An Explanation of the Genesis of Trauma

within the context of the Theory of the Protomental
Antonio Imbasciati

SUMMARY
Most authors characterize trauma as the (complete or partial) unrepresentability of psychic events. This paper offers an explanation of the characteristic description on which many authors have concentrated.  The concept of representation (and representability) is defined in the context of my personal theory – the theory of the protomental – which I have developed over the last twenty years. The genesis of trauma can be conceptualized in this context as a defect in the construction of the symbolopoietic network constituting the functional structure of the relevant individual’s mind. This defect involves the erasure (autotomy) of memories and, in particular, of memories of functions and of connections between memories.  It is not a matter of repression, but of the actual absence of memory.

Ever since the dawn of psychoanalysis, a huge quantity of literature has been written on the subject of trauma. And still today a lot is being written about it.  This article, which stems from an invitation to participate in a panel at the next IPA Congress in Rio, will thus be narrowly restricted to the subject I am dealing with, due to the particular context I am referring to. Since the latter concerns the theory of the Protomental, which I have been developing over the past twenty-five years, I hope readers will forgive my use of self-reference, and, consequently, my marginal reference to general literature.

Freud himself introduced the study of psychic trauma by developing a concept he had inherited from Charcot. In turn, this concept had been borrowed from the sphere of medicine and surgery. It’s no accident that a number of Anglo-Saxon authors use the term “injury”, which conveys the concept clearly: damage or injury to a body part, an organ or system which, often, permanently mars its normal function. Freud himself made the concept clear by referring to the impairment of the psychic apparatus. Along this line, “traumatic” events have been seen as a series of  stimuli that dominate the mind’s natural ability for elaboration, upsetting its “normality”.

It is common knowledge that Freud considered  some psychopathologies to be the result of a “psychic trauma”. This concept saw great popular success, to the point that, commonly speaking, people often think that any kind of psychopathology can be traced back to a cause that has injured the brain’s functionality, or, at any rate, psychic normality. At the beginning, Freud thought that any instance of sexual seduction suffered during childhood and perpetrated by an adult gave rise to traumatic effects. Later, after the historical date of 1897, he considered such episodes to be built up psychically, and thus, more than to real events, he attached importance to how events take shape in the mind (in the memory) of the subject. His dispute with Ferenczi over the relevance of real facts as related to psychically structured events is common knowledge (Bonfiglio 1996, 1997). This controversy was followed by a long series of debates (for instance, Balint’s theses, 1969), and more and more specific clinical examples which are still topical today.

Still today, a great amount of psychoanalytical literature deals with real facts and psychic structuring, whether they are more or less correlated or correlatable. Their correlatability has led to a variety of clinical descriptions and theoretical explanations related to intervening psychic mechanisms or processes. As to the “sexual” episode, still today it is noted that “traumatic” patients have often been subjected to sexual abuse during childhood, while other non-sexual episodes – especially involving separation and bereavement – have proved to be potential factors (by some called “causes”) leading to psychic trauma, both during childhood and adulthood. Special consideration is given to violent experiences the patients have undergone helplessly, such as torture, persecution, wars and cataclysms.

Today, despite the fact that trauma is gauged according to how it is configured in the psychic structure of the single subject – and through the consideration of real historical events, the aforementioned debate over how to regard the historical event on one side and the psychic structure of the subject that processes  it on the other –  with the consequent mental organization that ensues – is still well under way. Debates and interpretations follow one another on the psychic processes that have intervened, either in terms of defense or in terms of object relations, or in terms of thought production, which is seen from Bion’s viewpoint. In particular, a concept (Kris, 1956) first theorized by Khan (1963) has emerged: “cumulative trauma”: real and historical events or series of events that are irrelevant if taken individually, but that, in retrospect, gain traumatic relevance if repeated through time. Within this “retrospective”, the Freudian concept of nachträglichkeit was brought forward. As for the nature of such events, the focus is not on their variable nature, but on their interpersonal context: early childhood and an intimate, intense affective relationship with an adult. Thus, what is pointed out is the significance that specific events take on for those subjects. Object – or, at any rate – relational theories have extensively elaborated the contextual concept. Modell (1984) spoke of a disorder in a child’s affective communication with his/her parent figure. Along this line, prenatal trauma (Maiello 1988) and early childhood (Vallino, 2002) were examined, as well as a “vicious circle” between trauma seen as a historical fact or as a “shadow”, which, again, leads to trauma or to new traumas (Giaconia, Racalbuto, 1997).

Thus, to this day, psychoanalytic research on trauma has a long, wide way to go, and is still diversified (Garland, 1998). We might ask ourselves why: Why, after so much (now century-old) literature, do we still wonder about trauma today?

This is not the place to answer this question, so let’s go on to a recurrent clinical survey: patients that are considered traumatic cannot remember, or their remembering is defective, sometimes without its affects. Starting with Freud, traumatic oblivion has been brought up: the debate stems from a clinical survey on patients who are considered to be traumatic; in other words, from the difficulty that arises – both for the analyst and the patient – to reconstruct and experience affective ties that presumedly existed in the past, and that should thus exist in transference. Often, patients have revealed “empty spots” in their mental structure: they have proved incapable of experiencing or reliving specific situations; a pathology coming from deficiency – rather than conflict – has been examined. Even more to the point: as the number of analysts devoted to the development of Bion’s work has increased, a defect in perception has arisen, or, in other terms, in the representation of inner events that can only be inferred and around which a non-decipherable psychic (or supposedly psychic) area is sensed. Apparently, a part of the patient’s psychic structure not only cannot be expressed in words (interpreted), but does not exist or cannot be  represented in any way, neither in the patient’s nor in the analyst’s mind. A dark area ensues, a “black hole” that can be surmised but cannot be explored, if not with great difficulty. Following Bion’s theory regarding the genesis of thought – both in infant diachrony and in the synchrony of mentalization that is still under way in the adult – the earliest mental processes were considered: not only those that are indescribable (in other words, that cannot be verbalized), but even those that are “mental” or “premental”. Herein, the process of symbolization was considered (Imbasciati, 1998; 2001c; 2002c; 2003a), especially the ability to endure mental pain, so as to go back to the depressive position that is at the roots of the patient’s thought. The so-called trauma thus seems to be characterized by a lack of symbolization.

One of the elements that today, after a century, still leads to a lot of diversified debate on “traumatic” patients appears to be the question of the relationship between historical events that are considered traumatic and a syndrome that can be found in some patients. Why is it that patients who have been through the same kind of – even important – historical-anamnestic events react differently? Why are some  “traumatized” and why do others remain unimpaired, even if they’ve been through extremely disturbing experiences? Most psychoanalytic literature, in fact, seems to regard the study of the inner processes that connect the “historical” trauma to psychpathology, or in some cases, those that allow for the overcoming of traumatic events. This survey, however, must cope with the plurality of theoretical-clinical models that are used by psychoanalysts, as well as a certain “language confusion” which sometimes reveals conceptual confusion, or a mixture of concepts that leads to further differentiations and, consequently, more debate. Therefore, psychoanalysts ought to explain many of the terms and concepts they use, and, moreover, they should agree on the basic criteria by which to define certain patients “traumatic”.

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A recent article that has appeared on the Internat. J. Psa. (Tutté, 2004) seems to give an up-to-date account of the current situation on the concept of trauma, attempting to compare psychoanalysis with neuroscience, and especially with psychiatry. This work lends itself to some of my considerations.

