Beyond Fragmentation Clinical Journeys in Contemporary Psychoanalysis and Psychotherapy

In the last decades, an increasing convergence of epistemological principles brought about by results in neuroscience, infant and cognitive research and by the widely shared assumptions of attachment theory have engendered a more intense comparison and exchange among psychoanalytic schools and other therapeutic models. The relational turn, and a different conception of basic human motivations have revitalised the dissidents of the psychoanalytic movement, and clinical and theoretical concepts derived from Adler, Jung, Rank, Ferenczi are in the background of relevant turning points of contemporary psychoanalysis. A systemic-contextual approach has become wide- spread and with it, a radical reconsideration of real experience and trauma, in the line indicated by Ferenczi. Sexuality has lost its primary motivational role in favor of attachment bonds. The rigid distinction between primary process and cognition has been in various ways softened, blurring traditional differences from behavioural-cognitive models. Traumatic events are a wide spread explanation of aggressive behaviours, the result of personal vulnerability, not primary drive reactions as Adler had initially suggested. Jung had anticipated the striving towards integration as the central psychic motivation, while Rank had outlined the basic existential conflict between individuation and belonging. In my view, on his way from narcissism to self psychology, Kohut has successfully reassembled in his theoretical and clinical conception the torn fragments caused by the ejection in the first decades of the twentieth century of authors, whose basic constructs would inspire other major therapeutic schools (Ansbacher, 1990; Detrick & Detrick, 1989; Kramer, 1995; Mansager & Bluvstheint, 2017).

The shared legacy of these contributions, are, in my opinion, three intertwined and highly significant, theoretical and clinical features. The first is the priority that the patient’s wellbeing has acquired over the search for the