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This new book by Giovacchini is divided into three parts, on psychic development and psychopathology, technique in the treatment of character disorders, and integration and adaptation in creative individuals.
Giovacchini describes character disorders as having defects in “the architecture of the personality” that are the outcome of faulty early development. To understand how psychopathology develops, we must examine the background of the caretaking interaction. The mother must be able to soothe her baby in order to feed him; in turn, the feeding experience causes the infant to feel further soothed. Many patients feel constantly agitated because they were not soothed as neonates; their incapacity to soothe themselves is a prominent feature of their psychopathology. Giovacchini describes a patient who began to feel calm when the analyst's capacity for soothing was internalized.
The analyst can foster a symbiotic transference that will rectify childhood deprivation. The mother's fusion can result in pathology when it is an engulfment based on her vulnerability and destructiveness rather than a smooth symbiotic union fostering an intuitive resonance, that enables her to be in immediate touch with her child's needs.
When the analyst merges with the patient based on his need to analyze and to foster autonomy and individuation, rather than on personal idiosyncratic needs, the analytic setting becomes a soothing environment, and through timely interpretations, the analyst provides symbolic nurture.
This comfortable state of fusion, however, is often achieved only after considerable turmoil, and the terrifying experience of having repeated in treatment the early traumatic maternal destructiveness. Giovacchini argues that psychopathology is better understood in terms of ego defects and structural factors than as the product of id forces clashing with the ego and the superego. He recalls several patients who defied all his efforts to understand their emotional problems in terms