mercoledì 14 febbraio 2024

Bertha Pappenheim and the origins of the 'talking cure'

Bertha Pappenheim
Bertha Pappenheim (pictured), known as Anna O., was the first iconic patient of psychoanalysis. She was the first to call the Freudian method a “talking cure”.

What may seem a commonsense notion today—that simply talking through difficulties can promote healing—was truly revolutionary in Pappenheim's era in the late 1800s. The idea that carefully examining one's inner experiences through discourse could remedy extraordinary bodily afflictions was radical at a time when the mind-body connection was poorly understood. Anna O.'s case established what she termed "talking cure" as a groundbreaking treatment model that reshaped understandings of mental health.

Anna’s story:

Initially, she sought treatment from physician Josef Breuer, a colleague of Sigmund Freud. Anna struggled with symptoms like visual disturbances, hallucinations, partial paralysis, and speech problems. Breuer diagnosed the condition as hysteria after finding no physical cause. At the time, many believed her condition called "hysteria" was all in a woman's head.

Through their work together from 1880-1882, Breuer realized that simply allowing Pappenheim to freely talk about her experiences and feelings seemed to relieve her symptoms. She termed this novel approach as "talking cure" or "chimney sweeping" to describe the cathartic release of openly discussing traumatic memories and inner conflicts.

Breuer later discussed Anna O.'s successful case with his colleague Sigmund Freud, who took a strong interest. Her story became the basis for Breuer and Freud's seminal 1895 publication "Studies on Hysteria," which helped establish psychoanalysis as a psychotherapeutic method.

While Freud never directly treated Pappenheim, her iconic case was highly influential in shaping psychoanalytic concepts and proving the power of addressing unconscious mental life through verbal processing.
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#psychoanalysis
#psychotherapy
#mentalhealth
#historyofpsychoanalysis
#historyofpsychology

lunedì 7 febbraio 2022

La psicoanalisi a Hong Kong e nel contesto cinese


In questo video presento alcune riflessioni sulla mia pratica analitica a Hong Kong, dove opero dal 2010.

Intervento tenuto via Zoom nell'ambito del convegno internazionale "Crisi della psicoanalisi, psicoanalisi della crisi" organizzato dalla Societa' di Psicoanalisi Critica.


lunedì 31 maggio 2021

My interview on 'toxic positivity' for the South China Morning Post

 



Recently I was interviewed for the 'South China Morning Post' about what in everyday language is called "toxic positivity": what is it, why is it toxic, how to recognize it, on what assumptions is based, and why it is important to avoid it?


The interview published in the newspaper is an extract of a much longer conversation, which I publish here.



1. What is toxic positivity?

Toxic positivity is the need to always be positive at any cost, even in adversity, giving no room to unpleasant feelings such as sadness, anger, or despair. It comes partly from the idea that if you only think of nice and positive things, you will only attract positive people and positive things into your life, and you will feel good and be happier. However, it is not true that positive thinking brings better results. Some studies, as well as personal experience, have shown that those who think more positively may sometimes achieve worse results than those who think negatively, possibly because they tend to engage less. It might also be that anger and disappointment enables one to be more decisive and convincing toward others. Forced positive thinking can give the illusion that things will work out on their own; however, if this does not happen, the disappointment will be even greater. In fact, the paradox is that in a world that pursues the ideal of happiness, enjoyment, and consumerism, depression and lack of desire, direction, and purpose in life are among the most frequent symptoms.

 

2. Commons signs of toxic positivity, and how to spot it in your daily life.

Toxic positivity can manifest in various forms. Something bad happens to you and someone rushes to tell you to “Be positive” because “Everything happens for a reason” or because “It could be worse.” Do you find yourself thinking that it is your fault if you feel sad and that you should distract yourself and “Get over it?” These are examples of toxic positivity. Having unpleasant emotions is not negative. Actually, we would all be surprised if someone facing the loss of a loved one put on a big smile instead of showing sadness. There are moments when we feel very unpleasant emotions, and this is perfectly normal. Toxic positivity is when someone, confronted by your pain, desperation, or sadness, quickly dismisses your experience as though feeling bad was not admissible or there was something wrong with you. Sadness accompanies loss, and it is a necessary condition for the processing of mourning. That sadness must be acknowledged, expressed, and addressed. If it is suppressed or denied, if it is not shared, if the loss is not recognized, accepted, and processed, then it can lead to depression. Forced positive thinking is cheating yourself. It is a form of gaslighting or self-manipulation. Unpleasant emotions and fears are there for a reason. Ignoring them will only create more detachment with yourself. It is not wrong to be afraid or scared of something. Your unconscious is not stupid. You may feel something is unpleasant, uncanny, or unwanted, but nevertheless it is there. The idea of positive thinking is based on the idea that the world is “all around you.” Thinking that it is all in our hands and that we can control everything that happens to us may be appealing, but it is often not the case. In fact, this should be seen as relief, because it means that we do not all need to be superheroes, we do not need to be perfect, and we do not need to meet everybody’s expectations.