The “concept” of trauma is based on what can be inferred from clinical work: the latter, however, is described through other concepts, and these, in turn, are affected by the various theoretical models that psychoanalysis has developed in the past and is still developing now. Thus, the concept of trauma is continually permeated with different theoretical models, and, often, with a different general theory regarding mental functioningi. The latter often leads to great confusion, or, at any rate, to an amalgamation of description and explanation. Therefore, before even beginning to deal with the subject, authors ought to explain which theory or theoretical model the concepts of their words refer to; which words they use to pass on to their colleagues what they have observed through clinical practice, what they have deduced, attempted to describe and, at last, tried to explain. Concerning this, I will cross-refer to the distinction between description and explanation (Imbasciati, 1994), which are often confused in the psychoanalytic sphere.

Furthermore, Tutté (2004) has tried to apply psychiatric nosography in psychoanalytical terms. In my opinion, this is a praiseworthy effort from an epidemiological  –  if not demographic – viewpoint, but I do not think it can be applied to psychiatry if the latter is, indeed, to be considered an “-iatry” of the “psyche”, and not a simple treatment of a symptom. In fact, I believe a nosographic approach suits medicine (and surgery) when dealing with diseases (instead of syndromes) whose specific cause is known, but I do not believe it can be transferred to the psyche, because we would be shifting from a psychology of what is pathological to a mere (symptomatic) pathology of what is psychic (Imbasciati, Margiotta 2004, chs. 4 and 6). Although nosography is a part of psychiatry, it cannot be a part of psychology.

A third consideration can be expressed in the wake of the latter perspective. Tutté traces trauma back to the structuring of memories related to highly significant emotional events, and brings up the concept of “implicit memory” as opposed to that of memory that can be verbalized. He thus refers to the concept of retroaction highlighted by Laplanche and Pontalis (1973), who, in turn, go back to Freud’s nachträglichkeit. However, these admirable references to the effects of the present on the past do not appear to be adequately linked to the current and much more exhaustive studies on memory (and learning) that various experimental schools of  psychology are carrying out. The traumatic effect of real events that happened in adulthood is explained as a retroactive effect on memory: for instance, not only the inscription of new traces, but a reinscription of old traces, which would explain the emotional state of the traumatized subject. The general picture that psychological (not psychiatric!) sciences give of memory does not appear to be suitable, due to certain concepts and terms that are used, such as inscription, reinscription and others. The term “inscription” cannot be applied to any kind of memory, except for very short-term memory that can be verbalized; and even in this case it would be better to speak of a brief presence rather than of inscription. The latter term is endowed with a semantic aura of stability that does not apply to memory at all; it comes from the old concept of memory as a reflection of reality that records it faithfully. On the contrary, all the diversely classified memory heritage (L.T.M., S.T.M., procedural memory, implicit memory, memory that can be verbalized, memory related to recognition, recollection, work; episodic, semantic, spatial, motor, affective memory as well as the “known but not thought”ii, and so on) is not an inscription, but a “continuous processor” that continually transforms what is eventually coded and acknowledged, and that, moreover, is integrated (almost “mixed”) with what was organized earlier (Imbasciati, Margiotta, 2004 chs. 2.9, 2.10, 2.11, 2.12, 2.14). The memory heritage of the past conditions what is coded and viceversa: actually, the memory heritage, which is always present, conditions and is conditioned by what is being – and what will be – acquired. Even if no input comes from the outside, the memory heritage is continuously modified by the continuous “processing” that goes on in the mental system (the brain, even during sleep); thus, thought –  in Bion’s use of the term – modifies memory. In actual fact, the term “heritage” should not be used either, as it has a static semantic character. Memory is, essentially, a dynamic concept. Basically, it is unconscious, as well (Imbasciati 2001 a, c, 2002 a, b, d, e, f, 2004 b, 2005 a, b, c). Strictly speaking, “recollection” should not be used, either: recollection is only a conscious, temporary present (or maybe present) coding of what the subject thinks of events he/she places in the past. There is no true or false recollection; everything one remembers is a psychic product of the present. Furthermore, we know that “remembering” should only be referred to the (mental) system of memory that cannot be put into words, while it cannot be ascribed to implicit memory; the latter cannot produce recollections (Fonagy, 1999). Thus, speaking about the possibility or impossibility for “old traces” to be recovered from awareness does not make sense. They exist, but can only be deduced from relational behaviour. They are old neural-mental processes that always coexist in the mental system’s continuous activity. In this picture, the concept of repression is not helpful anymore (Imbasciati, 2001 d, 2005, 2006 a, b).

Therefore, the concept of trauma ought to be put in the right perspective, in terms of the particular ways in which the mind functions when dealing with certain information, but including all absorbed information in the picture, both past and present. From the outside, this information is coded by the individual subject inside, and from the inside it is self-produced (the “thought” of the individual). The multi-faceted concept of memory – and, within the latter, that of trauma – is to be framed within this way of conceiving mental functioning.

And here we come to the last issue I wish to point out, so as to frame the long-term, multiform psychoanalytic debate on trauma. Almost all authors dealing with the theme assume (implicitly) that by nature, the mind functions “normally”, according to the neurobiological development that belongs to the homo sapiens’s genetic inheritance, and that trauma – as well as other “pathologies” –  comes about due to some cause or other that has upset this development. This concept may have been perfectly justified in Freud’s time, but not anymore, not today. From a biological and genetic viewpoint, normal mental functioning does not exist: what exists is a normal brain in macromorphological terms and in the number of neurons it contains: but the connections of these nerve cells – or micromorphology, and therefore their physiology seen as the functioning of this organic apparatus as a whole – are determined by experience. It is experience, or what is generated in the brain due to experience, that determines the functioning of what we might call the “mental apparatus”. It is thus misleading to speak of a normal mental apparatus: this implies that mental functioning has its own normality, in the sense of a biological-genetic normality, and not normality as a statistic average in relation to the many types of functioning that are individually acquired by each single subject in the overall population. This misinterpretation consequently leads to think that when mental functioning deviates from the average, some cause  must have upset what is assumed to be normal development.

On the contrary, each mind – mental structure, not apparatus! – is built up according to each individual’s experience, or, in other words, according to how much the individual’s initial mental formation (in terms of structure) has allowed him/her to learn from experience and subsequently to build up a progressive distinctive functional structure that will allow him/her to learn  from experience in his/her own distinct way (Imbasciati, 1998, 2001 c, d, 2002 b, 2003 a, b, c; 2005, 2006a – Imbasciati, Margiotta 2004). There is thus no point in looking for a cause, or for causes to blame for a statistic deviance. Each individual will have his/her own different causes, seen as an endless web of relational – and thus experiential – circumstances through which the individual’s own distinct mental functioning has been built up. Costitutional factors were often misunderstood as a simplistic explanation of what would have been too hard to investigate. Within this picture, the concept of trauma as it has been interpreted – or misinterpreted – reveals its spurious origins. The term comes from the world of medicine and surgery, and has been transferred to the psychic sphere inappropriately; this concept only has a biological-genetic meaning, and does not apply to experience and thus to the psychic sphere. Hence, in my opinion, the word “trauma” should be erased from the language of psychological sciences.

