Three in one
Review of Roberto Girola, A Psicanálise Cura? Uma introdução à Teoria Psicanalítica, Aparecida, Ideias e Letras, 2004, 189 pp
Readers who were children around 1960 may perhaps remember the slogan “Three in one”, which meant a big novelty during that time: the Neapolitan cream, strawberry and chocolate ice cream. Years later, in a humourous allusion to this same catchphrase, Marilena Chaui gave the title “Three in one” to a nice article on Voltaire’s Candide. (1)
These two memories came to my mind straightaway as I finished reading the book by Roberto Girola. Initially I had not realised that they were associations; rather, these thoughts seemed to be somewhat out of place, like those that burst into our mind at times, only to disappear as mysteriously as they emerged. But as these two memories persisted in my consciousness I ended up asking myself about the reason. And after some jumps, from “duck to ostrich”, the light appeared: --- it was a sort of elaboration in the form of a metaphor and metonymy brought together, giving an initial shape to the still fuzzy impression in me by what I had just finished reading.
Well, I thought, this is the thrust of the review I had promised to write for Percurso. In fact, Roberto Girola presents us not with one but with three books that are interlaced. The first one discusses the concept of cure in psychoanalysis; the second makes a careful analysis of diverse concepts that are central to the theory and the clinic; the third presents a perspective on the history of our discipline, moving along the red line that goes from Freud to Melanie Klein and from her to Winnicott and Bion, her two main disciples.
Here are the “three,” I thought. To continue the metaphor, the “one” --- that which provides unity to the work --- is the question of cure. That is because Girola never loses sight of his main objective, for which as much conceptual discussion as historical outline converge. And the set, as noted by Tales Ab’Saber in the preface he wrote to the book, constitutes a fine introduction to psychoanalysis, directed mainly to students of psychology who begin to study the subject, but also accessible to any reader who wishes to obtain a general idea about what Freud and his main successors did.
Girola begins by remembering that the desire to cure is present in the very core of the Freudian enterprise, as proved for example in Irma’s dream in Traumdeutung. In fact psychoanalysis begins like a medical treatment, with the view to eradicating the symptoms of the male and female patients who sought Dr. Freud in his consulting room: they also wished to be cured, thus laying the “desire for a cure” in both the poles (analyst and analysand) of the analysis. This origin as a branch of medicine would leave a mark on psychoanalysis, whose course, however, progressively distanced itself from this root to make itself an autonomous field of knowledge. So that today the need arises to take up the question: if psychoanalysis cures, what does it cure and how does it cure? (p. 18). It is to answer this question that our author directs his attention to concepts and to history.
It is necessary to make two complementary movements in order to define what psychoanalysis cures. The first one, comparative, will distinguish the psychoanalytic view of health (mental, in this case) from its counterparts in common sense and psychiatry. The second will demonstrate that in order to grasp what Freud designated as cure --- the aim of analytic treatment --- it is necessary to understand how the mind works and how it can be messed up, producing the disturbances known as neuroses, psychoses, perversions and psychosomatic illnesses. The next step, therefore, is to present the reader with an introduction to metapsychology and psychoanalytic psychopathology --- that is where the “second” of the three books comes in. This is done as much for Freud’s ideas as for those of the other three authors and is called for because what each one understands as cure will obviously depend on his view of the genesis, development and structure of the “psychic apparatus.” In other words, the therapeutic work will always be guided by a conception, explicit or implicit, about what is the mind and how it operates --- whether in a good or bad way---, a conception that determines the manner in which the analyst judges that it is possible to intervene in this functioning, con-forming therefore the interpretative mode and the general stance in relation to the clinic of each one of the major trends in psychoanalysis.
This way we see the organization of a network of concepts that provide the foundation for each author’s practice--- the idea of pulsion in Freud, the idea of fundamental anxieties in Klein, the self in Winnicott etc. From each of these axles come, so to speak, derived elements, whose connection with the central trunk is evidenced by our author with exemplary clarity. When talking about Freud, for example, Girola directs us from the Trieb to the primary and secondary processes, the different architectures of the mind which we call topical, to the theme of repetition, and so forth. The same is valid for the study of Klein (the unconscious phantasy, the persecutory and depressive anxieties and the respective “positions”, the basic defence mechanisms), for the study of Winnicott (the self and the threats that surround it, whether or not there is the environment’s facilitating role, the ideas of potential space and the transitional object) and for the brief but highly enlightening study of Bion (his worry about “emotional turbulence” to the concepts of contained-continent, his theory about thinking, his so original clinical method).
Even this rapid enumeration of the topics dealt with in the book suffices to provide an idea of its utility for those who are beginning in psychoanalysis, or even for anyone who wishes to make a quick revision of any point in the theory. To his credit, the author --- rare, it needs to be said --- knows where to stop when opening parallel paths: far from being obliged to go back all the way to Adam and Eve to locate the transference or the envy, he explains to us the notions we need in order to understand those others, and returns safely to the main theme. The reader is grateful, for few things bewilder more than the digressions without end that have their origin, be it in the lack of capacity to synthesize in the one who writes, be it (unfortunately) in the desire to impress readers with what can only be termed “ornamental erudition.”
