The narrative and the living

Francesco Fiorentino, Gianluca Paolucci
One of the crucial moments in which, in recent years, the clash between the “two cultures” has occurred, it was the French publication of the Black Book of Psychoanalysis in 2005. Forty experts, among which former psychoanalysts, neuroscientists and philosophers of science, formulated a strong condemnation of psychoanalysis describing it as nothing more than a factory fairy tales with no clinical or gnoseological value as opposed to the scientific objectivity of the cognitive-behavioral therapies and medications. Immediately afterwards the publication of this work, an Anti-Black Book of psychoanalysis responded to the provocation with a number of arguments against the “positivist” and scientistic approach of such “theories of mind” highlighting how such theories solely aim to the re-establishment of functional and normalizing behaviors of the subjects ignoring their mental suffering and their desire of subjectivation. According to them, what is lost would be the inner dimension of the deep and inscrutable, as well as the hermeneutical activity implied in it; what is missing is therefore the idea of the unconscious as a reservoir of conflicts and, at the same time, as a possibility of regeneration through the medium of story-telling. The Freudian talking cure is, in fact, a practice of rewriting of the implicit history inscribed in the experience of the subject. In the end, the founding principle of psychoanalysis is but the capacity of the narratives to restructure our imaginary representation of the ego, seen as a character, to review our position related to it and reshape the ‘”I believe” and “I feel “that accompanies all our experiences.
The research will consist of a critical reconstruction of the debate that sees the opposition between Freud’s “culturalist” approach and the “naturalist” one as a new and especially significant case of clash between soft sciences and hard sciences; a clash between two forms of reductionism stimulating the development of new models of dialectical understanding and interactive connection.
In this perspective, narrative and physiology, neuroscience and psychoanalysis will be seen as two different cognitive horizons of knowledge operating at different analytical levels but inevitably related to a dialectic (even a negative dialectic) that colors the one of the characteristics of the other. Ultimately, the the research will focus on the study of narratives and story-telling as a way to organize the living and its comprehension.
If, in fact, the idea of Freud’s talking cure is that of a constructive activity for the creation of meaning (i.e. the production of plots as a structural principle of mental processes along with the whole set of human vicissitudes and cultural resources) this leads to a consequent transformation of the idea of narrative as a faculty not only capable of organizing the data of the symbolic communication and discourse, but also organizing the living itself. Interestingly enough, this is an idea that the anti-psychoanalytic approaches still deny.
Paradoxically, the indictment of the Freudian talking cure appeared when the new “narrative medicine” started spreading. The narrative medicine can be defined as a “doctrine” that emphasizes the value of the word and storytelling as a means of cure; not only to “treat” the effects psychological diseases, but also to provide a valuable support to the physio-pathological interpretation and treatment of symptoms. The idea, then, is that the narrative of the experience of illness will enrich the biological knowledge of the disease itself whereas the patient, being the expert on the condition that he lives, provides an essential tool for customization of the process of care through his words. At this point, however, a number of critical questions seems to emerge and the answer to them can only be given through the instruments borrowed from the discipline of textual sciences: which models and discourses does the patient choose to tell his/her own experience? What are the models and the discourses that filter the understanding of this story? etc.. etc.. In this way, the evaluation of the clinical process would also imply narratological, linguistic and hermeneutic skills such as the ability to detect and decode metaphors, allusions, quotations etc… In other words, this would require a truly “literary” attitude to project oneself beyond the discursive forms used in medical practice, recognizing how these models shape both illness and health.
If, modernity has been dominated by the biomedical model, which – in the apodictic words of David Morris – «divide the bodies of the minds, considering bodies as machines and reduces the disease to the language of chemistry and physics, », medicine – as Kathrun Montgomery Hunter writes – is an hermeneutic activity, adapting scientific abstractions to individual cases, which “has already something in common with literature and literary study for its use of figurative language and narrative organization of the events of the disease. From this perspective, the shift from a biomedical paradigm towards a bio-cultural one can therefore be seen “only” as a redefinition of the relationships between the two models through a rigorous reflection, not only “culturalist”, of the universal medium of storytelling.