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Dr. Mariano Enderle
Clinical Psychologist – Psychotherapist – Psychoanalyst
Psychoanalytic Society of the New York University Post Doctoral Program in Psychotherapy and Psychoanalysis
Faculty School for Integrated Short Term Psychotherapy – ISeRDIP Milano
Italian Professional Board of Psychologists “Regione Lombardia”
My background is mainly psychoanalytical and a relevant part of my training has been in New York. I went in search of a more eclectic formation motivated by the need to expose myself to the variety of different theoretical perspectives that have defined psychoanalysis in the last decades. I believe that a contemporary psychotherapist has the responsibility to know and practice from different theoretical approaches in order to better understand the problems presented by patients. Diverse theories of the mind become in the therapeutic relationship and process different and often necessary transformational opportunities for the Self that cannot be undervalued and discarded by using one approach only. I learned to appreciate a dialectical use of the psychoanalytical models, mainly the contemporary relational perspectives, reducing in this way the need for absolute truth and reifying theories.
Contemporary Psychoanalysis has integrated into the biological and reductionistic freudian drive-model the interpersonal and experiential dimensions recognizing the deeply relational nature of the human mind and its development. A new paradigm has emerged with a clear focus on identity and subjectivity, where what counts is not only optimal adjustment to reality but the achievement of the capacity to subjectively live our lives.
The need for attachment, of an intense and meaningful affective relationship characterized by appropriate mirroring and the clear sensation of being recognized by the other are considered the fundamentals for the development of a integrated identity rooted in the body. This stable sense of Self is what we need to immerse ourselves in the relational dimension without loosing our sense of separate individuality.
Trauma is considered a consequence of a deprivation of these basic needs of attachment and recognition. The traumatized mind develops into a defensive system, through dissociation, to prevent loss of control over disorganizing emotional states that could jeopardize our identity integration and the necessary affective relationships with the external world.
Psychoanalytic Psychotherapy and Psychoanalysis
Psychoanalysis as a method has the ambition of pursuing a deep transformation of a defensively structured personality into an identity that can contain a multiplicity of different aspects of the Self. This rigid structure is considered a consequence of relational traumas and deprivation of the needs for attachment and recognition. This method, based on long term containment, non judgmental listening and exploration of unconscious processes and conflicts, applies very well to the developmental needs of the Self. The process consists of the repetition and working through within the relationship with the analyst of the traumatic developmental deprivations of the past in the search of the emotional corrective experience needed by the patient.
Short Term Focused and Integrated Psychotherapy
The psychoanalytic theory integrated with the cognitive approach is the essence of a short term psychotherapy that is often appropriate to the specific need of a patient who does not seek a deeper and long term treatment. This technique is focused on the recognition of the specific problem and conflict presented by a patient which interferes with the achievement of normal development and autonomy. The diagnostic evaluation is crucial to properly identify the problem, taking into consideration the specific needs, the evolutionary resources and the resistance to change.
An essential part of this approach is the belief that the patient’s vitality, resilience and life choices will be an important component in the ongoing process of cure once the stalemate has been recognized and resolved.
This integrated approach has been proved to be particularly appropriate and useful in couple therapy. The identification of the underlying conflict between the psychological structures of the individuals involved in the relationship is one of the important aspects of this approach in order to understand, contain and resolve the tendency to repeat inappropriate modalities of attachment.
Areas of Intervention
Integration of relational psychoanalytic models and different psychotherapeutic approaches such as cognitive-behavioral therapy, can be crucial in approaching different forms of pathology like: depressive states and actual pathology (panic attacks, somatic and eating disorders). In the case of psychopathology, expressive psychotherapy is preferred, as in the treatment of hysterical, obsessive and narcissistic unconscious conflicts that constrict the development of the Self.