Girola escapes from these obstacles, the Scylla and Charybdis of theoretical-historical writing in psychoanalysis, with elegance. His aim, stated clearly right in that page 18, is to “understand what psychoanalysis cures and how it cures.” For this, as stated earlier, he is led to compare the ideas on illness, health and cure derived from “common sense” and psychiatry to those that have a course in our field. Here the author’s classical education--- born and educated in Italy, with bachelor’s degrees in theology from Rome’s Lateran University and in philosophy from UNISAL --- brings to his mind very interesting links to certain elements that are imbedded in current ideas about sickness and health, which can be traced to the religious view of disease as a divine curse, and as moral disorder. (As I write this I note that my associations with Adam and Eve on the one hand, with the Strait of Messina (2) and with ice cream, peninsular invention that quickly gained the world in the 19th century, on the other, have nothing in them that is casual: they are links with what I have just said about the national and intellectual origins of Roberto Girola. That is the reason why I previously mentioned metonymy in the article).
These religious conceptions infiltrate, without our noticing them, the rationalist view of illness and health as exclusively bodily disturbances in Medicine, especially by the mediation of belief in miracles --- today no longer those of Lourdes or Fátima, but the belief in the possibility of removing cito, tuto et jucunde mental suffering by means of anti-depressives, anxyolytics et cetera. It is the path of the diverse DSMs and laboratory propaganda, which use relevant scientific facts ---such as the discovery of neurotransmitters, or the probable location in certain brain areas of the physical base of certain psychic disturbances --- to draw ideological conclusions that encourage the contemporary illusion to the highest degree: that the subject is no longer the originating focus of his acts, and therefore responsible for them, but in essence the consumer of what is presented to him by the industry. The lesser the questions, the better it is! Consume and enjoy; so appears to be the impoverished contemporary version of the categorical imperative.
Another important aspect of this small big book is the relation of continuity that it establishes between Freud and his successors. While he explains clearly where their differences lie, Girola firmly grips the diverse threads that unite the theories he presents to us --- of affiliation, it is quite clear, but also of dialogue. That is because if it is necessary that these theories do not coincide completely with each other in order to constitute trends in the psychoanalytic field, they need to have something in common with one another in order to form trends in the psychoanalytic field, and different from the “non-psychoanalytic.” And, as we progress in reading, we understand what these common factors consist of: the notions of the dynamic unconscious and the need to erect defences against impulses and anxieties --- which places the idea of an inescapable psychic conflict in their cores ---; a shared vision, in essentials, of what is the human mind and how it works; an ethical stance resting on the neutrality and the rejection of the pretence of being, as Freud says at the end of The Ego and the Id, the patient’s guru; the attention paid to the modalities of the transference and the characteristic use of interpretation that follow. The brief study of notion of the self in Jung (p. 131 and following pages), by contrast, shows us how the landscape changes when we cross the bridge and depart from psychoanalysis.
To conclude, a mention of the bibliography Girola makes use of. He agilely goes from the classics to the present, from Susan Isaacs to Laplanche and Pontalis, from Kohut to Nicole Zaltzman, from Saint Theresa of Lisieux to an article from Veja magazine. The reader is thus introduced to some main psychoanalytic commentators, learning with them to read the fundamental writings and to discern all their richness. That is no small thing, in these days of wide ignorance in which the task of understanding is considered to be useless and tiring, because its pace is not that of a television clip but the patient journey through arguments that are sometimes complex.
“Three in one”: the children’s song Little Theresa of Jesus comes to my mind (ah, I think, Theology, Saint Theresa, Lateran University… how the primary process interferes with the “secondarized” activity of writing a review!). Little Theresa fell down on the ground; three gentlemen came to her rescue, and the third “was the one whom she gave her hand.” We, readers, are a Theresa, and Girola gives us a hand --- the hand of friendship, which leads us with kindness in this walk through the always interesting land of psychoanalysis.
1. M. Chaui, Três em uma: as viagens de Cândido, in Do mundo sem mistérios ao mistério do mundo, Sâo Paulo, Brasiliense, 1981.
2. Scylla and Charybdis are obstacles that navigate between the tip of the Italian boot and Sicily. A Greek legend used to say that they were two monsters; Scylla, the female monster, was turned to stone, and Charybdis, the male monster, into a whirlwind. In Poetic Art Horace employs their names to designate the opposing risks to which an author subjects himself, as for example the excess or lack of something in his work; “avoid Scylla to fall into Charybdis” came to signify escaping here to stumble there. As for the one who “navigates between Scylla and Charybdis” he obtains success in overcoming the risks of the enterprise he undertook.
3. “Quick, complete, with happiness” was the motto of the good doctor, the order to cure as quickly and radically as possible, with the minimum of discomfort for the patient.
The review was published in Percurso magazine, year XVII, No. 33, 2004
Renato Mezan is a psychoanalyst, member of the Department of Psychoanalysis, Sedes Sapientiae, professor titular at PUC/SP and the author of several books, among them Freud, Pensador da Cultura (new edition of 2004, by Companhia das Letras) and A Sombra de Don Juan e Outros Ensaios (new edition by Casa do Psicólogo, 2004)