The distortions of the interpersonal relationship </h1> <br> Luigi Janiri

The distortions of the interpersonal relationship


Luigi Janiri

THE DISTORTIONS OF THE INTERPERSONAL RELATIONSHIP

 

LUIGI JANIRI

Professore di Psichiatria – Università Cattolica del Sacro Cuore

Direttore UOC di Psichiatria – Policlinico A. Gemelli

Roma

 

 

Abstract

The peculiar point of view of this paper moves from an individual perspective to an interpersonal and couple’s context that can be assumed at the same time as an object of knowledge and a not reducible unit of observation. In other words, the proposed pathway goes from person, subject of relationships in a monadic sense, to relationship in an intersubjective and dual sense. The distortions of the interpersonal relationship represent a class of relational disorders in which the couple and its functioning may be considered as a clinical and study object. The idea of distortion leads to a dimensional psychopathology describing not discrete nosographic categories, but a continuum from the normal relationships to those that are more severely affected.

 

Key words

Person – relationship – couple – intersubjectivity – empathy

 

 

 

  1. Person and interpersonal

1.1 The subject and the mask on the horizon of the other

The concept of a person in psychology recognizes two semantic domains (Galimberti, 1999):

1) a person as a presence in the world and as a subject of relationships, in this way coming to integrate with the concept of personality, and 2) a person as a mask according to the meaning Latin (from per sonat, “re-sounds through”, referring to the actor’s voice that resonates through the mask adapted to the face), and therefore as the role that an individual represents in social and social imaginary. On the other hand, it is the face / mask that becomes the resonance chamber of the breath / spirit and it is to be noted that both in Greek and in Latin, spiritus mean breath, breath or breath.
The first area is precisely the concept of “relational gradient”, the ideal path of subjectivities that denotes the level of relational with which a subject can be thought: from monadic individuality to the relationship with oneself (self-reflecting ego consciousness), to the relationship with others and with the world (man as being-in-the-world of phenomenology). Therefore, compared to the individual, the person is distinguished by the recognition that comes from others and for which it is able to attribute references. The loss of the perception of oneself as a presence in everyday life and as a subject of interaction with others is the essence of the person’s anomaly par excellence, known as depersonalization.

 

As for the person as a mask, we can refer to the theory of Jung (1921), which defines the person as the aspect that the individual assumes in social relations and in the relationship with the world, a true mediator between the ego and the world. External, opposing to it the soul, intended as a mediator between the ego and the internal world. Person and soul are complementary in Jungian thought: the first is conscious appearance, the second unconscious interiority. If the individual identifies himself completely with his own person, with little attention to interiority, he is a hyper adapter who only lives socially, foreshadowing what Winnicott (1965) later calls False Self.  Depersonalization and False Self constitute the pathological models corresponding to the two meanings of the concept of person, both connoted in the sense of both existential and relational: the first psychopathologically organized in the form of a crisis, the second as a personality disorder.
But how are people and personalities articulated?  If we assume the latter as a set of psychic characteristics and modes of behaviour that form the irreducible and invariant nucleus of a particular individual immersed in his environment, in the face of the innumerable technical definitions in the framework of multiple theoretical frames, we find a fund of truth. It is also correct to affirm that stability, fluidity, social and cultural appropriateness, adaptation, intimate self-consistency, continuity of oneself from personal history to existential project, relational skills are some common denominators of the concept of healthy personality (in its well-being) and normal (in his being a frequent type within the community  of reference).
The personality anomaly is not so much a deviation (statistic) from the norm, as a loss of individual well-being or balance between the subject and his environment, between himself and others. This loss occurs in a global sense, involving all or a substantial part of the areas of the individual’s existence, in an evolutively important phase of his history, when he enters into early adulthood, the structural nucleus of the personality is crystallized and the whole of behaviours and traits is stabilized accordingly.

 

 

 

This explains why to describe a personality disorder we use the term “evolutionary disharmony”: because it is in this global movement of aspects and functions of the subject that we perceive, in a certain moment, this loss of balance, which translates into a suffering expressed by him or by those who are in relation with him.  Some psychopathologically relevant consequences of this condition can be identified as: discontinuity, rigidity, astorality, decontextualization, maladjustment, dissociation or conflict, egocentrism and relational inability. The pathological stability of this picture gives it that caricature aspect, devoid of spontaneity and naturalness, which is perceived in every anomaly of character.

However, the concept of personality ultimately refers to a unique and unrepeatable relationship: in ordinary language, having personality means possessing specific traits, a proper mask that distinguishes us well from others. Therefore the personality manifests itself also through a character or a role, as a realization of the worldly image of the individual. In this sense the character, in the vicissitudes of the roles in the “theatre of life”, as Resnik (1982) talks about, is what is acted out from time to time on the scene and it is what is perceived by the others. .One could then say that the idea of ​​a person implies a relationship in the specificity of a personality: that between the inner self and the mask of the character or, also, between the subject and the others with whom he enters or is in relation. And with this we return to the two semantic ambits of departure. A strict loss of freedom and capacity for responsibility concern the anomaly of the person in his ethical status, where the specific forms of lack or relationship shape the heterogeneous set of personality anomalies.

 

1.2 Interpersonal as a fundamental element of the couple union
From the psychological point of view the concept of interpersonal denotes a space crossed by a relationship between two people, then everything that, from different visual angles, unites them and separates them: communication, interaction, exchange, affective and sentimental dynamics, according to different degrees and different forms of this relationship, from interpenetration to distance, from fusion to articulation to interdependence, thus realizing a real field between the self and the other, between the two components of a couple (Janiri, 2008) .The “field” is here understood in the sense of Kurt Lewin (1951), as a living space constituted by the person and his environment, permeable to the outside world, and by Harry Stack Sullivan (1953), for whom in a relationship between two people each member is involved, as part of an interpersonal field and not as a separate entity, in processes that are influenced by the field and which in turn influence it.

 

Interpersonal can be interpreted in the process of psychic evolution considered from the point of view of individuation and cohesion, which are in an inversely proportional relationship, so that a decrease in cohesion corresponds to an increase in individuation and vice versa. When the individuation has reached a sufficient level of maturity and it is no longer simple reactive separation from the other, and when cohesion has evolved from symbiotic need to need the other as other-from-itself, then the conditions are created for a mutuality that, according to the definition of Erik Erikson (1964), is: “a relationship whose members depend on each other for the development of their respective potential”.

 

The pathological drifts of mutuality, inheritance and unconscious repetition of infantile relationships, are represented on the one hand by egocentrism and possession, on the other by dependency and symbiosis. The integration between two people presupposes the bracketing of the satisfaction of their individual needs in favour of “new needs” (to use a terminology dear to Joyce Mc Dougall, 1986) that are an expression of the experience of the other and with the other, and the establishment of a paradoxical dependence between two independent people.

