Time.news – The pandemic and its consequences have had among the many side effects on the psyche also that of making the so-called “sane” understand what it means to have a psychosis. This is supported by Paolo Milone, active for 40 years as a psychiatrist in the emergency department of the Genoa hospital and recently author of the book The art of binding people, published by Einaudi, in this interview with Time.news.

What consequences has the pandemic had on psychiatric patients?
“There have been many, not all negative. The first one I think of is the fact that many psychiatric patients tend to go into ‘lockdown’ on their own: there are patients who have been locked up in their homes for months, for years. They are schizophrenic, paranoid, depressed: for them, that someone from outside obliges everyone to stay at home is a relief of responsibility, it is not us who lock ourselves in the house, but someone else. The opposite is true for the maniacs who never stand still and continually challenge limits and borders : for them not being able to go out is terrible “.

What are the effects of the pandemic on those who have not previously had diseases of this type?
“I am especially concerned about small children. They need to be with other children: the relationship with the parents is important for the development of the brain, but the brain circuits, those that create the paths to get by in life, are formed in the first years of life playing with peers. These are the synapses that are then crossed more quickly when one grows up, and if they are not formed by playing, creating one’s own mimicry, learning to clash with others, the paths are not formed and growing one risks get lost in the woods. Even when they play with them, parents are not enough to replace their companions in the play of the little ones “.

What about adults?
“The so-called lockdown can make everyone experience some of the sensations that are typical of the onset of a psychosis. In particular I think of what we psychiatrists call derealization (the dissociative symptom that gives a distorted perception of reality, ed). at the beginning of the pandemic, the virus has so to speak taken control of our lives: an invisible biological being managed to win over all our means, centuries of culture and progress, of laws, of industry. the coronavirus has changed our lives. This feeling of helplessness, the unknowability of the enemy, can create in everyone a small feeling of derealization: reality is no longer what we knew, it is not that familiar and benign reality. Evil can overcome the well and the danger that the virus represents is insurmountable not only for me as a person, but for our species. Many people have experienced this anxiety, a beginning of psychosis c he in most cases is exceeded, but for the sick it goes on for years. Culturally it is important that anyone who has experienced on himself what is a beginning of psychosis, or the feeling of anxiety and helplessness. It is one of the many doors that can be opened onto the world of psychiatry ”.

Could you explain the title of the book about your long experience in emergency psychiatry, The Art of Binding People?
“It is a title that alludes to different situations in which it” binds “in psychiatry. There is an emotional bond: it means binding patients to us, to create a relationship that makes it possible for the patient to distinguish between himself and Then there is the need to tie him to himself and to reality: in psychosis, in generic mental disorder, one has to face depersonalization, the fact of not recognizing oneself as a single entity and this unties the patient from himself. “then there is derealization, not being able to feel reality as something one lives in, feeling it distant. There is, but only in the last place, the need, at times, to have to tie the patient to the bed. Urgent psychiatry is all a tie, a mend: in all cases, in the end we will think about untying “.

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