 

3. How might some people benefit from a “good vibes only” approach to life, especially during the pandemic?

There is the continuous search for vibrations and excitement, as if one must always vibrate and be moving. Modern symptoms such as attention deficit hyperactivity disorder (ADHD) indicate this inability to simply “be,” this difficulty in finding moments to breathe and think. There is this idea that one always has to be moving, as if stopping would break something. Today, many cannot stand still, yet in their constant movement, they have no direction. They go from one thing to another, from one object to another. In an attempt to keep the disappointment out of their lives, they do not realize that they are feeding that very feeling of disappointment and frustration. The pandemic has disrupted the rhythm of our lives, we cannot deny that, but it also gave us a chance to rethink what we were doing. For some, it may have been a chance to review their goals and their relationships. For others, caught up in the anxiety of always having to be on the go, it was a disaster. It is also important to be able to admit these vulnerabilities. Ultimately, the most significant connections concern our vulnerabilities. Relationships based on being positive at all costs, smiling, and partying are superficial. It is a way of being among others, but not with others. There can only be something authentic, something true, when we show the innermost side of us. The pandemic may have made us feel more fragile, but it is the awareness of our fragility that makes us stronger.

 

4. What are some instances in which being positive is a useful coping mechanism, and when it is not?

It is important to highlight that always being positive is, at best, a coping mechanism, i.e., a response to environmental stress. However, life is not just about solving problems or fixing what is wrong, this is not living life, these are survival strategies. It is not about being optimistic or pessimistic. One should not represent the obstacle as good or bad, positive or negative. Rather, one should understand that life does not end as a result of an obstacle, it is not insurmountable. Instead, obstacles should be seen as an opportunity, something that pushes us to do more, and which sets us in motion. If you are facing a fear, it means there is something precious to take advantage of. Put in those terms, there is no more positive or negative, good or bad. It is about maintaining a pragmatic attitude and being open to something new. Keeping a positive outlook can help in some cases, but it becomes toxic when it imposes itself as a stretch, as something that closes every possible question. It is toxic when it takes away our ability to ask (open-ended) questions about something we perceive as important but do not understand. Because positive thinking is made up of slogans and catchphrases that, in fact, do not allow for a reply,  such as “It will be fine,” “Failure is not an option,” and “Other people have it worse,” they close the conversation. In this way, they do not allow for any thought and invalidate all other feelings. This is counterproductive and harmful.

 

5. Are negative emotions such as anxiety and disappointment inherently “bad,” and why?

One might call anxiety and disappointment “negative” emotions, but who says they are positive or negative? For now, let us just say they are unpleasant emotions, it does not make them negative. Anxiety, for example, can signal what we are afraid of, but also what we yearn for, what makes our heart beat, and what our ambitions are. Although the disappointment is unfortunate, it indicates that there was some expectation there, and so it says something about us. To use a well-known idiom, we cannot throw the baby out with the bathwater. Positive or negative is a judgment. It means jumping to conclusions. But life does not end. How can we tell what is good and what is bad? An unpleasant event can be an opportunity for growth, for learning, it can be a turning point that pushes us to do new and different things. Life happens precisely where we stop exerting control or imposing direction. Something new can be produced there, and it seems as though it is generally more interesting than when we make a conscious effort to make events happen.

 

6. Is accepting negative emotions, rather than dismissing them, more beneficial for a person’s mental health in the long run?

Negative emotions exist whether we want them to or not. We can put our heads in the sand, but it is like amputating a part of ourselves. Some of my patients have repressed parts of themselves so firmly that they eventually do not know who they are or what they want. It is as though they are anesthetized, numb, and they find themselves prisoners of this absolutely positive image that they must convey at all costs. They struggle to be authentic with themselves and with others. They make an incredible effort to appear nice and cheerful when they are with others, then when they are alone, they feel exhausted, lost. Drugs, substances, compulsive shopping, even food are ways to stifle emotions. They are ways to fill the emptiness one feels inside. But they are temporary solutions that end up feeding our fears, our fantasies. So, the best thing we can do is try to put these fears into words, these feelings that seem unspeakable. There is often the idea of an internal world, a Pandora’s box, so that if one expresses their emotions they take over.  Some people are afraid they might “go crazy” if they open up. However, in my experience, I have never seen anyone go crazy because they talk about what they feel inside. Instead, opening up allows us to get to know ourselves better, discover how we function, get in touch with our emotions, and understand what drives us in life.