A great amount of misunderstanding has arisen due to the transfer of concepts and terms belonging to the medical-biological arena to the psychic sphere. This has slowed down research, steeping it in confusion (Turchi, Perno 2002): this does not only concern the term “trauma”. Other misunderstandings include the concepts of illness and diagnosis, which have also been incorrectly tranferred from medicine to psychology (Imbasciati, Margiotta 2004, ch. 6). I believe that continuing the use of the term “trauma” – with its misleading semantic aura – in the psychoanalytical sphere is one of the causes of the heated and, by now, century-old controversy regarding the psychic characteristics of patients who are to be considered “traumatic”. This does not mean that characteristics that have been attached to “traumatic” subjects do not exist, nor does it mean that the psychoanalytic concepts which are best suited to communicate what analysts have most recurrently noticed in certain patients shouldn’t be put together in a relatively homogeneous description. But we must keep in mind that the categorization that arises will be syndromic, and not diagnostic, with relative considerations regarding therapy. However, I think our conceptualization and terminology is not univocal enough to be able to erase the term “trauma” and identify a certain type (keeping in mind that in psychology, a type is not a category but a prototype) of patient, although I do not find the label “traumatic” appropriate  for these patients. To describe what analysts observe, another label should be found, with less misleading terms and concepts. Furthermore, we need to identify a starting point and the criteria that should be used to achieve such a description.

If defects regarding symbolization are noticed, the meaning of the terms “symbol” and “symbolization” should be specifed, and the same applies to representability; in this case, the concept of representation must be made clear (Imbasciati, 2001 a). Even more so for other terms and concepts, such as “void”, “black hole”, “mental space” and others. Also, if psychic processes, or “events” that are not yet mental (or cannot be mental) are observed, such as those that can be generally attributed to the first days of life or foetal psychismiii, we ought to agree on the relative concepts and terms to be used. Many concepts and terms that are used in psychoanalysis are believed to be univocal, but when we hear reports by other authors, we realize that they have different semantic nuances. This makes every description appear new to us, and enriching: but is it really so or does it depend on the use of different languages? Isn’t it possible to achieve a precise vocabulary in psychoanalysis, just like in other mental sciences?

If terms that have different – even only slightly different –  acceptations are used, or concepts that are full of different theories and the latter are not explained; or if a clinical description is mixed up with an alleged explanation, along with the above-mentioned concepts and terms, this obviously leads to endless different expositions of the “characteristics of trauma”. So as to reach a definition or at least be able to focalize on a certain prototype of patient, a basic standard needs to be identified as well: do we consider the anamnestic standard suitable? And here, real historical events come to the fore, such as mistreatment, abuse, and so on. On the other hand, do we consider the criterion referring to intervening psychic mechanisms suitable? Here, however, theory comes in: which theory? Traditional defense mechanisms? The description of the inner world in neo-Kleinian terms? Bion’s theory of mentalization? Or should we focus on the impact the patient has on the anlayst; or on the patient’s ability to experience certain emotional states or eventual interpretations: in consequence, we will be working in different frames, with different concepts and terms. Confusion on a clinical – or essentially descriptive level, an attempt, which is explanatory – often underlies this possible variety of criteria. There is an attempt to consider the “causes” in all the descriptions. But, as mentioned earler, the concept of “cause” must be put in the right perspective. Yet, an “explanation” implies “causality”: therefore, in psychoanalysis, in what terms can we find an explanation? Often, when certain defense mechanisms are detected, we think we are explaining something: however, these are theoretical models that help us understand how the clinical situations we are conducting have been generated, but they do not tell us much about why they have taken place. Let us keep in mind that description is related to “how”: only an actual explanation tells us “why” (Imbasciati 1994, 1998). We can also see a deficit of mentalization as related to deficitary depressive function as an explanation is considered, but we still need to explain why this happened. We might trace an inadequate relationship with the caregiver, which would lead to anamnestic factors or primary relations with objects – but does all this really explain why?

Furthermore, we have spoken about memory: but in what terms could we consider it a key to explanation? How could we deal with continuous, dynamic transformation and memory processes? It is deceptive to consider memory in clinical terms, or as what is “remembered”, and describing it confronts us with the vagueness of surfacing “memories”. Nor could we speak of it in terms of biochemical-molecular transformations: perhaps this might constitute an explanation, but we would be leaving the sphere of psychoanalysis and that of psychology as a whole. We should then speak of memory only in psychological terms.

The problem is that analysts operate on a clinical level, and this entails direct emotional experience, which helps them understand; but they can only communicate this to their colleagues with the right concepts and theoretical models, which attempt to describe (aside from their polysemy) but do not explain. An explanation could arise through a general theory on how the functional structure we call the mind is gradually formed (throughout the individual’s life, beginning with his/her embryonic stage), and on how this is formed in relation to the individual’s experience, as well as his/her way of processing it. With his energetic-drive Metapsychology, Freud attempted to find an explanation, but today it cannot be shared (Imbasciati, 1994, 1998, 2001 d, 2002 b, e). Other metapsychologies appear to be impled (Bion’s, for instance), but, in my opinion, they have not been exhaustive enough for an “explanation”.

Finally, if we were to focalize on a patient prototype that we can trace back to what until now has been called “traumatic” – without running into polysemous, non-univocal concepts, or concepts that have been inadequately transferred from medicine to psychology, or an unsatisfactory distinction between clinical experience and theory, description and explanation, which, as mentioned above, underlies the past hundred years of controversy on the question of trauma – we would probably need too much clarification. And a “strong” theory is required. Certain choices must thus be made in the current multi-faceted  nature of the psychoanalytic situation. This is what I am attempting to do with this paper.

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A common denominator in the current clinical descriptions by most authors that have dealt with the question of “trauma” concerns the total or partial unrepresentability of psychic events that constitute the precipitate of a person’s past vicissitudes. These past events persist in the subject’s mind (the psychic events, not the vicissitudes themselves), giving rise to a sort of void, a deficit in what we would have expected in terms of mental structure, and on which the analytic couple finds it extremely difficult to work. This paper offers and explanation of the characteristic description which many authors have focused on. What I have to propose is set within the context of a particular theory I have developed over the past twenty years through a series of publications (articles and books). This theory offers an explanation in psychophysiological and semantic terms. In fact my aim is that of formulating a theory of mind that may be omologated to neural theories: this is the exact meaning of “psychophysiology”. This theory, keeping memory into account, may explain the origins of the mental functional structure; in other words, of the construction of the individual mind beginning with foetal life, and the mind’s general functioning throughout the rest of the individual’s life. I called this theory the Theory of the Protomental (1979), introducing it with a book that was first published in 1981, entitled The Protomental (Imbasciati, Calorio, 1981). Underlying this theory, the criterion I chose for explaining it concerns learning and memory, considering the formation of progressive memory traces of functions, which gradually constitute the global functional structure that can be called the “mind”.

I must mention some of the main points of my theory: I can only do this  very briefly here, referring to my publications for further comprehension (see my last bookConstructing a Mind, 2006a).

The mind is conceived as a gradual construction of an information system that can utilize various inputs, process them and build up progressive operational abilities; the mind can also produce its own internal “products”, which can be used again along with external inputs. The theory’s explanatory value consists in organizing, elaborating, building and transforming memory traces, and thus the respective meanings within these transmitted signifiers. Thus, the mind builds up an extremely individual semantic-mnesic structure which is unique for each individual according to the environments and relations that – starting at a foetal stage – will have offered him/her different inputs throughout his/her life. The explanation I am expounding here for the so-called trauma is presented in terms of a non-optimal organization of memory traces throughout an individual’s lifetime, and their non-optimal progression for the “reading” of inner life.

