In questa parte affronto il tema dell’autolesionismo compulsivo. Per autolesionismo compulsivo intendo il bisogno irresistibile di farsi del male utilizzando il proprio corpo come “COSA” da incidere con la lama del coltello, bruciare con la cicca della sigaretta, affamare con diete crudeli, torturare con cilici ,mortificare in ogni maniera. Questo comportamento è messo in atto prevalentemente da adolescenti e tardo-adolescenti ,sia maschi che femmine. Ero a NewYork, agli inizi della professione, seguivo un seminario di terapia di gruppo come osservatore straniero. Il gruppo era composto da 10 pazienti con tratti di personalità ossessivo-compulsivi e un analista. In ogni seduta, che si svolgeva due volte alla settimana per la durata di due ore , era previsto che un paziente parlasse di sé per la prima mezzora, poi gli altri intervenivano o con osservazioni su quanto avevano ascoltato o con riferimenti alla loro storia personale. L’analista interveniva per ridimensionare eventuali interventi ” giudicanti “, che non potevano evidentemente essere di aiuto a nessuno. In quell’occasione mi sbigottirono le parole che un ragazzo di vent’anni usò per descrivere come usava il coltello per ferirsi :” l’ ho portato dall’arrotino per farlo affilare……ha una bellissima lama, lunga e luccicante……mi chiudo in bagno, mi porto il rotolo dello scottex e poi incomincio….dalle cosce ….avvicino la punta del coltello e…poi con una spinta decisa lo affondo e traccio una bella riga….rossa di sangue……” E continuava a descrivere l’azione del coltello sulle cosce e poi sulle braccia e il tono di voce era sempre più esaltato, si sentiva invincibile, diceva di avere il controllo totale sul suo corpo. Terminato l’incontro, dopo che tutti i pazienti furono usciti, l’analista mi diede qualche ragguaglio per poter comprendere il comportamento autolesionista del ragazzo. Il ragazzo era figlio unico di una famiglia molto benestante, della cosiddetta upper class americana. I genitori prima di arrivare al divorzio si erano fatti una lunga e feroce guerra, coinvolgendo il figlio nei loro litigi e poi abbandonandolo per lunghi periodi, affidato a cameriere e a tate varie. Secondo l’analista il ragazzo si sentiva colpevole per il divorzio dei genitori, perciò farsi del male diventava un’autopunizione. Inoltre il controllo sul proprio corpo, la raggiunta insensibilità al dolore fisico lo proteggeva , perché lo faceva sentire superiore a tutto e a tutti e niente lo poteva ferire. Solo lui poteva essere l’artefice delle sue sofferenze. Era un delirio di onnipotenza. Per molti anni non ebbi più a che fare con pazienti autolesionisti, anche perchè l’esaltazione debordante del ragazzo mi aveva sbalordito e non ero propensa a ripetere una simile esperienza. A mia discolpa va detto che ero molto giovane e proprio agli inizi della professione. Qualche anno fa invece , forse ero diventata più coraggiosa, accettai come paziente una ragazza di venticinque anni “autolesionista compulsiva dichiarata”: furono proprio queste le parole che pronunciò per presentarsi, sedendosi compunta davanti alla mia scrivania. Alta, esile, con un caschetto di capelli neri , che cadevano a frangia sulla fronte quasi a coprire gli occhi, occhi scuri, profondi di una tristezza infinita. Il tono di voce freddo, metallico, non era gradevole. Sembrava che le emozioni si fossero rifugiate tutte negli occhi. “Lei è l’ultima occasione che mi do. Non credo che mi potrà aiutare, ma faccio il tentativo per una forma di onestà con me stessa. Il mio problema è il seguente: sono costretta a mettere in atto un comportamento, dopo le specificherò di cosa si tratta, che prima mi dava soddisfazione, adesso non più, ma non riesco a smettere. Le anticipo che sono laureata in psicologia e quindi razionalmente so di cosa si tratta. Glielo dico, così tanto per essere chiara. ” La guardo e la ascolto. Lei continua : ” Mi fascio il seno, lo comprimo sino ad