 

People in the interpersonal field appear strong in their ability to individuate, origin of consistency and persistence, and at the same time weak in their instrumental willingness to give each other (leaving shares of themselves to the other and for the other) and to give life to a new psychological and social subject, the couple, bearer of new needs and a new (inter-) dependence, delicate in its inaugural instability and in the continuous search for a balance through changes. Obviously this weakness or fragility is revealed as strength and a resource if the instability and the precariousness of relationships become a sort of unsaturated matrix within a stable and constant framework. Definition of roles and attribution of functions can stiffen and sterilize the interpersonal matrix, and so happens in the case of couples too connoted in their symmetry or complimentarily.

 

 

Another point of view from which to look at the couple starting from the individualities at stake is that of competence or, in Bionian terms, unsaturated preconceptions (Bion, 1963): just as happens in the acquisition of language, when the child’s innate competence meets the  competence of the environment permeated with language, or in the psychoanalytic relationship, when the respective competences of patient and analyst meet in the setting, we can think that interpersonally derives from the meeting of two distinct competences to find the other. In some ways the subject is ready, in his potential, to realize himself in the actuality of the encounter with another subject with a corresponding competence (Janiri, 2008).
Identity, otherness, duality: the reflections of the last phenomenology highlight, recovering the relational dimension, how being in the subject’s world is in reality a con-being, that is, being in the world with the other-from-itself which is also, at the same time, alter ego. The interpersonal area is then connoted as a “being among” and is the privileged place of the phenomenology of the meeting of two people. Here then the anthropological approach to the encounter implies the “constitution of intersubjectivity” (Kimura, 1988, among the various authors), and postulates that “the individual as an individual is an abstraction, and only the individual who is in a constitutive relationship (ab origine) with a You in the World has concreteness “. The Ego, taken as solus, only conceptually precedes intersubjective life and Heidegger first says that ours is a time of the We (Wir-Zeit) and not a time of the I (Ich-Zeit) (Callieri, 1995). The dimension of dialogue is therefore the “noity” (Wirheit of Buber) and depression represents the psychopathological correlation par excellence of the loss of such “noity” (Callieri, 1995). The developments of the relational point of view in phenomenological psychopathology come to constitute a social psychopathology.

 

2. Development of personal identity and gender identity

 

The formation of identity must be seen as a process of slow construction of that global, individual and relational instance, which goes by the name of “Self”, in continuous and constant exchange with the environment and with others, a true maturing nucleus of the personality and delicate path in progress at risk of psychopathological drift.
It is possible to artificially decompose, for convenience, this process, since childhood, in various and simultaneous movements of identification of the subject: to himself, to others, to the kind of belonging and / or choice. However, it should not be forgotten that the identifying dynamics are imbued with relationally and each of them bears its trace in the interpersonal relationships of adulthood. Freud states (1921): “identification is known to psychoanalysis as the first manifestation of an emotional bond with another person”.

 

 

2.1 Narcissistic Relationship

 

The child perceives images of themselves and images of others from the beginning of his life simultaneously, but when he succeeds in integrating them into (conscious) representations? This is the crucial crux of identity, since the self-consciousness, even if primitive, implies the conscience of the other and, whether it is recognized in the mother’s gaze or in the mirror’s paradigmatic situation, the child distinguishes at that moment its image from that of others. This narcissism of identity or speculation is then really a primitive relationship that is established at the basis of recognizing itself as a single subject-object, as a unitary Gestalt.
In such an early evolutionary dimension everything seems to play in privileged moments, as in the Lacanian stage of the mirror, in which the transition from the imaginary to the symbolic takes place on the edge of the recognition / disownment of oneself. And if instead of a single moment it was a process, a progressive construction of an identity and narcissistic structure, of a complex movement of sedimentation of representations and of relationships between them? The theorists of Infant Research and attachment, as well as cognitive psychologists, would probably agree. Identity formation and narcissistic investment may be subject to the same procedural fate.
Perhaps everything is already written in the myth of Narcissus, as it is handed down to us by the poetry of Ovid, a myth in which we can glimpse all the possible dynamics that pervade the complex relationship between the beautiful young man and his reflected image, and that we could try to summarize as follows (Janiri, 2004):

Perhaps everything is already written in the myth of Narcissus, as it is handed down to us by the poetry of Ovid, a myth in which we can glimpse all the possible dynamics that pervade the complex relationship between the beautiful young man and his reflected image, and that we could try to summarize

at first Narciso does not recognize its own image, but is captured, remains entangled, falls in love with it: it establishes a privileged relationship, unavoidable, a link that is the necessary prerequisite for self-recognition, but that is still the link with another (Self as another);

Entangled, he falls in love with it: it establishes a privileged, ineludibly relationship, a bond that is the necessary prerequisite for the recognition of self, but which is still the link with another (Self as another);

 

-at some point something happens on the basis of sensibility: the perception of invariance, a crack in the system of differences; Narcissus realizes that some of his features, experienced by his own senses, are not different, but similar to those of the image of the unknown; the complementarily (that which the other has and which strikes me because it has no equal in me) gives way to the pleasure of similarities (Self as another similar);

 

– against the backdrop of the astonished and painful presence of Eco, emblem of self-repetition or doubling, Narcissus comes to split and to see the image of himself in the pond not yet as such, but as a replica of himself, the image of a another identical to himself, but not yet himself: a twin, an illusory alter ego (Self as a double);-

 

by now we are close to the fusion of the two images, the one reflected and the one that Narcissus is building inside; the other is another loved one, invested with affection and recognized as identical to himself; in the mirror of water he reproduces the same gestures and the same loving mimicry of Narcissus, who thus identifies himself in what the other loves of himself; for love, the subject becomes the object of himself and identification undergoes a fundamental transformation: from the recognition of the identity of the other with respect to himself to the will and feeling himself equal to the other (Self as object of the other Self);-

 

The drive is in motion and at the pleasure of identifying with what the other loves of himself we add the second, final, pleasure in the externalization of the image of self: Iste ego sum! One who has discovered himself as another and has been captured by his own image now recognizes himself in this image. Pleasure and together pain for the loss of the object, more and more “subjective”, and for the solitude to which this dimension of uniqueness irremediably condemns us (Self as an image of oneself).

We find in this process the perceptive certainty, but even more the sensorial ambiguity, the drive dynamics, but also the research of the object, the theme of identity but even before that of otherness. And it may be that the various Sé / Narcissus that symbolize the phases of the process are representations of different types of narcissism, in some respects guessed in their physiology as in their possible pathological drifts.

