L’OGGETTO DELLA CURA

Ho partecipato recentemente ad un seminario tenuto dal Dott. Domenico Marcolini, psicologo clinico di formazione psico-analitica, formatore-didatta e supervisore.
Ne riporto qui sotto un estratto a mio parere significativo.

Nel 1937 lo scritto di Freud “Analisi terminabile e interminabile” mette l’accento su quelli che diventeranno i pilastri della psicanalisi contemporanea.
Essa abbandona la concezione di uno psicanalista che osserva e interpreta dal proprio punto di vista, con uno sguardo dall’alto, dove il paziente viene studiato in maniera obiettiva da un osservatore distaccato; si giunge infatti alla rappresentazione di due soggetti che co-costruiscono la relazione psicanalitica creando un campo relazionale bi-personale capace di produrre inediti significati. Analista e paziente sono quindi sempre coinvolti in un processo, prevalentemente inconscio, di reciproca influenza dove la terapia si configura essenzialmente quale storia di una relazione, di un lavoro a due in cui si costruisce e si narra insieme. Così come è tutta la natura umana a essere relazione.
Nel modello interpersonale che va delineandosi gli attori sono dunque due, accomunati da una relazione la cui natura è radicalmente dialogica e intersoggettiva.
Ne deriva che il terapeuta delle relazioni di aiuto svolge una professione legata alla materia sconfinata della soggettività e dell’intersoggettività, materia che si declina nelle singole persone e nelle specifiche situazioni di cura in maniera unica e irripetibile.
Emerge un Freud meno legato la modello pulsione e che pone maggiormente l’enfasi sul ruolo dell’ambiente e dei vissuti traumatici nella storia individuale che hanno origine in relazioni antiche.
Anticipa quindi un pensiero centrale per l’attuale modello interpersonale: la nostra vita mentale è perso più determinata dalle nostre esperienze e il soggetto è visto come risultato della propria storia.
Ecco qui una visione della mente umana che pone le sue radici nelle relazioni interpersonali dell’infanzia. Ne deriva, quindi, che l’oggetto di cui la psicanalisi si occupa sono gli ostacoli al processo di soggettivizzazione, al divenire soggetto di ciascuno come capacità di esistere, di creare legami, di amare e di essere amato. Acquista quindi centralità la teoria del trauma e delle difese quale modalità per gestire le sofferenze derivate dalle deficienze nelle cure genitoriali e dagli eventi traumatici più in generale.
In linea con questo ripensamento dell’oggetto della cura, nel 2008 esce sulla rivista Il Ruolo Terapeutico lo scritto di Sergio Erba “La ferita primaria”. Sergio Erba definisce così il “frutto di un’esperienza infantile nella quale i nostri bisogni di amore, di riconoscimento, di rispetto, sono stati gravemente traditi da chi ci ha messo al mondo con il compito di iniziarci e avviarci alla vita”.
Erba è appieno dentro la centralità data al trauma dal modello relazionale. Ma, coerentemente al suo pensare la pratica della cura come una pratica etica, ecco che l’accento viene subito spostato sulla persona del terapeuta, in quanto non può esservi spazio per l’aiuto al paziente se non è parimenti innescato e sempre vivo uno spazio di continua cura, ricerca e soggettivizzazione del terapeuta.
Così infatti prosegue nel citato scritto: “Per potersi disporre in modo autentico e non solo intellettuale di fronte alle modalità malate con le quali il paziente si difende dal dolore, dalla rabbia, dalla paura provocatigli dalla sua ferita primaria, il terapeuta dovrebbe per primo aver riconosciuto e accettato dentro di sé questa sua personale ferita”.
Nasce da qui quella peculiarità che assegna alla formazione permanente del terapeuta un’importanza imprescindibile.
Rispetto al tema della ferita primaria resta da dire un’altra cosa parimenti importante.
Diversamente dal sapere tecnico-scientifico che vede nel sintomo una condizione incoerente e malata da eliminare, nella psicoanalisi quel doloro sconosciuto, che è il sintomo, è visto anzitutto come un segno prezioso che vuol rendere udibili alla sordità del paziente i messaggi dell’inconscio, premessa indispensabile affinché la persona possa ricercare l’originalità della propria individuazione.
Sergio Erba assegna al sintomo l’importante statuto di ricerca, seppur mal adattiva, di una condizione di salute e benessere che asserisce come sempre potenzialmente possibile, a conferma di una concezione esistenziale che ci vede tutti desideranti d una maggior armonia personale e relazionale.

Note: 
Il Ruolo Terapeutico (2017) “I Quaderni. Antologia semestrale di clinica e formazione psicanalitica.”

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