 

7. Why might toxic positivity be counterproductive and harmful to our mental health?

Many people repress parts of themselves, which they imagine to be negative, wrong, or shameful, in order to be accepted by others. But how can you expect others to accept you if you do not first accept yourself? Modern society pushes us to be functional, productive, and always happy. There is this idea that (negative) emotions are a hindrance and can make one less productive. I see so many people who, in order to perform, reject parts of themselves that they perceive as bad, not positive, or wrong. To the point where they do not know who they are, what they want, or where are they going. Repressing painful emotions may work for a period of time, but sooner or later they will come out even more strongly and unpleasant. You will probably live life feeling ashamed, observed, and judged, until the day you decide to deal with it. Many adult patients I see complain that they have waited so many years to take care of themselves and their emotions. You do not want to have the same regrets. Anxiety and depression are two main symptoms nowadays. In particular, the pandemic has triggered so many anxieties in many people. There is a fear of contagion (the virus), but also a feeling of being disconnected because of the restrictions. Now more than ever, it is important to prioritize your emotions without having to be positive at all costs. Interestingly, forced positive thinking drives people to become cynical, absolute, verbose, and to fight against everyone and everything. It is time to be gentler with yourself and others.

 

8. If toxic positivity is counterproductive, is tragic optimism/emotional acceptance a better way for us to cope with our feelings?

It is not simply a matter of “accepting how you are.” It is not about “surrendering” to your limitations. Quite the opposite. It is a matter of not representing oneself at all, either as a failure or as a hero, either as inferior or superior. Emotions and affections are a result of thoughts and words of which we are not always aware. Emotions can change, they can transform, but first they must be recognized, they must also be able to be said. Only then can we make something of it. That is what we normally do in psychoanalysis. However, writers, artists, and musicians also start from their experiences and inner worlds to produce their works. Much of literature, poetry, and music is about ended or unrequited love, loss, despair, and painful moments. Beautiful pages have been written about dramatic moments, characters, and emotions that are anything but “positive;” for example, the recent movie Joker, which was a huge success. However, by putting these painful emotions into words, we can do something with them, we can transform them until they are less scary. Often, the act of expressing this less pleasant part of oneself brings about extraordinary results that can be highly artistic, transformative both for the audience and artist. Most art, literature, music, and film are representations of this “dark side,” these negative emotions. Imagine if Shakespeare had not put his own inner turmoil down on paper. Imagine if a friend had just said to him, “Happiness is a choice, so choose to be happy.” Or imagine if Van Gogh, instead of putting his anxieties on canvas, had had a friend tell him, “Just look on the bright side.” We would never have had their masterpieces, and Shakespeare and Van Gogh would have lived mediocre and conventional lives.

 

9. Tips for avoiding toxic positivity or helping a friend who is prone to it.

There may be parts of us that we do not like because they go against our ideals and principles. However, little by little we can try to get in touch with these parts. There is no point standing in front of a mirror and telling yourself “I am a wonderful person.” It is probably not true, at least not all the time. The parts we like the least are still an important part of us. Fear, for example, makes us more alert, disappointment puts us in touch with those who have failed or who struggle. It is not about rejecting unpleasant emotions. It is about not indulging in arguments, discussions, and quarrels. It is important to surround yourself with interlocutors with whom you can talk, open up, and say what you feel. If you have the right interlocutor, someone who does not judge and who does not give easy answers, then it is possible to talk about unpleasant, painful, and hurtful emotions. You might want to talk to a psychoanalyst who can listen and remain non-judgmental, and who should be able to help, while also ensuring privacy. I listen to people who are desperate or angry, and in the midst of their excited stories, with the activation of emotions and corporeality, sparks of authenticity and stifled vitality are produced. Emotions that are once drawn out take their natural course. In anger there is vitality, and in sadness there is reflection. “Positive” emotions come from getting in touch with your “negative” parts. Compassion and respect for others can happen if we first make contact with our less beautiful parts. We can listen to and welcome others if first we listen to the Other (the unconscious) that is within us.

Freud said that it is important to be honest with yourself. What you feel, even unpleasant feelings, is part of you and can become an opportunity for self-discovery, growth, and learning. It can be a turning point for doing new things for the better.

 

 













giovedì 11 marzo 2021

What causes panic attacks and how to understand them?




Panic attacks are a very frequent symptom today. However, for those who experience it, panic attacks remain something unpredictable and often incomprehensible. 


Starting from my experience as a psychotherapist and psychoanalyst, in this video, I propose some reflections on panic attacks: what are they, how and when they occur, from what they originate, and how they can be better understood.





martedì 23 aprile 2019



Impossible to 'comprehend'. (Mis)understanding, and listening in psychoanalysis (video 2/8)




Comprehend derives from Latin comprehendere (“to grasp”), from the prefix com- + prehendere (“to seize”). It means to include, comprise; to contain, to grasp fully and thoroughly. However, the very idea of the unconscious implies that something escapes comprehension. Conversely, understand indicates...(continue in the video)





Click HERE to see the video