Two chapters from

“Coming out of panic”

by Nicola Ghezzani

ghezzani.n@tiscalinet.it

www.psyche.altervista.org

(Pay attention, please! If you can or want to publish this book in your country, and if you have a good translater, send a e-mail message to my italian publisher at this address:

angeli.ila@francoangeli.it

 Now, read the abstract and two chapters from my book. Thank you.)

Nicola Ghezzani

Coming Out of Panic

Anxiety, Phobias, Panic Attacks

New Strategies for Handling and Curing

Italian Editor:  Franco Angeli

Year of publication:  2000

Pages 126  Euro 14,50

PAD (Panic Attack Disorder) is a rapidly ever-increasing psychopathological syndrome:  from 15% to 20% of the population suffers from it.  The estimate is by default, because if it were considered along with other related syndromes (such as GAD, “generalized anxiety disorder”, specific phobias, social phobias or other forms of spatial phobias – agoraphobia and claustrophobia), in reality it would reach 30% of the world population.

Anxiety syndrome, divided between a frenetic “hunger for life” and a pathological need for restrictions and control, PAD is a sign of the intimate division of the contemporary conscience between opposing and competing universal values.  Often banalized or even damaging when faced only by classification and repression instruments used by biological psychiatry, it is likewise greatly misunderstood by orthodox psychoanalysis.

Ghezzani’s book – based upon a new clinical method, Structural – Dialectic Psychopathology – gives back the syndrome’s intimate meaning of “illness of freedom”, an illness which is at the core of society and a world which seems to offer infinite keys “to be free”, but no “instructions for use”.

In the book, anxiety and panic are observed from a point of view which by-passes the restrictive ambit of psychopathology to open a discussion on the compatibility of individual human wealth with the poverty of collective mental structures.

The success of the book – which has reached its third edition – depends both on its style, immediate and evocative, and its new psychological theory – dialectic psychopathology -, clear and incisive in demonstrating the genesis of and the solution for the disorder.

This book which I am proposing is set in a cultural tradition way , which individualizes in the crises and the disfunctions of the social and anthropological structure the causes for the individual psychological disorders.  It firmly opposes, along with precise cultural arguments, biologically based psychiatry, in which the psychic disorder depends on organic factors without taking into consideration the social complexity.

Subsequently, this book is directly inspired by the works of Ronald David Laing and Michel Foucault (also by classic authors such as Carl Gustav Jung and Karl Jaspers), and aims to promote a new psychotherapy:  dialectical psychotherapy, where Nicola Ghezzani is co-author along with Luigi Anepeta.  The dialectical theory studies the relation between internalized cultural structures, individualized motivated conflicts and psychopathological crises.

This book “Coming Out of Panic” treats in a refined revealing manner the problem of anxiety and panic attack (PAD), interpreting it as a alarm and a psychological arrest when one already has a motivated unconscious conflict.  It accomplishes this by means of refined ample literary clinical histories, and by a precise theoretical comment.  Therefore, it is suitable both for a public of professionals, to whom the new theory is proposed, and also for a public of common persons interested in the genesis of the disorders and in personal reflection to promote the processes of healing and self-healing.

Nicola Ghezzani, psychologist and psychotherapist, lives and practices in Rome, where he has contributed to the formulation of the principals of Dialectical Psychotherapy.  He is a scientific consultant for mutual aid and patient associations; he is President of one  of these.  He has published many books. 

Example

Chapters 2 – 3

2. The Story of Marina

Anxiety about closed spaces: claustrophobia

                                                                        She said: “I’m sick, sky and earth are too

                                                                        Tight for me”

                                                                        Meister Eckart, from the Treatise “Sister

                                                                        Katrei”.

Marina eventually decided to start a psychotherapy only when she was touched by the tongue of flame of the psychopathologic fire. If she had not had a series of violent crises ending into strong panic attacks, she would remain closed in her mental prison cleverly and superbly disguised in an ideological choice. As a matter of fact Marina was a young educated and very proud woman and therefore she felt humiliated to be forced to consult someone to solve her psychological problem that suddenly had become unbearable. Some people, in fact, if they are not deeply hurt by a symptom in their rigid identity, if they are not hurt in their “psychic body”, i.e. in their soul, would never realise of their need for a change. They need that suffering strike deeply in their personal “Achille’s heel”, because only in this way they are obliged to examine obligations and duties in respect of nature which is in them.

1.     The critical episode

That day, late afternoon of a feast day, Marina was in a car with her boyfriend and a couple of her friends. It was a fine day and the four of them had had a very ordinary trip “out of town”. Marina had not enjoyed herself: she had been deeply bored for the whole day with flashes of restlessness. At the motorway toll station, a first grip of anguish: a long queue of cars were stuck  waiting.

The compact line of cars snaked their way with  implacable slowness. She then felt to be trapped; and it was then that she started to feel the first symptoms of her uneasiness. She knew well, as she had experienced it other times – what it was going to happen; she was not aware yet, with which powerful strength she would be grasped in its implacable grip to throw her subsequently in the mud of a unrestrainable terror.

She had, with violence, shivers, tremors, palpitations, blinding anguish to go mad and die. The person who came to see me few days later was the shade of the brave girl of the past, although some frail traces were kept: it was a frightened-to-death tiny little girl, and nevertheless hurt and humiliated in her pride, almost “offended” to be forced to stop and reflect on her life, confessing doubts and fears to a perfect stranger.

2. First meetings

The person I saw in front of me was a 30 years old beautiful girl in her whole physical and mental vigour. Very frightened and also very angry to be in front of a stranger, forced by her psychic  condition to stake her identity entirely. The reason why she was so angry was soon clear to me: she had assumed until shortly before to have a strong and autonomous identity, based on stable and objective choices; on the other end she was now forced to admit that that belief rested  on fragile and unreliable foundations. Now she should admit the numerous doubts which had been always harbouring in her mind, hidden behind her mask of intellectual pride and independence.

The tiger, forced to take note of  the cage in which she actually lived,  for a very long time had been trying to use her teeth and nails against me. She strongly contested the logic coherence and the efficacy of any sort of psychotherapy; she also affirmed – not without foundation – that a patient could be made passive and dependent for the whole of his/her life. I used to answer that the logic coherence of psychotherapy was due to the fact that it utilised the same instruments that had cause din her the pathology (words, affections, human relations…), and that therefore the pertinence dominion was the same; Regarding the passivity and the risk to become dependent I said that now, under the burden of the symptoms, she felt certainly worse than how I could drive her.  Furthermore that the therapeutic dependence is a dependence consciously  induced, which would therefore cease as soon as she would consider it right.

Actually Marina with her last panic attack had had a crisis which was a true and proper cry for help. A cry for help launched to herself: to that part of herself which had remained in the years insensitive and deaf  as regards needs which try to emerge from her conscience.

To understand how she had arrived to have those striking anguish crises I put her questions on the current situation. I got to know that after many years of engagement Marina was approaching her wedding with Mario the fiancé, and that secretly she was terrified. She feared that her imprisoning and  enclosuring feeling which pervaded her existence, rather that  solving itself would at that stage continue for ever.

A couple of dreams, told me during the first therapy meetings, clarified the terms of this anguish.

In the first dream while proceeding with her fiancé towards a theatre, she could get again away from him to secretly betray him with a young and ambitious militant of a wing side party. The dream had a clear significance of protest: it declared explicitly that the theatre staging of the “nice couple” shown to relatives and friends did not hold any more and was collapsing under the furious transgressing impulses.

The second dream was even more explicit.

In the dream she had been living with her fiancé in his parents’ house. At a point the boy’s father comes into the scene as a boss and sits in front of the tv set. Looking at him from behind Marina notices his old-man nape and feels repulsion. Now Marina’s mother appears in the scene and she is wearing a kitchen overall……Marina informs her of her father-in-law’s presence, but her mother nods with indifference as if everything were normal.

It is from this dream that Marina started to make flow to her memory and in our meetings her lived experiences of “oppression” and “enclosuring” relevant to her family and its history.

In general  phenomenological terms it is interesting to note how in the oneiric sequence described by Marina the already known concept mentioned in the first chapter regarding Eveline’s history comes back to memory: anguish is strictly connected to a forecast of annulment of one’s identity.

Eveline does not reach the panic stage but when her soul turns to the house’s objects and the family duties delegated to her from her dead mother and while she is living dependent on the escape with Frank, she is moved by a complex state of claustrophobic anguish . Indeed she lives the anguish of being in-closed, i.e. closed inside the order of death of her family “inheritance” and simultaneously she lives the anguish of being ex-cluded, closed outside, the vital relationship with the world (the world “outside”, the world she wants to reach together with Frank) just due to her inclusion (captivity) in the family world. Nevertheless as soon as she is ready to escape with Frank to reach the external world, there the agoraphobic anguish springs up: the fear to be ex-cluded for ever from the relationship with the world to which she belongs, the oxygen of her most intimate identity.