The idea of ​​physiological narcissism remains as a specific and fundamental object relation, as a premise and condition of all the relationships that the subject can establish with his objects, as if to say: without love of self, love for others can not be given. . It is a bit ‘as if the objects can be, referring to Kohut (1971), objects-Self, at the service, for an important part of their “subjective” function, of the implementation of the sense and structure of the Self, function that alone can allow the phenomenology of exchange, of inter-being / interest. Someone has legitimately spoken of “narcissistic kit” that, like the chromosomal set, guarantees “the relationship between stability and change within it”, we could say between constancy of the Self and its persistence / consistency / stability in the metamorphoses that occur in meetings with others and in object relations (De Risio, 2004).
In this perspective one could begin to think over and over the phase of the opposition between narcissism and object love, in favour of a dialectic relationship between the two instances, between the two movements of instinctual research. After all, Kohut himself (1971), in postulating and proposing for Narcissism an evolutionary line independent from that of the object relation, simultaneously and simultaneously constitutes the autonomy of the latter, relocating the question originally born with Freud into the bed. Natural dynamics that provide for intersections and overlaps, but in no way mutual exclusion.
2.2 Object relations  

In psychoanalytic theory the vicissitudes of the subject’s relations with objects, both internal and external, total and partial, are found intertwined and often contrasted on one side, as we have seen, to the narcissistic relationship, on the other to the drive theory, in Freud , according to some authors, still too intrapsychic and too little relational (Conrotto, 1995). It is also true, however, that if the goal of the drive is that of the discharge of tension and the attainment of pleasure, this can not be without the contest and the mediation of the object. Of all the theorists of object relations, Fairbairn is certainly the most explicit in emphasizing the continuous interaction of the subject with the environment, taking a stand against the concept of pleasure that derives from the discharge of the drive energy, with statements, like this one 1952, in which he argues “that libido is primarily a research of the object (rather than a search for pleasure as in classical theory)”. Fairbairn intends with this claim that pleasure is the result of the quality of the relational state between the ego and the object (rather than a search for pleasure as in classical theory) “.

Fairbairn intends with this claim that pleasure is the result of the quality of the relational state between the ego and the object and anguish decreases due to a change in the object relationship, rather than following any discharge of energy

As for the narcissistic relationship, even for object relations we can imagine a process of progressive maturation, of a perceptual and affective type together. Meanwhile, the use of the plural instead of the singular must be emphasized: the objects of psychic and relational life are varied and proceed from the primary maternal object to those that are structured on the model of this and other significant ones that the subject finds on his evolutionary path , starting from the paternal one. Secondly, the object becomes indistinct, at the dawn of psychic life, and partial (the breast of the mother) distinct from itself, in the simultaneous appercective movement of recognition of the image of oneself and correlatively of the other, and total. In this phase the reflexive Self, in constituting itself as an object, establishes two important functions: the introjective capacity, which enables the subject to internalize the representation of the external object, and the differentiation of the instinctual flow in the dual direction of the self and the object (Janiri, 2008)

Now that the subject has “discovered” the identification to himself, he can model and modulate successive identifications to the other, from time to time mirror, alter ego, twin, complement or attribution of parts of himself. The maturing stages of the relationship with the object, as is well known from the path traced by Freud (1913) towards genitality, contemplate the pruning or loss of idealizing or projective residues, which derive from primitive mechanisms of acquisition and stabilization of the object, the acceptance of this in its totality, and therefore also the conflictuality and ambiguity of which it is the bearer, and finally its re-constitution from an introjected external object (internal object) to an object of intersubjective and real relation. It is not always the same object, but a transference object, transfigured into the imaginary and fantasized by primary figures, the affects towards which they are now made available to be “transferred” unconsciously to other objects

In this tension from the indistinct to the distinct, from the inside to the outside, from the subjective to the objective, the concept of “transitional object” of Winnicott (1953), root of the symbolism and yet still the real object, exponent of a “intermediate” area towards the acquisition of the “external world as perceived between two people in common”. Winnicott argues that the term transitional object opens the way for the process of becoming capable of accepting difference and similarity. Difference from the other, similarity to self: we are at the origins of that process, previously described in its evolutionary stages, and that we could call narcissistic identification and “discovery” of the other. On the other hand, the original meaning of the transitional object is also that of grounding and discovering, along the vertiginous thread of instability / stability, or, again, using a psychological metaphor, of arriving at the construction of a complex figure-background (self and the other)

In the interpersonal relationship the whole range of valences of object relations resonate: from the instinctual to the transference, from the identifying to the transitional, configuring a framework of great dynamism in which desires and needs emerge, animate the foundational mechanisms of psychic functioning and permeate projects, choices, trends. In some theories of personality the dialectic between drive and object reappears in the form of defined psychic traits: for example, in Cloninger’s theory (1993) the Novelty Seeking dimension re-echoes the drive untied from the object, whereas the Reward Dependence (dependence on gratification) represents the social tendency to seek contact with others, to enjoy the warmth of the object.

 

2.3 Differentiation between male and female

 

Pulsional and object in turn are subject to a more basic and fixed logic, that of the instinctual. In this framework the differentiation between masculine and feminine offers itself as the foundation and model of every complementarity: the perception of difference from the other, correlated to the sense of self-identity, proceeds from gender recognition. Complementarity presupposes the constitution in the mental of pairs of opposites: pleasure / displeasure, good / bad, etc. they are born as specific modes and qualities of thought following the first splitting and projection / introjections movements. The sexualization of the brain, given biologically and genetically, establishes the articulation of the instinctual mental space of gender identity, in which the mechanisms of primitive functioning of the psychic apparatus, in the appropriate evolutionary phases, split the male from the feminine, projecting out of the aspects perceived and experienced as strangers, and they retain their own and syntony with themselves as internalized.

 

It is clear that identity originates from differences and all this implies a constitutive, fundamental bisexuality of the human being, an indistinction of gender that, similarly to the indistinction between oneself and the other, or between the subject and the object. , precedes, in the primordial chaos, the differentiation of sexuality and sexual orientation and establishes the dialectic of opposites. They are still the defense mechanisms, archaic as denial or more evolved as the removal, which establish the relationship, more or less rigid and more or less functional, between themselves and the excluded part of their original bisexuality. Homophobia, object choices to affirm a presumed “normality”, culturally mediated foreclosures and prejudices, projections in the partners of split parts of their sexuality, are just some of the pathological consequences that in the adult age the subject actualizes on the basis of the legacies of his own childhood sexual history.

The dialectic between masculine and feminine necessarily intersects with that between paternal and maternal, the harbinger of transgenerational instances and the transmission segment of the species’ inheritance (Menarini and Neroni, 2002). These are undeniable principles, which are placed at the core of the sex genre, which constitute it as a model of functioning. Here then the maternal inheritance, in continuity with the feminine, is given as matrix (matrix) of acceptance and receptivity, as a hollow space, pure potentiality, humus and original nourishment. Likewise, the paternal inheritance, in continuity with the masculine, is given as form, configuration, structure (pattern) constructed starting from the interaction between space and matter, jutting out, intrusive, pure actuality. Each subsequent mode of functioning of the individual will carry with it the imprints of these ancestral functions in their complementary relationship.