I will start with the latter term: “reading”. Already during foetal life, the stimuli that are susceptible to sparking off the sensory receptors that have gradually matured generate afferences in the incipient CNS. If they are to leave some sort of trace, the nervous system must feature organized neural connections that can recognize – and thus read – certain groups of afferences, attaching a meaning to them: this is how reading can trigger a form of memory. The meaning, and therefore the “reading” of certain “afferential sets” does not correspond to any real object or realistic meaning at all: we are not dealing with recognizing afferential sets belonging to real objects, as this is only achieved laboriously at the end of the second year of life. At the beginning, reading takes place due to sets of afferences that are completely heterogeneous and that come from disparate sensory processes, both from without and within the body; these are all absurdly mixed up in comparison with actual “perception”. This is how the first “engrams” are formed; here, the incipient information system that is being constructed begins processing (the term is being used in the acceptation of cognitive science schools) information. The engrams are the psychophysiological signifiers that are likely to be constituted by neural connections which transmit just as many psychological meanings.

At first, the engrams are simple and absurd in relation to any adult meaning, but they are necessary to make the system work. As they grow more and more complex, they serve as memory traces of corresponding operations that the system becomes able to carry out: therefore, these engrams regard “objects”, although they are different from any real object; they are mental “contents”, but also engrams of “functions”. These last engrams concern affective functioning. Affective functions too have its traces. With both of these, the system can form further, more complex engrams, processing and mixing both external inputs and its own products (affects) through a more and more articulate functioning, gathering afferential sets in a different way and thus forming new engrams, or new traces that can lead to new possible operational abilities. In turn, the latter will have their own traces, as well. Thus, engrams constitute both the memory trace that serves to attach significance to something that represents an “object” that is totally different from real objects but can be compared to psychoanalytical descriptions of inner objects, and the trace needed to “operate” (trace of functions) the acknowledged afferential sets in more and more diversely articulated ways. This is how each structured engram allows for the subsequent, gradual construction of more engrams. The afferences are thus processed, giving rise to hallucinatory images at first, and, slowly, along a continuum, to the perception of some correspondence with real objects. Both deserve to be called representation, even if the former do not represent anything real, but something that constitutes representation and that is necessary for the functioning of the system.

Soon, the signifiers – or traces – produced by the system itself are mixed with this progressive and more and more articulate aggregation, which signifies some meaning that the system attaches to (“read” in) afferential sets coming from without. That is, as soon as the system becomes operational to a certain degree, it is able to produce new signifiers itself; this is an inner product that can be compared with what will subsequently be the production of “thoughts”. At first, these “products” are mixed up with inputs from the outside: interiority – to use a term that will gain meaning at more evolved stages – is mixed with a protoperceptive activity, resulting in quite a bizarre significance as related to an adult, but is physiological in newborns.  It is on this type of operation that traces of what we call affects are built.

The memory-representational system carries on in a more and more articulate construction, producing a progressive symbolization, and, along with this, building up further symbolopoietic abilites. The unconscious is to be conceived thus (Imbasciati 2001 d). This progression allows for a more and more articulate reading, along which the system will gradually – and more realistically – be able to read (and thus to perceive, in other words) what sensory inputs are offering, and to distinguish these (perception and objects) from its own interior products. In other words, it should be able to distinguish the exterior from the interior, the “inside” from the “outside”, and within the “inside” it should distinguish what comes from the the body from what is being produced  –  more and more frequently – by the mind, and he should be able to distinguish perception from affects or imagination, reality from one’s own thoughts.

The Theory of the Protomental, therefore, describes the construction of an information system that is made up of a progressive net of signifier-chains and the capacity for further symbolopoiesis, each level of which depends on the preceding levels and conditions subsequent levels. The explanation of this description leads back to what we know (from other mental sciences) about learning, memory and neuronal synaptic proliferation. In particular, memory is to be seen as a continuous activity of processing new traces, where older traces condition the structuring of new traces and viceversa; where every operational level – even the oldest – potentially remains below more evolved functioning. So the persistence of even the most primitive (and, at any rate, unconscious) affectivity is explained, below and within any cognitive type of functioning, considering the great mass of processing that takes place at a totally unconscious level. This conception can be compared to Bion’s grid. As far as learning is concerned – or the possibility of building meanings and keeping them within the system – the theory highlights the indispensability of relations: in informational terms, the quality of relations is translated into the degree of possibility the caregiver has (high or low, continuous or inconsistent) of offering communicational gestalts that can encourage (or discourage) the formation of new engrams in children and, likewise, in affective relationships among adults. This possibility is related to environmental circumstances, but especially to the unconscious abilities of caregivers. Which means affective structure.

The ability to read inner reality develops along with a more and more honed and realistic ability to read outside reality; not only is there a sufficient distinction between the two, but the differences in the inside reality can be read. This is reflective ability, illustrated in other terms in works by Fonagy (Fonagy 2001; Fonagy, Target 1997, 2001). The opposite of this is represented by the dimension of alexithymia. In my theories, reflective ability is related to the concept of “intrapsychic permeability”, and this is explained by the continuity – instead of the discontinuity -. in the construction of progressive signifiers in the symbolopoietic network.

Progressive construction of the mental structure does not only come from constructive progressions, but from the presence of an opposite type of functioning that destroys symbolopoiesis and the harmonious continuity in the construction of progressive engrams. I have called this reverse process “autotomy”, as the system which is being built can, in fact, construct itself, but it can erase itself, as well, cutting out (tomy = cutting) engrams on which further constructions may have been possible. This activity is particularly intense on the first of the eight levels of protomental operations I have described: characteristic of the neonatal period, it continues throughout further development. This “autotomic” processing can be compared to the antimental activity Bion describes, and its dialectical alternation with constructive processes is compared with the PS D oscillation. The explanation is hypothesized in the deletion of protoengrams that are susceptible to further constructions – thus traces – and probably neural connections that could have provided the mind with new functional possibilities. Memory is built and is transformed: and it can destroy itself. In these terms, a metabolism concerning the development of mental structure is described – with its anabolism and catabolism, whose neural correspondent is not difficult to configure.

Obviously, everything described above happens well under a level of awareness: all the mind’s processes and processing abilities are fundamentally unconscious. Actually, the original concept of the unconscious – which arose in the wake of Freud’s query: “why the unconscious?” – is reversed: the mind is basically unconscious; what we really need to explain is why the dimension we call conscience appears in the mind (Imbasciati 2001, e). The emergence of the capacity for some kind of conscience, with all of its misconception (see the deceptive recollections in) (comparision with memories) is the epiphenomenon of complex mental functioning that has yet to be studied, and which is certainly linked to the built-up structure, but also to the processing related to the interpersonal moment in which this takes place, and, at any rate, it is not a dichotomous phenomenon. There is a continuum of processes, or processing, along which, time after time, some phenomenon of some conscience may take place concerning protomental operations, especially those that can be translated into what we call affective dynamics.

