Freud and the dialogue with medicine: on the challenges of psychoanalytic clinics in the face of diagnosticism

Abstract

In this article, we follow Freud’s theoretical and clinical career, highlighting how his medical training and his dialogue with the neurology and psychiatry of his time were decisive for the construction of a new clinical model. We analyze the emergence of psychoanalysis within the medical field as a fundamental conceptual inflection: from the organ to the subject, from the lesion to language, from observation to listening. Through a chronological and articulated reading of pre-psychoanalytic, clinical and metapsychological texts, we demonstrate how Freud approached symptoms and phenomena, moving from localizationist neurology to a listening guided by the logic of the unconscious. By examining Freud’s critical dialogue with central figures of classical psychiatry, we also demonstrate how, in psychoanalysis, diagnosis is not reduced to classificatory naming, but is inserted in the direction of treatment, highlighting the unique function of clinical listening. We therefore propose a refusal to standardize, reaffirming the ethical position of psychoanalysis in the face of the contemporary challenges of widespread pathologization, by supporting a clinical practice that is guided by listening to the subject: a practice capable of resisting the diagnosticism of subjective experience.