LA CURA E LA POLIS AL TEMPO DEL CORONAVIRUS

Sotto riportiamo l’articolo tradotto in inglese,  l’articolo originale in italiano lo potete leggere su:  http://www.psychiatryonline.it/node/8455

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“The Care and the Polis in the Time of COVID-19″

Michela Gecele and Gianni Francesetti

We published this paper on the the blog of Italian psychiatrists, POL.IT, on March 7th, at the beginning of the COVID-19 emergency in Italy.

We felt the need to share our feelings and thoughts with a wider community. We are doing the same now by trying to reach you on this online publication.

Children of our age           (Translated by Stanislaw Baranczak and Clare Cavanagh)

(…)

Whether you like it or not,
your genes have a political past,
your skin, a political cast,
your eyes, a political slant.

Whatever you say reverberates,

whatever you don’t say speaks for itself.
So either way you’re talking politics.

(…)

Wislawa Szymborska

Frantic days, literally metaphorically feverish days. Gianni should be in Kazan teaching in a seminar scheduled, like many other  seminars, three years ago. Michela came back early from a tour for the launch of her latest book. Seminars abroad, scheduled a long time ago without any concern, are cancelled. Seminars as part of the international trainings on psychopathology in Turin are cancelled. Basic trainings for psychotherapy cannot be continued face to face. We have to discover new ways of teaching and learning for our Italian trainees.

Normal daily activities, both in the Public Mental Health Service and in the Clinical Centre Mattia Maggiora, are cancelled or are online, as well as supervision groups and team meetings. Everything we used to take for granted until yesterday, or even until a few hours ago, has changed. Yes, because medical and security reports arrive and change scenarios, no longer in days but in a few hours or even in minutes. Taken-for-granted contacts, which before supported – and limited – us, are now cancelled. The ground trembles, sometimes collapses like an earthquake.

We write and communicate with each other because we need to, a need that involves us and oversteps us. A way of expressing the  voices of the field and of listening to each other and of touching each other, at least virtually. We perceive a responsibility, first of all towards our patients and trainees with whom we live this moment, but also towards the wider community which includes all human beings. Therefore we want to weave, or to baste the narrative texture that creates threads – even only in the air or in the ether – in order to sew, to hold together those affective resonances that would otherwise remain chaotic. We wish to create an opportunity for everyone’s experiences to settle and ripen,  not in  lonely or idiosyncratic memories, but in shared and traced ones. Our attempt is to weave a ‘social personality’ for gathering the experiences which may otherwise remain individual splinters without connection, without ground, without support. Upsetting. Panic is, by definition, an overwhelming affect, which is not contained in that edge between individual and social dimensions that we  call personality. It is not con-tained (from latin   continēre: con – tinere, to hold-with): we use this verb in its dual meaning of holding-with-another and to be  the texture-that-holds. Narrating and sharing with others creates invisible, but very effective figures in order to hold-together and endure-together. The fertile ground is common ground. That’s why, since the beginning, we need to narrate. The way to express ourselves is to link our experience to the theory. Once more, we can find an understanding of our experience by referring to the theories already established. These theories, in turn, come from the experience, through a circular track of impulse and pressure.

In order to express what we feel and see in these strange days of coronavirus, there are two different but complementary works that support us. The article about bipolar experience written by Michela in the book ‘Absence is the bridge between us’ (and inGestalt Therapy in Clinical Practice’) and all Gianni’s interdisciplinary work about atmospheres, recently published in Psychopathology and Atmospheres.

Why do we choose these two papers?

If you want to read, or reread, these articles you can find them here: www.ipsig.it. But here we would like to link the content of these papers with what we are experiencing here and now.

The chapter on manic states supports the notion that bipolar experience is a kind of experience that oversteps and precedes psychopathology and involves all the foundational parameters of human experience:  time,  space,  the wound, sense of limit, the need to go beyond, the support and the lack of support, the need for a relationship and often the difficulty of living in it. And then, there is a very simple idea that condenses all this. The idea that the manic or ipomanic episodes, the experience of well-being, of excess, of challenge, of going beyond, of daring to, of taking risks, depend on a favourable relationship between energy and limits: they depend on a dissolving of what Gestalt calls introjections, in a dual meaning of bricks that define and establish experience’s criteria and contents but also the limitations of the experience itself.

In this time of coronavirus, why do we care about this? Because, as we said at the beginning and as everybody is experiencing, in this period a lot of our certainties, daily habits, daily routine, implicit and explicit rules, taken for granted ways of living, are dissolving. They are fading away.

This dissolution  of  for-granted contacts, by definition, produces and releases energy which is no longer  tied to preformed patterns and is no longer prisoner or contained in them. In the early days of this ongoing “novelty”, some of us could have sensed a strange and paradoxical increase in energy, excitation, almost good mood, exhilaration. This is not psychopathology. We simply sense the energy released from an everyday life that unsettles and dissolves. We can touch the entire range of manic and hypomanic experiences, with their risks, limits and potentialities. But after a while we may experience a kind of down, a depressive impasse in which we feel blocked, by fears, by words from the world, old worries, ancestral warnings. These blocks occupy the space of the meeting and block the experience. We don’t want to give positive or negative value to this ongoing process of oscillations.