appiattirlo e farlo scomparire. Ho cominciato all’età di tredici anni, quando ho sviluppato. IL seno si vedeva troppo, a me sembrava enorme, i ragazzi della mia classe mi puntavano gli occhi addosso, così ho trovato il modo di liberarmene. D’altra parte io volevo essere un maschio, anche mio padre avrebbe preferito che lo fossi. Insomma è diventata un’abitudine e un bisogno. Toglievo la fasciatura soltanto quando facevo la doccia. Sono andata avanti per anni, ma adesso mi sento più sicura di me e non ho più bisogno di fasciature per negare la mia femminilità. Sotto queste sembianze femminili io so di essere maschio, mi riconosco come maschio e voglio essere maschio.” Il tono della voce si è alzato un po’ e ha assunto una colorazione meno metallica. ” Non voglio più impormi la sofferenza della fasciatura. Lei non sa quanto sia tremenda. Però, c’è un però : non riesco. Ho perso il controllo del mio corpo. Assurdo, assurdo, voglio smettere ma il mio corpo non risponde più alla mia volontà.” La voce si è incattivita, gli occhi sono cupi e pieni di odio. Non può tollerare di aver perso il controllo sul suo corpo. E’ evidente. che il sintomo( cioè il bisogno di comprimere il seno fino a farlo scomparire) la proteggeva dal prendere coscienza del suo vero problema, l’accettazione di sé come femmina. Abbiamo lavorato molto e alla fine è riuscita a riappropriarsi di sé in modo autentico. Lo scopo di tutte le psicoterapie infatti è proprio aiutare il paziente a diventare veramente consapevole di sé, dei suoi limiti e dei suoi punti di forza e accettarli. E’ incredibile quanta fatica facciano le persone a riconoscere di essere intelligenti, sensibili, gradevoli e degni di essere amati. Sembra provino piacere nel mettere in risalto quelli che essi considerano il loro difetti. E dopo questa incoraggiante conclusione mi accingo ad affrontare una delle più diffuse dipendenze, la DIPENDENZA AFFETTIVA , che però tratterò nell’ultima parte di questo lavoro
La corda al collo della dipendenza 5°parte
LA DIPENDENZA AFFETTIVA La dipendenza affettiva non riguarda soltanto il rapporto di coppia, riguarda la relazione amicale e anche la relazione genitori/ figli-e. Invece di descrizioni teoriche ti racconto le esperienze di alcuni miei pazienti, sperando che ti possano essere utili, qualunque sia l’uso che vorrai farne. Il primo esempio è il rapporto di amicizia fra Marcella e Viviana, due ragazze di ventisei anni, amiche d’infanzia. Me ne parlò Viviana, che era in analisi da un anno per problemi di somatizzazioni. La loro amicizia era stata troncata da Marcella , che ,senza dirle nulla, aveva fatto domanda per seguire un master a Palo Alto in California e, quando era stata accettata, glielo aveva comunicato il giorno prima della partenza senza darle spiegazioni. Viviana l’aveva pregata invano. Ecco le sue parole: “Mi sembrava di parlare a un muro……..ho girato le spalle e me ne sono andata. Ero talmente sconvolta che non riuscivo neppure a piangere. C’è voluto un bel po’ di tempo prima che riuscissi non solo a farmene una ragione, ma soprattutto a capire perchè ero stata trattata così. Fin da quando eravamo bambine facevamo solo quello che decideva lei. Marcella decideva come ci dovevamo vestire, quali amici dovevamo frequentare e quali scartare, i film da vedere, le feste a cui andare, insomma tutto, decideva tutto lei e dava per scontato che io obbedissi. E quel che è peggio, me ne rendo conto soltanto ora, io obbedivo , grata che mi elargisse la sua amicizia. Ero la sua ombra. Fino al giorno infausto in cui comparve Gianluca. Non so perchè Gianluca cominciò ad interessarsi a me. Marcella ed io eravamo piuttosto carine , abbastanza alte, magre, tutte e due con occhi e capelli lunghi scuri. Eravamo caratterialmente diverse, lei estroversa, spiritosa ,sempre al centro dell’attenzione, io piuttosto timida e insicura. Gianluca stava seguendo un master di economia alla Sapienza, l’avevamo