Interview with the psychiatrist Prof. Luigi Cancrini
‘This is a time for care, not hate.’
By Simonetta Fiori
Original article:https://rep.repubblica.it/pwa/robinson/2020/03/28/news/lo_psichiatra_cancrini_questo_e_il_tempo_dell…
On fear for the future, solidarity, patients who feel ‘normal’ and normal people who feel ill. Reflexions on mental health.
‘This is a time for care, not for hate. A time for listening and for sharing pain that is good for all of us; even for my own patients who are playing out the most horrible fantasies in their internal worlds.’ The pandemic, through the eyes of Professor Luigi Cancrini, one of the greatest Italian psychiatrists, is an opportunity for rebirth, for regeneration. ‘It is a chance for everyone to discover closeness and solidarity – our most important resources for living better.’
Eighty-one years old and with an impressive career behind him, Cancrini founded the Centre for Family Therapy and Human Relations with Franca Basaglia in the 1970s. He sees the centre as his professional home.
Professor Cancrini, we are experiencing solitude, fear, death, pain and the suspension of our freedom. Many people have compared today’s unease to the experience of a war.
‘I have a very vivid memory of the bombings of 1943. We lived close to San Lorenzo, a Roman district destroyed by the Anglo-Americans, and I remember well the terror, the deafening sound of the airplanes, the sheltering in basements. But we are talking about very different experiences here.’
Why?
‘War is a time of hate. In war, in order to survive, you are forced to kill others. As De André says in his song, Pierro dies because he hesitates to fire at the enemy and he pays for this hesitation with his life. In contrast, today is a time of closeness and solidarity. The enemy is external to humankind; men are obliged to unite to face a common threat.’
Fear is making us find closeness?
‘Yes, this happens when everyone shares a common enemy. I was struck by the motto: stay at home, you’re doing good for yourself and others. The idea that helping oneself is also helping others gives an emotional impulse that strengthens solidarity.’
A feeling far from the recent collective mood in Italy, diagnosed by different psychoanalytic societies as ‘psychopathic’, ‘paranoiac’, ‘authoritarian’ and ‘intolerant’.
‘I would use different terms. Our country, like the west as a whole, is suffering from narcissism. Having anything we want at our disposal, we tend to feel omnipotent and, at the same time, distrustful of our neighbours, whom we see as a threat. The experience of coronavirus is forcing us to face our limits – we cannot have everything – and we need solid relationships: it might be the best remedy for our narcissistic disorder.’
Have you observed a change in your patients during this time?
‘I am struck by the reaction of those with psychotic disorders, patients who are capable of terrible fantasies, who project their internal world onto the external world. Now that this threat figures in everyone’s imagination, these patients feel more ‘normal’, equal to others. They actually feel better like this.’
Being exceptional might liberate unexpected energies?
‘The literature of psychiatry tells us that many seriously ill individuals get better during times of war. Suicide rates go down, because in times of danger the survival instinct takes over. For the human mind, dealing with an internal enemy is far worse than dealing with an external enemy that we are defending ourselves against collectively.’
Is this true even for those suffering from addiction?
‘Yes, people living with addictions tend to be escaping death via bewilderment and by hiding from reality. When you need to be on alert to destroy an external enemy, all this disappears.’
Do these reactive mechanisms also disappear in people who don’t have particular pathologies?
‘Of course. And that feeling of closeness that we spoke of earlier is reinforced. When the emergency is over, we should attempt to keep this intact; closeness and solidarity are the most important resources for living a better life. I’m afraid that when the virus disappears the cohesion it has created will be missed. I’m already seeing signs of this in some of the discussions on talk shows.’
What advice could a therapist give for cultivating the vital flame during this difficult time?
‘In psychoanalysis we say that a good therapist is one who knows when to hold silence. In silence, emotions, respect, concerns, doubts and verbal communication limits are transmitted. At this time, each of us, in our homes, may be compelled into a silence that could bring us to a better relationship with ourselves and with others.’
Are you experiencing this transformation yourself?
‘Yes. While I’m continuing to see patients who have a great need for the therapeutic relationship, I have more time for myself, to read my dear Russians, to listen to classical music and to play the piano. I watch the trees from my window, something I have never done. And I’m dreaming a lot: remembering dreams is a sign of recuperating your relationship with yourself.’
Once the health emergency is overcome, the economic and social crisis will be overwhelming. Is there a risk of returning to an even fiercer individualism?
‘Yes, of course there is. Everything will depend on how this crisis is managed: whether it is done in solidarity or via oppression. As a man of the left, I watch with sadness how nowadays in Europe the strongest countries reject solidarity with those are weakest. And the huge speculation on the stock exchange frightens me.’
Like all collective trauma, coronavirus will leave its mark. Among the cruelest symbols of this pandemic will be the solitary parade of coffins. People are dying alone. We are impotent witnesses of the solitary deaths of our loved ones.’
‘It is a distressing and terrible aspect, but in these life experiences there is a closeness and collective exchange that we were hardly accustomed to. Certainly, mourning rituals are central to working through loss. Being unable to cry and to hug together at the time of burial could leave deep wounds. Many pathologies that I face are related to grief that has been left unelaborated.
Will we hug and kiss again with our previous carefree joy or will unconscious fears act within us?
‘We will do so with more enthusiasm, giving a new value to everything we used to take for granted.’
You have defined coronavirus as the time of solidarity and cure. Committed front-line doctors and healthcare workers symbolise this.
‘Freud said that the doctor’s vocation came from a desire to heal one’s own parents. I think that in many vocations within the healthcare profession, there is a profound feeling of love for humanity. They are the ones who should lead the transformation of the community we must deal with: it is the best way not to succumb to despair.”
Translation by Amy Bramley, HESTIA, International Psychotherapy Centre.
