Massimo Fagioli Research Articles

A Primer on Human Birth Theory.

In the 1970s Massimo Fagioli (1931-2017) proposed a new theory of mind that he called the Human Birth Theory, based on a healthy conception of the baby and of the nonconscious mind. Fagioli made significant contributions to the understanding of mental dynamics at birth, the pathophysiology of mental illness, and the nonconscious identity of psychiatrists and psychotherapists. His original contributions to psychodynamic psychotherapy included variations on the setting and understanding of transference and dream interpretations that deviated from classical psychoanalytic techniques. This article introduces the basic tenets of Human Birth Theory, its neuropsychiatric correlates, and clinical applications.

Psychopathology of anorexia nervosa: a defence from depression. An interpretation according to Massimo Fagioli’s Human Birth Theory – two case reports

This paper focuses on anorexia nervosa with an emphasis on its onset and treatment, and it particularly addresses two aspects of the disease, which seem completely in contrast with one another – prolonged fasting and recurrent episodes of binge eating/purging behaviour. From a psychopathological viewpoint, these can be considered two symptoms of the same disease, whose psychopathological core is often depression. The anorexic phase is characterised by control of food intake and interpersonal relationships due to a paralysis of affections and mental rigidity, which often provide a schizoid defence against depression and sometimes against fragmentation. In the bulimic phase, a break in this defence reveals violent and uncontrollable affects beneath depression. One possible hypothesis to evaluate would be whether these alternating phases can be overcome if they are interpreted as a false resolution of an intrapsychic conflict as defined by Fagioli’s Human Birth Theory, based on a psychic defence reaction that may arise in newborns, and which he termed annulment pulsion. If pathogenic factors are present in the first year of life, the annulment pulsion may become pathological and can explain the psychosis in anorexia nervosa patients. This paper presents two clinical cases involving two young women, one suffering from anorexia nervosa purging type with self-induced vomiting complicated by comorbid drug abuse and the other suffering from anorexia nervosa binge eating/purging type and comorbid drug and alcohol abuse. Both were successfully treated with psychodynamic psychotherapy (individual and in groups) based on the interpretation of dreams according to Human Birth Theory, which posits that a dream is a thought expressing itself through images. The patients were treated for 4 and 5 years, respectively. The scores on three standardised tools, Eating Disorder Inventory-3, Symptom Checklist-90-Revised and Toronto Alexithymia Scale, administered before and at the end of treatment, accurately reflected their baseline condition and their clinical improvement. The treatment induced a reduction or resolution of symptoms and a qualitative improvement in the patients’ oneiric activity. The encouraging outcomes for these patients support the interpretative hypothesis proposed in this article and the value of the approach based on Human Birth Theory in treating anorexia nervosa. Further work on the subject is clearly warranted.

L’affannosa ricerca per una diagnosi “utile”: tra criteri soggettivi ed evidenze oggettive

The psychiatric and even more the psychotherapeutic diagnosis is still nowadays a highly debated concept which lacks a clear definition. The different theoretical framework references do not agree on a shared etiopathogenetic mechanism responsible for mental illnesses onset. Many psychiatric and psychological health care workers report the need to revise the current diagnostic manuals which, in order to favor a more operational approach, often set apart from the clinical reality. Scientific research claims a method of knowledge able to maintain its scientific nature without overestimating the importance of objectivity. Subjectivity cannot be sacrificed in order to reach an objective diagnosis. In contrast, the psychotherapeutic relational dynamics and the patient’s unconscious reality such as dreams are fundamental for a correct and deep comprehension of mental pathology. Massimo Fagioli’s Theory of Birth represents a theoretical framework able to connect the patient’s unconscious dimension to the different clinical category manifestly expressed.

