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Psychodynamic therapy in the public sector in Italy: then and now. The opportunity of evidence-based practice in the birthplace of ‘care-in-the-community’

A brief account of the history of psychodynamic therapy in Italy is made, with special reference to the public sector. The peculiarities of the history of psychoanalysis in Italy, and the differences with countries such as the UK, are highlighted. In particular, the delay of the development of a psychoanalytic tradition is seen also as due to the historical influences of fascism, the Catholic Church, and the rigidity of the university system. The effects of the de-institutionalisation and community psychiatry movements, which in Italy were quite important, are highlighted. These movements, especially for their more radically ‘anti-psychiatric’ aspects, together with the resistance of the university system which in Italy was mostly based on biological psychiatry, represented obstacles for the development of a psychotherapeutic culture. Psychoanalysis, in particular, in some quarters was seen as ‘conservative’ because in those years it was perceived as only interested in the intrapsychic sphere and not in the social context. For these reasons, in the 1970s psychoanalytic culture had to struggle simultaneously with two opposite forces, from the right and from the left, so to speak: the rigidity of the university system, on the one hand, and some extreme fringes of the anti-psychiatric movement, on the other.