Winnicott in Creativity and its origins (1953) associates the “pure” masculine element with the idea of ​​doing, of establishing an active relationship or of undergoing a passive relationship, within the framework of the instinctual drive; this already presupposes a separation from the object. On the contrary, the “pure” feminine element has to do with being, in the sense that the child becomes the breast (or the mother) and the object identifies with the subject, before and beyond any instinctual drive. The author states: “Here in this relationship of the pure feminine element with the breast a practical application of the idea of ​​the subjective object takes place and the experience of this prepares the way for the objective subject, that is to say for the idea of a self and for the feeling of reality that springs from the sense of having an identity … This sense of being is something that precedes the idea of ​​being one with, because there was no thing except identity “. This is how the identity for Winnicott, but also according to the concept of matrix, is acquired through a feminine and maternal element, where the paternal and the masculine diverge in their determinations and achievements.
In the pathology of the couple, many problems arise because of the lack of sexual complementarity that is mental even before the body, or the lack of formation of a dimension of mutuality or reciprocity between welcoming and seeking / finding acceptance or, ultimately, between being and having, between being and doing. The same lack of intimacy reveals non-spontaneity, a difficulty in the comparison between the masculine and the feminine. I also consider particularly interesting for this discourse the idea that a part of one’s own sexuality, split or dissociated from remaining sexuality, can have its own evolution, live its own independent life and project itself into the other as unconscious determinant of object choice.

 

3. Empathy, reciprocity and relationship skills

 

In the psychoanalytic field, the author who has studied the empathic phenomenon with more depth, in the theoretical framework of narcissism, was Kohut (1971), for whom the concept of empathy concerns first and foremost the very nature of psyches. Starting from the philosophical meaning (Dilthey, Husserl, Stein), in the current language we can consider this term synonymous with emotional participation and describe it as a process by which a subject temporarily assumes the inner position of another to share his experiences especially emotional. In fact, taking up the critique of Scheler’s concept of empathy (1923), what is shared is not the affective experience in itself (since one can not enjoy and do not suffer like the other), but its value and meaning are transferred to our similar experiences. The clinical point of view of Kohut (1966) is much broader: he defines empathy as an essential constituent of psychological observation, consisting in the ability to collect data through the apprehension of complex psychic configurations of other people whose image we imagine internal experience. In fact, it is a means of delimiting the area of ​​psychic phenomena and in that sense it is equivalent to a vicarious introspection, that is, to observation and knowledge of the internal world of another through the intimate perception of a correspondence with one’s own.

It is thus the inner human life in its dialogic and intersubjective dimension that is made accessible by empathic-introspective immersion. The double movement of apprehension of the other, in correspondence with parts of himself, and of projection of himself in the experience of the other leads to a complex phenomenon that in its fundamental relational nature is no longer reducible to its intrapsychic partiality and new throws light not only on the experiences of the other, but also on their own, a method of self-knowledge as well as knowledge. The empathic listening, guided by the attempt to tune with the other by means of vicarious introspection, strengthens the cohesion of the other’s self, nourishing self-esteem and feelings of well-being and this is the basis of the Kohohian psychoanalytic method addressed above all to pathological narcissism. Psychological theory, an instrument of knowledge and therefore also of diagnosis, method of treatment: the widening of the empathic horizon in Kohut is comparable only to the extended conception of understanding and empathy in phenomenological psychopathology, from which it draws inspiration (cf. Karl Jaspers, 1913).

If empathy establishes the interpersonal relationship, reciprocity substantiates it, as the couple’s ability to exchange on a design, stable and fluid basis. In the couple union the anomaly of the person and the anomaly of the personality, concepts often (but not always, as we have seen) coinciding and starting from the problems of the individual, involve a lack of spontaneity and fluidity that can reach invest the choice of partner and the relational project. In particular, the ability to formulate a project, maintain it and grow it over time may lack in one and/or the other component of the couple.                                 .
However, what is missing, regardless of the specific forms of disturbance or characterization that are found in clinical reality, is reciprocity, the ability to exchange with each other, or in other words the relationship of love (Baldassarre, 2008) , because of lack of empathy and pathological concentration on oneself and on one’s needs, or by unconscious attraction towards patterns and relational representations of the past, however due to a discrepancy between the structural self and the relational self, in some ways between the face and the mask. The other-from-itself is not the recipient of a communication, an exchange, an object of curiosity and feeling, but is involved in a closed system, however self-referential (and this is well beyond the specific case of narcissism!), in which it comes to play a function of support and strictly rigid meaning. The other must give meaning and meaning to the existential experience and to the experience of oneself, but it is important that this represents a starting point for a transcendence of oneself and of the other in the couple, and not a mere instrumental point of arrival.                                    .
Another way of looking at reciprocity is the function of roles in the couple, which determines the symmetrical or asymmetric quality of the same: a symmetrical interpersonal relationship is one in which both partners play an equal role. On the contrary, an asymmetric relationship can imply the meaning or exercise of control and power. Relational ability is a bridge-concept, which allows the jump from the individual / subjective to the relational / intersubjective, between empathy and reciprocity, which constitutes a stable mode, a personality trait of the subject, which allows for the possibility for him to establish a relationship of reciprocity in the interaction with a partner. Several elements fall into this mode, including: ego strength, level of neuroticism, drive and tension towards the object, empathic and introspective capacity, autonomy and interdependence.

 

4. Bipersonal field and intersubjectivity

 

We have previously seen the notion of an interpersonal field as a privileged place for the realization of interpersonality and the actualization of interactive dynamics. At this point it can be added that for this to be established in a positive way it is necessary that two persons endowed with sufficient relational skills and who exercise a sufficient degree of empathy enter into a reciprocal relationship, becoming actors of the same field. Once again, the abandonment of the individualistic position must be emphasized in this passage.
From a psychodynamic point of view, the transition from theoretical intrapsychic models, centered on individual mental functioning, to others of a relational type, in particular by the Anglo-Saxon school (Winnicott, 1953, 1965; Balint, 1952), with a first on the mother-child unit and then on the analyst-patient couple. In the most recent developments, intersubjectivity represents, supporting the symmetry of analyst and patient positions, the most advanced conceptualization of the analytic setting, which becomes the “bipersonal field” in the Baranger model (1961-62). For relational psychodynamics, the world of external and real relationships, those that establish a person’s way of being and his interpersonal behavior, is forged on object relations, relationships that the subject establishes within himself with internal objects (representations of people) . This world of internal objects is in turn constructed on the basis of childhood relations, in particular with the primary object (mother). They are the first family relationships, therefore, to determine in the unconscious the type of interpersonal relationship that a man or a woman is predisposed to put in place with the privileged object.

 

According to Sullivan (1953), whose most significant contribution can be considered the interpersonal theory of psychiatry, every situation evolves from the relations of the individual with other people, especially those with whom he lived in childhood: the parents or their substitutes, that he defines “significant adults”; for this author a large part of mental disorders is the result of inadequate interaction. Sullivan’s thinking, for which interpersonality is a product of infantile relationships, is a link between psychoanalytic and system-relational theories, in which communication plays a major role. According to the latter, and in particular for Bateson (1972), Watzlawick (1967) and the school of Palo Alto, the interpersonal relationship, with a reciprocal exchange of information, constitutes human “communication”: this concept is mainly attributed to the meaning of interpersonal relationship. Citing Bateson: “Communication theory studies how behavior occurs as a response to observable communication in others, and how behavior is in itself communication”.