“Dimenticare” il bambino in auto: l’intelligenza nelle parole

The author begins the article by stating the inappropriate use of the words “to forget” and “forgetfulness” when referring to describe a child abandoned in a car under the blazing sun. She particularly speculates about this wrong use, since the concept of “annulment pulsion” was elaborated by Massimo Fagioli decades ago. By tracing back the history of the words “oblivion” and “memory”, the author demonstrates how since ancient times the ars memoriae conceived the mind as a physical space, a place. This spatial conception of the mind was widely spread among many philosophers such as Agustin, Giordano Bruno but also Descartes, Locke, Kant and Freud. This latter, in particular, was the founder of the psychoanalysis which is based on a process of uncovering what had been repressed. According to Freud, the amnesic trace does not disappear but is rather repressed (verdrangt in Freud’s language, that means “pushed away”). However, based on the Human Birth Theory framework, the mind expresses itself as movement throughout time: the amnesic trace disappears and then reappears. Understanding the mind as movement rather than space allows the comprehension of how a child can be unconsciously annulled.

Un ricordo di Massimo Fagioli

This article introduce to a special issue of “Il sogno della farfalle” entirely dedicated to the Italian psychiatrist Massimo Fagioli, who passed away on February 13th, 2017. Fagioli was the founder of the Human Birth Theory and of our journal. In this issue we transcribed and collected most of his recent public speeches, both at book presentations and in television broadcasts. The texts included cover a period starting in 2010 but belong mainly to the last one and half year, after the conferences of October and November 2015 celebrating the 40th anniversary of the Analisi collettiva. They allow to follow the thread of Fagioli’s research, showing how much it was active, vital and still continuously in development, in search for the most appropriate terms to describe the child’s reality, the dynamics of human birth and the definition of one’s own identity.

Psichiatria e diritti umani: aspetti storici

Human rights, as well as activists who fight for these rights to be acknowledged and safeguarded, are under siege due to terroristic attacks taking place in the heart of France and Europe, and to migrations, the bombardments, and wars raging in the Middle East and throughout the world. Do we live in the age of rights or of their systematic violation? Psychiatry, which was born within the context of the ethical and religious rationalism of the French Revolution, just as human rights were, deteriorated until the first few years of the Twenty Century, going as far as lending ideological support to the Nazis’ criminal activities of sterilization and euthanasia of mentally diseased people. Psychiatry has also been an accomplice in the violation of human rights’ not only in Russia but also, more recently, in China. The Declaration of the Rights of Man and Citizen in 1789, just like the Declaration that was passed in 1948, made reference to a concept of “natural” which refers to the reality of human birth, whose meaning in individuals’ psychic life has never been understood by either philosophers or psychiatrists. Human Birth Theory by Massimo Fagioli, insofar as it refuses the term “natural” to be synonymous with inborn and with rational, as was true for Enlightenment thinkers, proposes a new idea of the origin of human rights and of relevant juridical capability on which these are based.

Car l’homme est fait pour rechercher l’humain. Rileggere Eugène Minkowski

The current crisis in reductionist psychiatry has aroused new interest in psychopathology. The intent is to go beyond diagnosis based on set categories and tackle mental disease not only from a biological point of view. Within this perspective, Minkowski’s thought is particularly interesting. The article proceeds by highlighting Minkowski’s originality in his time and how he differs from Binswanger, who lived at the same time as Minkowski and is possibly more appreciated and undoubtedly better known. By providing a new interpretation of his best known works, the article develops and highlights the link between Bergson, Husserl and Minkowski on the one hand, and that between Jaspers, Heidegger and Binswanger on the other. Apart from Minkowski’s relation with philosophy, the Authors also evaluate his relation with psychology, the unconscious and psychoanalysis, language and existential analytics. The Authors, by making reference to Human Birth Theory by Massimo Fagioli, highlight some intuitions and the originality of the phenomenological analysis in Minkowski’s work, which have never been evidenced.

