"...I went towards the orchard where I picked one or two apples from the tree, and I devoured them immediately. I didn't feel guilty for picking these apples... Indeed, I had a clear impression that I was living in a deserted, inanimate, unreal and desolate place... Then Mummy brought me kilos and kilos of wonderful apples but I could not touch them because they were not my apples, still attached to the mother-tree... But Mummy did not understand and exclaimed amazed: " But aren't all these apples real too? Why don't you eat them?" These words irritated me and pushed me still further away from her. Only when she took the little monkey in her arms and spoke to her - something which I think she did too seldom - did I manage to feel in contact with her."
In the famous episode of the apples picked still sour from the tree (to the understandable annoyance of the farmer, the owner of the orchard) from "Diary of a Schizophrenic" (Marguérite A. Séchéhaye, Journal d'une schizofrène, P.U.F., Paris; Italian edition: Giunti Barbera, Florence 1955, Chapt. XI, pg. 63), Renée illustrates clearly and simply her mental illness problem: she had been plucked too soon, "still sour", from the "mother-tree", that is from the love relationship with her mother, and literally "devoured" by the pain, which had caused her to practice anaesthesia of feeling - the cause of her illness.
This was why "other" apples, however wonderful they were, had no meaning for her: they lacked the chief requisite, that of being sour, but most of all still attached to the mother tree. This aspect is very thought-provoking, especially if we think of certain "survival structures" where often gratuitous cruelty predominates. For Renée it was enough to take it out on the daughter apples, "which she devoured immediately" (and not because she was hungry, but because she made them suffer her own fate of being torn away from a primary relationship and immediately "devoured" by pain and the subsequent illness); others turn straight to the person closest, at various levels.
This is all the more frightening if we consider how little work is required to give parents and teachers the little psycho-analytic knowledge necessary for them to take effective preventive action. Renée's mother had been admitted into the Geneva psychiatric hospital when her daughter, the oldest of various younger brothers and sisters, was still little. After various vicissitudes, and periods spent first in TB sanatoria and then in psychiatric hospitals, at the age of 18 Renée met the psychoanalyst Marguérite Séchéhaye who took her into her home and basically stood in for her real mother.
Over a period of ten years of treatment, with repeated suicide attempts and subsequent periods in clinics, Renée reached an equilibrium which was precarious, if it is true that she committed suicide when her psychoanalyst died. Séchéhaye's pioneering, courageous work, although brilliant in itself, did not solve the problem: Why? For the simple but decisive reason that although she got the daughter she had adopted to call her Mummy, she was not in fact her real mother.
In other cases that we have followed over a period of thirty years, which are just as serious, if not more so, than the one described, the result is always successful when the treatment is carried out with the parent of the same sex (the homologous parent: mother for girls, father for boys).
But the most significant aspect of our method, lies in the role of the psychoanalyst, who is seen mainly as a support, and never as an alternative to the parent. The role played by Séchéhaye was very different, although very generous and full of sacrifice (and risk: as we have seen Renée repeatedly attempted suicide) as well as frustration; in enacting René's need to be loved, and also the attitude of the times according to which children's psychic disturbances were the result of inadequate parental love, Séchéhaye did in fact stand in for the real mother, believing that she was able to really love this daughter who was not hers.
The process, duration and result of the treatment would have been very different if the psychoanalyst had been able to involve Renée's mother, even in the state she was in - psychotic and in a psychiatric hospital. In fact, Renée had experienced the primary love relationship, the first great love of her life (in other words, the one we never forget) with her own mother, not with the Psychoanalyst Mother (the capital letters in the Italian translation - in German all nouns have it - seems to emphasize the distance between the psychoanalyst and Renée).
However ill, hopeless or, even worse, dead, homologous parent may be, they are the tree on which the miraculous fruit of a daughter or a son has grown, and which can never be replaced. This is fairly obvious, if we consider the need to construct and maintain a solid personal identity, to have a model love relationship (and thus stable throughout the vicissitudes of a whole life) which will always underpin the constancy of one's own image, which we need in order to remain ourselves throughout the whole process of adapting to change that life imposes.
The seriousness of the illness, and the effort required to recover, are determined therefore by the difficulty of regaining access to primary love with the patient's same-sex parent, a relationship previously engrained in the person as a primary experience, and only subsequently the object of anaesthesia.
When the patient is young and the same-sex parent is physically present, the seriousness of the disturbance is minimal, and the duration of the cure is shorter. Seriousness and duration increase with age and with the extent of obstacles to the physical availability of the parent. In the past the theory was that the seriousness of psychic illness was proportionately related to behaviours considered most disturbing (known as psychotic) or less disturbing (or neurotic). Scientific research reveals how the illness is the same for everyone, and therefore for everyone we speak of psychosis, but making a distinction between endogenous, in other words intrinsic to the patient, and exogenous, in other words the result of psychotic induction in the disturbed patient from another person suffering from endogenous psychosis.
External manifestations, used to diagnose the extent of the disturbance, reveal the survival structure enacted by the person to enable them to keep living without having recourse to their emotional sensitivity.
Thus the seriousness of the disturbance is determined not so much by the survival structure enacted, as by the extent and quality of obstacles to regaining access to the experience of the primary relationship.
Rather than through comparison with types of disturbance which vary in seriousness, according to a hierarchy of behaviours, the seriousness of the case is determined by the complexity of action that recovery requires, with a personalized approach for each case of disturbance, considered as it were horizontally, on the same level as the others.
There are not more serious or less serious cases, and in fact the problem is the same for everyone: recovery of access to love with the same-sex parent. The differences are determined by existing difficulties in the external situation such as opportunities offered to the operator to take on the case, the co-existence of other cases of psychosis, the level of social and psychological deterioration of the group, or the acceptance of pathological manifestations as normal by those around.
It is no coincidence that mental illness has often been spoken of as cultural illness, or even as produced by social injustice. Nothing is further from reality, but it is true that mental illness is contagious.
Through psychotic induction, patients sometimes acquire credibility with the people around them to create a real line of defence, kept alive by those involved in their pathology. If we consider that psychosis strikes the emotional ability to relate, it is easier to understand how the disturbance, transmitted by induction from the ill person to the healthy people around, transforms them, unbeknownst to them, into allies of the illness, with group dynamics which are sometimes difficult to deal with. I am not really referring only to those phenomena such as gangs, or lobbies, which tend to claim that pathological behaviours such as war are normal; but to the daily routine of work, study or leisure situations, where manifestations of illness are welcomed and protected as character traits which are sometimes even entertaining.
We need only think of the survival structures of the alcoholic, and of erotic survival structures. The result is that the specialist training of the psychological analyst requires specific training in scientific research and in collaboration with others. Which seems obvious, if it were not for the fact that knowledge of the illness and its manifestations is only the first step.
The subsequent one consists in acquiring the capacity to adapt to changing work conditions, and to use tools of scientific research to tackle problems around the patients, related to their pathology, and which, if solved, provide the conditions for recovery.