 

According to the latter, and in particular for Bateson (1972), Watzlawick (1967) and the school of Palo Alto, the interpersonal relationship, with a reciprocal exchange of information, constitutes human “communication”: this concept is mainly attributed to the meaning of interpersonal relationship. Citing Bateson: “Communication theory studies how behaviour occurs as a response to observable communication in others, and how behaviour is in itself communication”.

 

The field then comes to configure the situation of two people inextricably linked and complementary for the duration of the situation, and involved in the same dynamic process. The Baranger claim: “the members of this couple are not intelligible, within this situation, one without the other”. It is clear that the authors refer here to the analytic couple; however, it is possible to extrapolate the concept of bipersonal field to affective relationships, bearing in mind that in daily experience we try to enter into relationships with others by sticking to their objective reality, but without succeeding independently from our subjective projections, especially when others they are the object of desire and love. The field is therefore crossed by unconscious dynamics.

The Barangers speak of modifications of the Gestalt of the couple, meaning with this particular structure or configurations of the field that emerge from one another and manifest themselves as one unmistakable whole: “a married couple can unconsciously transform into a couple father-daughter … the transformation of the couple, its change of Gestalt or of meaning, is a disorder, often pathological, of the original couple.”According to the authors, natural couples tend to define and crystallize their Gestalt, the loss of which, associated with the related permeability to a different Gestalt structure, is therefore an alteration of the original arrangement that often has a pathological meaning. Projective identification mechanisms can support the dynamic or energetic lines of the bipersonal field and constitute the supporting axes of the structuring of a Gestalt of torque, whereas the term “crystallization”, with its connotation of rigidity, represents in my opinion already the tendency to pathological slippage.

 

Finally, in the analysis of the interpersonal relationship, one can not fail to mention the intersubjective theory, which in authors such as Stolorow (1995) stands in continuity with the psychology of the Self, always with the warning to consider that, as well as for the field bipersonal, theoretical reflection arises as an effort to conceptualize the psychoanalytic relationship, from which we can extrapolate and generalize applications to interpersonal relationships. Well, the relational experience, from this point of view, is intrinsically interactive in that it involves two subjects, for each of which the other assumes the origin of a self-object. In kohutian narcissism, the object-self experience includes an object that acts and is perceived only as a function of the subject and of its psychic sustenance and is therefore experienced as part of itself. In the interaction of couple, which is defined precisely starting from the idea of ​​mutual influence, intersubjectivity tends to underline in such interaction the participation of two subjects with a narcissistically founded (but not necessarily for that pathologically connoted) and their tension in overcoming the monadic isolation in the dual encounter, each seeking in the other that complement of self which is also and above all completion of self.                                 .

 

5. Couple pathology according to the type of relationship and the life cycle of the couple

 

During childhood and childhood we all experience a unique relationship with a person of our sex and with one another: so every child learns first and foremost from her mother, that is identifies with her and develops an exclusive relationship with the father, while the reverse applies to the male. In the couple there is a tendency to relive these original identifications and relationships and, when they present problematic elements, it is highly probable that these perturbations are repeated in the union of the couple.

As we have already seen, oedipal and pre-oedipal phantasies animate the individual unconscious and the couple’s imaginary, giving rise to symptomatic formations that express themselves in interaction and interpersonal communication as relational uneasiness.

 

An approach to the pathology of couples could use a model that calls attention to two significant elements: 1) the relationship can for convenience and artificially be decomposed into different types of relationship, each of which can develop a disorder, and 2) the couple goes through a life cycle and some problems are more relevant in one phase than in another (Dominian, 1979).

The sub-relationships that underlie the couple relationship are related to the areas:

1) Physical or sexual, 2) emotional or psychological, 3) social, 4) intellectual or cultural,

5) Spiritual, where the phases of the couple cycle can be recognized schematically in the following three:

1) The first years without children, or with still young children,

2) The period in which the children grow up (“middle years”), until the last house is released,

3) The reconstitution of the couple without children (empty nest syndrome) until the death of one of the couple’s members.    It is obvious that they are conventional approximations, subject to the peculiarities of the combinations (for example sub-relationship x phase), to the variability of the single couple situations and to the effect of the historical periods in which they are lowered (for example, the three phases described are all much delayed compared to thirty years ago).

 

The first question to consider is the willingness of the participants to establish a stable or even more permanent relationship: in the distortion of this variable, the union of a couple can be a means to surreptitiously reinforce an identity, perhaps to escape from family of origin, to loneliness or to social uncertainty, and participants may not succeed with the passage of time to achieve integration and reciprocity.

A second problem is represented by the difficulty of one or both components of the couple to free themselves from the parents and more generally from their family of origin: there can be collusion in dependence on it or guilt in feeling that they have repudiated or hurt parents.

In both cases, family fantasies or real behaviours and relationships, which manifest in the form of interference or pathological attachment, do not allow the autonomy of subjects from their past. But even if the separation from the family apparently and superficially takes place, there is always the risk that one of the two participants will treat the other as a parental substitute, thus transferring idealizing tendencies, loving or hostile feelings “by proxy”, ambivalent or conflicting attitudes.

We are here in the domain of that distortion of interpersonal relationships called by Sullivan (1953) “parathassia” and due to the activation of infantile impressions projected onto others, so as to transform them into something different from what they are. The contiguity with the concepts of transference and projective identification is quite evident.
One of the most common pathological situations of couple is that of emotional deception (Dominian, 1979): sometimes it happens that a partner is chosen who appears in a certain way (safe, strong or weak and submissive, or faithful and reliable) for then realize that in disguise lies a person with opposite characteristics. Excluding the conscious simulation, we are here to deal with the question of the False Self or unstable identities (as in borderline subjects), so that the unconscious symptomatic production (reactive or defensive) concerns massive parts of the personality. Pathological jealousy in some ways can be seen as an emotional deception in relation to an unstable and elusive internal object.

 

In the pathology of couples, even the children are symptomatic formations, being able to play the role from time to time vehicle of exclusive communication between the spouses, then the glue of the couple, or attempt to unlock or refound the relational situation, or move the dependence or even to produce a self-object that is believed to be controllable and often functional to a certain torque dynamic. The same reactions of parents to the birth of children are important tests revealing their personalities and their relational dynamics and are an important source of unilateral changes that can turn the cards into relational play. Finally, many behavioural anomalies unveiled in pairs, from addictions, in particular affective dependence and co-dependency, to the control of impulses, can be usefully framed as pathologies of social relational, allowing to understand how a schematic classification such as the one mentioned in the sub-relations is a heuristically valid tool in order to think to a   diagnostic grid of the couple operations.                                            .
 6. Distortions of the interpersonal field and pathological drifts of the couple

 

Through an observational semiology of the couple’s interactions it is therefore possible to arrive at a delimitation and description of the interpersonal field, of its elastic twists and of its rigid distortions. The latter, if left untreated, imply irreversible pathological drifts, which are completely incomprehensible if an individual and one-sided approach is attempted.

 

The pathological interactions of the couple are the object of study of systemic theories, which have led to enucleate concepts such as “affective divorce” (Bowen), “division and conjugal deviation” (marital schism and marital skew respectively according to Lidz), “pseudo mutuality” (Wynne ).

