The paradigmatic theory of modern epistemology holds psychoanalysis in its scientific statute Even if there is no explicit epistemology in the Freudian writings, it is undeniable that the genesis of psychoanalysis has a rigorous dialetic between theonzation and clinical observation. Metapsychology is an organized and consistent set of concepts, capable of explaining and coordinating the analytical experience. It is through metapsychology that clinical work encounters the possibility of universalization, while metapsychology finds the possibility of fulfillment in clinical work. Clinical experience also confirms the interrelation between psychopathology and culture. Modern times have brought about new versions for psychopathological symptoms, which, in turn, have special effects on the narcissistic personalities and the manifestations of anxiety, giving place to different neurotic configurations.