In Eveline’s case, then, as in the case of Marina, the annulment of the identity depends upon the logic of the actual interactive system and of the affective and ideological systems integrating the ego. The profound logic of these systems implies that inside a certain system balancing, either family or social, individuals, taken in themselves, have no bearing, strictly speaking they are in effect individuals, not persons  (ie subjects provided of social personality and rights). Therefore, individuals similar among themselves can replace one another leaving the system order unaltered. This logic-affective order can be interiorized  by the subject in as much as to make it the central element of the identity. Eveline could go and take her mother’s place with no substantial modification (except for her) being registered in the family connections. Her need to split up from the assigned role was lived by herself as a mark of moral indignity, as such to make her even more agreeable to her slavery. In Marina’s dream the father-in-law had gone to replace her father and yet the family life was continuing according to the scheme just the same. Marina was aware of this but her refusal did not find any confirmation, as her own sense of duty, represented in the dream by the mother, was imposing to her to carry on in any case.

It is evident, therefore, that for certain systems what counts is not the individual’s life taken in its singularity but the general balancing of the system. We could say of these families that they cannot welcome in themselves a “principle of deconstruction” allowing them to be modified, “moved” on their axis, by the need of the baby or the adult meant as “persons”.

Equally one could say that the ideological structure of these families (or social systems) has suffered a jamming in the mechanism of its reproduction as it comes with no recombination, with no variation, i.e. badly. Therefore these families not only  result as identical to the others, but even identical to themselves in the course of generations, for this reason even if one of their element  were replaced by another similar to the structure of the whole it would not change (cfr. p.<es.<Laing 1971, Ghezzani 1999).

In Marina’s dream, as already mentioned, the father-in-law has taken her father’s place, indeed everything had remained unaltered. Marina’s intuition she had expressed through the oneiric image was then that the two family  units(Marina’s and Mario’s) could overlap one on top of the other (starting from a common element: the father) without entering in contradiction between themselves.

In terms of mathematics theory of sets we could say that the two systems were “equivalent”, i.e. identical in their constitutive elements. Marina’s anxiety sprang from this intuition and from the presage that even the new couple under formation, the one formed by her and Mario, would be included soon, with no contradiction, in this homogeneous, cannibalic, “identity”. The sense of anguish felt by the firl consisted in an upsetting feeling that the distinct personality and the same feeling of existence of each of them counted absolutely nothing and could be cancelled “cannibalised” any moment. In substance, what could be discriminated and given value in terms of individuality – to promote a varied reproduction of the existent – was on the other hand dispersed, “devoured” in a mechanic, insensitive, abnormal identity, in an absurd repetition of the same. In this profound intuition (not even clear to her conscience) the nucleus of Marina’s claustrophobic experience was contained.

This was the general feeling of the dream and this was confirmed to me by the clear and punctual data which were later referred to me. Marina started to confess the psychological and economic difficulties which she and her fiancé had as a couple. With the dream when meant to let me know of her secret anguish for the marriage and the consequent life together, considered by her as a change which would be only apparent which would not modify things in any way, which indeed would get worse.

The father-in-law was a practical and rough man who had gained money with the sale of cars and who had kept his son and his two daughters in a knuckleduster. Owner of numerous flats he did not give any to his children. He denied them any economic availability and had totally cancelled their personal willingness. He had been hard particularly with his son: made ridiculous for his scanty practical attitude (he was more of an intellectual), Mario was not able to express his opinion in his father’s presence and, although he had been working for a long time, his bank account was jointly run with his father who kept entirely his personal accounts. The boy, furthermore, made weak in his will and in his initiative, could only find temporary jobs and of little reliability. Consequently Marina had to hold the couple entirely on her shoulders: she had to bear the father-in-law who was greedy and bossy, support her fiancé’s fragility, hidden by “proud intellectual superiority”, meet the economic requirements of both making sure that her modest “job” at the Ministry was always secured. Marina, then, was on the edge of handing to this man her future and the hope to get rid of the existential oppression lived with her own parents. But the first step estimated as a consequence of the marriage was already full of unpropitious signs: after the wedding the couple would go  and live with Marina’s parents, taking advantage of the fact that being retired her parents would spend the summer period in the Marche, in her father’s ancestral house. So Mario and Marina would live, she feared, as the copies, the clones of the two ageing parents, in an early senility with no escape and exit way.

3. Family micro history. How a trap is built

Marina’s parents were a couple from Marche of country origin and culture. When young, soon after their wedding, they had tried to emigrate, working as manual workers in an industrial area in France. Unfortunately it gave no good fruits. The economic conditions were unstable and did not compensate the lived cultural and social isolation. A bit sad they came back to Italy and eventually accepted a job as concierge in Rome. They were responsible for maintaining a smart building in the historic town centre . The palace was one of the numerous properties of an ageing noble man, a prince, in whose respect they always kept a humble and formal behaviour. The prince had let them in the palace (at a favourable rent) a small but prestigious flat at the top floor, this made them feel in some way promoted as for God’s grace to the rank of the rich owners and tenants whom they used to meet on the stairs. They spent the whole of their life enchained to this illusion. In spite of the nice house, they were indeed frustrated and angry. The father, when young, had not been able to study and had adapted himself badly to the humble jobs which life had proposed to him: he had grudge for his past and present, he developed a maniac-depressive neurosis and when at its tops he was exuberant and unfaithful with his wife with very young women. When at its bottom, he used to lock himself in the house frightened by any human contact and often trembling at the idea of having caught illnesses and of being next to death. The mother, an obstinate and ascetic woman, had not tolerated at all her husband’s excesses and had closed herself in a dumb and obstinate conviction. Marina was their only daughter. When a little girl, her mother was very careful about her manners and decency: it was a conquest for her when, a bit older, was allowed to go out wearing trousers. With her large and curious eyes she watched her mother’s fussy and quarrelsome obsession and her father’s dark and alternate depressions. She attended the best schools and, once she had got her  diploma, she entered the Philosophy faculty.

What did her mother expect from her? And her father? Her mother used to get angry for her rebel femininity, her father enjoyed it: he hoped in a male daughter able to bear with strength life’s difficulties. Marina sprouted at her maturity as a strange flower: rigid in relation to her impulses, icy rational regarding life’s prospects. Some secret sexual adventures, a public examination, passed, for a job at the Ministry, then the engagement. Everything, at this stage, rested upon her: her parents’ tranquillity, who saw her as being settled with a good boy; the boy’s tranquillity who saw himself as being settled with her and her parents; and the whole building of her feminine morality passed to her by the tradition, cemented in her identity. In the ideological cell in which she lived, Marina had no windows from which she could grasp the light. She did not want to disappoint anybody, and used to do her best to ignore the existence of spontaneity and happiness. She pretended she was free as she used to read a lot and carried on with her studies for the “formation” of her thoughts. A thought rich and alienated. She had found the perfect way to entrap herself.

4. Claustrum The identity as a prison. Is there a way out?

During these long meetings, meetings of open conflict first, then of open “confession”, it followed a foreseeable period of atony and of stasis. Having said “everything”, having “dropped the mask” made Marina feel totally lacking of resources and as emptied. Perhaps she felt as the lady from the novel by Oscar Wilde The sphinx with no secrets. In this novel, a mysterious and attractive young lady is followed by a young man in love with her who wants to discover her secret. It happens that every day at the same time the woman dresses herself up in a refined way and covers her face to go out (a smart house in a London rich district), therefore, every day at the same time, she reaches a small rented flat situated in a remote area of the same town. The truth of this lady, eventually discovered by the young man – and described with malicious skill by Wilde – is that unfortunately there is no secret and no adventure waiting for her there: she ends up by finding herself on her own and is there for the only purpose to pretend there is some sort of secret to hide, a bud of individuality. This fantasy of individuality – which is a germ of individual freedom – reveals itself  in the novel as a mere “aspiration” a wishful thinking beyond which there is the revelation of the pathetic powerlessness of the feminine character.

Beyond the explicit intention of the author, however, this mysterious feminine archetype could reveal to us even another and deeper meaning: that the void, i.e. the absolute lacking of any meaning, is the intimate plot of existence and therefore even the seed from which every thing springs, then even the new meaning to give to life. Finding with a naked face with ourselves, in the complete atony, depersonalized , i.e. undressed of the usual identity, can reveal the absolute relativity of each thing, then of the same identity, thus losing any claim of certainty and steadiness. In my view the fundamental problem of the woman represented in the novel by Wilde is that she did know how to lose herself therefore she could not meet herself again. Until she had not accepted to lose herself to the bottom – and to lose with herself even her social image – she could not find inside herself the source for new meanings and then for a new and more authentic personality.

