BOOKS REVIEWS, NOTES AND COMMENTS
Edited by Federica Napolitani Cheyne
I MATTI DEL DUCE
Manicomi e repressione politica nell'Italia fascista
Roma: Donzelli Editore; 2014. 237 p. ISBN 978-88-6843-131-0.€ 33,00.
[Duce's lunatics. Mental hospitals and political repression under Italian fascism]
Sometimes an attractive title conceals the true contents of a book; so what may look as a joke, I Matti del Duce (Duce's lunatics) lives up to the rich data and the thoroughness of this study, dealing with the use of psychiatric internment for repression of political dissent during the two decades of fascist dictatorship.
The author analyses quite effectively the close plot between the culture of the time, psychiatric science, ancient prejudices, ideological motivations and medicalization of dissent serving political repression. In parallel, it documents the responsibilities of many psychiatrists, mainly mental hospitals' directors, in implementing the expulsion of the dissentients from the social body, often for the rest of their lifetimes.
Based on the examination of 44 540 records of antifascists filed in the Casellario politico centrale (Central Political Records Office) of the Home Office Department an analysis performed by Adriano Dal Pont for the Quaderni dell'Associazione Nazionale Perseguitati Politici Italiani Antifascisti, ANPPIA the author identifies 475 cases (1.06%) of psychiatric internment; of these, 122 (25%) died in a mental hospital, a higher mortality rate than that of prisoners or dissentients assigned to confino (internal exile). Research in some of the sections of the Archivio di Stato (Bologna, Macerata) suggests that hundreds of other dissentients were interned in mental hospitals without placing their records in the central Casellario.
The practices of psychiatric internment and social exclusion were founded on the well-known theories of Cesare Lombroso, dealing with the relations between degenerative stigmata, criminality, mental illness, and libertarian and subversive attitudes. The 1904 psychiatric Law sanctioned the social dangerousness of the mentally ill and their manifestations as a cause of public scandal. In the fascist vision these premises were readily connected to the theory that utopians, theorists and inconclusives are mad; and with the affirmation that there is a relationship between being uncultivated and mentally inferior and embracing marxist ideology (hence a biopsychology of marxist fanaticism).
The author stresses the substantial continuity of cultures, regulations of internment, and management of psychiatric hospitals between previous political times and the fascist period. In this context, considerable emphasis is placed on the crucial role of psychiatrists who had acquired, thanks to the aforementioned 1904 Law, a despotic and almost boundless power in decisions of internment by means of uncontrolled emergency procedures. Considerable emphasis is also placed on their active collaboration with some exceptions duly mentionated in the book in the repression of the anti-social behaviour of the mentally ill. Consequently, the psychiatric asylum evolved to serve more and more as the maidservant (ancella) of the police, and thus became a container for those sick or social deviant who disturbed public order; a dump for vagrants and for subjects discharged from prisons and even from hospitals.
The author also analyses the process of gradual elimination of the constitutional guarantees which were still present in the 1889 Zanardelli Penal Code. In this code, political offenses were not considered harmful from the common right viewpoint; therefore, they were not penalised as criminal offenses against universally recognized values, but as crimes directed against the political organisation of a given state at a given time.
This process took a decisive acceleration during World War One, in the name of the greater good of the Homeland, an acceleration which continued relentlessly in the years of the fascist regime, so that from a certain point on political dissent was identified as a sign of social deviance. Moreover, the repression of dissent eventually came to coincide with the escalation of the struggle against the degeneration of the race, based on social selection, eugenic selection and social exclusion through the internment in mental hospitals. Insanes, criminals, prostitutes, homosexuals, and parasites in general were lumped together as degenerates. Political opponents professing ideologies adverse to the regime, thereby posing a threat to the established order, were added to this dump thanks to the psychiatrization of dissent.