La mente e il corpo nella schizofrenia

Starting from the etymology of the term “mind”, the Author analyses the question mind-body involved in the history of human thought since pre-socratic philosophers. In particular, the question still stands unresolved, both from an ontological and a methodological point of view, within the “philosophy of the mind”, neurosciences and psychiatry. Moreover, in the article, the Author analyses the implications of the concept of “causation” when it is used in its deterministic and simplistic meaning to understand human beings’ behaviour, which makes one fall into mistaken interpretations and tautologies again. The Author suggests a new way to face the question in the light of Human Birth Theory by Massimo Fagioli so as to escape from the traditional opposition between the mind and the body.

La chiusura degli OPG: quali prospettive terapeutiche?

Closing down the OPGs (Judicial Psychiatric Hospitals) in March 2015 was a historical event given that such institutions existed in Italy from the 1930s and remained unchanged even after the abolition of mental asylums. The new structures that substitute them, the REMS (Residences with Security Measures), seem to still be in a project phase; shortly, the number of OPG patients could saturate them with repercussions on mental health centres. The author offers a historical overview of the concepts of imputability and the security measures underlying the OPG system. He then goes on to discuss the theory by which mentally ill offenders would not be held responsible and dangerous. In the light of recent houghts deriving from Massimo Fagioli’s Birth Theory and his statements regarding the psychotherapy of interpersonal violence, this regulatory system can now be considered outdated, and it is now considered possible to cure these mentally ill offenders in an appropriate period of time and with specific methods.

La nascita e l’origine della mente: la luce e il tempo vissuto

The author demonstrates how the most recent biological and neonatalogical research integrate with Massimo Fagioli’s Birth Theory. At birth, when the light makes contact with cerebral matter, a real and proper shift takes place: from the foetus which has only a biological specificity void of any mental activity, to the newborn whose “lived” body is at the origin of psychic processes.

Introduzione. La teoria della nascita nella cura delle psicosi: un confronto internazionale

This article introduces a special issue of the journal which includes the papers inspired by the Human Birth Theory presented during the 9th International Conference on Early Psychosis (Tokyo 2014) and the 19th International Congress of the International Society for Psychological and Social Approaches to Psychosis (New York 2015). The author reconstructs the diffusion of Massimo Fagioli’s theory out of Italy from its origins to its most recent developments, in the context of the ascent and decline of organicist psychiatry.

EPA-1666 – Physical and psychic birth coincide. about bioethical implications of the birth theory (1972)

After refusing the belief that a voluntary interruption of pregnancy (VIP) must necessarily lead to depression, the paper reports the clinical observation according to which, after a VIP, guilt feelings leading to depression may but do not have to inevitably arise in women, in their partners, in medical staff. These kind of guilt feelings are centred on the self accusation of having taken away the possibility of a life to a child. So the point is whether the embryo and the fetus can be considered scientifically human life. Surprisingly, it was psychiatry that gave an important answer to this relevant issue. As a matter of fact, the so-called Birth Theory - which has been laid down by the Italian Psychiatrist and Psychotherapist Massimo Fagioli since 1972 – is hard-and-fast as to this point; human life presupposes a psychic activity which is absent in the fetus. According to this theory, the fetus is a biological existence which becomes a potential human being from the 22 nd /24 th week of pregnancy only. Such a potentiality of the fetus can occur only at the very moment of birth when the first stimulation of the retina, caused by the light, originates a transformation of the brain functioning, generating the beginning of its psychic activity in a specific form defined by the author as’imaginative capability’. It is even more surprising that the Birth Theory, initially elaborated on the basis of clinical observations and deductive reasoning, has recently received important, increasing backing from fetal and neonatal neurology.

La psichiatria come psicoterapia

This unpublished text by Massimo Fagioli dates back to the summer of 2004, and deals with the indissoluble link between psychiatry ad psychotherapy, to the point of having to affirm that one does not exist without the other. Fagioli clarifies the fundamental terms of psychotherapy, which are setting, transference, interpretation; talks about his particular group setting, the Collective Analysis which has been operating for 40 years; reaffirms his method based on a fusion between theory and practice; defines fundamental concepts like image, instinct, drive, dwelling, in particular, on the existing confusion that surrounds words like negation and desire.