The whole Theory of the Protomental draws inspiratoin, concepts and terms from cognitive science schools: yet, it is fundamentally psychoanalytical, as many times I have pointed out in my related works. Almost all psychoanalytical concepts – especially those that have emerged during the past thirty years – can be resolved, and, as I intend to do – clarified –  by interpreting them in terms of (relational) learning, representation due to memory constructions and especially memories of progressive symbolization functions. The concept of a symbolopoietic chain and a symbolopoietic network points out that the optimum construction of the functional system is achieved through a gradual contiguity of the progression of the constructed engrams, without the autotomic processes intervening too much to create jatos (holes? Silences?) in the symbolopoietic network. On continuity and contiguity, a suitable intrapsychic permeability is produced. Although in some cases this permeability can lead to the emergence of some kind of conscience, more generally it allows the subject a closer or remoter contact with his/her older engrams, with his/her experiences. With a traditionally psychoanalytical expression we might say with his/her memories – in terms of memory that is not equivalent to recollection. Perhaps a contact with what Bollas has called “states of being”, or “known but not thought” (Bollas, 1987, 1992, 1999); in other words, with the subject’s primitive states, when the construction of his/her mental structure was beginning.

If, on the other hand, the continuity and contiguity of an individual’s symbolopoietic progression has been more or less touched by autotomic processes,  some engrams, some traces of its proceeding towards more complex mental functions have been destroyed: what could have constituted the construction of a certain engram has been aborted. We might see Bion’s concept in this process: something that could have become a thought but didn’t. Autotomy can be especially conceived in very early childhood, in a newborn child, when the mind-system builds its foundations (and synaptic proliferation is at its highest), but it also takes place later. Erased memories, or, at any rate, traces that were never constructed produce defects in symbolization; a subject of this kind does not have the right engrams to acquire certain meanings that could be transmitted to his/her interpersonal relationships. When the continuity and contiguity of the constructive progression of engrams is missing – and this is the case in question – this especially concerns the connections among the various engrams (probably certain synapses), and, consequently, the difficulty or impossibility for the subject to retroactively – with the help of new experiences such as analysis, for instance – regain the possibility of acknowledging certain meanings: the subject lacks the needed signifiers, the engrams that are absolutely necessary to be able to “read”. For the comprehension of oneself, which can be offered by certain existential occasions, the ability to read messages is needed on multiple subverbal and preverbal levels, and thus implies corresponding inner engrams. Without the latter, there can only be a partial understanding of  messages, devoid of their actual meaning: certain meanings entail reading at multiple levels, and this happens for just as many engrams, whose contiguity allows actual comprehension and retention.

If the construction of a symbolopoietic network is compromised in its continuity and contiguity (each engram can generate a further engram: with a functional memory, new functions can be built) the subject cannot come into contact with – or understand – the signifiers and meanings that come before what he/she is currently capable of reading and having: there is only a partial reading, an inadequate acquisition. In other terms, such subjects cannot come into contact with their own “more” affective levels, or older levels. And it is not even possible for them to benefit from new, additional inputs such as those that can be generated through analysis, because there is no trace of these, although they could help if these subjects could form connections with them and fill voids within the network of signifiers. So indeed, the most useful inputs an analysis can offer cannot be read, they can only be framed in a (rational) recognition of mere verbal signifiers. This is produced by what more evolved engrams can read, while a simultaneous reading of lost traces is impossible. The latter would have its own meanings, which should have corresponded to what, psychoanalytically speaking, can be called an emotional or “affective” auraiv of each cognitive event; the aura that could produce “mutative” interpretation (in the sense of Strachey). The lack of the traces in question can be minimal, but it can also be so vast that there can be an absence of any engram that could trigger a recollection.

I believe that on these psychophysiological grounds, we can identify the origin and mental organization that characterizes so-called traumatic patients, and that this can be considered the common denominator around which to focus on the prototype of the patient we are dealing with. It is clear that due to their – even if only “affective” – oblivion, we cannot speak of repression: in this case we’re dealing with a true lack of memory. The latter is to be considered in the broader and multi-faceted terms that have been demonstrated by all the different, current mental sciences, and is not to be interpreted restrictively as recollection. Patients with the above-mentioned symbolization defects can have some reminiscences, but the “mass” of their eventual recollection does not exist: it was lost in their autotomic processes, aborted in the constructoin of their mind-system.

For some years, in psychoanalysis we have been dealing with deficit pathologies: the term is very broad, but certainly focuses on a deficit in symbolization processes, especially if we frame this term as specified here; deficit for the symbolizations that were not produced, deficit for what the structure is not capable of producing. This is why even with the help of analysis, certain structures are not able to produce what the poietic capacity did not construct. In my opinion, so-called traumatic patients are paradigmatic within the deficit pathology. But, perhaps, any deficit pathology implies such a symbolopoietic deficit: fundamentally, the mind – the unconscious, we might say – is symbolopoiesis; we have used the term “traumatic” for certain patients who were unable to undergo analysis when this could be linked to a precise outside event; the event that was thought to traumatize “the normal mental apparatus.”

 

* * * * *

 

From what has been said until now, one might deduce that analysis is impossible. Once one would have called this a contraindication. In actual fact, it is our psychoanalytic technique that ought to be changed. In a classical sense, interpretataion seen as a verbal explanation of inner dynamics makes little or no sense. With his “developmentally based psychotherapy”, Greenspan (Greenspan 1997) has broadly illustrated (on an exclusively clinical level and in different terms from my own) how, in deficit pathologies, the patient cannot be expected to absorb interpretations, and that these can be “mutative”: the patient is not capable of this. So the analyst must adopt a technique that is comparable to that of a caregiver who helps a one- or two-year-old child to think. What was never constructed in the development of that  mind must be constructed now. Therapy must keep the patient’s developmental level in mind: it cannot naively be presumed that interpretation will reveal repressed mental events, because the latter never took place. The analyst’s mind can imagine them, because his/her mind has developed well (hopefully!), but the analyst is likely to project them onto the patient.

Greenspan’s “developmental” insight – or the underlying concept of construction – fits in well with the theoretical picture we are dealing with here. Patients with a symbolization deficit are not able to grasp the semantic aura of an interpretation, and cannot understand much, beyond its verbal content: they can only comply with it, often in a way that deceives the analyst. Interpretation consists in a series of inferences that have arisen in the analyst’s mind, because that mind is capable of such a process. This means that an analyst is provided with the engrams of the mental functions that allow for the characteristic operation of intuition and inference: he links his own emotional impact and what he has sensed in a patient, into a specific phrase, expressed at the right moment, with the right words and a suitable tone. This “link” is possible because analysts have the right linking engrams, both in continuity and contiguity. But these links cannot be read by patients, because they are deprived of engrams. They need to be built. This does not mean they must be reconstructed, but constructed from the beginning. The analyst will try to identify the specific patient’s symbolopoietic course that features most voids, and will try to begin building from there. The clearest example is that of a caregiver taking care of a newborn baby or a baby who is only a few months old. With the analyst’s ability for rèvérie, he/she will offer “thinkable objects” to the baby, who cannot think. This term of Bion’s corresponds to my own theories on the construction of missing engrams: the (affective, or – even more to the point – pre-affective)  signifiers and meanings that have never been part of a patient’s mind.

In this context, here I will present two excerpts from clinical situations.