Already in the years before the approval of the 1930 Penal Code (the Codice Rocco), hypotheses were formulated concerning measures aimed at eliminating those who had been declared irrecoverable to social reintegration. The enormous influence of Cesare Lombroso's theories on psychiatric culture and practice is clearly and effectively highlighted in the central pages of the book. These theories were further developed, supported and spread by Lombroso's pupils, most of them respected scholars: Leonardo Bianchi, Benigno Di Tullio, Giuseppe Sergi, Luigi Rusticucci, Enrico Ferri. They all claimed that the community had the right and the obligation to defend itself by promulgating and enforcing appropriate laws against anyone who could constitute a threat to its security. They also affirmed the duty to eliminate, through appropriate methods, useful and humane the delinquents unable to abide by the complex discipline of social life (Di Tullio). The socialist physician Gaetano Pieraccini Lombroso was himself an active socialist with the paleopositivist/reductionist convictions then widespread in the left theorized the ban on marriage for the ill with tuberculosis or epilepsy, the crazy, the alcoholics, the idiots, the vicious criminals. He also theorized X-ray sterilisation for those who were discharged from mental hospitals.
In parallel, the number of people committed to mental hospitals increased from 12 913 in 1875 to 39 500 in 1905, to 62 127 in 1927, to 94 946 in 1941. This is indeed a highly significant index of growing social problems and mental suffering in the population; and at the same time, strong evidence of the increasing grip of social control involving the exclusion from the social body of an increasing number of subjects of the most fragile categories.
The repressive rules to combat degeneration of the race will soon be published in the Testo unico delle leggi di pubblica sicurezza (Unified Collection of Police Laws, 1926 and 1931 editions), including the obligation not only for doctors and nurses, but also for family members, to report within two days any case of mental illness or severe psychic trouble, of alcohol or drug intoxication, of syphilis and tuberculosis. At this point it became an all-too-easy accomplishment to add to such a mixed bag the persecution by psychiatric internment of several hundred political dissentients.
The theory of race hygiene, although not pushed to the extremes of the Nazis, exerted a strong influence on the practices of many physicians and psychatrists. This and related theories were readily accepted, basically confirming ancient and deeply rooted prejudices which included racist and stigmatising attitudes towards the mentally ill. Such attitudes are still widespread today, although sometimes concealed in one way or the other; and this helps explaining the survival of anomalies in our laws, such as articles 133 and 203 of the fascist Rocco Penal Code concerning social dangerousness. These provisions still exert a nefarious influence on psychiatric practice and the fate of the mentally ill. In fact, a series of recent negative developments the gradual dismantling of community mental health services; the prevailing offer of institutionalisation in mostly private structures; the survival of the Ospedali Psichiatrici Giudiziari (OPGs, the asylums for the criminally insane); and, last but not least, the insistence for replacing OPGs with the so-called REMS (Residenze per l'Esecuzione delle Misure di Sicurezza, Residences for the Implementation of Security Measures) testify of a dramatic cultural and organisational backwardness that pushes many of the mentally ill towards chronicity and disability; not to speak of the massive waste of financial and other resources.
Going back to Petracci's work, the reconstruction of many case histories (about sixty) concerning political dissentients, often moving and painful human ordeals, provides a significant picture of the atmosphere of prevarication and violence in a widespread and pervasive control system. Control started bottom-up with the enlistment of house janitors and was implemented by innumerable informers of both the regular and the special fascist police, the OVRA (believe it or not, experts have never agreed about the precise words behind this acronym, indicating an extraordinarily efficient body whose mission was repression of antifascism coinciding with repression of antistate subversive activities). Cases of political dissent were judged by a Tribunale Speciale per la difesa dello Stato (Special Tribunal for the Security of the State), a direct emanation of the political power which also influenced decisions to intern antifascists in mental hospitals and exerted a strict control on them during their detention.
In chapters III and IV the author carries out a detailed analysis of conditions in prisons, in places of confino (internal exile), generally remote and uncomfortable ones, and mental hospitals, characterised by frequent recourse to isolation, to a regime of silence, to practices of intimidation and punishment, to all kinds of abuses and tortures; practices which caused not infrequently mental disorders warranting the internment in a mental hospital or the extension of a previous internment.
In conclusion, Petracci's book is a far-reaching analysis of repression methods during the two decades of fascist dictatorship, focusing on psychiatric culture and practices of the time by means of a meticulous examination of a large body of documentation and detailed narrations of representative case histories.
An imposing body of footnotes, providing inter alia precious information on primary archival sources, a meticulous author index, and an extensive bibliography constitute a solid support to the text, as well as a guide for readers who may wish to go deeper into this dishonourable chapter of our history.