conosciuto alla presentazione di un libro all’Auditorio. Era alto, biondo, fisico da rugbista, piuttosto snob. Quando Marcella si rese conto che Gianluca si interessava a me, mi disse subito che lo faceva perchè mio padre, che è un docente universitario, avrebbe potuto essergli utile e mi impose di scoraggiarlo e lasciarlo perdere. Io ,come mio solito, le obbedii. Mi ricordo ancora lo sguardo misto di sconcerto e di pena che Gianluca mi rivolse quando gli dissi di non chiamarmi più e me ne andai con Marcella, che lo guardava con un sorriso ironico. Io per nulla al mondo avrei rinunciato all’amicizia di Marcella. lei era tutto quello che avrei voluto essere io, aveva soprattutto la forza, la sfacciataggine, la volontà di farsi strada, di sfondare e soprattutto di allontanarsi dalla povertà della sua famiglia, di cui si vergognava. Io invece ai suoi occhi, l’ho capito tardi, ero una privilegiata. Qualche tempo dopo Marcella si mise con Gianluca, ma mi disse che niente sarebbe cambiato fra noi. E così fu. Loro si vedevano soprattutto alla sera, dormivano insieme, ma durante il giorno Marcella stava con me e questo a me bastava. Benché avessimo la stessa età , io mi sentivo protetta da lei, con lei mi sentivo sicura. Mi sono chiesta spesso perchè. Forse perchè ero figlia unica e avevo perso mia mamma da piccola, mentre lei era la primogenita di ben quattro figli, due femmine e due maschi. Da lei si sprigionava una forza incredibile. Mi sembrava giusto che Gianluca dopo il mio rifiuto avesse cercato lei. Rimasi assolutamente basita quel mattino al bar dell’università quando mi rivolse la parola ” Com’è che non stai con la tua padrona?” “Io non ho nessuna padrona” riuscii a balbettare. ” Si che ce l’hai. E’ lei che ti ha ordinato di allontanarti da me. E tu come una scema hai eseguito gli ordini. Beh, di alla tua padrona ……..lascia perdere……stammi bene…. curati piuttosto, che ne hai bisogno”. E se ne andò. Io uscii dal bar frastornata. Quando incontrai Marcella però non le parlai dell’incontro con Gianluca. Fu la prima volta che le dissi una bugia , o meglio che omisi di dirle quello che mi era successo. Poi qualche tempo dopo mi piombò fra capo e collo la notizia della sua partenza. Ripensando adesso a tutti gli avvenimenti penso che probabilmente Gianluca in qualche modo sia responsabile della decisione di Marcella di andarsene in America lontano dalle fonti di umiliazione per lei che eravamo diventati io e Gianluca , io inconsapevolmente, lui ben consapevole. ” Viviana ha elaborato il suo rapporto di dipendenza con Marcella ed è riuscita a liberarsene. Onestamente però riconosce che se Marcella non l’avesse bruscamente e definitivamente abbandonata, probabilmente sarebbe ancora dipendente da lei, perchè non era consapevole di quanto quel rapporto fosse malato. Purtroppo è proprio così: i protagonisti incastrati in un rapporto malato non si rendono conto della gravità del disturbo e quindi difficilmente chiedono un aiuto psicologico. Spesso iniziano un trattamento psicoterapeutico per altri malesseri e poi, man mano che proseguono nel loro cammino diventano consapevoli anche degli aspetti anomali della loro relazione affettiva. Questo secondo esempio riguarda un padre di 50anni e una figlia di venti. Il padre è professore di storia in un liceo della capitale e la figlia è all’ultimo anno della triennale in scienza della comunicazione. Sono quindi due persone che dovrebbero essere in grado di riflettere e rendersi conto di ciò che non va nel loro rapporto. Invece no. Sono ciechi e sordi. Quando sono in campo i sentimenti e le emozioni , cultura, studio, logica , dialettica non aiutano, anzi possono essere usati per negare la realtà del rapporto malato. Infatti di fronte ai sentimenti, alla passione, all’amore un professore universitario è cieco come un pastore isolato con le sue pecore in alpeggio. Questo cinquantenne, di bell’aspetto, apparentemente cordiale, mi era stato mandato da un collega di Milano, che lo aveva seguito per sei mesi prima del suo trasferimento a Roma. “OVVIAMENTE (!!!) mia figlia si è trasferita con me…..lei capisce ….io sto attraversando un periodo molto difficile…….separarmi da mia moglie dopo ventanni di matrimonio……ho dovuto farlo….ma è pesante, pesante….lei non sa quanto……per fortuna Luciana mi sta molto vicino…….se non avessi lei……non so cosa farei……..