La bottega della psichiatria: l'operare psichiatrico a quarant'anni dalla Legge 180

Abstract

Some important aspects characterize the movement of humanistic from John Conolly to Wilfred R. Bion and Franco Basaglia, up to the many colleagues who intervened in the debates published in the last issues of the journal Psicoterapia e Scienze Umane around the 40 years of the Italian Law no. 180/1978 that provided for the closing of Psychiatric Hospitals. Among these aspects there are a culture of acceptance and inclusion, respectful and affectively rich, and the abil-ity to understand and treat psychiatric patient without relying only on descriptive diagnoses and overt symptoms. These aspects can be considered an antidote to a return of mental asylums and of a mental attitude and an ideology of exclusion that can come back in any moment. Many Commu-nity Mental Health Centers tried to deal the new forms of psychopathology (eating disorders, adolescent crises, depressions in the elderly, personality disorders, new forms of addiction, etc.), while other Centers remained attached to ideological or self-referential approaches. Two concept are discussed: the idea of craftsmanship of psychiatry, sensible to improvements and open to external influences; and the idea of psychiatry as a discipline at the border of different areas of expertise and specialized in the relationship with the Other (institution, biological psychology, sociology). This psychiatry is light and poor without being fragile. Italian psychiatry should be proud of these 40 years after the Law no. 180/1978: Psychiatric Hospitals, differently from any other country of the world, are still closed. Pessimism could be an alibi to avoid further progress, and future developments of humanistic psychiatry are possible.