Marina felt humiliated for having confessed (to me and to herself) the substantial impotence of her life. The trap in which her parents had lived and in which she had fallen was the lack of couratge (and hope) to live her life personally i.e. not as copy of an abstract pattern, with an effect of incessant repetition of the same along the chain of generations, but as the only and unrepeatable  expressions of an existence and of a meaning. At this stage Marina should initiate a research inside herself to identify and give new life to her actual needs, removed from life and therefore reduced to the state of “interior dead bodies” (a research to be understood as Eraclito says that “souls sniff towards Hades” (fr.110). This research would lead her to getting rid of death’s charm produced by the duplication of the identical, to discover beyond it a truer life). But as she still thought she would be unable to do it and therefore considering herself condemned to live for ever in the slavery of her lunatic identity, she tried to darken in me this awareness humiliating for her. She put then in front of my eyes the screen of sexual fancies. She had a dream and the day after she described it to me maliciously. In the dream I welcomed her in my studio and she, inadvertently fell upon me. Caused by our fall, a door leading to the bedroom opened. In that room, astonished and breathless, we ended up by having a sexual intercourse. She stated, commenting her dream, that she felt she had no more to say, that the analysis had reached a standstill and that she could not imagine how our meetings could still be of help to her. Was that the moment when she had to be dropped towards something more concrete and involving?

I told her that transgressing sexuality (as the one obtainable from an ethic-professional relation which has totally different finalities) is just a way to turn over temporarily in its contrary the feeling of impotence and death in respect of one’s own life, however, without resolving it. It is, in other words, a parallel way (a false way out) in which tensions produced by needs are unloaded and annulled, not channelled with all their changeable power in the every-day’s life. I told her that as a man I felt alive and flattered, but as a therapist it would be for me civil death.

5. Needs and the new identity

At this stage of our therapeutic history, when I refused any form of pessimistic collusion, Marina started to produce fantasies, thoughts and projects for life.

Before starting on  this new direction she had initially another crisis of anguish followed by an “unusual” episode, then a couple of new crises followed by panic attacks. The first of these crises and the “unusual” episode happened as follows:

Marina, still entangled in her sexual fantasies, had realised she had a strong attraction for a work colleague, one who used to play tennis, handsome and in conjugal  crisis. Neither one nor the other took the opportunity to declare their reciprocal interest and make each other available. As if she could compensate repressed wishes, Marina accepted to rent from the man a house near the sea to spend a week’s holiday with a friend of hers. When on holiday, however, this friend resulted to be a very depressed woman, taken by a dark and obsessive recalling of her dead father. Furthermore, unable to establish sentimental bonds with men and closed to an emotional life, she resulted to be atonic and ineffective even in respect of Marina: a true scourge. Marina bore her for few days, then she was invaded by anguish up to top levels. Claustrophobic anguish, I commented at her return. The anguish to be closed with this woman (or as this woman) in a destiny of immobility and death (as a foetus restrained in an icy marble uterus).

But the anguish episode could be further clarified thanks to the understanding of detailed facts, not less distressing and revealing. Marina in that same period was nearly going to live with Mario in his parents’ house, who had just retired. The two fiancés, this was the agreement, would live together at first, then they would get married. The true anguish was indeed due to this; the claustrophobic episode had done no more than “bringing” Marina’s conscience near this stronger and more dramatic truth. As an answer, one morning when she felt lonely and sad, Marina in her office, on her own in the room, she masturbated! In the low spirits of those seconds she thought of her tennis player colleague and used his image to cancel with anger any worry. She would never think of being able to do something so imprudent: it had happened indeed!  Would she, perhaps, be able to carry out other “dissoluteness” of that kind?

Yes, indeed, she was. But at last it was constructive dissoluteness.

First of all she started looking for other jobs, first an internal public exam, then an external one, then – on Mario’s presentation – a first contact with a newspaper. Eventually, after outbursts and disputes, miasma and poison, she asked her sluggish fiancé to demand his father the donation of a house. Criticism and blame fell from every part as hail. The father-in-law said that she was an “interested” woman and that in any case his son was an idiot. Mario said that she was not able to understand the “complex and deep” relation his had with his father and that in any case I was a feel as I had understood nothing both of her and him. All of them at the end said that Marina was mad (or idiot) as only a mad (or idiot) person could send to hell the security of a permanent job.

After hail many timid buds of enthusiasm and protest were broken into pieces. Marina was again depressed and, naturally, under the risk of new crises. She resisted for nearly a year, alternating her work at the Ministry and her new job (temporary) at the newspaper, wearing herself out for the fatigue. Then she mentioned the possibility to give up and abandon the job as a journalist. In any case she did not obtain any house from her father-in-law and cold criticism continued to fall upon her from all directions.

The summer of that year she accepted to have a holiday on her own with Mario, on the Amalfi coast. She was not anxious: she had imagined something more lively and more sociable, but he was adamant. At Amalfi, punctually, suffocated by small spaces, by the little desolate boarding house but mainly by his hostile silence (barricaded in the reading of St. Thomas), she had another (the last) anguish crisis with consequent panic attach.

Even on this occasion she could tell me in detail the prior events which, looking at them afterwards, made the episode of an algebraic transparency.

First of all she told me of one of her dreams. In the dream she saw herself in a church, at the ceremony of her wedding. Her father was holding her arm, lost in as much as she was, in front of them a dark, narrow, oppressive, unending corridor of the nave, at the end of which they would find the altar. The prospect was so distressing that Marina woke up with a moan!

After the dream description, Marina informed me of the events which had caused it. The two fiancés – as agreed – had decided to get married; Mario, however, although declared himself as a laic, (as well as Marina) was not happy with a normal ceremony in a normal catholic church;  they young man had had the bright idea to get married with the Byzantine rite in an Orthodox church, with suitable clothes and proper ceremonial vestments, professional photographer and a crown of relatives and friends to charm! Marina, at the idea, was literally upset. But she had had no courage to protest and thus she had agreed. In herself she felt bewildered and perplex as a milk lamb during at Eater time. It was in this context that the inevitable panic episode arrived. And it was only after having interpreted it with me that she found the courage to disappoint everybody and subtract herself from the horrible situation. There was another fall of criticism: orthodox or not it was indeed a rite! Friends and relatives said. But she was hard. At last, for her own volition, the wedding took place in a laic form in the Commune, and in full intimacy.

Since then Marina had been firmer in her propositions, even because she was at last aware of the mathematical coincidence between claustrophobia and claustrophobic crises. Any doubt regarding a “genetic of mental diseases” was put to flight: a paroxysmal crisis coincided with “scientific” synchrony to any of her “solutions” based on masochism. She got down to work: she threatened her new husband to leave him as a dog if he would not take serious steps. At last she obtained few things: her father-in-law undertook to give them a house as a gift; Mario got in touch with a psychotherapist in order to be helped himself.

Marina did not leave the newspaper, but she took a long period of unpaid leave from her Ministry so that she could verify the possibility of working as a journalist full time. A year later after this drastic decision she had become fixed co-operator and editorial manager.

6. Theoretical considerations. Sensibility: a genetic differential character

Nothing in psychological life is stupid and casual. But when the organicist psychiatrist argues that an anxiety peak, an anguish crisis, a panic attack are mental phenomena determined by a mere genetic disorders he is indeed affirming that these  phenomena – and therefore psychic life of some  (subjects – are stupid and casual. The “best” that organicist psychiatric culture has been able to elaborate to date is that the cause of  psychic problems is multifactorial. Multifactoral cause means that the symptom is indeed caused by factors external to the subject (the so called stress factors: i.e. the “ordeal by fire”, the “battles” of that “war” which is life), but these external factors produce so striking effects just because they impact with another factor, more determining, which is a weak, vulnerable mental base, i.e. genetically predisposed to emotional reactions which are dysfunctional. In substance they affirm that the real rising event in the case of psychopathological crises is always, more or less, in life practice (practice which is common to everybody, even if at times harder), on the other hand, the mental base of the subject is not in the practice, because it is weaker, more vulnerable than what it is in the average population, i.e. genetically corrupted. Therefore in these cases the abnormal psychic reaction is aspecific, i.e. it has no meaning: it is mere and simple fear. Thus – quod erat demostrandum – according to this “scientific” mentality phobic symptoms are no more that stupid and casual reactions of cowardice! This is the bast that the organicist psychiatric tradition could produce regarding panic phenomena! At least fifty per cent of the population suffering from disturbances of personality trust in this type of “cultural tradition”!

