Foreword

Although the approaches vary, the Annual 2019 has as a fundamental theme: the changing of clinical practice as a consequence of the change in our patients, and the resulting attention to the non-represented which is manifested in the session by a fundamental involvement of the bodily dimension.

The first articles centre their reflections on two central themes of Bionian thought, the concept of O and the use of the Grid.

The article by Giuseppe Civitarese can also be read on the website of the Italian Psychoanalytic Society (spiweb) on the «Dialogues» pages, with comments by foreign and Italian analysts.

The concept of O is complex; Bion himself makes varied uses of it and it is sometimes used too broadly. The key point of Civitarese's article is the need to insert the concept of O into a system in relation to other concepts that define or limit it. The Author suggests that the image of a dense interweaving of lines drawn between the angles of a geometric figure with at least 16 sides gives an idea of the play of forces which describes the concept's complexity and its clinical repercussions.

In dealing with a concept like O that tends to the absolute, Bion exploits the penumbra of possible meanings which it evokes in order to make it «work». In the permutations it undergoes in Civitarese's thinking, O loses all its transcendent features and is read in the light of consensuality, sociality, language.

Maria Adelaide Lupinacci and Lara Bancheri start out from a historical reflection on impasse, underlining the ever-greater attention being paid to the analyst's subjectivity in forming blockages to the analytic process. They discuss two brief case histories in which the insight that comes about in the session has no corresponding developmental elements in the patients' lives, which seemed to have stopped on the threshold without achieving the vitality which characterized their analysis.

The Authors show how the internalisation of a model may enable aspects of theory to present