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How psychiatry should be in the footsteps of Basaglia

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THE ‘INSANE’ he is none other than a person who takes himself too seriously, while the ‘sane’ realizes an inert and bad faith existence. But between these two ideal polarities exist the ‘real’ people, charged with a certain amount of anguish that protects from obtuseness, but with the ability to lie and lie to each other so as not to be overwhelmed. It is one of the unsettling reflections of Franco Rotelli, one of the main collaborators of Franco Basaglia and protagonist of the reform of thepsychiatric care in Italy. His long experience, gained both in the mental hospitals pre-existing to the reform and in national and international health organizations, is distilled in the volume ‘Which psychiatry? Notebook and lessons’ (pages 208, Euro 14.00), published by AlphaBeta, which collects essays and articles written by Rotelli over a period of over half a century.

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The weak points

Rotelli’s thought, advocated by the author both in clinical practice and in political activity, strongly criticizes the normative and excluding conception of a reductive and normalizing psychiatry based on diagnostic labels that sometimes respond more to the needs of social control than to scientific criteria. and often in any case far from grasping the authentic experience of people. According to Rotelli, psychiatry has too often, at different times and in different places, lent itself to acting as a factor of social exclusion through objectification, it stigma and the segregation of patients: it is instead necessary to give universal and complex answers to the problems of people, whose health is influenced not only by health determinants, but also by social and economic ones, which the psychiatrist from Casalmaggiore urges to take into consideration by going beyond the model paradigm doctor based only on the hospital and health institutions.

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The affective dimension

Between the two extremes of conformist normativity and unattainable utopia, which risks becoming abstract ideology, Rotelli urges to privilege the affective and relational dimension of the encounter with the other. The other can save us and keep us on this side of the limit, but also push us beyond and abandon us. Mental health means for Rotelli to be able to show one’s difference by also seeking a commonality, to find together with the other a shared practice and project. The author of the essays also questions the efficiency model to which it is believed that mental health services must comply today, called to intervene as early as possible when discomfort occurs: but Rotelli warns against the always lurking risk of transform any deviation from social norms into mental “disorder”, remembering that the words “diversity” and “fun” have the same root, and that mental health could be “the infinite fun of finally recognizing ourselves as different”, but not for this unequal.

Francesco Cro is a psychiatrist of the Mental Health Department of Viterbo

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