In Italy today eight out of ten dioceses have specific services for the homeless: canteens, dormitories, clinics and street units. This is the unpublished data of the survey on poverty and exclusion that Caritas carried out on the occasion of the world day to combat poverty. The survey refers to September 2020 and involved 218 dioceses, of which 151 who answered the questions. It turned out that as many as 125 offer services for those who do not have a home (87% have the canteen, 74.4% have a dormitory, 72.8% have showers, 43.2% have clinics, 30.4% have street units), in a period in which poverty, due to the socio-economic effects of Covid, bites more than ever.
Caritas assists around 28,000 homeless people every year, but who exactly are the homeless? Why does a man come to have nothing and nobody left? Is it a choice or an implacable fate? We asked three psychiatrists, who tried to explain what leads a person to reject society and then immerse themselves in a dimension that lacks any sense of identity, in which roots no longer exist and in which the lack of hope even prevents respect. of one’s body, pushing to take refuge in alcoholism and addictions.
Luca Pani: “Mental problems are rampant among the homeless”
“We can say that almost all of the homeless have mental disorders”, explains Luca Pani, professor of Psychiatry at the University of Miami, former director of the Italian Medicines Agency, “and often these disorders are not even recognized by them”. In many cases in these people there is a strong “component of rejection by their families” and “if you are familiar with a disorder that leads to that type of social pathology, it is not that your mother, your father and your brothers are all very well psychically “.
The psychiatrist explains that often we start from families in which there is “a lot of expressed emotionality, a lot of violence, a lot of emotional, physical and often substance abuse”. These are “extremely complex pathologies that can lead to the rupture of the social fabric”. So what happens in the head of a person who, in spite of himself, lives on the street, without a house and covered in cartoons?
“The level of pain in the brain is much higher than normal, because basically human beings all have social brains, they are social brains.” The homeless man, having given up his normal life, like everyone else, usually “does not recognize the role of society in helping him and in the end, I admit, I’m not sure I can blame him”, says Pani with a long sigh . “This is a ruthless, terrible society, which does not forgive anyone or anything”. We, society as a whole, “it is true that we want to help them, but a moment after we help them we set the rules. And if you say to these people ‘I’ll help you if …’, they’ve already gone to ‘if’ and you can’t see them anymore ”.
Among the most common ailments of homeless people are “psychotic disorders, so these men and women have delusions, hallucinations, ideas of persecution. You often see them confabulating alone, responding to auditory hallucinations that do not allow them to focus on anything else, including taking care of their own person “. Mental illnesses of this kind if left untreated “lead to crises and they can last for many months”. At that point “their inconsistency with the world becomes difficult to assimilate by others, by those who do not feel that discomfort” and it is from there that the classic indifference on the part of society arises, which often prefers to pretend that these human beings do not exist.
Pani tells us that the parable of the homeless begins when a person “realizes that being alone, on the fringes of society, the reaction of those around you to your bizarre behavior is much lower than being in contact with others and that reduces that kind of added stress a little bit. ” At that point, substance abuse becomes the additional modality “which teaches you that you can alleviate the symptoms and therefore do this too: you use smoke, alcohol, drugs…”. In his opinion, Italy has a “good psychiatric, clinical and also social assistance system, but I must say that de-medicalization, that is the tendency not to intervene from a medical and pharmacological point of view, and anti-psychiatry are very widespread “. This “limits the ability to intervene on these cases in a more continuous and not just extemporaneous way”. He complains that even today in Italy there are limits on beds for psychiatric patients by population: “I don’t see why a large hospital shouldn’t have psychiatric wards that are suitable for this type of suffering and its real numbers”.
Elio Sena: “We live in a society that lacks education in the gaze”
HuffPost he met Elio Sena in Rome, a psychiatrist and neurologist who, over the course of his career, has undergone many interventions on people who live in stations or around the city. According to him, “there are social interventions for situations of marginalization in Italy, but basically we live in a society that lacks education in the gaze”. It is the “trivialization of the social gaze that must indignant, the same that pushes us not to be interested in these homeless people, but only to not want to see them dirty and aesthetically unpleasant in a park where they may take their children”. Going to investigate, the situations of homeless they are very varied, “the stories are each to itself”, he tells us with a particular delicacy in his voice.
