Psychoanalysis On and Off the Couch

Reflections on Our Changing Field with Stefano Bolognini, MD (Bologna)

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Apr 6, 2025
Stefano Bolognini, a prominent psychiatrist and former IPA president, shares insights on the evolving landscape of psychoanalysis. He discusses the shift from internal conflicts to contemporary issues of self-perception driven by societal pressures. Bolognini emphasizes the importance of long-term therapeutic relationships, highlighting how transformation in a patient can emerge from deep engagement with their internal world. The conversation touches on the impact of modern family dynamics and the need for personalized care in navigating the complexities of identity.
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INSIGHT

Shift To Relational Focus

  • European psychoanalysis shifted from studying the patient to studying the analyst–patient relationship.
  • International exchanges, especially North American, broadened technique and theory.
INSIGHT

Ego Ideal Replaces Guilt

  • The modern taboo is the ego ideal and fear of not measuring up, replacing old superego guilt dynamics.
  • Cultural idols with aesthetic value impose rigid evaluation standards on the self.
INSIGHT

Shame Masks Underlying Guilt

  • Shame and narcissistic concerns have grown but guilt persists, sometimes masked by shame.
  • The vertical moral superego influence weakened while horizontal social evaluation grew.
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