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Mental health and the weakness of the answers you give

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Mental health and the weakness of the answers you give

by Francesca Beans, Marcella Beans

28 NOV

Dear Director,
mental health is fundamental in the existence of a human being and has repercussions on the entire community. It is a theme that cannot be avoided. Mental well-being, like physical well-being, must be at the center of health policies and politics in general. Mental health is a common good in the highest sense of the term; it concerns, borrowing those indelible words of the Constitution, “the full development of the human person”.

The two years of the pandemic, the difficult climate we are going through due to the social and economic crisis, the oppressive atmosphere due to the war, have brought out a vast demand for mental health protection, especially from the youngest. A question that also revealed the weakness of the answers that were given. The students themselves – think of the “Ask me how I am” campaign – have repeatedly raised the problem of the need for psychological support in schools in recent years. Furthermore, the attention that has been generated around the so-called psychologist bonus, albeit partial and full of limitations, demonstrates how urgent the need on the part of citizens to have clear, effective, competent answers on the prevention and treatment of the disease has become mental. Not to mention, then, the WHO itself which has raised an alarm to the States asking them to strengthen interventions in the field of mental health and the Unicef ​​report which has highlighted the data on the increase in adolescent discomfort.

Clearly all of this calls into question psychiatry. A theme to which Quotidiano Sanità has dedicated and still devotes ample space. In particular, Andrea Filippi’s article of last October 3 focused attention not only on the organizational deficiencies of the mental health services system – the most penalized, in terms of resources – but also on the need “to deal with the” superstructure culture” for an inversion of the paradigm that puts the role of scientific research, of therapeutic practice, of the training of operators and of professional identity at the center in order to untangle a skein that favors a fruitful collaboration between politics and medical science for the knowledge and cure as human achievement and liberation from disease”.

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In this ambit, precisely in the direction of scientific research in psychiatry, we would like to make a contribution aimed at everyone – psychiatrists, psychologists, health service operators, citizens. On November 18 and 19, the international scientific conference “Fifty years of death instinct and knowledge – The theory of human birth and its implications” was held at the Teatro Olimpico in Rome on the occasion of the fiftieth anniversary of the publication of the first book by the psychiatrist Massimo Fagioli who, released in a period dominated by organicist psychiatry, on the one hand undermined Freud’s psychoanalysis and on the other laid the foundations for psychiatry as psychotherapy. The conference, which had the patronage of the Lazio Region and the provincial order of doctors, was the first public event promoted by the Massimo Fagioli Foundation which was established in 2021 and pursues civic, solidarity and social utility purposes by statute. through the protection, conservation and dissemination of Massimo Fagioli’s work, continuing his research, elaboration and theoretical and practical training, with specific attention to the diagnosis and treatment of mental illness.

Massimo Fagioli has always considered Death instinct and knowledge, to which the other two books were added – The marionette and the puppet and Theory of human birth and castration – as the first text of a trilogy in which the fundamental psychic dynamics are verbalized for a new approach to the study of the origin and development of the human mind, especially the unconscious mind. This text is a critique of what is continually proposed, namely that historically there would have been a so-called discovery of the unconscious by Freud. Above all, the book underlines that those assumptions, those propositions and those statements relating to the unconscious have heavily conditioned culture and society, proposing an image of man fundamentally split and in constant struggle with a constitutional and intrinsic destructiveness to himself.

Conversely, what we find in Death Instinct and Knowledge, as well as in all subsequent scientific production, is the explanation of a physiological process relating to the birth of the unconscious mind. Originally healthy human mind which however, as happens with the body, can become ill and fall into destructive dimensions which are not a natural condition but which represent an illness. And perhaps the key is precisely this: what we find destructive in man is not inherent and unalterable but is disease, precisely, and as such must be treated.

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The two days saw a huge audience participation (about 4,000 people who followed the proceedings in person in a completely full 1400-seat theater and thousands in live streaming) and a scientific production, after an international call for paper had been launched , by 231 authors (between papers and posters). Furthermore, the contents of the 28 hours of work (including 7 pre-recorded sessions and published online) are permanently available on the conference website.

The first day was dedicated to the implications of the theory of birth in psychiatry, psychology, developmental psychology and bioethics. In addition to dozens of reports by Italian psychiatrists, psychologists and psychotherapists who proposed contents and research related to the Theory of Human Birth, discussions were held with international guests Joanna E. Chambers, Eirini Karyotaki, Natalia Solovieva and César A. Alfonso. The first aspect to note is precisely the participation of colleagues from different backgrounds with whom there was a harmony in considering psychotherapy as the main road for the treatment of mental disorders. And it is precisely in this perspective that death instinct and knowledge has become the object of study and reflection for the search for a psychotherapy that is able to address the increasingly pressing demands of mental health.

Among the many interventions, the report by Joanna E. Chambers (professor of psychiatry at Indiana University) is worth mentioning, where for the first time the intersections between birth theory and attachment theory for patients with opiate addiction were discussed. A second relevant aspect is the large participation of colleagues who follow this research and who have immersed themselves in the study of Death Instinct and Knowledge bringing contributions of considerable interest and high level. At the Conference of the Teatro Olimpico there was a breath of collective research that also involved non-experts. And the search for a language that could promote the Theory of Birth and make it known to the guests of the conference also emerged.

The second day was dedicated to the socio-cultural implications of the Theory of Birth and the new anthropological vision proposed by Massimo Fagioli’s writings: from art to language, from law to pedagogy. Among others, original contributions were presented on the relationship between school and knowledge, on the concept of equality deriving from Massimo Fagioli’s theory in relation to law and on the concept of natural human sociality.

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In conclusion, compared to the difficult challenges that psychiatry has to face today, we can say that the theory of birth has enormous implications for the treatment of mental illness. It was developed in the relationship with psychiatric patients and derives from a medical practice that should never be forgotten. Mental illness is perhaps one of the most frightening human diseases. Because it affects not simply an organ of the body but questions human identity and the possibility of being in relationship with others and with the human and non-human world. Having available a theory that proposes an originally healthy psychic reality and that explains the reasons why this original sanity can go into crisis and therefore configure a state of disease, allows us to face any diseased dimensions with a therapeutic practice that has in itself an idea of ​​curability.

Massimo Fagioli’s theory has marked the history of Italian psychiatry: from the unique group psychotherapy practice of Collective Analysis (1975-2016), to the training of hundreds of psychiatrists who also work in the public service, from thirty years of scientific research through the journal The dream of the butterfly, until the birth, in 2018, of the Bios Psychè School of Dynamic Psychotherapy recognized by the Miur.

Now the Massimo Fagioli Foundation intends to carry forward that heritage of knowledge, medical practice and profound interest in human beings that has always distinguished the author of Death Instinct and Knowledge. For it to be a heritage for everyone: for the world of psychiatry, for public health, for the community.

Frances BeansPsychiatrist and psychotherapist, president of the conference “Fifty years of death instinct and knowledge – The theory of human birth and its implications”

Marcella Beans
Psychiatrist and psychotherapist, president of the scientific council of the Massimo Fagioli Foundation

November 28, 2022
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