The doubt whether the mental pathology is genetic or not is a question always very embarrassing for our patients; truly it should be rather for the organistic psychiatrists and neuropharmacologists who induce this sort of doubt in the collective awareness. As if it would be “made known” that  psychopathology has indeed genetic causes and these causes consist of a mental deficit, i.e. in an inferiority (and this even for the most common type of anxieties), then who could stop that an  “enlightened” political regime could decide to practise mass sterilization for the individuals “genetically inferior”, or the use of genetic engineering in order to alter their hereditary estate? But if we didn’t reach that much, who could avoid that the subjects considered inferior are so upset from the shame of themselves and the anguish to transmit a hereditary defect to their children to establish spontaneously themselves a regime of “internal police” with the desperate aim to check, through the extensive use of neurotechnics, their own mental life, and to avoid the coupling and  the reproduction with other subjects similarly defective?

I (as well as many others) hold a very critical position and diametrically opposite to that of the oraganicist psychiatrist. I think that the symptom always has a specific meaning and that the “disturbed “ personality is in its whole (i.e. with its symptoms) a confused and contradictory answer, although totally relevant, to a social  interiorized  ambit which has produced predomination and abuse of identity.

However the datum of a peculiar and not homogeneous distribution of mental troubles in the majority of the whole population resists to this position of mine: no doubt some feel ill, others don’t. This happens also in the within the family, or even in the same social surrounding. Starting from similar conditions, some develop anguish, phobias, tendency to the panic, alimentary disorders, obsessive ideas and so on, others seem to be exempt. This morbidity, this tendency to fall sick is casual and therefore void of any scientific comprehension or is it understandable at the light of genetic laws? Well, I think there is nothing contradictory in admitting that there is indeed  a genetic difference between those who live these disorders and those who don’t. This difference however is not a genetic deficit but a genetic character. I consider that this different genetic character is the sensitivity.

During an interview R.D. Laing says:

I have received from (some men of science) letters in which they state that they are totally in agreement with me: that ….there is not any true reason authorising the psychiatrists to support a genetic relation for schizophrenia  (and, consequently, for all the other less important psychic problems). Be careful, even if it existed, this would mean  no more than that it exists a certain psychological style which is hated and hindered by our society (1995, p. 374).

This “psychological style” to which Laing refers, this different genetic character is, in my opinion, sensitivity. In fact it is sensitivity which binds a determined subject to be a way rather than another, i.e. to define itself inside a specific identity. It is its need to belong to a determined affective and social or even just cultural context which gives clear patterns of desire, of thought and behaviour to that subject, to which the subject must conform to avoid the activation of the sense of guilt and shame. It is, therefore, sensitivity (i.e. the intuition of others’ affective condition and harmonious potentiality of systems) which generates the need to conform in his heart, and with it, the possible intimate contradictions among the personalities sections remaining prisoner of a value system with its behaviour scheme, and sections of the personality that want to escape subject to the need to live more autonomously. The sensitivity, therefore, it that thinking style expressing itself in the ability to adhere to the surrounding  human world through the intuition of others’ interests and welfare; but in addition to feel with intensity anguish for one’s disregarded  and denied needs: this makes the sensitive person (if he/she develops harmoniously) a subject generically able to doubt and have critical thought.

7. Theory  considerations. The inter-psychological conflict

The panic attack is the psychosomatic alarm that springs when the individual’s conscience gets in touch with a situation by which it is going to be altered (i.e. estranged to itself, subtracted to its certainties). This individual’s conscience, that we call  conscience number 1, gets at a certain point in contact with strange and disturbing own feelings or thoughts (but before removed). These feelings and thoughts signal discomfort condition in regards to conscience number 1. We call these inter-psychological signals conscience number 2.

Eveline is going to leave her house: the dissatisfaction for her life (the discomfort condition called conscience number 2) has caused the imminent event of leaving. But Eveline’s usual identity (her conscience number 1) is anguished by the betrayal that is going to happen, it feels altered and threatened by rebellion and escape thoughts. At this stage the conflict between conscience number 1, demanding loyalty to the role, and conscience number 2, pressing for rebellion, grows making the anguish excessively increase till the acme generator of panic is reached: the “alarm signal” springs then for the existing danger, the risk of destruction of conscience number 1.

The conscience number 2, therefore, is a psychic condition signalling how conscience number 1 is insufficient to contain and represent all the generic needs to which that individual should give full expression. The criticism from the condition of conscience number 2 in respect of condition of the conscience number 1  is a destructuring criticism, thus a criticism generating crises, dissolving of the ego and therefore anguish.

Panic rises as defence “psychosomatic reaction”, and it activates on the border between ordinary conscience (n. 1) and a second conscience (n. 2) opposite to the first and destructuring in respect of that. The panic emergency signals the imminence of a sliding from one identity to another, identity that is going to deny the first, with guilt and/or shame effects. The anguish or panic reaction comes, in its quality of alarm, to avoid the conflict to mature and that the conscience of the subject feels the guilt or the shame for the criticism and the present crisis, which is a refusal, reject crisis, in respect of one’s identity and of social and/or psychological relations integrating it.

Eveline avoids to fall in an anguish or panic crisis because, in the topic moment of her history, her sense of guilt prevents her from forcing her hand and put in a crisis her life system. In the moment when she is going to realise that she is not free but conditioned by affections and values of her tradition she also realises that the freedom she has planned with Frank her man is a betrayal of her affections and values, then guilt: at this stage she stops she prefers to betray her personal needs rather then those of the system; she doesn’t force her hand and thus avoids to enter a crisis. The renounce however flows into a life with  no solutions, a life dejà vue, dejà veçu, an already seen and lived life, the life of a dead person.

Marina has carried further then Eveline the criticism in respect of her ordinary identity: she felt discomfort and anguish for her father’s depression, she has had betrayal fantasies in respect of her partner, she planned escape projects from the Ministry where she carried out a job which she didn’t like. The panic attack in her case, signals that her conscience number 2 has already elaborated a radical criticism and is going to dissolve conscience number 1. But as soon as it is appearing to her ordinary conscience (n. 1) that she is little and entrapped and that she is not free as she pretends she is, Marina is blocked in her reflection by the panic burst. The surfacing of her critical thoughts is felt by her ordinary conscience (n. 1) as an absolute, total and annihilating threat: threat to her whole psychosomatic identity, that feels to be at risk of death or madness. Only in the moment when she admits (and makes of it a subject of conscientious reflection with a whole series of practical consequences) that truly one part of her personality risks to die or to become mad if the right to live and to get mentally organised is not recognised to her, only then Marina is free from anguish. But to make it feasible, Marina must also recognise that the criticism to the ego system, to her ordinary conscience can’t betray her sensitive nature, it can’t deny her need of affective and moral coherence. I.e. she had to understand not only that she is a  prisoner of her affective and ideological realities, but that she is also of her own redeeming fantasies, because being sensitive, she can’t legitimate some fantasies centralised on betrayal and not on right. The solution is then, for her, a personalization of her life that allows her not so much to betray but on the contrary to demand her rights, right to the acceptance of her intelligence, of her autonomy, of the possibility that marriage and reproduction are not reached if there is no regime of full dignity of the person. In general terms, a crisis evolves positively when the chosen selection allows not to be anymore in the mere transgression, i.e. in the rebellion and crime but in the change, i.e. in her right and coherent revolution of the identity.

8. Theoretical Considerations. Close examination of the conflict and the new personality

The philosophy of each period (at least the best, the one not subordinate to flat dogmatisms) has underlined that the ethic position of a subject always springs from the resolution of the doubt, i.e. it springs from the choice. The same is applicable in the most common psychological life and in the psychopathology.

Each psychopathic structuring of personality is based on an affective doubt, of the behaviour and ideology (an ethic doubt) not only unresolved but indeed transformed by the ignorance of same in a conflict becoming more and more serious because confused and crystallised in an antinomy either alternating or tending to immobility. To resolve a doubt of this kind (and the intrapsychic conflict based on it) one must above all know with the maximum depth which are the alternatives represented by the doubt. Therefore on the base of this knowledge make a choice.

The word doubt originates from the same root from which it derives the numerical term two. The doubt is what in our thought is expressed in a “two”, in a duplicity, a scission, a dissociation: therefore in a potential “double identity”. Usually one avoids to face the structured doubt inside the identity as it reveals the polarities under conflict, which both, in their extreme ends, generate moral anguish and symptomatic developments. Furthermore the idea that resolving the doubt could imply the sacrifice of one of the parties under in conflict causes an anguish of lessening non less paralysing.

