ABSTRACT
This chapter deals with the problem of the integrated treatment of psychotic disorders with drugs and psychoanalysis. The author starts with a review of the literature on psychodynamic psychopharmacology, from the North American area, and with a reflection on some methodological issues, inspired by European psychopathology. In particular, he emphasizes the contradiction between the symptom understood as a sign (in psychiatric semiology) and the symptom understood as a symbol (in psychoanalysis), while maintaining that it is essential to accept this contradiction and attempt to resolve it in clinical practice. In light of this, he discusses a number of important issues. These include the choice between a separate or unified treatment in relation to the diagnosis and the person, transference and countertransference dynamics during the pharmacological treatment and the relationship that is created between the psychoanalyst and the psychiatrist. The work includes a number of clinical cases that get to the heart of the aforementioned issues, focusing mainly on the emotional experiences of a psychoanalyst who is also a psychiatrist and is sometimes involved in the simultaneous delivery of both treatments, sometimes forced to “forget” a part of his/her professional identity.