Mostly, we don’t want to make either a judgment or a psychopathological value nor to give interpretations and solutions.  Simply, as we used to do in our clinical and training practices, we would like to highlight the risks and the possibilities of this moment, of every moment of life, of every positive and negative, simple or difficult period of life.  We try to do this with you. Weave threads that sew and hold the experience, find meaning, settle down memories, support the assimilation. Produce presence.

A key word in that chapter about mania and also about all Gestalt theory and practice is ‘support’: the question is what kind of support do we need in order  not to be gripped by fear and what kind of support do we also need to catch the potentiality of a time that will be, and already is, for better or worse, changing a lot of aspects and  assumptions about our daily life, and for the future? There can be many forms of support  and this one is definitely one of them, at least for us: to express what we are living  and thinking, to share this  with you as part of a wider ongoing dialogue. To give meaning – not justifications or solutions – to what we are experiencing, in order to find, to glimpse, paths to take,  even if painful or exhausting. In this way we take the first step that constitutes us as human beings: we create a shared world. Belonging to a shared world is no more immediate, taken for granted, self-evident in the emergency. That’s why we are writing to you.

At this point we link to the other theoretical background, and not by chance we call it background: the one about atmospheres. At the end of February, we came back to Italy from abroad and we found another world. First of all, before any report or event, before any chronicles, it was perceived as a different atmosphere: tense, floating, suspended. Something in the air which kept us in suspense. Atmospheres which emerge through us and take us, which simultaneously overwhelm and include our individuality.  We’ve known for a long time that in Gestalt therapy relationship precedes the individual, that the relational and social field precedes the individual human beings and contributes to their growth. Now our theoretical and experiential challenge is to address the atmospheres by means of which we can perceive and sense the movements of the relational, social, human and non-human field. The affective attuned space that sets the tone of our feelings. From this dimension emerges our experience.

How many times in these days have we have sensed or thought that we are living in a movie, in a novel with a precise atmosphere, in a dystopia set up by others. It is a creative way to give  a familiar shape to the atmospheres that we are experiencing, a framework that we can understand and get connected to. What happens, in a condensed and predetermined way, when we watch a movie, or when we are exposed to different art forms, it is the same as  in life. As life is a sort of artwork overstepping us with its own atmospheres. But the movie ends and we leave the cinema: then we realize – in an immediate way – that we were into the movie story. Trembling, hoping, hating, loving, clinging to the arms of the chair while the main character was in extreme danger. Then we leave the cinema, we chat, we comment, we laugh, we create a distance from the artistic experience, from the atmospheres where we were immersed. We differentiate ourselves. It doesn’t matter if we have different opinions about the movie or the piece of art, when we talk about it we create new threads that hold the experience. The movie becomes memory, we can turn the page and go and have a drink.

That’s what happens when the movie ends. But what if it’s not a movie? We simply cannot leave the  cinema. Therefore we have to learn to live there, to dwell in that atmosphere. And here is the crucial point: to be able to become aware of the atmospheres when we are living it, since we cannot leave the room. Otherwise we can only be played by them. Feeling the power of atmospheres allows us to recognise them and recognising them allows us  not to be just subjected to them, not allowing them to be amplified. Science is a great help because it’s the great differentiator; its point of view is detached, objective, impersonal, quantitative. That’s why it is the great rescuer in times of emergency. But it is not enough. First of all, science creates specific atmospheres which we must be aware of. Scientific atmospheres go beyond subjectivity and they can become in-human. There are many examples of this in  history, even of the extreme actions by nazi doctors for the good of science. A little contemporary example: during these days, people in  hospitals cannot have any direct contact with their loved ones. Here there are no funerals any more. The passage that in the history of humankind created  civilisation, is cancelled. The point is that this is now beyond any discussion, never considered a problem, since science just imposes it. Science is not enough  because it can be an  authoritative point of reference as long as it has something accurate or at least probable to say. There’s a lot more in the experience, in  the anguish, in the fear, in  the insecurity, in the fast changing scenarios. It’s not enough to just follow science to keep the boat steady. We want to be clear: this is crucial. But we also need to nourish the relational spaces where we can narrate our stories in order to differentiate ourselves from the situation. In this way we are not just hooked. We recognise the present moment – at least a bit – we don’t loose the background – not completely -, we can support each other – as far as we can. We remember that we are fragile, vulnerable, limited. It’s only because of these in-between spaces that we manage not to get lost. They remind us that  our constitutional vulnerability and our need for the other are not novelties. They are our nature. Even more in times of emergency by COVID-19.