Una pillola per diventare bambini buoni? Considerazioni sul disturbo da deficit dell’attenzione e iperattività

The authors describe Attention Deficit-Hyperactivity Disorder( ADHD) from a clinical, epidemiological, historical and cultural point of view, focusing on the two main approaches present in the Italian debate. On the one hand, the neurological-organicist approach helps form the current guidelines adopted by the Istituto Superiore di Sanita regulating pharmacological therapies. On the other hand, public opinion is sensitive to the position of private associations made up of experts and parents, who interpret the behavior of distracted and hyperactive children as a mere “diversity”, and look forward expedients that facilitate a better social integration of these student. The vision of the child which arises from Massimo Fagioli’s birth theory and forms the basis of the clinical work of the authors is in direct contrast with the two above-mentioned approaches and will be further explored in a subsequent article.

Das Unbewusste: l’inconoscibile

The publication of the debate held on the occasion of the publication of Massimo Fagioli’s Das Unbewusste. The unknowable (Nuove Edizioni Romane, Roma 2007), in Rome on 9.12.2007, follows on from the papers, published in the last number of the magazine. The questions and answers developed some of themes raised in the papers delivered: the spiritual and religious character of the concept of a distinct unconscious, starting from Schelling, with the term das Unbewusst; the annulment of human reality by rational thought, from Spinoza, to Hegel up to Heidegger; the ineluctable relationship, in medicine and in particular in psychiatry, between knowledge and aim of a cure. In conclusion Fagioli has highlighted the social and political consequences of the observation of the fact that the passage from the adjective unbewusst to the noun das Unbewusste implies a definition of the unconscious no longer as a condition, but as a substance: an analogous process, in fact, may lie at the bottom of racist phenomena.

Leggere la biologia e la vita umana

Following two lines of research, one relating to biological medicine based on an experimental method and the psychiatric one which follows the deductive method starting from interpersonal relationships, the irrational and the non-conscious, the author, without referring to religion or philosophy, attempts to identify the moment in which human life starts. In order to achieve this result the morphological and functional changes of the nervous system of the foetus and the newborn are analyzed. The compatibility of data coming from the international scientific community with the psychiatrist Massimo Fagioli’s birth theory is also assessed.

Pazzia, amore, identità, annullamento, libertà

Massimo Fagioli answers five questions which the journalist Carlo de Blasio asks him on the occasion of the release of two psychiatry texts by Fagioli (the 8th edition of Bambino donna e trasformazione dell’uomo and the first edition of Una vita irrazionale, a volume which collects his university lectures of 2006), discussing a series of arguments equally central to his theory and practice as a psychotherapist. Rejecting the abolition of the concept of mental illness brought about by the psychiatry of the last few decades based on the DSM, Fagioli defines madness as a disease of the unconscious that, contrary to common thinking based on a mentality deeply-rooted in a religious and philosophical tradition, he considers to be originally sane and therefore curable through psychotherapy. The question on love brings him to define sexuality as the realization of an identity in a dialectical relationship with a human different from oneself which is neither based on compassion nor solidarity but is based on an irrational movement; in turn the realization of one’s own identity not based on a scission between the unconscious and reason constitutes the basis of freedom. With regards to annulment, Fagioli is synthetic in summing up, whilst making references to a number of recent discoveries in biology, his own theory of the disappearance fantasy and the formation of thinking based on the capacity to imagine.

Che cos’è l’invidia?

In this interview, given in July 2005 during a television program on the theme of envy, the psychiatrist Annelore Homberg explains Massimo Fagioli’s conceptualization of envy that puts it down to an aggressive drive that aims at destroying an object by negating its qualities and criticizes fiercely the Freudian concept of penis envy in that it has at its basis a stagnatingly negative vision of the female identity.