1. Un'odissea partigiana. Dalla resistenza al manicomio. Mimmo Franzinelli e Nicola Graziano. La Feltrinelli Editore, 2014. ISBN 978807111389. 18,00.
già Servizio di Ematologia Pediatrica, Istituto di Clinica Pediatrica, Università "La Sapienza", Rome, Italy
We have just learned about a recently published book dedicated to a series of absurd post-war events which resulted in a severe penalisation by psychiatric measures of several partisans who had risked their lives fighting the Nazis and their fascist cronies (1). Specifically, these men were arrested and tried for murder or other serious crimes, sometimes justifiably (e.g., for having indulged in ruthless personal vendettas), sometimes unjustifiably (e.g., for having killed Nazis and Fascists well-known as torturers and killers); and this, thanks to the persisting presence in the courts of quite a few fanatically fascist magistrates who resented the defeat of their beloved regime. In the latter cases, to avoid heavy convictions (mostly between 20 years and life sentences), even the best defence attorneys of the left e.g. Lelio Basso, Gian Domenico Pisapia, Umberto Terracini manoeuvred to obtain the recognition of insanity and the subsequent assignment to a psychiatric prison, with a shorter (but renewable) period of detention. As a result, the "sane" were liberated within a few years after amnesties and other measures, whereas the "insane", due the routine of repeated renewals of the terms motivated by "social dangerousness", remained in psychiatric prisons mostly in horrendous conditions for a much longer time, up to more than ten years.
ATLANTE DELLE DIPENDENZE
Leopoldo Grosso, Francesca Rascazzo (Eds) Torino: Edizioni Gruppo Abele; 2014. 675 p. ISBN 978-88-6579-076-2.€ 30,00.
[Atlas on Addictions]
The Atlante delle dipendenze (Atlas on Addictions) is a valuable joint work. It tackles old and new dependences, old and new psychotropic substances and approaches chemical and behavioral addictions that can significantly affect people's lives around the world. It provides a general overview of the prevention and treatment for substance use and behavior disorders, policy, legislation, traffic in drugs, facilities, knowledge and media research.
The Atlas offers the reader a structured panoramic view of a varied complex world. 92 experts in the field have dealt with and discussed with every plug of the mosaic. Different opinions, that are sometimes divergent, and many issues are of great value.
Clearly written, the Atlas is to advantage those who wish to find one's way through different points of view. The mosaic develops gradually during the reading, one page after the other, surprising those who think they are trained enough to know and to recognize the addictions, and those who wish to find their way through this complex field.
The Atlas suitably quotes the significant difference between use/abuse and addiction; highlights a number of similarities as well as some differences between drug and behavioral (non-substances related) addiction covering many fields such as gambling, drug abuse, computer gaming or chatting and internet browsing. Eating disorders or food-related addiction, affective disorders, compulsive physical exercise, sex addiction, compulsive shopping, pathological working are also treated.
A difference appears also with respect to the object of addiction: in substance-related addictions the object that one looks for is something unnecessary to one's life (drugs, alcohol, tobacco); as regards behavioral addiction, on the contrary, one behaves as in essential parts of everyday life such as food, work, love, sex, sport, social touch. Preventing approach aims to an aware, responsible, moderate use rather than to avoid occasion and contact.
But are behavioral addictions a real thing?
Behavioral science experts believe that all entities able to stimulate a person can be addictive, and whenever a habit changes into an obligation, it can be considered an addiction (S.S. Alavi et al., 2012).
Specialists co-authors of the Atlas agree with the existence of behavioral addictions, but dissenting opinions still feed a debate about whether Internet use can be classified as one of them.
Lack of common shared diagnostic criteria makes difficult to define and identify the Internet addiction, it's hard to pin down a quantifiable negative effect of Internet use; and then it must be borne in mind that Internet is not a self-sufficient benefit activity but it is a simple medium; furthermore Internet is a part of our daily life by now.
The Atlante delle dipendenze describes, explains, considers, proposes; it provides the readers with items to think over about debated matters (such as legalization liberalization), offers a panoramic view of available prevention and treatment resources for substance use and behavior disorders; policy and legal issues are discussed, role and insufficiency of the information are pointed out.
Besides all the above, pleasant reading, wide-ranging and careful treatment of the topics, a good many references make the Atlas a useful tool not only for the workers in the addiction field.
Istituto Superiore di Sanità, Rome, Italy