Z is a woman who decided to undergo analysis at 37 years of age. Unmarried, a successful professional and a sole trader, she realized she had led a life without affection, totally swamped with work. She lived alone, and was completely self-sufficient. She was always in a good mood: she was always optimistic, although she acknowledged that her life was a failure, and that, due to an intricate affective situation, what she earned from her work – which was painstaking, lively, intense and intelligent – was almost all handed over to an aunt of hers. After a little over a year of analysis (three sittings) that seemed to be extremely beneficial, she realized her actual situation, and told me about her very clear plans for her life and work. She knew what she wanted to do and how to do it, both on a professional level and concerning relations and love, and she knew how to solve the exploitation of her work. An intense transference unfolded, first erotic and then, through the years, markedly filial and deeply affectionate. But none of her plans came true. She never cried, except once when she had decided to give up analysis but then came back the week after. Her case history revealed that for educational reasons, from when she was ten years old to when she was eighteen, she was sent to a nun boarding school, far from her family; she could only go back home three times a year. The patient spoke of this as an insignifican event she was able to withstand. Analysis appeared to proceed better than ever, and the patient showed remarkable insight. But a characteristic factor kept on repeating itself: just before taking any important step, such as associating with people, looking for a man, making the economic exploitation stop – the patient made it appear to me that she had almost accomplished these things, but in the subsequent sittings she would talk to me about something else. At a certain point I would realize that nothing had been done; on the contrary, she had done something that tied her even more to her stagnant way of life.

Afterwards, when in one of our sittings I was able to ask her for explanations on what had happened, Z showed surprise over the question, and had totally forgotten what she had planned and what she wanted to do, and any possible interpretation. When she realized this, in the following meetings she acknowledged she had completely forgotten what had emerged in analysis, and at the same time she did everything she could to recover it. But, although her recollection of former sittings were clear, they were aseptic. She admitted she had behaved exactly the opposite  of what she had resolved, or even planned to do, and she appeared annoyed and regretful.  She realized she had behaved automatically, without thinking, and that the fact she had done so showed her incredible tendency to maintain the status quo, moving away from feelings and emotions. In subsequent sittings she seemed to get back into contact with herself and me, recovering what seemed to be lost. But after a few months the cycle was repeated.

After the first two years, analysis took place four times a week. This change highlighted both the positive and negative moments, making the cycle last longer; but it would be repeated. Therefore – I thought – her insights were being erased. Or, perhaps, had I been mistaken, had they never existed as such? Yet, in the “good” period of the cycle I thought there was excellent contact, and that the patient had the ability to work through, absorb and restructure herself. I felt I was sharing with her, and she with me. But, inexorably, and especially whenever there was a separation (during the holidays, for instance), the cycle started again, despite the question of separation had been faced each time, both before and after the moment of separation itself. Analysis went on like this for years. So what was it that wasn’t working?

The fact that the “cycle” coincided with the separations and the fact that even after rehabilitation the patient did not show signs of having suffered – as well as her anamnesis related to the nun boarding school, onto which Z always drifted in her scanty recollections, implying that everything had gone very well – directed my attention towards that particular period of her life and similar situations at an earlier age. Z now began telling me that her father was never home when she was younger, and that her mother often absented herself, leaving her with aunts or grandmothers, and she spoke about her younger sister, who used to break all her toys. She acknowledged she had suffered and been jealous, or so it seemed. But she never seemed to bear a grudge. Slowly, I changed my technique. I was silent a lot, limiting myself to grunting in various ways to assent to what she said, and every so often I would comment on her moods, especially her sexual attractions, anger, grudges, loneliness. I did not make any sort of transference interpretation as I had been doing for a long time, but I very sparingly put into words the feelings I thought she should logically have towards others during the ups and downs of everyday life. Without speaking, I used my countertransference to approve the eventuality of her feelings, especially her negative feelings. I felt she needed to be accepted, but that she especially needed me to identify myself with what she was doing in her daily routine. This change was not easy for me, however. Whilst the patient had always adhered enthusiastically to the transference interpretations (and she still would have), which really seemed to stir her emotions, this other type of intervention, instead, seemed to fall flat. But some years had passed, and I had realized that with the former type of work, the emotions that emerged were then lost, and no change came about in Z’s lifestyle. Therefore, I insisted on this second technique. I felt like I was taking care of a little girl who wanted to play by herself.

Meanwhile, in those years, as I elaborated my theory, I realized how much it could help me in this case. Now, the patient could have some sort of memory trace that was constructed through analysis, and that had made her able to recognize her emotions: adult emotions, however, even if they were of an infantile type. But the emotions themselves were not infantile; they were not like one would presume they had been during her childhood. They were the emotions of an adult towards a hypothetical little girl, not a little girl’s emotions. Furthermore, this mnesic-emotional heritage that was now emerging needed to be confirmed by my presence. This could happen in what, for her, was the extraordinary context of the thorough, continuous analysis she was experiencing through me. But the four sittings we had been carrying on with for many years appeared not to be enough to fill the void between one sitting and the other. Z was managing to have feelings she had never had before, but when she was not with me and was alone in everyday life, these feelings seemed to disappear, without helping her to behave congruously with them. She had managed to recognize those feelings thanks to the fact that she had learned to read what was happening between herself and me in the “here and now” of her adult mind, while together we dealt with a little girl. But when she was not with me she couldn’t be that girl: without me she could somehow remember about it when she thought of me, but throughout the events of her hectic everday life, when she had no time to think of me, every trace of what seemed to have been structured inside her together with me appeared to disappear.

I started thinking that my caregiving might have helped her acquire engrams that were deeper than those that could be put into words, but not the even more primitive engrams that were related to her loneliness as a child, when no one was there; those engrams that had to have been generated somehow, but that had been soon autotomized – or – in other words, that were forming themselves but were aborted as they were being structured. Z had become a sensitive adult, but she didn’t yet have the engrams she needed to live her loneliness in the gaps between one session and the other as a child. Perhaps I should have been at her side all the time, in her everday life, while she was with other people; just like a mother with a three- or four-year-old little girl.

I  persisted with the above-mentioned way of working with her, trying to have her speak about what she did in her daily life, and accompanying her during the sittings with signs of my presence. Little by little, Z started speaking about her childhood differently, about her mother who would go away, her father who was never at home and her little sister, who got all of her parents’ and relatives’ attention (while she was considered “big” and therefore didn’t need any attention). She especially spoke about the nun boarding school: the miserable days – especially holidays – she had to spend there. And about her sister, who was now happily married and thus enviable; and about her aunt. She began showing signs of resentment – first cold and sarcastic, then, as I “accompanied” her, with feeling. Speaking about her daily life was beginning to turn into being able to live it; and she was beginning to live her life by feeling my presence even between one session and the following. Therefore, my kind of work, my participation in every moment of her life probably made her learn what I was feeling, and this was teaching her to feel. Obviously, my teaching could not be casual, nor could it be cold, or an “adult” way of teaching. I used my rèvérie ability, but I was especially careful about what I transmitted to her – the messages could not be too highly evolved, because she wouldn’t have been able to learn them since she didn’t have the means to read them – so I transmitted elementary messages, like those that can be given to an infant who is from ten to thirty months old.

Analysis is still going on: I believe that Z is not only learning to feel like an adult who is able to “understand” children, but also to construct the oldest engrams, her little-girl engrams. Currently, the patient has put an end to her condition of economic exploitment; she has bought herself a house and is giving herself a lot of free time to look for “someone”. But there is still work to do.

Thus, although the so-called trauma is connected with real historical events (eight years of boarding school), we cannot say it was “caused” by this. A network of previous relationships had stopped the patient from learning what children learn about themselves, and, especially, had favoured a continuous tendency to suppress any feeling: an autotomy of what might have been dawning thoughts (“affects) on which other thoughts could be built. The college experience was built up on this primary deficit. Concentrating on this cleared the way to change, but this study could not be mediated by evolved languages, let alone by words. The case shows that the analyst risks relying too much on what a patient who appears to be evolved shows him/her: this is not compliance; it can be genuine, but rootless.