Actually the resolution of the structural doubt never amputate the richness of the phenomena: on the contrary it brings the personality from the typical paralysis of the intrapsychic conflict structured to the dynamic and changeable dialectic of the opposites.

Being the human conscience fundamentally and unavoidably dual i.e. dialectic (as it is based on the Other’s thought objectivated in one’s own), it cannot de facto give up the doubt; the resolution of a conflict limits itself  to move it to a level of more complex integration and composition, thus culturally, socially, humanly richer.

The resolution of the intrapsychic conflict is a process which goes through a complex series of passages. These passages allow the transformation of the basic alienation, for which one adheres unconsciously to an identity drawn/received from the Other, in a more subjective condition of personalisation/individuation. In this new condition an wider conscience of one’s own allows to operate selections among the various existential possibilities,  therefore to live according to a wider autonomy. These passages are:

1)    the definition of the polarities in conflict, definition through which the subject realises of his intimate duality, of his radical doubt unresolved regarding peculiar ethic selections;

2)    the deepening of the knowledge of the polarities in conflict, deepening through which the subject picks up the connections between his internal contradiction and his memories, affections, relations, idelogical interiorised positions;

3)    the choice to place himself in tune with one polarity rather than the other, choice through which the subject pushes the conflict towards the direction of need to a greater extent sacrificed for the purpose of “making it grow”;

4)    the reassembling of the identity and personality at a more complex and integrated level of conscience.

Eveline had a doubt: remain in her place of origin, continuing to live in the same house as her family, or leave with her lover for Argentina. It is clear that Eveline’s doubt is a structural doubt, as it refers to non purely practical choices but also affective and ideological (in the most deep meaning of the word). At last she “resolved” the structural conflict giving up its living in the whole of its dramatic power. It is a possibility. We don’t know, in the concrete reality, if this brought to her a benefit rather than a damage.

Marina had another sort of doubts, but when she called on me, she was still unaware as she was too much upset by the impelling motives given to her by the symptoms. She had to select between two opposite existential positions. In an existential position she copied her mother’s feminine role – integrated in the essential conniving with her father – and adjusted to found her couple and family life entirely on her sacrifice. At this level she would have to censure the impelling critical requests in respect of her parents’ numerous sufferings, of her fiancé’s uncertainties, of the social world’s indifference in respect of her personal destine as an intelligent  woman sacrificed to the anonymous routine of a modest job in the public service. In the other existential position she saw herself proudly free from her roots as a daughter of humble concierge and free from any obligation in respect of her boyfriend (and any other boy who would relegate her in a subordinate role), as well as from any religion: she was indeed an atheistic, a communist and full of a complex and refined culture. The one personality was in conflict with the other.

Truly speaking, when closely analysed, the fight between the two parties was not equal. Marina was emancipated only at a level of verbal conscience, i.e. “verbally”; “when acting”, i.e. in her material praxis, she lived in the first existential position, in substance subjected to the feminine roles typical of the traditional order. The party to favour, with which become allied to promote a structural change, and with it the coming of an identified conscience was therefore the other one, i.e. that one setting the emancipation, which had to lead to the real effects of real life. This is what happened: Marina cured herself from the symptoms of agophorabic  panic when she could impose herself and leave the job as a clerk for another one more active and complicated (journalism), in the moment when she refused the wedding with a religious rite and got married at the Commune, in the moment when she could express her blame in respect of her fiancé’s family (defended by him) which deprived the boy and herself of the necessary support to live as a couple. But she stopped, full of doubts and feeling guilty, when facing the prospect of a separation. In lieu of the agophorabic symptoms she suffered from a slight but insistent depression, fruit of the awareness to be responsible of the matrimonial crisis. Awareness which gave her a painful sense of guilt, of which the depression was indeed a tangible sign and which nailed her to a doubt which apparently had no way of development or escape.

Just recently – when approaching the end of the analysis – this doubt has started to be handled and resolved. Up to then there had been an ideological value which had prevented Marina from separating from her husband: it was the religious value of sacrificing for others. Rather than hurting (and disappointing others), Marina was prepared to sacrifice her life. It was hard indeed for a laic intellectual personal to admit to be guided by a religious value; but this had been to that moment the truth of facts. The decisive opportunity arose when Mario fell into an even deeper crisis, appearing to her more and more as a martyr of her history. The young man’s mother was operated for a cancer to her genital apparatus, which was removed. The whole family gathered around her and Mario, visibly prostrated, asked Marina to help. Marina asked herself if she was obliged once again to save her partner, subjecting herself to the sacrifice for a woman for whom she had no feeling and for a family which had always treated her badly. Should she immolate to the devotion for her man up to her personal degradation?

The choice was dramatic, but it made her grow. Marina subtracted herself: she faced the sense of fault bound to the distance she had taken from Mario, and became conscious that a “right” action is never, it cannot be, selfish. From this to the decision of the definitive separation the step would be shorter.

9. Theoretical considerations. The contract on the identity

Our conscience cannot be determined by social will (and therefore reveal to be its prisoner) and intimate and invisible ways. We can be subjected to ideologies outside our most authentic nature in the way one conceives and lives both unselfishness and selfishness. We are therefore subdued by identities alienating to ourselves, taking away from ourselves, robbing of our best and most authentic existential possibilities. We are divided between parts of ourselves forcing us to be functional to an ideological system expropriating of ourselves and other parts arisen from our rebellion, which estrange us no less than the others from our truer nature.

This phenomenon of discomfort due to the expropriation of our possibilities is called alienation. I have already defined  as basic alienation (or ontological) that which is more constitutive; I would define now as antithetic alienation that arisen from rebellion. We are split, in conflict with ourselves, doubtful with no real identity.

It is necessary at this stage to solve our general alienation having full conscience of it and thus obtaining a contract on the identity.

Having a contract on the identity is a formula, a slogan, which has a meaning and a target in the dialectic: to obtain a contract on the identity means realising that the identity – which we erroneously consider as our natural property – is indeed the product of two dimensions in reciprocal tensional connection: our fundamental needs  (of which we have an intuitive perception, always indirect and therefore “obscure”) and the social world (which is not reduced to the mere “society” but is rather the system of material relations and  cultural values modelling our personality). Having a contract on the identity means that the ego, which is in the middle between these two terms, must become aware of the radical needs on one part and of social pressure, and on the other part of affective and ideological “conditioning”.

In order to be fully aware of this dual essence of personality we must understand that the social ideologies can deeply obscure the need perception; and the need pressure, on its part – if they are repressed or removed – can utilise the ideologies in their extreme sides, up to formulations (which are personal ideologies) which cannot morally b appropriated for the ego.

A person living a strong psychological conflict between belonging and independence can arrive at the radical doubt up to the intimate contradiction with himself: becoming on one side too docile and obedient and too insensible and infringing on the other, thus drawing away to be simply himself. It is therefore necessary that the conscience knows how to show up personal ideologies (always of social origin) both in the most extreme order solutions  and in the not less extreme of disorder: there are in effect collective ways of thought (ideologies and mentalities) promoting transgression so that everything changes without that anything changes.

The deep understanding that the external and the internal worlds interlace inside ourselves up to form those entities which we call ego, character, identity, personality and more, psyche, mind, soul etc. can help us not only to make us free from that capital vice of thought which is organicism (thinking that each of our production of thought – mainly is pathological – is the reflex of a certain organic determination); but also of the other not less serious ideological vice which is psychologism (i.e. the thinking that there could be a mind avulse from social reality, or even a mind which could have had a day – obviously in the mythic childhood – a contact with reality, but after then never again).

In questions of psychology we must always think that there exists a body – ours – which is a sensible body supplied with intrinsic needs, which goes through history and it is deeply marked by it. The brain is no more than the central station connecting this body and that social-historical world, and that as such not only become soaked – with knowledge – of that world, but also reacts to it: shaping on it, developing functions in antithesis, producing molecules which will enter the blood system, selecting in their own genetic list the most suitable biotypes for a reply  which should be as adequate as possible. There is no abstract body which is not animated by this dialectic game; similarly there is no psyche which is not intrinsically determined by this mediation between body and mind.  Why does it exist a medicine which knows nothing of neuropsychic reality and a psychology which creates abstract theories describing a mind avulse both from the biologic body (genetic) and the social body and history?

In order to give a practical and handy shape to this complex series of theoretical statements, I propose a personal redefinition of some concepts taken from psychodinamic metapsychology.

A)   The social historic world expresses itself in the subject as an instance of the superego; it produces objects, it produces furthermore the ideals of the superego, which are indeed the behaviour objective models proposed to the individuals.