 

Wynne is the first from the observation that the main concerns of every human being are two: the problem of the relationship and that is the fundamental need of man to relate to other human beings, and the need to develop consciously or unconscious, a sense of personal identity.

 

6.1 Emotional distance
Examining the conjugal life of parents of schizophrenics, Murray Bowen (1985) points out that a constant and characteristic element is a marked affective distancing between the two, which he defines as “affective divorce”. The way in which spouses establish this distance is very variable. On the one hand there are couples whose members maintain an extremely controlled and formal relationship and show little and hidden divergences among them. They consider their ideal marriage, maintain a satisfying sexual relationship, use affectionate terms with each other, but find it very difficult to share feelings, thoughts, and experiences. On the other hand there are spouses whose proximity triggers litigious discussions, hostile criticisms or reciprocal threats. They only get along when they are among other people and avoid conflict by alienating each other. Between these two extremes there are couples in which the affective divorce manifests itself with various combinations of formal control and open disagreement.
Bowen highlights how two partners, both equally profoundly immature, can experience their immaturity in a different way: one denying immaturity and acting with an appearance of hyper-adequacy, the other accepting immaturity by acting with apparent inadequacy (cf. Kerr and Bowen, 1988). Neither is able to function in an intermediate position between being hyper-adjusted and being inadequate. The hyper-adjusted element is dominant and aggressive, the other weak and complacent. This false relationship between a hyper-adequate partner and an inadequate partner creates constant tensions in the life of a couple, which are manifested above all in the moments in which common decisions have to be taken, which re-proposes the “hyper-adequate-inadequate” relationship as “dominator-submissive”. The hyper-adjusted element is considered obliged to be responsible, considering the other as unreliable, while the inadequate feels forced to submission and considers the other as a tyrant. In reality what strikes in such couples is the inability to decide: everyone avoids the burden of responsibility and the anxiety of submission by postponing the decision.

In this situation of tension, lack of real communication and uncertainty, the birth of a child becomes an important factor in stabilizing the relationship between the parents, obviously to the detriment of the child. This constitutes an “interdependent triad” father-mother-child in which the child is the keystone, being able to act as a symbiotic appendix of the inadequate and weak spouse and thus “rebalancing” the asymmetry of the couple.
The three summits assumed by Bowen, formal control, open disagreement and hyper-adequacy-inadequacy, thus come to configure torque dynamics characterized by excessive emotional distance, for which spouses lack or lose in relational capacity, sharing and reciprocity. But then it is legitimate to ask: with respect to other situations of distance, such as emotional detachment, in which the partners become estranged from each other and become apathetic and insensitive, what is the qualifying element of emotional divorce? I believe that in all the couple situations described by Bowen the divorce is subject to superficial “facades” of functioning and emotional commitment that either give an impression of falsehood, or of empty conflict, or even of relational stereotypes, distorted and shared images of self and of the other such as childhood heritage (personifications according to Sullivan). Emotional distancing is therefore the common denominator of relational conditions characterized by emotional separation or divorce.

 

6.2 Marital division / deviation

Referring to the pathogenic marital relationships, Theodor Lidz (1965), with his working group at the Yale University Psychiatric Institute, distinguishes two forms of relationship:

1) conjugal division (marital schism) and 2) conjugal deviation ( marital skew), the former being more frequent in families of schizophrenics. In the conjugal division, the couple does not provide mutual support for emotional needs; there are only constrictions between the spouses, distrust, threat, violence, frustration or in any case the absence of gratification, discord and lack of complementarity of roles. The husbands do not share either their satisfactions or their difficulties, they are lacking in empathy and pursuing selfish goals, trying to overcome the partner and creating a climate of competition for the affection of their children. Wives, on the other hand, try to impose a system without rules or heat, eccentric and misleading, where communication disorders are massive.

The author classifies the distorted communication of these couples along three axes: 1) competitive axes dominated by man, which appears rigid, dominant and violent, 2) competitive axes dominated by women, in which man is often totally excluded from the family, leaving absolute leadership to her, 3) axes of double dependence, in which neither man nor woman manage to establish a regime of stable power and withdraw each other, often developing a dependence on a third person.

In conjugal deviation there is a different relational regime: in this case within the couple there is a frankly disturbed component, more or less accepted in its pathological parts, which involves the whole environment in its Weltanschaung.  The opposition of the spouse is not as alive as in the marital schism; on the contrary a sort of convergence is realized between the two partners which translate into a “neoequilibrium”. This creates a couple formed by a strong and abnormal element and a weak and dependent element, which participates in the convictions of the former and tends to make them adopted by others. The result of this interaction is the formation of a relational and family system closed to the outside, whose reality clashes with that of the surrounding world. In this atmosphere of unreality, so similar to that of a folie à deux, Lidz says, the conflict is noticeably concealed, but not absent.
In both conditions there are evident evolutionary distortions for the offspring: the frontiers between the generations are not respected, and the parents do not come to represent models of identification that can be used for the children, who therefore do not reach a structured and stable self-identity. After all, the coalition and the complicity that should permeate the relationship of the couple give way to schismatic breakdown or deviant collusion, with dramatic consequences on the psychic balance of the children, who are forced to position themselves in conflict with one or other of parents.
The relational pictures described by Lidz are clearly more openly pathological and pathogenic than the subtle and conformist ones described by Bowen. The great merit of Lidz’s work is to have introduced the psychotic dimension in couples in order to demonstrate a causal relationship with the production of family psychotics. The interpersonal scenario is thus crossed by mechanisms of splitting, projection and projective identification, of the cancellation of borders and of closure towards the outside world, and on this scenario struggles are fought to the death for the conquest of power. The question of leadership, violent, exclusive of the other, rapacious towards the children, represents the appropriate dimension of psychotic relationships, whose acme is reached with the conjugal deviation, shared system more or less openly delirious and already started to an autistic organization.
6.3 Mutuality and pseudo mutuality

 

The third author, from whose vertex to look at the pathology of the couple in terms of distortion of the dynamics, roles and interpersonal communication, is Lymann Wynne (1958) who, starting from the need of each subject to harmonize the relational development and the formation of personal identity, describes three modalities offered to solve this dilemma: non-mutuality, mutuality and pseudomutuality.In non-mutuality the subject makes no effort to save the relationship, but only protects his integrity of perception and judgment, and his identity; here there are significant points of contact with the narcissistic pseudo-relationship. In mutuality the relationship is accepted with all its riches, in all its breadth and depth, but also with all its unforeseen and risks. The development of the individual takes place through this relationship and is questioned and shaped by it.

 

Pseudo mutuality is a very particular relationship, in which there is a sort of separation between relationship and identity: solitude and alienation are avoided through the relationship, which however is distorted because every attempt at spontaneity, lived as threatening with respect to self-identity, is trapped in rigid and sclerotized barriers. On the other hand, every affirmation of individual identity and every process of identification is experienced as an attack on the relationship. Everything then takes place in a climate of illusion and false appearance, so the relationship, in real competition antagonistic with the identity, is saved at the expense of the latter and vice versa.