R is currently sixty-four years old. Apparently, during his childhood  he was well taken after by his parents, grandparents and affectionate nannies. At school he was advanced and successful for his age (4-7 years old), but during puberty he developed a delirious psychotic syndrome – a poussées – which lasted 4 or 5 years. The psychotic syndrome was treated with drugs and some electroconvulsive therapy, and then with psychotherapy (his parents were very wealthy and highly educated for that period). At eighteen, the psychotic syndrome seemed to disappear, leaving an obsessive character in its wake, as well as a block in his studies. For six years, he was in analysis with a qualified colleague, and during this period he graduated from university (in a difficult subject, as well) and found a job. Nine years after analysis was completed, he went back to his analyst, but he didn’t feel at ease with her and looked for someone else: me. He was having difficulties at work and was going through a period of general discomfort. He presented an obsessive, pervasive and tenacious structure, a huge detachment from any kind of emotion. We worked for eight years (three sessions), during which he managed to have his first sexual relationships and find a partner; he also left his job as an employee and devoted himself to the management of his large family business, achieving decent results, and this led to the end of the second period of analysis. But he came back to me when he was fifty-five. His business had gone downhill, amidst an ocean of lawsuits that – with a more legitimate alibi – now constituted the object of his obsessions.

After a few years of analysis five times a week – during which he managed to keep a certain balance and during which we spoke about ending the anlysis itself- he kept on asking me to continue some sort of psychotherapy, so we decided to carry on with two vis-à-vis sessions. In the meantime, I had developed the  theoretical-clinical experience I am discussing now. I decided to keep very quiet, only echoing – with brief comments or facial expressions and movements – his lucubrations. This technical change made new events emerge. I discovered that the patient had always been encopretic: a small quantity of faeces always remained in his pants. Also, I found out that he devoted meticulous rituals to both his anal and urethral evacuating activity, and that this took up much of his day. The same ritual was applied to his diet. He had to control everything that came in and went out. Within this picture, I understood his enormous resistence to interpretations, which until then had been hidden under his typical acceptance of interpretations, which until then he had to turn around in his mind, questioning on it in, his ruminations and evacuate in the following sessions. He had to control what entered his mind. And I also understood the meaning of his obsessive arguing and brooding: he needed to control what thoughts might come out of his head. He couldn’t conceive that a “thought” comes by itself: instead, he thought he himself voluntarily produced his thoughts with a sort of controlling superthought, and was alarmed that unwelcome, dangerous thoughts might come out of his mind. And I then understood a problem that had been incomprehensible until then: it was impossible for him to masturbate, as there was a kind of terror (but the emotion wasn’t felt) of what might come out of his penis. On the other hand, in a sexual relationship, a woman’s vagina gave him the certainty that what he rationally knew to come out did not, because he couldn’t see it. And, furthermore, I realized he couldn’t identify what came out of his body: faeces, urine, sperm; nor did he know where it came from; in other words, he did not have normal, differentiated sensitivity: he couldn’t distinguish what came out of his anus or his urethra, and in the latter, the difference between urination and ejaculation. He did not feel specific sexual sensations: he noticed he had an erection when he saw it, or through tactile perception due to the bulk, but he did not sense the difference in his penis; he spoke to me about ejaculations in non-sexual circumstances (but probably emotional) where he did not know whether or not he was having an erection. In other words, he revealed he practically had no means to distinguish and thus to recognize the various sensations in his body.

The same confusion occurred with his thoughts; he couldn’t distinguish his mind from his head. In other words, he put his mind on the same level as other organs of the body, an organ he could control: but, just like for his other organs, it lacked sensibility.

During the past year, R has discontinued any sexual relationship with his partner, who is elderly and sick, but with whom he still lives a part of his life. He has begun seeing prostitutes, preferring one to the others because he feels she has more to share with him. In these relationships he manages to realize what a confusion he makes among the different sensorial areas of his perineum, but he still can’t feel them or distinguish them. He does not know what sexual pleasure is: his satisfaction lies in the act itself, and, perhaps, in noticing whether or not the woman has an orgasm. At the same time – still rationally– he realizes that he puts thoughts on the same level as body excrements, which must be controlled. Furthermore, he also realizes that his rituals related to diet, excretion and other functions – which before he justified in many different ways – reveal his need for control. And also that his ruminating obsessive thoughts (on what to do or not do, on what to plan, decide, etc.) are a form of deceptive control of his thinking. He even manages to presume that behind this incoercible need for control hides alarm for some danger that must be avoided. But he feels nothing.

In this patient there is no clue as to any possible trauma due to historical events: yet, there is an enormous defect of symbolization that involves much more primitive levels than those that were identified in the previous case. R has no body representations, he lacks the elementary engrams to be able to recognize and distinguish the afferences of the various parts of his body; and not only of his urinogenital parts: his musculature, too, is inadequate from a motor-proprioceptive viewpoint: he controls it visually. Formerly, a robot-like psychomotoricity had ensued, and only now is it loosening up. His voice was stentorian, as though he were acting: now it is becoming conversational. In parallel to these changes, R realizes he had considered what he thought and said as a product that had to be controlled: now, his thought seemed a bit freer, and his voice, as well. But he still needs to “feel”, and here we’re not referring to affects – who knows if we’ll ever get there, even though Z often cries now during the sittings – but sensations!

I believe what I have achieved until now may be due to my change in technique, which comes from keeping my theory in mind. I was aided in thinking that the level this patient was, corresponded to an age between six and sixteen months. He has to learn about his body, and consequently about his mind. Thus, the technique did not simply consist in intervening only with comments, but also in a visual and gestural dialogue, and, from a verbal point of view, in my defining what was happening on an intimate level, in his body: just like when a child is taught to move, eat, look around him/herself, go pooh-pooh or pee-pee.

With this patient I’m certainly using a non-traditional technique: the results do not seem bad, if we consider the seriousness of the case and the failure – on my part and on that of my colleagues, previously – to make the situation improve much.

The gaps in his “memory” regard the engrams related to the most elementary distinctions, such as those between outside afferences and those of the body, and the differences between the two as related to the parts of the body they come from, as well as the primitive differences between a sensory input and that which is produced by the mind, which can eventually be constructed on these afferences, such as, for instance, in sexuality. I have undertaken a very difficult task: now, with him at sixty-four years of age, I have to make him learn what he didn’t learn during the first years of his life: I must pay a lot of attention to what happens to him during our sessions (révèrie), especially when I tell him something or make some sort of gesture.

Simply diagnosing a “psychotic structure” doesn’t mean anything, except that this patient’s mind works very differently from how we would expect a so-called normal mind to function. I think my theorization has allowed me to frame more or less serious patients’ structures – in terms of deficit in protomental symbolization – in the levels of initial psychic development for which many authors do not use the term “symbolization”. We are dealing with the most elementary distinctions a dawning mind becomes (or should become) capable of making; so that such a mind can function, different orders of representability – or protosymbols –  are necessary: for instance, those that allow us to distinguish our own body from the surrounding environment, the in/out of our own body, a first Self from a non-Self, the various orders of afferences in our body, the places they come from, their constituting specific, recognizable sensations, and, at last, the distinction between inner mental/interior and body/exterior. Often there are partial deficits that are not easy to see, as, due to certain gaps, the subject has been able to construct his/her further, more complex symbolization, but in a very particular way, spawning the incongruent functions (behaviours) we notice. I think that keeping the theorization illustrated here in mind may help the analyst to concentrate more on looking for the most elementary levels of a lacking symbolization, instead of focusing on psychic events that are totally impervious to restructuring, if this is not done within the reconstruction or construction of its primary roots.