è l’unico mio sostegno.” In ogni seduta finiva sempre di parlare della figlia, di quanto gli fosse vicina, trascurava persino il suo ragazzo per stare vicino al suo papà. E lo diceva son soddisfazione e orgoglio. In quei momenti la tragedia del suo prossimo divorzio, come diceva lui, era lontanissima dalla sua mente, tutta occupata dalla figlia adorata che gli stava sempre vicina. Quando tentavo di parlargli dei normali bisogni e desideri di una ragazza di vent’anni , mi liquidava in fretta : “Ha tempo, ha tempo, è così giovane e bella, ha tutta la vita davanti. I figli hanno dei doveri verso i genitori……ma poi lei non lo sente come dovere, lei è contenta di stare con me. Usciamo insieme e.. lo sa.. cuciniamo anche insieme e ci divertiamo…..” Come vedi non c’era alcuna consapevolezza di quanto fosse malata la relazione con la figlia e di quanto lui le stesse succhiando via la vita. Forse ti stai domandando se la figlia si rendesse conto del comportamento morboso del padre e lo assecondasse per aiutarlo a superare un brutto momento di depressione, convinta che presto ciascuno di loro due avrebbe ripreso la propria vita. Ero propensa a credere che in realtà la figlia colludesse inconsapevolmente con la nevrosi paterna e ne ebbi conferma da una telefonata con il collega di Milano, che aveva avuto dei colloqui sia con la figlia che con il padre. Egli mi parlò ironicamente di sindrome da crocerossina. poi più seriamente mi disse :”Luciana avrebbe bisogno di una buona analisi, perchè ha seri problemi di autostima . Deve compiacere tutti, è sempre pronta a curare con grande abnegazione chiunque stia male e soprattutto le scelte sentimentali e amicali cadono sempre su persone inferiori a lei. Solo con loro lei si sente sicura.” Un padre debole, come il mio paziente cinquantenne si stava rivelando, era l’ennesima occasione per fare sentire Luciana forte e indispensabile. Luciana stava pagando un prezzo molto alto per la sua nevrosi purtroppo. La speranza era che qualcosa o qualcuno la provocasse tanto da farle aprire gli occhi e uscire dalla dipendenza di quella relazione malata. L’ultimo esempio che ti porto è la coppia di Francesca e Sandro. Sono sui trent’anni, lui qualcuno di più; lei medico pediatra, lui ingegnere informatico; sono belli, di una bellezza tipicamente italiana con occhi e capelli scuri, alti ma non altissimi, magri, fisico sportivo ma non. palestrato. Stanno insieme da due anni , ma ognuno a casa propria. Un progetto di convivenza è all’orizzonte, ma l’entusiasmo di Sandro non è pienamente condiviso da Francesca, che, reduce dal fallimento di una precedente relazione, ha paura di sbagliare. Chi telefona per chiedere l’appuntamento è Francesca, che tiene però a precisare che l’idea di consultarmi è di Sandro! Da questo particolare ti rendi conto che Francesca è un po’ restia ad assumersi responsabilità. Vedrai in seguito come questa riluttanza incide sull’equilibrio della coppia. Si presentano puntuali all’appuntamento. Lui appare più disinvolto, lei più riservata. Lui espone con chiarezza il motivo per il quale hanno richiesto il colloquio: la riluttanza di Francesca al progetto di convivenza, che include anche il progetto di avere figli. Sandro parla, parla, in sostanza per dire che non capisce Francesca, le sue paure, le sue indecisioni. Francesca ascolta, il suo sguardo va da Sandro a me, da me a Sandro, ma non interrompe neppure per un attimo il profluvio di parole del suo compagno.
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