A journey into the world of psychiatry, between pain, fun and deep humanity

There are those books that you would like to never finish, those that you would like to read all in one breath and then there are books that have both these characteristics. "The art of binding people" by Paolo Milone is one of these and contrary to what the text seems to suggest, it is not a book on sadomasochism.

Paolo Milone is in fact a psychiatrist who worked for almost forty years in Genoa and in this book, which for me is a masterpiece, he describes all the poetry, suffering, wonder and brutality of his work. It does so in short or very short paragraphs narrating moments or anecdotes of ordinary and at the same time extraordinary working life.

As an insider, what Milone does in this book is extremely complex and rare: the narration of this world takes place without making judgments but allowing the reader to get his own idea by guiding him in the understanding of psychiatry in all its humanity, its brutality and its poetry.

My work, very similar to that of the author of the book, leads to profound reflections on our society, on the work of the doctor, on the ethics of this profession and often leads alas to bitter observations. Told by a psychiatrist with a lot of experience I found myself reading sensations, emotions and frustrations similar to mine in a job where the rewards and satisfactions are there but require time and effort. Devouring the first pages of the book and slowing down in the last, I perceived the difficulty in doing this work, the structural deficiencies, the lack of desire and the poor ethics of some insiders circulating in this world. As a contrast, the great passion and great enthusiasm of the protagonist for his work emerges; emerge, under an aura of fatigue and pain almost unbearable, even the fun and human enrichment inherent in this discipline. In short, there is all the ambivalence of this work, there are all the contradictions.

The book poses in a never trivial way one of the unresolved themes of psychiatry which is that of restraint. More generally, controversial and delicate, the central topic of the book appears the control that can be exercised over the psychiatric patient and that can be abused by those who exercise it.

The author apparently justifies the idea of physical containment as a last resort in "necessary" cases when the fragmentation of the self and the ego is absolute and involves a risk to one's own and others' safety. In fact, with this book Milone almost seems to apologize for the mistakes made, for the professional defeats that inevitably are part of the work of the doctor and the psychiatrist in particular. At times he almost seems to want to be redeemed for the darkest aspects of this work as for lucrezia's suicide, for the pain of the loss of all the human lives that he could not save.

The doctor, the psychiatrist not seen as an invincible hero, as the one who has control of others, but seen in all his fragility and his humanity. It is clear, paragraph after paragraph, how extreme it is to fight the fragmented and meaningless pain of psychiatry, to face death and madness without getting lost, without fraying, without fragmenting but remaining hooked to reality.

Love, the sea, the wonders of Genoa, the feminine beauty, the tree outside the interview room; these are the things that can save, that can make one remain anchored to reality, that can prevent one from falling apart, losing enthusiasm and drive.We must also find beauty in patients, see beyond "madness", see "the person" beyond the disease, we must preserve the ability to be amazed, not to stop at appearances. If you do not do this you have already lost and this Milone does it very well in his book and it is evident how he has done it throughout his career continuing to be amazed and have fun being a psychiatrist. Without ever judging because

"Fools are our brothers. The difference between us and them is a successful roll of the dice."