Often, deficits of this kind tend to be present in patients who, through analysis, somehow manage to restructure themselves, reaching an acceptable level, except for some downside in their behaviour or way of life. What can be useful for these aspects is the analyst’s careful consideration: “what can there be under this structure, which we have only partly been able to restructure?”. The analyst must not only think of anxiety and defense mechanisms, but of something much more elementary.

The deficits I am referring to can arise from countless inner events that are difficult to connect to relational events if not only generally. Therefore, referring to trauma, with its semantic aura of “something that has damaged something” makes little sense in my opinion. For example, could we call the second case presented here traumatic? Please refer to the previous considerations that have been set forth.

 

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Imbasciati A. (2003c), Cognitive Sciences and Psychoanalysis: a possibile convergence, J. of Am. Academy of Psychoanalysis: 31, 627-643.

Imbasciati A. (2004a), Um suporto teorico para a transgenerazionalidade: a Teoria do Protomental, Rev. Brasileira de Psicanalise: 38 (1), 181-201.

Imbasciati A. (2004b), Proposta per una teoria esplicativa in psicoanalisi. Riv. Psicoanalisi: 5 (2), 351-372.

Imbasciati A. (2004c), A Theoretical Support for Transgenerationality: the Theory of the Protomental, Psychoanalytic Psychology: 21, 83-98.

Imbasciati A. (2005), Psicoanalisi e Cognitivismo, Roma, Armando.

Imbasciati A. (2006 a), Constructing a Mind. A new basis for Psychoanalytic Theory, London: Routledge.

Imbasciati A. (2006 b), Il sistema protomentale, Milano, LED.

Imbasciati A., Calorio D. (1981), Il Protomentale, Turin: Boringhieri.

Imbasciati A., Margiotta M. (2004), Compendio di Psicologia per gli Operatori Sociosanitari, Padua: Piccin.

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i Here, I am referring to the existence of different metapsychologies which are often unrecognized in psychoanalysis (Imbasciati 2001 b, c, 2002 a, b, c, d, 2003 a, c, 2004 b, 2005 a, b, c).

ii I’m using Bollas’s term and concept (1987), referring it to the relative memory traces here.

iii  Such events, or mental products (premental? Protomental?) – which can be considered as the foundations of mental structures that are being constructed – could open up new ways to clarify phenomena related to transgenerational transmission, especially in alternate generations without direct contact, which psychoanalysts are so interested in today (Imbasciati, 2004 a, c).

iv Obviously, anlysts will have to get used to considering that affects, as well, have their relative memory: the memory of operational functions.
An Explanation of the Genesis of Trauma
in the Context of the Theory of the Protomental
ABSTRACT

Most authors characterize trauma as the (complete or partial) unrepresentability of psychic events constituting the precipitate of past life vicissitudes and persisting in the subject’s mind, albeit without, or with very little, representability, thereby in effect giving rise to a void, on which the analytic couple finds it enormously difficult to work.  Although historical (external) events in the patient’s life may be remembered, it proves virtually impossible for them to be elaborated in affective terms in such a way as to produce a change of mental attitude (mutative effect).  Clinical descriptions that highlight this unrepresentability are often at variance with each other owing to the differing definitions of the concepts of representation and representability applied in each case.  These descriptions are commonly explained by the impossibility of enduring mental pain, which prevents the patient from “thinking” (in Bion’s sense) of what has happened in his or her inner history following a given life circumstance (or, more frequently, life circumstances), often dating back to infancy.

This paper offers an explanation of the characteristic description on which many authors have concentrated.  The concept of representation (and representability) is defined in the context of my personal theory – the theory of the protomental – which I have developed over the last twenty years and which offers an explanation in psychophysiological terms (i.e. terms also consistent with experimental psychology and the neurosciences) of the origins and construction of the individual mind.  The paper therefore gives a succinct outline of this theory, whose main elements are as follows:

Construction of the mind by a progressive process of symbolopoiesis, involving (relational) learning operations each of which modifies the subsequent modes of learning. Memory traces of these. Symbolopoietic chains and network of capacities for symbolopoiesis. Memories of protomental acquisitions. Concept of representation. Continuum extending from protorepresentations, or proto-inscriptions of certain functionalities within the mind, to internal objects. Widened concept of the internal object. Representation as memory of affects. Holes in the symbolopoietic network that is to be constructed. The concept of autotomy and the absence of any memory trace.

The genesis of trauma can be conceptualized in this context as a defect in the construction of the symbolopoietic network constituting the functional structure of the relevant individual’s mind. This defect can be described as an empty, or rather emptied-out, area, “autotomized” during symbolopoietic construction.  It involves the erasure (autotomy) of memories and, in particular, of memories of functions and of connections between memories.  It is not a matter of repression, but of the actual absence of memory.  The concept of Nachträglichkeit is reconsidered in mnemic terms, as the possibility that, in the continuum of transformations in any case occurring in memory, various “holes” in the symbolopoietic network may flow together into a single deficit, and indeed reactivate autotomic processes in the reverse direction.

This theoretical framework may help the clinician to be aware that interpretations concerning the traumatized “area” cannot be effective without a prior process of construction of what was not constructed, or was destroyed, within the functional structure of the patient’s mind.  The analyst must therefore base his approach on that of a caregiver looking after a child and teaching him or her to think.  That child may be one, two, three, five or seven years old, according to the mental level identified as referable to the trauma.

Clinical examples are given.

Short chronological autobiography

1936 – Born in Pisa
1961 – Degree in Medicine and Surgery (University of Milan)
1964 – Specialization (= Master) in Psychotechnics  (Milan)
1965 – Specialization (= Master) in Clinical Psychology (Milan)
1967 – Specialization (= Master) in  Infant Neuropsychiatry (Pisa)
1968 – Candidate of Italian Psychoanalytical Society
1971 – Associate Professor in Psychology (University of Turin)
1973 – Associate Member of Italian Psychoanalytical Society and International Psychoanalytical Association
1975 – Full Professor in Psychology (Turin)
1980 – Full member of Italian Psychoanalytical Society and I.P.A.
1986 – Full Professor in Clinical Psychology (Faculty of Medicine, University of Brescia)
1994 – Training Analyst of the Italian Psychoanalytical Society

Main topics in his works:
Perceptology – Mass media – Projective testing – Psychotherapy – Psychoanalytic Theories and Clinics – Cognitive processes and Cognitive Psychoanalysis – Medical Psychology – Training for Health operators – Perinatal Psychology.

Printed Works:
42 volumes and more than 200 other papers.

For details see his web-site: www.imbasciati.it

Autobiographical  Notes

The Author is Full Member and Training Analyst of Italian Psychoanalytical Society, and he is Full Professor of Clinical Psychology in the Faculty of Medicine in the University of Brescia.
He wrote many papers, and 38 volumes, in Experimental Psychology, Clinical Psychology and Psychoanalysis: on his website: www.imbasciati.it you may see a detailed curriculum, the list of all his works and the topics he wrote about. Since 1978 most of his works relate to confront psychoanalysis with Experimental Psychology. He worked out a personal theory –the Protomental Theory- whose last elaboration is described in his last volume, “Constructing a Mind, Routledge, London.