Mutuality and pseudomutuality are opposed in several respects: 1) primarily because of the role and weight of tension in the couple, since in a mutual relationship the tension that is lived is fully accepted and divergences can be perceived as stimuli, whereas in pseudomutuality every tension is experienced as a threat of destruction and breaking of the relationship and therefore carefully avoided; 2) for the fate of emotional investments, which in mutuality are fully perceived and accepted and are subject to changes, while in the pseudomutual relationship they stiffen and tend to remain unchanged, giving a sense of emptiness and suffocation to the relationship. Wynne claims that “the pseudomutual relationship involves a characteristic dilemma: divergence is perceived as a harbinger of breaking the relationship and must always be avoided; but if the divergence is avoided, the growth of the relationship is impossible “.
The pseudomutual family situation appears characteristic due to a fixed organization, with a limited number of immutable roles that assume the value of stereotypes. The distribution of roles must never be questioned and must always appear right and desirable, an agreement must always be found beyond divergence. In these families and in these couples an aggressive and independent behaviour towards the established structure of roles is experienced as an imminent catastrophe, so that there is no space within it for spontaneity, dynamism or true participation, nor for change.

 

The members act as if the family were a self-sufficient system delimited by a complete boundary line, which can be extended to include what appears to be functional to the maintenance of the system and to expel what is not: what Wynne calls “the barrier of rubber” .In pseudo mutual families various mechanisms are employed to maintain the situation: 1) the creation of a family subculture of myths, legends and ideologies, 2) indiscriminate approval as a way of reinforcing roles, 3) secrecy, 4) the tendency to institutionalize experiences; 5) use of intermediaries between family members. Everything is functional, therefore, to the rigid preservation of the internal structure, even, paradoxically, the elastic means of the rubber barrier.

 

The importance of Wynne’s observations and thinking lies in having grasped a factor, or rather a fundamental variable, through which to explore, from a dimensional point of view, and therefore of continuity, the normal and pathological relationship: the relationship between relationship and identity, which in other words could be seen under the profile of the subtle balance, already highlighted, between cohesion and individuation.
6.4 Incompatibility of character

 

Beyond the popular acceptance of the term “incompatibility of character” between two people, the concept remains, scientifically and clinically founded in a psychopathological key, of a relational distortion defined by a missed or impossible meeting between the personalities of two partners who commit themselves in a couple relationship, due to mutually repulsive aspects of them. The question is whether these aspects, which remove the components of the couple, must be considered opposite or similar, reminding that a certain degree of opposition (but evidently not of opposition) is necessary for complementarity, whereas the similarity pushed up to equality can be source of distancing.

By resorting to a metaphor borrowed from physics, just as opposed charge particles attract and cancel each other and those of equal charge repel each other, so the compatibility of two elements in relation to each other should be the result of a distribution of attractive forces such as not to determine the cancellation of the elements and to keep them in a proximity that does not disperse them. Once again the antinomy between separation and fusion is repeated, in search of the optimal relational distance, a problem that couples therapists have empirically tried to solve.

Another aspect from which to look at the question is that of object choice, which in psychoanalysis, argue Laplanche and Pontalis (1967), and “includes the idea of​the irreversible and decisive character of the subject’s election, at a decisive moment in its history. of his type of object of love “. For Freud (1905, 1914), in fact, the objective choice derives from infantile models and the unavoidability of its nature depends on the transference or coercive character of the repetition of the infant relational pattern in post-biracial age.  He distinguishes an object choice for support or analytical and a narcissistic object choice: in the first the subject transfers the original impulse to an object of love that has to do with nutrition, care and protection as a child has received them; in the second the model is the relationship with one’s own person and the object can represent real, ideal, nostalgic or self-fulfilling aspects.

These modes of choice may be co-present in varying degrees but, above all, they are not univocal in their (apparent) contraposition: thus the anaclytic choice, modelled on a support of sexual drives on those of self-preservation (the breast as an object of love and source of heat and nourishment), is in some ways also profoundly narcissistic, while the narcissistic choice, as is well seen in subjects unable to love but with a desperate need to be loved, is also structurally supportive.                                     .
Here it is proposed a theme that has fundamental relapses in the clinic, for example personality disorders. In fact in dependent personalities the object of dependence is functional to the maintenance of an internal structure unitary and cohesive, which in order to express itself, needs an external support assimilated as an anaclytic internal support; from this point of view one can perhaps say that this completion of self constitutes a narcissistic function. On the other hand, the narcissistic personalities, in an attempt to satisfy their needs for reflection and idealization, forge relationships with Self-objects, which are wholly instrumental to self-implementation and to the strengthening of the self-image, but which actually realize a support for self-preservation.  The difference is that in employees the way in which the object is associated with itself is passive; in narcissists it is active and manipulative. From this point of view it is very difficult for an assortment of couple between an employee and a narcissist to be compatible, as one might be inclined to believe given their apparent pathological complementarity.                        .
The discourse on personality disorders introduces that of the dysfunctional couple constituted as addition or enhancement of two individual weaknesses. It is obvious that in the couple relationship both components bear the intrapsychic or relational “wounds” or “flaws” they have accumulated over the years of infancy, adolescence and early adulthood; it can be added that if the partner is able to make the missing or complementary element, the relationship can offer the ingredients for a healing experience that will last a lifetime. This does not happen when unfortunately the partner does not have the capacity to provide this natural therapeutic resource, or when, as often happens, both components have a compromised personality, so that they do not have the means to act as mutual healing agents. The concept of incompatibility of the character arises in the context of this interpersonal relationship difficulty of the couple, when the natural therapeutic resources in the one and/or the other part are lacking.                                                           .

 

7. Conclusions

 

As we have seen, the distortions of the interpersonal relationship represent a class of psycho-relational disorders in which the couple and its functioning can be assumed as a clinical and study object. The concept of distortion refers to a dimensional psychopathology, descriptive not of discrete monographic entities and clearly distinct from each other, but of a continuum that goes from the normal relationship to the relations of psychotic type. Certainly also in this sense there is a breaking point, identifiable in the loss by the couple of elasticity and plasticity instead of

Stiffening and a stereotyping, but this can be considered the result of an excessive “twist” of the torque dynamics, with all the intermediate degrees of this process, a perspective that does not belong to the competence of a categorical psychopathology, such as that of the DSM-5 (2014).

The distortions of the interpersonal relationship involve three orders of consequences:

1) A certain level of suffering (distress) individual, couple or family,

2) A symptomatology that is expressed relationally and

3) A certain degree of pathogenicity that tends to hit weak elements or defenceless, like the most vulnerable children or spouse.