B)   The interpersonal world coincides both with the instance of the superego and that of the ideals of the ego. It is in the interpersonal world that fixes its roots its persuasion power of the superego and of the ideals of the ego, because it introduces these objective instances (social-historic) inside the single personalities through the vehicle of the affective relations and of social interest.

C)   The personal world is the world both for the superego and the ideal of the ego, but it is also the world of the ego. The ego, not withstanding its subjection to the social ideals, can in fact dissociate from them then from the superego. The subjective conscience springs from the ego, from the personal world, and its founding characteristic is indeed that of existing in as much activity of objectifying, i.e. of subjective reflection of the objective world, thus of the super-ego and of the ideals of the ego. The conscience, springing from the inside of the ego, is the instance which allows us to be free.

Therefore in psycho-dynamic terms, having a contract of the identity means that the ego (my conscience) must be made able to freely select the ideals of the ego without being dominated by the super-ego will: i.e. the ego  must be able to contract with the super-ego and select for itself ideals and value conforming to its intimate nature.  

3. De-realisation and depersonalisation

Fears of psychiatry

You will never reach the soul limits, as much as you can walk, not even if you go through all the ways; so deeply  they develop. (Eraclito, Dell’origine, fr. 108)

The distinction which I have just made between ordinary conscience status and antithetic conscience status presupposes, on one side, that the conscience number 1 is a coherent and integrated conscience and that satisfies the function to give a sense of coherence and integrity to the ego itself; on the other  that the conscience number 2 is the psychic subject of a part dis-integral, distinguishable, of the same personality. Thus, in the same personality two antithetical structures can co-exist, opposite one to the other, each with its egos, super-egos  and ideal of the ego.

It is evident that some biological, neuro-biological and psycho-biological systems must be present in the psyche (beyond psychic instances described in the psycodinamic psychology) determining both the personality tendencies and their conflicts. I would call needs these psycho-biological tendencies: needs rather than instincts and pulses because, although of organic origin, they are socially codified; needs and not simply codes because, although being knowledgeably organised in the  relations with the social world, they stand on a biological base which expresses itself in the psyche as emotion and affection.

1. Dialectic of needs and related affective forms

I would call need to belong/social integration with the correlated systematic affective form (or super-egoic) that psycho-biological tendency to feel and live one’s life not as a single life but as one unavoidably cast in a systematic unit with the Other. To feel and live through the need to belong and the systematic affective form brings in a basic feeling of empathic harmony, dissolving it is automatically (philogenetically) associated to a sense of void, inadequacy, loss, which can lead to a sense of guilt where the ego feels responsible of the scission of the unity.

I would call need of opposition/individuation with the consequent individual affective form  (or egoic) that psycho-biological tendency to feel and live one’s individuality in terms of an existing identity absolutely in itself and for itself, dissociated from any link of any kind. To feel and live through the need of individuation and the affective individual form brings in a feeling of an unavoidable autonomy, threatening it produces social shame and subjection anguish when at its minimum and anguish/panic for the dissolution of the ego when at its top.

At their extreme limit these two psycho-biologic tendencies can coexist synergically and become one single thing: then mental status are produced (with a strong psycho-somatic connotation) in which are lost the distinctions in/out, I/another, me/not me, here/there, now/not now, mind/body etc. (these distinctions are required in the articulation of the two needs) and – if the conscience is able to accept it – one carries out the pleasant feeling of an harmonious union accompanied by a full and self-sufficient freedom.

It is curious to note that many of these intuitions are already contained in the notes of the diary of an original Hungarian psycho-analyst of Budapest: Sàndor Ferenczi since 1932. I quote few passages. Here it is a theoretical and clean petitioning and with no misunderstanding.

The splitting of two personalities, which want to know nothing one of the other and which are not grouped around different tendencies, obtains the economy of the subjective conflict (Ferenczi, 1932, p.94).

Notwithstanding everything, it is not entirely unreasonable to sustain the viewpoint of the dualism; the numerous examples of dual polarity, ambivalence and ambitendency traceable everywhere seem to justify considering the whole of the nature not only from the viewpoint of the principle of selfishness, but also from that of altruism coming from an opposite pulsing direction . The unilateral prevalence of the principle of selfishness is sadism; that of wanting to suffer is masochism (ibid. pp. 98-99).

The concept of a dialectic human nature, i.e. both individual and social, a human  unidual nature, has been taken from many other theorists (not only in the psycho-analytic sphere).  I quote the most current and complex of these: Ignatio Matte Blanco. For Matte Blanco there are in the human mind and culture two forms of thoughts, one called symmetric, for which it exists only the undivided unity lacking in distinct individualities, and the other called asymmetric, for which on the other hand exist only distinct individualities, in autonomous relations among them, for which the feeling and the idea of unity are inconceivable at all.

The way to be symmetric is the fundamental root of sociability because what, at an asymmetric level, is felt as a co-operation among individuals, or taking part together or being together, is, on the other hand, at a symmetric level, a true unity in which individuals are not separated and distinguishable one from the other.

In as much as we are symmetric individuals we are not independent from the others in that we are a unity with the others. For the asymmetric being, this lacking of individual limits is inconceivable…..This contrast between two ways of being would constitute the deepest source of conflict (Matte Blanco, 1975).

The most complete and exhaustive elaboration of these two aspects of the psyche and thought in the exact terms of psycho-biological tensions, i.e. needs, is by Luigi Anepeta who wrote:

The need of social integration (is)….need to belong, even though formally, to a human group and to have confirmation of this.

…..One can logically assume that the educational plasticity of human nature, due to the need to socially get integrated, recognises an intrinsic limit, biologically described itself, suitable to avert that that need promotes a homogeneous cultural pheno-typification…..This limit, genetically intrinsic in the human nature, can be defined as a need, the need to oppose, the purpose of which is to promote a differentiation of the personal identity and the progressive acquisition of a critical power in relation to reality (Anepeta, 1992, pp. 35-37).

Along this last theoretical approach, I have already expressed my point of view in the book Psychotic passions (1998), the first chapter of which outlines the theoretic foundations on which my practice moves. The two fundamental needs are described there, indeed, as a need to belong/to socially integrate and as a need to oppose/to individualise. To be precise, I state, inter alia:

a)      The need to socially integrate is the most archaic and basic need, as is involved in the processes of primary identification and of cultural belonging….The man’s dependence to the bonds with the other human being……supplies to the human societies and to the individuals themselves a potential of cancellation and auto-cancellation for the perpetuation of the social system and the participation.

b)    The need to oppose/individualise is “anaclitic” as to the first; in other words it needs the relative satisfaction of the first in order to manifest itself, due to its smaller relevance for the survival. However it is, during the psycho-biologic (and I would add historic-social) development destined to assume an importance at least equal to the complementary need……If  dramatised in the various social interactions, starting from those of the child with the adults, the need to oppose/individualise loses in part or in toto its functional character until it degrades in various

types of pathology (Ghezzani, 1998, pp. 40-41).

The need to individualise, i.e. that neuro-psychological push for which the generic individual gradually transforms himself in a person distinct from others and supplied with moral autonomy, gains in the course of the individual psycho-biological development and of the philo-genesis, ie of the evolutional history of humanity, a prominent character. Why? Simply because many persons distinct the one from the others offer a variety of types of behaviour higher than those of an anonymous and non-diferrentiated crowd. And the human species is interested to have availability of many different behaviours to strengthen its adaptive and surviging capacities.

The species, however, is neither far-sighted nor illuminated. It varies the individualities in the same way as it changes the genetic equipment, i.e. casually, blindly. And it produces indeed casually, sensible and insensible individuals. The variability of individual brains (the difference among the individuals) can therefore push the species and the cultures either in the direction of higher selfishness and higher interpersonal and global destructivity, or in the direction of a higher moral conscience, potentially socialisable, but still  and in any case critical. Societies generally, however – worried for their stability, i.e. to perpetuate the order of the system – end up by dramatising this change interpreting it univocally as egotistic and destructively  potentiality or simply unsuitable for social life. They, truly, don’t mistrust so much selfishness (that can be totally functional to a competitive and individualistic system) and of mere inadequacy (that can utilise in ideological terms, i.e. as negative example good enough to confirm the existing) they rather mistrust moral critical potential, because this always aims at transforming the existing in function of the emerging needs.

