its contribution, in a context in which family members âstruggle to look each other in the eyesâ, proceed on parallel lines, in a society in which subjects are growing increasingly âcloser and farther at the same timeâ.
The subject is born of a family, and can contribute to the birth of a new family, in a genealogical chain that precedes the birth and continues after death . All this happens in an ever-evolving cultural environment which also precedes our birth and survives our death.
It has been known for years how the subject is constituted and constitutes itself within the bonds in which it is immersed and insertedâespecially family ones.1 It is then only natural to ask oneself: What is the role of the family today? Why is it so central now? Functioning as an intermediary between society and the individual, it is the area that mediates the family group. How do we clinicians position ourselves in relation to this data? How can it be useful in the context of a âhelping professionâ?
It would be superficial to think, as has often been the case in literature, that family or society are responsible for the subjectâs symptoms, in a unidirectional manner. For example, and having regard to practice, it would be simplistic to say that a person develops an eating disorder because âit is all his familyâs faultâ. However, we cannot consider a subject independently of its evolving context, as even this would be superficial.
Perhaps there is a need for an overall, comprehensive vision that goes beyond not only the linear simplification âfamily, therefore an individualâs symptomsâ but also the combining of âthe subjectâs zoomâ and the âwide angle of family and societyâ . It is not enough to have a clear picture of both âthe frameâ and âthe pictureâ; we must conceive the mutual implications.
1.1 Family and Psychoanalysis: From Freud to the Contemporary Era
To expand on this, we can say that at first glance in the works of Freud, psychoanalysis would seem to be a theory of the individual, but it is reckoned that these theoretical elaborations also contain a latent family-group dimension ; in fact, even if psychoanalysis originated as a method of treatment of individuals, and Freud elaborated most of the theories in terms of âintrapsychic structuresâ, we must not forget that it was psychoanalysis that discovered and signaled that the human being is not conceivable without the existence of others, and that those paradoxical âattempts at careâ that make human beings, classified as âsymptomsâ, have a meaning not only for the individual, but also for the relationships with others.2 The relational theories are therefore salient in psychoanalysis and embrace the family dimension, in continuity with that of the couple: indeed, group, family and couple are privileged areas of relationship, of bond . The approach to the family and the couple has attracted the attention of psychoanalysts to the importance of the function of intersubjectivity in the genesis and maintenance of the structure of the psyche (and the symptoms) and has opened up new horizons, even on the most âprimitiveâ levels of the psyche, which are expressed also in the context of family sessions.3 The experience with families allows us to focus on the importance of real and concrete actions within the family ties, leading to a clear evolution and openness to relationships, which allows the possibility for creating new technical conditions to deal with situations in which usually âwe do not know how to do with the individual approachâ. The explicit intention to develop this theme has progressively been revealed, starting in the first half of the last century with authors such as FlĂŒgel, who published a psychoanalytic work on the matter,4 illustrating a careful study about family members .
As already mentioned, the family-group dimension is found in several texts by Freud.5 Also, in the Three Essays on Sexual Theory (1905), Freud speaks of the possible influence of the parents in the transmission of neuroses to their children: he states that neurotic parents open up routes that are more direct than the hereditary ones to transmit their disorder to children, and also that disagreements between parents, or their unhappy marriage , determine the childrenâs serious predisposition for a disturbed sexual development, or for a neurotic illness. Freud also refers to the negative effects of the motherâs lack of attention to her offspring or to the harmful effects of the early absence of one member of the parental couple, which may be related to the development of hysteria, for example.
The case of Dora, which is the most studied among Freudâs clinical cases, reveals an indispensable family dimension. Freud (1905) describes the situation of a young girl entangled in an intricate family situation, packed with power games and secrets: Dora had been âimplicitly delivered in sacrificeâ by her father to a lord in exchange for toleration of his adulterous relationship with the lordâs wife. Freud also reports that Dora was complicit in the situation, and in turn colluded with her fatherâs clandestine relationship. Curiously, the girlâs mother also âclosed one eyeâ, or perhaps both. This famous case indicates how the family dimension was an important focus of attention, in theory and in the clinic, even in Freudâs time. The symptoms appeared in fact as a communication for a certain person: as a message and accusation. Equally famous is the narration about a patient suffering from intense anguish, with the unconscious purpose of taking the mother prisoner and removing the freedom of movement necessary to attend the lover (but consciously the subject is unaware of the motherâs betrayal ). Here, the problem of family secrets, which we so frequently find in dysfunctional families, arises.
