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This chapter examines the concept of "subject" and "subjectivity" in relation to mental pain in the context of the development of psychiatry and psychoanalysis. The issue of the "subject" of mental pain is of tremendous interest both for the clinician and the human sciences, because the history of subjectivity is intimately tied into the adventures of psychiatric approaches to mental illness from the end of the nineteenth century to the present day.We then go on to present the stance of psychoanalytical thinking and practice within hospital structures, and outside of them, in other words in the community, using illustrative examples, and the major, important role psychoanalysis played in the move for psychiatric reform in the last decades of the twentieth century.An attempt is then made to (a) highlight the ways in which psychoanalysis is present in psychiatric care structures and (b) determine the conditions for establishing a mental health structure governed by the principles of psychoanalytical thinking. One part of this chapter is dedicated to depicting the aspects of how such a structure could work.Before the general discussion, we propose a series of conditions about how individual and social pain are connected, which was an issue of concern to Freud from as early as 1880s, and which today in a period of generalised crisis is particularly acute and challenging for clinical thinking and practice.

DOI: 10.1007/978-3-319-28616-7_6

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