Tra molecole e mente: la neuropsicoanalisi come ponte epistemologico e strumento per una psicodiagnosi dinamica e personalizzata

Abstract

The persistent gap between neurobiological explanations and clinical understanding of subjective experience is one of the most significant challenges for contemporary cognitive science. This Article argues that neuropsychoanalysis, understood specifically as that interdisciplinary research program that, inspired by Freud’s original project and developed in particular by authors like Mark Solms, seeks to translate the constructs of Freudian metapsychology into terms of affective and computational neuroscience. It provides a robust epistemological and methodological framework for dealing with this fracture. Via a thorough analysis of the literature, it will be demonstrated how fundamental concepts – the dynamic unconscious, repression, defense mechanisms, and drives – can be operationalized and empirically investigated, revealing plausible neural substrates without claiming a reductionist identity. In the second part, a systematic critique of nosographic systems will be articulated, in particular the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, text revision (DSM-5-TR) and the International Classification of Diseases (ICD-11), extending the analysis to more recent dimensional models such as the Psychodynamic Diagnostic Manual, now in its third edition (PDM-3), which offers an alternative framework focused on the subjectivity and functioning of personality, in dialogue with the Research Domain Criteria (RDoC) and computational psychiatry. The importance of psychotherapy-induced cognitive and neuronal plasticity will also be discussed, with a focus on post-traumatic stress disorder (PTSD) and the role of the social brain, as well as a neuropsychological redefinition of conversion disorders in light of the body-brain-mind connection. We propose that neuropsychoanalysis can guide the development of diagnostic approaches based on a dynamic, personalized case formulation, illustrating this point with evidence-based interventions rooted in neuropsychoanalytic constructs, such as mentalization-based therapy (MBT). It is concluded that neuropsychoanalytic integration, despite its challenges, represents a necessary path toward more humane psychiatry and a clinically more effective psychology.