“We can overcome anything in life as long as we are healthy and have someone who loves us”

In psychoanalysis, the term neurosis seems to refer to a kind of spiral spring: it would determine the way we are, our suffering and also that of some members of our environment. And just as we, without realizing it, shape our children’s neurosis, we were shaped in our childhood by decisive actions or omissions from our parents.

Is the past a crucial issue? For psychoanalysis it seems so, yes. And the lives of the patients told in “Ten Stories of Life, Suffering and Love” (Paidós), recently presented in the country by the renowned psychiatrist and psychoanalyst Juan David Nasio, seem to confirm this.

—Is there a feature of neurosis that occurs more frequently and more intensely in most people?

—Yes, dissatisfaction is very common in healthy people, it is one of the characteristics that is most mixed with health: we are very hard on ourselves and sometimes we are not satisfied with what we have.

—Is dissatisfaction usually one of the reasons for analysis in neurotics?

—Yes, when there is suffering. Psychoanalysis needs a starting point, which is suffering. And three things are required: suffer, consult someone not to suffer, and trust that someone will help me.

—Then is the middle class in Argentina over-psychoanalyzed? Many people go to therapy for years and are not necessarily suffering, but are trying to cope with their everyday lives.

“Well, there are times when we first suffer and then go into analysis because a relationship has emerged that balances us in life and suits us, even if we don’t suffer as much as we did at the beginning.

—There are three types of neuroses: hysterical, phobic and obsessive-compulsive. Should we all recognize ourselves in one? Or can we represent all three characteristics?

—There are some who dominate more than others. In the photic, the fear of abandonment dominates. For compulsive people, the biggest fear is humiliation. And in the hysterical, the greatest fear is being unwanted.

—In the book he explains that neurosis has its origins in childhood, with severe trauma (in this case there is a pathological neurosis with symptoms) or with microtraumas of growth, such as the birth of a sibling. Things that happen to everyone. How do these traumas shape our neurosis?

-Depends on. In the book I give the example of thermometers (N. of R: refers to the case of the mother of a 10-year-old girl who was told by the doctor to take her to the emergency room if she had a fever due to her illness, and she took the girl’s temperature rectally four times a day). This is sexual microtrauma because the mother unintentionally caresses the girl’s anus several times every day, which is terrible. There is a micro-trauma and when the girl grows up she will have sexual problems, I know that for sure. When an adult patient has problems such as vaginal pain during penetration, which is dyspareunia, I know that woman likely suffered trauma or microtrauma as a child or adolescent. I don’t know whether it’s with the mother or with the older brother, as that also happens very often. Something happened to this woman today that caused her to suffer from this mental, psychosomatic disorder.

– And can we always reach this fact of the past through analysis? Very traumatic topics can be repressed…

-It’s true. We don’t always arrive, but we are attentive and search. It’s very complex, it’s also not that systematic. For example, I have a patient who has a phobia of leaving the house. And I can assume that physical abandonment occurred as a girl. It may or may not have really happened. As in the case of another patient, when she was a child, her mother was in the hospital for a month and her father did not take her because he did not want her to go to the hospital at such a young age. The girl didn’t see her mother and didn’t understand. This is an example of unreal abandonment trauma because the mother must also have desperately longed to be in the hospital and not be able to see her daughter.

—Psychoanalysis is sometimes criticized for the importance it places on childhood. In the book you confirm that we feel very determined as if we were living out this past in the present. What scope do we have left?

—There remains some scope: for improvement, for freedom. Not very big. Meeting a new person, having a new job, having a new context. My daughter, an architect for 20 years, got excited one day and started working with pregnant women. Suddenly he completely changed direction and started doing something related to health, probably including me. This is an example of the freedom we have, namely choosing a different career. In short, there are freedoms, not everything is systematic, nor a closed machine, there is a scope of freedom to correct and improve ourselves.

—They say that one of the goals of analysis is for the person to be satisfied with who he is, with what he has and with what he does. Isn’t that a conformist view?

—The central theme is that the person is happy with who they are. This bodes very nice things for the future. And you also have to be happy with the past.

– Even if it were bad?

—There may have been a drama, this is the case of a patient who had the drama of not being able to conceive and when, despite great efforts, she succeeded, the child died two days after birth. And finally, at the end of the last session, she tells me at the door: “I believe, Doctor, that my great sadness calmed down the day I understood that the death of my son, which is and will remain the central event of my life, that death is not my whole life, the memory of that terrible night no longer overwhelms me, today I can work without thinking about my son all the time, but I know that he will be next to me at the moment of my death.” In a word, yesterday’s drama does not penetrate her, yesterday’s drama was yesterday’s drama, but she continued to live and realizes that the drama is a moment in her life, but not her whole life.

“It was the work we did, she worked it out, it means that the past defines us, it may be a tragic past but we can do better than that past.” When I see the Paralympic Games, where people with disabilities compete in sports without legs or without arms, it is extraordinary that they have achieved what they have achieved.

—Can you overcome everything in life?

-I think so. As long as there is health and there is another who loves us and whom we love. These are the two requirements to be able to overcome anything.

Juan David Nasio was born and educated in Argentina. After studying medicine, he specialized in psychiatry. In 1969 he traveled to Paris, where he became a student of Jacques Lacan. Author of 37 books, he was appointed Doctor Honoris Causa by the UBA and was awarded the highest honor a doctor can receive in France: he was promoted to the rank of officer in the National Order of the Legion of Honor.