To these consequences we must add two others, which have to do with the couple’s history and the construction of the relationship: 1) an excessive attachment to the past: in the distorted relationships the partners continually revoke the past, sometimes in a nostalgic sense, more often in recriminatory and vindictive way, from diametrically opposed (and opposed) vertices; in this “reification” of the couple’s history, real regressions to the traumatic points of repere, the families of origin regain weight and value and exercise specific morbid attractions towards the spouses; 2)a block of the existential relational project: the couple seems to stop in an eternal present, concrete and objectified in a kind of hyperreality, without the ability to develop an imaginative or symbolic dimension, losing the project, that protensio towards the future, charge of promises and hopes, which had characterized the dawn of the relationship.

As for the causes, the previous analysis of the psychological dynamics of the individual and of the couple, as possible points of vulnerability and weakness, and of the psychopathological processes that unravel from them, had the purpose of presenting an exemplary, if not exhaustive, overview. Above all to show that the interpersonal relationship is constituted as a subject of psychopathology.

The strong appeal of the DSM-5, in the alternative diagnostic model of personality disorders, to interpersonal functioning, in its two declensions of empathy and intimacy, is clearly oriented towards relational psychopathology.  The group of personality disorders is indeed heterogeneous but recognizes as a common denominator, in almost all cases and contrary to mental disorders, a strong expressive characterization in a relational and social key. The personality disorder tends, so to speak, by its nature to manifest itself and to exalt itself in the encounter with the other, therefore in the area of ​​interpersonal.  This can be seen from the severest features, think of schizoid asociality or paranoid distrust and persecutoriness, to those so-called intermediate, where we find borderline instability, antisociality, histrionic seduction and narcissism, to those of a neurotic level, including dependence and avoiding sociophobia. The stable character, by definition, of personality disorders makes them ideal paradigms not only of a given relational disposition, but also of an effective modality of establishing a relationship, bridging personal psychopathology towards interpersonal or social psychopathology, supported in this by modern trends in phenomenology and psychoanalysis.
REFERENCES
American Psychiatric Association (2014). DSM-5. Manuale Diagnostico e Statistico dei Disturbi Mentali. Milano: Raffaello Cortina.

Baldassarre M. (2008). Evoluzione della coppia. In: Coppia, famiglia e patologie emergenti. Roma: Alpes.

Balint M. (1953). L’amore primario. Milano: Raffaello Cortina, 1991.

Baranger W. & Baranger M. (1961-62). La situazione analitica come campo dinamico. In: La situazione psicoanalitica come campo bipersonale. Milano: Raffaello Cortina, 1990.

Bateson G. (1972). Verso un’ecologia della mente. Milano: Adelphi, 1976.

Bion W.R. (1963). Gli elementi della psicoanalisi. Roma: Armando Armando, 1979.

Bowen M. (1985). Family therapy in clinical practice. Lanham, MD: Rowman & Littlefield.

Callieri B. (1995). Lo scacco della donazione di senso nella psicosi melanconica: aspetti antropo-fenomenologici. Noos 1 (1): 61-70.

Cloninger C.R., Svrakic D.M., Przybeck T.R. (1993). A psychobiological model of temperament and character. Arch. Gen. Psychiatry 50: 975-990.

Conrotto F. (1995). Pulsione o relazione: una opposizione irriducibile? Rivista di Psicoanalisi 41: 583-609.

De Risio S. (2004). Derive del narcisismo. Milano: Franco Angeli.

Dominian J. (1979). Terapia matrimoniale. In: S. Bloch (a cura di) Introduzione alle psicoterapie. Firenze: Martinelli & C., 1984.

Erikson E.H. (1964). Introspezione e responsabilità. Roma: Armando Armando, 1972.

Fairbairn W.R.D. (1952). Studi psicoanalitici sulla personalità. Torino: Boringhieri, 1992.

Freud S. (1905). Tre saggi sulla teoria sessuale. OSF, 4. Torino: Boringhieri, 1970.

Freud S. (1913). La disposizione alla nevrosi ossessiva. Contributo al problema della scelta della nevrosi. OSF, 7. Torino: Boringhieri, 1975.

Freud S. (1914). Introduzione al narcisismo. OSF, 7. Torino: Boringhieri, 1975.

Freud S. (1921). Psicologia delle masse e analisi dell’Io. OSF, 9. Torino: Boringhieri, 1977.

Galimberti U. (1999). Enciclopedia di psicologia. Torino: Garzanti

Janiri L. (2004). Recensione del volume “Derive del narcisismo” di S. De Risio. Idee in Psichiatria 4 (2-3): 97-98.

Janiri L. (2008). La relazione terapeutica in psicoanalisi. In: P. Petrini, A. Zucconi (a cura di) La relazione che cura. Roma: Alpes.

Jaspers K. (1913). Psicopatologia generale. Roma: Il PensieroScientifico, 1964.

Jung C.G. (1921). Tipi psicologici. In Opere, vol.VI. Torino: Boringhieri, 1969.

Kerr M.E., Bowen M. (1988). Family evaluation: an approach based on Bowen theory. New York – London: W.W. Norton & Co.

Kimura B. (1988). Aïda. Tokyo: Kobundo.

Kohut H. (1966). Forme e trasformazioni del narcisismo. In: La ricerca del Sé. Torino: Boringhieri,1980.

Kohut H. (1971). Narcisismo e analisi del Sé. Torino: Boringhieri, 1976.

Laplanche J., Pontalis J.-B. (1967). Enciclopedia della psicoanalisi. Bari: Laterza, 1973.

Lewin K. (1951). Field theory in social science. New York: Harper.

Lidz T., Fleck S. (1965). Schizophrenia and family. New York: International Universities Press.

Mcdougall J. (1986). Identifications, neoneeds and neosexualities. Int J Psycho-Analysis 67:19-31.

Menarini R., Neroni G. (2002). Neotenia: dalla psicoanalisi all’antropologia. Roma: Borla.

Minkowski E. (1966). Trattato di psicopatologia. Milano: Feltrinelli, 1973.

Rayner E. (1991). Gli indipendenti nella psicoanalisi britannica. Milano: Raffaello Cortina, 1995.

Resnik S. (1982). Il teatro del sogno. Boringhieri: Torino.

Scheler M. (1923). Essenza e forma della simpatia. Roma: Città Nuova, 1980.

Stolorow R.D. (1995). An intersubjective view of Self Psychology. Psychoanal. Dial. 5: 393-399.

Sullivan H.S. (1953). Teoria interpersonale della psichiatria. Milano: Feltrinelli, 1967.

Watzlawick P., Beavin J.H., Jackson D.D. (1967). Pragmatica della comunicazione umana. Roma: Astrolabio, 1971.

Winnicott D.W. (1953). La creatività e le sue origini. In: Gioco e realtà. Roma: Armando Armando,1974.

Winnicott D.W. (1953). Oggetti transizionali e fenomeni transizionali. In: Gioco e realtà. Roma: Armando Armando,1974.

Winnicott D.W. (1965). La distorsione dell’Io in rapporto al vero e al falso Sé. In Sviluppo affettivo e ambiente. Roma: Armando Armando, 1970.

Wynne L.C., Ryckoff I.M., Hirsch S.I. (1958). Pseudomutuality in the family relations of schizophrenics. Psychiatry 21 (2): 205-220.

 

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