Another famous Freudian case is that of little Hans. The child presented a phobia, which, according to Freud, indicated not only a psychic conflict but also the denunciation of a family conflict; as Freud himself states, both in the case of Dora6 and little Hans,7 the iteration of the family group tends to crystallize the symptom and gives it meaning, depending on the context in which it is located.
Freud believed that the closest relatives of the patient showed little interest in promoting the healing of their family member; rather, they seemed to preserve the current status, substantiated by the same recursiveness of their interactions, so that the patient cannot move differently in the context.
Even today we see how, superficially, when conflicting relationships occur between family members , the publicly defined âhealthyâ relative often seems to put their needs and desires ahead of the interest of healing the family member labeled as âsickâ; on the other hand, often in family therapy , parents request the transformation into a ânon-problematicâ child, but once the child is restored, he goes his own way, which, paradoxically, frequently leaves parents feeling more dissatisfied than before. âWhat is of concern here is not primarily Freudâs speculation about archaic society but the insight into the family as a societally determined locus in which personality structure is formed, and which in turn is socially relevantâ (Frankfurt Institute for Social Research 1972, 133).
Several theories have been developed with regard to this phenomenonâexpressed in a few concepts: âfamily connectionâ, âdoor-entryâ, âlinkâ, âfunctional couplingâ (by, respectively: Ronald David Laing [1984], Enrique Pichon-RiviĂšre [1971], RenĂ© KaĂ«s [1996], Enrico Vincenti [2013])âto highlight the tendency to maintain oneâs own configuration. These bonds emerge and are substantiated in the mutual commitment to preserve their way of being, and some through the attempt to regulate the way of being of others (acting on the experience of others).
These dynamics also decline on the coupleâs level; various cases reveal that when a man has been freed from his inhibitions, he decides to break the marriage (which promoted those inhibitions). Freud himself clearly shows how neurosis always has an interpersonal and family dimension, and how family ties condition the presence of symptoms: if the symptomatology disappears, the âpathologicalâ links also disappear. Freud anticipates the ideas that systemic theory will develop much later,8 both on familial homeostasis and on the family sense of the symptom.
Passing now from father to daughter , we can say that Anna Freud was an influential psychologist who had a great impact on psychoanalysis , psychotherapy and child psychology. Anna Freud did more than live in âher fatherâs shadowâ; she became one of the worldâs foremost psychoanalysts and is recognized as the founder of child psychoanalysis. She built her theory of infant and child growth from hundreds of detailed written observations of infants and young children at various ages and stages of development, from a few months to five years old. Even for Anna Freud (1962, 1965), it is important, in therapy with children, to include parents in the field of observation, so as to ensure their collaboration: this allows the therapist to then switch from zooming in on the subject to a wide angle viewâthat of the family. In the first chapter of Normality and Pathology (1965), Anna Freud in fact notifies her desire to provide parents with the corresponding indications to âdiscovered discoveriesâ. For example, parents were asked to try to reduce their childrenâs fear of them. This passage reveals initially that one has in mind an âideal subjectâ that must act in a certain way, according to an idealization, for which it is necessary to âcorrect and straightenâ. Anna Freud, however, noted the ineffectiveness of a corrective approach, which gives advice, for the full prevention of neurosis. Indeed, it must be stressed that the role of parents is of great importance in the development of children, but is not the determinant causing neurosis or health ; there are many other factors that intertwine with each other (Engel 1977, 1980). Extending the argument, we can say that Anna Freud devoted herself also to the prevention of neurosis and developed an excellent theory of object relations; conducting research on how to prevent the rise of neurosis in the development of children, she investigated if a psychoanalytic education could help in an appropriate process of growth , even for children who came from concentration camps. Anna Freud strengthened awareness of the importance of the mother to the child in wartime (even if ânot a particularly good motherâ), which is the outcome of detailed knowledge of the growth and structure of the childâs mind, in which the figure of the mother is for a certain time the sole significant representative of the outside world. She noted, for example, that children were less likely to be traumatized by bombing if they were with their mothers, and if their mothers remained calm (Dawson 2001). Her decision to include relations with parents in the field of observation of the childâs psychoanalysis , in order to obtain parentsâ collaboration, was an innovation in the psychoanalytic field (Irtelli 2016). Unfortunately, however, over time, she became less optimistic about the possibility that a psychoanalytic education would always manage to prevent psychopathology: she ob...