To give an example of how much this can be singular and powerful – at psychological level and, at least virtually, even at social level – full maturity of the need to individualise i want to report hereunder a biographical episode. It is an episode from a young Jewish-American student’s just over sixteen and was witnessing with his rich sensitivity the tragic events of the second world war. He  had been for more then five years very perplex about the “truth” propagandised  on the “noble” reasons of the war, and had constantly been avoiding to take precise position in that regard. But it was still unavoidable for him to reach the top of the doubtfulness and of the critical discomfort when,  on a day of 1945, he got to know of the nuclear bombing suffered from Japan. On that occasion he could not avoid “listening” with absolute clearance his dissociation from events, therefore living experiences which in some way led him to express his dissociation towards the exterior. That boy was Noam Chomsky, one of the most important linguists and philosophers of contemporary history, who tells the episode of a long interview of 1987.

I remember that the day when the bomb over Hiroshima was released I couldn’t literally speak to anybody. I could see nobody… I went for a walk in perfect loneliness. I happened to be in a summer camping and when I listened to the news I went into the wood and stayed there on my own for a couple of hours. I didn’t speak to anybody of this and later I could never understand the reactions of people. I felt completely isolated (Chomsky, 1987, p. 45).

It is in this case the need to individualise brought to a very high degree of development: this sixteen-years-old boy is able to feel and to think in a totally disharmonious way as compared to those who are the dominant feelings and thought in that very moment not only in America, where he lives, but also inside the winners’ world. This is certainly not easy: he is a minor, he belongs to a minority culture, and lives in a country and in a world kept together by that particular form of conformism which became later the “official version”  of events. At sixteen he disconcertingly discovers that his intellectual sensitivity cuts him out from his country’s community and from the “meaning” that the entire world wanted to give to history. 

The episode is striking; but it is clear that the same dramatic intensity can reveal itself in events connected to apparently minor contexts: The conflict with one of the parents or the family or with a local tradition can be an event of not minor relevance, thus able to radically “unbalance” the asset of a personality, then of the affective world to which it is connected. It is a question of intensity not of dimensions.

The psychological process that leads to the formation of an autonomous identity and of a moral person is usually fenced, slowed down or in any case accompanied by phenomena of “settling down”. The unbalance among the needs, caused by the alienated surfacing of the need of opposition/individuation, is the productive cause of all phenomena which are classified by  the classical psycho-pathology as symptoms and syndromes of disturbances of the character, personality and mind. In punctual sense, then, psycho-pathologic syndromes are no more then dynamic phenomena: unbalancing, socially induced, between two fundamental needs, expresses itself in a morph-genetic drift determining a finished number of more or less stable configurations: these configurations are the psycho-pathological structures. Between one and the other there space for a transformation during which the ego is at the mercy of the anxiety.

2.  A formula

Having two fundamental psycho-biological needs equally represented in our mind and personality causes as is obvious a series of advantages and disadvantages. An evident advantage is making us potentially “elastic” for what concerns the development of our identity; i.e. able to integrate us in the social world through the individuation – which goes through the whole life course – of “characters” which are more peculiarly personal. Only if lived in terms of this elasticity the life of the single individual can be considered as a generically universal event and in the meantime a unique and unrepeatable event. The disadvantage, no less evident, is that the personality, in the course of its history, is always susceptible of unbalancing itself either in a direction or in another. Given the ontogenetic (i.e. concerning the caring and growing phases) and philo-genetic (i.e. historic-cultural) prevalence of the social need to depend and belong, it is relatively easier and more frequent that one is overloaded by this rather then the other aspect. As is equally possible that the subject that feels “alienated” in the dependence enters a psychic discomfort indeed due to his attacks to it. Hence, from this unstable balance, the tension nearly constant in the human life to handle as best as possible the social and affective antinomies of the kind heteronomy/autonomy, others will/own will, social dues/personal dues.

In our deepest nature exists, then, a strength which opposes itself, rejects and divides and there is also a strength which connects. From here, from the dialectic yoke of their alternation, derive the good and the evil which (within human limits) we can experiment.

I write a formula

A1→A0→A2

This formula represents, in essential terms, the dialectic of identity. Letter “A” stands for “Other”: the symbol A1, then, represents the co-ordinates (affective, social, ideological) which constitute a determined identity state, a determined way of being and showing oneself in the world. I have defined this state as basic alienation.  From this identity state A1 it rises at a certain point a contradictory strength meant to deny and exceed it. The identity  structured on determined identifications, affective bonds, social interactions, cultural values, in put in crises by a part of the personality which refuses it, which aims at obtaining a change which reports of a complete series of emerging needs. The change, however, doesn’t happen immediately:  because the previous ego is not replaced by a ready made new ego. There is a need for a long research and elaboration. Then, the first feeling which one perceives during the crises is that of the loss of acquired certainties, the loss of the co-ordinates which organise and make functional all the balances of our life. This loss, in the formula is represented by the symbol A0. “A with 0” means that there is a fading, a disappearance of the old categories. Only by accepting the anguish which this passage produces it is possible to pass into A2, i.e. in the new identity, identity more adherent to the emerging needs.

A1 (the basic alienation) starts to dissolve itself; the critic and dissolving pressure of A2 (the antithetic alienation); in coincidence with this here it rises the anguish. Beyond the anguish (or in its fogs) the lines of the new configurations start to appear.

The door then is the anguish; the symptoms   of this passage are often the loss of credibility in the habitual world (de-realisation), and loss of certainty compared to the configuration of one’s ego (depersonalisation). Starting from the reality, the transition process from a reality to another can be described as follows:

Reality (alienated) → de-realisation → Ri-realisation.

Starting from the ego, the transition process from one identity to the other can be described as follows:

Personality (alienated) → depersonalisation→ Ri- personalisation.

3. The de-realisation

If the conscience can’t or doesn’t want to welcome inside itself the conflict perception (and of the potential transition) in process, it can “make it perceptive” in an analogical form; i.e. it can transform in a feeling of perception (in any case evocative of the conflict) what doesn’t present itself spontaneously to the conscience in clear and distinct terms of emotion, thought and concept. A phenomenon relatively simple of this making it perceptive is when for example in a dialogue the interlocutor suddenly appears  far away, remote smaller than what he should be for his real distance. The interlocutor (who is for some reason the representative of an area of internal conflict) has been “distanced”. It is a feeling but also in part, a perception.

In other more complex cases a situation can appear unreal, strangely void, or totally unreasonable, or still “false”, “mechanic”, “dead” (indeed “as if” the social actors were liars or robots or dead people). In these cases the conscience has not so much physically but emotionally distanced the situation, giving it in addition a vague but powerful interpretative connotation: unreality, falsity, mechanicity, death given to the perceived situation are as many unexpressed value judgements through which the subject picks up the alienation of the surrounding world or of the tout court world.

We are then in the de-realisation: with it the conscience declares itself suspicious of the whole world gear: the ego opposes itself to the Other and does not separate from it, becoming hyper-real towards a world more and more felt as “false”, “dead”, “unreal”; the ego, in substance, is identified de-realising the Other, though the feeling or perception of unreality and ambiguity intrinsic of what is opposite to oneself and from which one depends. The Other becomes – it is true – threatening; but operating this way the ego avoids that the conscience be permeated by the reasons of the conflict, be it internal or external. Being a matter of conscience of the ontological dependence, and of the fact that in the dependence the Other can be a source of falsity, mortification, trick, regarding the ego, the phenomenon of the de-realisation limits itself to separate the cause from the effect (the Other from the ego) modifying objectively neither one nor the other.

Psychiatrists are generally not adequate to the complexity of the object they treat. The weak organic competence for the classification of which  their culture is formed, does not permit them to understand neither the somatic base (which requires evolutionistic, genetic, neuro-biologic, neuro-psychological, endocrine and psychosomatic knowledge) nor, even less, to approach the psychological phenomenon in itself (which requires not only psychological, psychopathologic, psychodynamic, of the behaviour, of psychology of development, as well as anthropologic, historical and sociological, but also of a particular philosophic sensitivity). In the case of de-realisation and depersonalisation (which I will treat shortly after), psychiatrists admit their personal (and cultural) “fear to become mad” putting between them and these phenomena a distance equal to their phobia. In fact they arrive at considering them – with rough liberty – phenomena comparable to hallucination, therefore classifiable as signs of psychosis.

Better than many of them, who have produced very little beyond a rough classification, it seems to me that the philosopher Martin Buber caught with fine and fading psychological precision the essence of the phenomenon of de-realisation.

Buber says that in many cases those who love feel a sensation which is mysteriously “redeeming”. Why? Buber replies that when a person loves something of the world, that person experiments the unity with that thing, unity which is sources of pleasure in as much it realises in the beings whom or which one loves a formidable strength of contrast in respect of the objective external world; in this sense love is a form of freedom from the “fatigue” to be determined by the social mechanism, as functioning parts of a gear. Then, in this case,

the soul…. contracts spasmodically to get the gear jump and  rescue from it.