“We psychiatrists can testify that in most cases there is a psychic discomfort at the basis of this choice, even if we should ask ourselves about the ultimate meaning of the word ‘choice’, because choices are never abstract, but are the expression of a psychic dimension “. You can live an ascetic or hyper-competitive life, ignore the impositions of society, or “in order to reach any type of compromise, after all that is also a choice, as is deciding to live under a bridge or at the shade of the trees “. There is a ‘normal’ vision of social functioning, which is the one that more or less all of us have, “and we think that people who do not fit into the line of intersection composed with the other components of the social context, are human beings who have made a a clear choice, which is not invested with dramatic emotional holes ”.
Sena is keen to point out that the situations from which barbonism arises can be the most varied: “Everything can start, for example, from a post-traumatic disorder that can affect one’s family, one’s work environment and other branches of the meetings of the our soul with the other, so there is a collapse of the defensive and trauma processing skills for which the subject can be emotionally overwhelmed and no longer have the strength to interact according to the laws of the social consortium and decides to withdraw “. More often, “we found conditions of psychic distress that had already been announced in the family and more or less subtly the family had exercised a progressive expulsion of the sick subject from its nucleus”. It happens that families are not able to understand, even in perfect good faith, the problem, often because the latter is relieved by “irregular behavior, by taking drugs, by alcoholism, identifying these subjects as black sheep, as people unreliable, with personality disorders or with impulse control pathologies “. The same people are also likely to have “problems with the law which resulted in a destructive desire for isolation”.
The romantic vision of going to live on the street “must be taken into consideration, imagining that the world is seen as the universal embrace that can wait for you, that can welcome you where I did not perceive the embrace addressed to me by well-defined subjects and then we return to the first experiences in the family ”. It is not uncommon for people to become homeless after “a family despair, even of an economic nature, and suddenly the external light becomes stronger and more attractive than what you can see in a house”. Among the cases he dealt with were those of “bipolar people who, after a madness of the manic phase, found themselves in total economic and relational chaos and once they fell into the depressive phase, they fell into the vortex that sucks you in”. Then there are “the paranoid, those who think they are always right and those who contradict them are cruel, as well as women who may be afraid of submission to the male code because they interpret everything as violence”. Another very typical figure among the homeless is the tied up, the lady with the bag, who has her whole world there.
Fabrizio Starace: “Living on the street is like living in the jungle, in the end you are afraid of everything”
“The question has to do with the sense of identity eradication” that people living in these conditions present and this can be “both consequences of serious conditions of mental illness that have a social drift which then led to a drift of homelessness, or it may be the effect of a condition determined by socioeconomic factors “. Psychiatrist Fabrizio Starace, director of the department of mental health and pathological addictions of the AUSL of Modena and also a professor of social psychology, points out that “there are people who, even if only through a divorce or separation, have found themselves without materially money to look after a house ”and from there“ this uprooting syndrome inevitably sets in ”. There are elements that are fundamental for the balance of a human being. The first is “the place where we put our roots”. Not necessarily the place where we were born, but the place we enter feeling a “sense of security, the one in which we have our most significant relationships”. Here, all this fails in the homeless and thus generates that mechanism of instability that characterizes them and in which always “great suffering”. To these elements of balance “each of us resorts to moments of great pressure, of great emotional distress, on the occasion of difficulties”. What physical and relational context can a homeless person use? “Inevitably it makes use of mechanisms, methods and lifestyles that are taken on to cushion the emotional outbursts that these anxieties can cause”. It is no coincidence that among homeless people there is a very high percentage of alcoholics and those who use substances. “I have often volunteered at the station and there I realized that life is comparable to the life that can be done in the jungle”. Even just falling asleep deeply “means being able to wake up without finding your little luggage or shoes on your feet, so a suspicious thought arises in them”.
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