But this anyway is dependence,  it is not yet full freedom.

As a matter of fact:

… Neither this is full freedom for the soul. It has not been obtained from oneself but from the other (from the beloved), another one who is prey of the gear.  So, any event of the gear … can seize the soul and mine its unity, so that it finds itself abandoned and enslaved again to the vortex of sentiments and object. And even in the purity moment a sort of laceration can appear, the bursting of something and in the place of unity, suddenly, there are two separate worlds, and between them an abyss (Buber, 1987 p. 24).

That is, obtaining the feeling of freedom through another being also determined by the external world causes the risk that the other, from whom one depends, can determine the breaking of the charm, due to the way he is or he acts. Having ascertained then the cost of dependence, the beloved, and with him/her the entire world, is refused, rejected by the ego as a useless, unreasonable, indifferent thing: as a hated thing.

4. The depersonalisation

The depersonalisation is considered in psychiatry a index of mental disease, usually serious mental disease. Psychiatrists who have written manuals and essays on the subject compete to show their own total inability to understand the phenomenon (a sort of selective obtusity) and the psychological terror  of which they are themselves victims and that can induce in others. But in the history of culture it has not always been like this.  It is enough to open any biography of a saint at any page to discover that at least up to 1700 those same mental states were considered as a grace and were classified under the definition of “beatitudes” and  “ecstasies”. In the same century, in his Confessions as well as in his Fancies of the lonely walker, Rousseau describes abundantly the phenomenon and talks about it as the most seducing experience of his life.

But contemporary psychiatry treatises disagree. They centre the problem on the physical picture and on the perception connected to the ego identity and decide that any of their alteration is a terrible sign of dispersal. They show this way to practice a  static and above all phobic psychiatry: terrified by any indication of interior movement to which a movement of perception of oneself and of the world matches. It is said that  not recognising one’s imagine at the mirror it is a sign of psychotic  dispersal or at least borderline, then in cases of this kind one is facing the first tangible sign of a mental morbid process of certain genetic origin. He who tells or relies on the psychiatrist to feel light and to wander on the clouds or to feel as a stranger in front of his/her imagine at the mirror, or to feel as strangers or only “peculiar” his/her family members, or to feel as being separated from the world by a film of indifference or of melancholy, must be very careful as to how he speaks: he/she could find him/herself suddenly admitted into a psychiatric hospital  and submitted, well before he/she can understand what is happening, to a series of electroshocks and/or a “treatment” (emotional and creative a complicated series of sedation)  through psycho-medicines. At this stage the dulling of the perception is referred and commented as a therapeutic success. Statistics on “recoveries” (remissions) in psychiatry are mainly built on paper on manipulations of this kind for which a thin and faded perception  (not always anguishing) is dulled and removed on a flatter and flatter poor and remote affective and conceptual background.

But which are the terrible symptoms of depersonalisation?

Here they are perfectly referred (in their “complete” experience, not averted by “ignorance”, then by fear) in the witnesses of mystics, philosophers and anthropologists, under the dignified chapter of human ecstasies and ontological reflections.

Jalàl-Od-Dìn-Rumi

Sometime my state seems like a dream… My eyes sleep, but my heart is alert; … my eyes are shut, but my heart is in front of an open door … such a cowardice as yours will not deceive me; what looks night to you is a clear day for me; what looks to you as a prison is a garden for me. … It seems that I am on the ground and I linger in the house with you, and on the contrary I go up… to seventh heaven. It is not me coming with you but only my shade. My elevation goes over your thoughts, as I myself have gone over the thought. I am the lord of my thought, I am not dominated by it (Jalàl-Od-Dìn-Rumi, from Mathnavi, in Buber, 1987, pp.63-64).

What shall we do, oh Muslims? Because I don’t recognise myself. I am not a Christian, I am not a Jewish, I am not a Parsi, I am not a Muslim. I am not from East, neither from West, I do not come from earth, I do not come from the sea. … My place is what has got no place. … I have abolished duplicity. … I look for one, I know one, I contemplate one, I invoke one. (Jalàl-Od-Dìn-Rumi, from Divan, ibid. p.64).

Enrico Suso

(talking of himself in third person) He saw and heard what is ineffable to any language…. the  oblivion of himself and of any thing … it lasted one hour or half an hour…. When he regained consciousness he felt totally the sensation which can feel a man coming from another world. For that brief moment, he felt in his body such a pain that he felt no human being could suffer in so brief a moment  without dying for it. (Enrico Suso, in Buber, 1987, pp. 114-115).

Teresa d’Avila

The difference between rapture and abduction is that in the rapture one dies to external things second after second, one becomes unconscious and lives in God. On the other hand abduction arrives only at the news that His Majesty (God) sends to one’s intimate soul and it is so sudden that the soul feels to be taken to the upper part of itself  and to separate from the body.

…Other times …the soul, feeling to be prevented from enjoying God as it wishes, is taken by strong

hate for its body, which looks to it as a large hindrance wall  (Teresa d’Avila, The Book of Relations and Graces, 1982, pp. 42-47)

Martin Buber

The gear of our human existence, which encloses everything, all the light and music, all the thought eccentricities and the variations of pain, the flood of memories and that of expectations, is refractory just to one thing: to unity. …The gear allows me things and ideas concerning themselves; but it does not allow me unity.

… And the soul that… has stretched itself spasmodically to make the gear jump and to escape from it… and the soul… experiments unity.

… It exists …. an experience which  grows in itself from the soul… The soul which is immersed in itself and is in itself, possesses itself, experiments itself – with no limits ….because it has plunged entirely in itself. This experience absolutely interior is what the Greeks called èkstasis, i.e. going out.

….Men, who live laboriously, day after day in function of their body and lack of freedom, receive in the ecstasy the revelation of their own freedom (Buber, Ecstatic Confessions, cit. 1987, pp. 23-27).

Jean Jacques Rousseau

The gear has something which animates and brightens up my ideas: I can hardly think when I do not move, my body must be in motion in order to give the headway to my mind. … The distance from what makes me feel my dependence…liberates my soul, it gives me greater audacity in thinking, in a way it throws me in the immensity of beings to combine, select, acquire them to my talent, with no obstacles and fears. I dispose as an owner of the entire nature. My heart wandering from one object to another, joins, identifies with those that it likes. (Rousseau, Confessions 1955, p.178).

I had been good up to then: from that moment I became virtuous….

I was really transformed. My friends, my acquaintances did not recognise me any more. I was no longer the shy man, and the man, more shameful than modest, who did not dare to introduce himself or speak…. Bold, proud, I used to bring everywhere a confidence the more  simple it was the firmer it became… The contempt….toward uses, the maxims and prejudices of my century, made me insensitive to sarcasm…moments of my life when I became another person and stopped to be myself (Rousseau, ibid. p. 457-458).

Claude Levi-Strauss

Rousseau’s thought moves therefore from two principles: the one of identification to others ….; and that of denial of the identification to oneself, i.e. the denial of whatever can make the ego “acceptable”.

…..Rousseau’s revolution … consists in refusing obliged identifications, be they of a culture to this culture, to a character or a social function which such a culture tries to impose. In both cases, either culture or the individual, claims the right to a free identification (Lèvi-Strauss, Rousseau, founder of the human science, 1962, pp. 91-92.)

I refer again to the already mentioned formula:

                                                A1 ®A0 ®A2

What has happened, at this level, in the case of depersonalisation?

Simply that the ego has abolished its ordinary identity not as much by rejecting as a stranger its world of reference (as in the de-realisation), but rejecting and dissolving itself (body and mind), refusing to recognise something comprehensible as “oneself”. And in refusing oneself it has had to refuse and dissolve even the habitual co-ordinates of one’s own existence. More or less as it happens to a normal drinker when he dilutes the ego in the alcohol: the disappearance of the habitual points of identification of oneself allows the alarming appearing of new configurations. Not differently, in the psychopathological phenomenon the anguish of dissolution of the ego, already strong as for itself, can combine itself with the anguish to see removed needs emerging (in the emotional form or incompatible ideas with the habitual ego) until a panic reaction is provoked: i.e. the starting of the psychosomatic alarm-bell.

In extreme synthesis, with the depersonalisation the ego projects on the surrounding world the possibility – intrinsic to it – of lack of bonds, and it plunges into it; it loses its way and it melts with the whole: it does not depend from anything which is the foundation of certainty, if not from this immaterial self , from this self which has expanded  and diluted itself up to include and cancel the real time and space. The drawing with no obstacles of this simple mood allows to express in “pure” form (not “applied” to something specified) the sentiment of one’s intrinsic autonomy and therefore of one’s absolute freedom.

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