“I am not a fax? They overestimate their analytical skills. They reject science because it does not give certainty but certainty”

Giuliano Casu

The past two years as a psychiatrist and psychotherapist in public service have been the most difficult. And not because retirement is approaching: “There are – as Giuliano Caso, Director of Mental Health and Addiction at ASL Toscana Centro explains until last January – millions of deaths from Covid and measures limiting social contact with closely related psychological consequences for a large segment of the population. Sleep disturbances have increased Anxiety crises, panic attacks, eating disorders and obsessive-compulsive disorders in adolescents are increasing in large numbers. It is an emergency within an emergency.” In this case, there are those who refuse vaccination or even hospital treatment, attacking health personnel and facing death.

Professor Sergio Harari spoke in Corriere della Sera of “a feeling of frustration over an incomprehensible grief”. But what is behind these attitudes?


“Let’s immediately assume that they are in the minority, and most of those who arrive at the hospital are treated. These are extreme cases that put the doctor under observation and make us think about his role. How many cancer patients undergo severe treatments in order to have a life expectancy? Instead, these people die denying the evidence. It only happens if they are dominated by a belief that has developed over time and they cannot give it up psychologically.”

Why can’t they give it up?

“The whole fortress of certainty will collapse. They live in a cognitive constellation of dominant and therefore indisputable ideas. The leitmotif always seeks the support of others, and it is a widely used strategy: a person blindly believes in something more if he finds support in a general group and the fact that his certainty is refuted by clear evidence is secondary. Another cognitive mechanism that characterizes them, the Danny Krueger effect, is an overestimation of one’s ability to analyze situations that are instead very complex.”

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But can we talk about mental illness?

“I will be careful to generalize, we must not stigmatize in a psychopathic key. Of course: that many of them use psychological defense mechanisms such as denial, denial and projection in fact. But I’m not going to talk about psychiatric illnesses, rather the prevailing ideas that have been moved forward based on life experience and psychological structure. In relations with others they acquire only patterns and information that confirm their certainty, and selectively exclude everything else, the so-called save cherryThat is, I take the cherries that I like and leave the others.”

However, this situation is detrimental to those who – fortunately the majority – are trying with great efforts to confront the epidemic confident in science …

“The newcomer does not reject knowledge because it does not give certainty: knowledge gives certainty, but not certainty. There is a tendency to simplify very complex issues which is concerning. Then there is the aspect of fear, which is often underestimated in analyses, but as a psychiatrist I feel I can confirm: many situations are justifications for inner anxiety, of a phobic nature. There have been studies conducted in the past on followers of denial theories and in the end it turns out that most followers were afraid of blood and needles. Many do not want to use masks because they are actually anxious, afraid of enclosed spaces and prone to panic attacks.”

“The problem with the obligation is that you then have to find a way to enforce it. How do you do it? An exception in our legal system associated with compulsory health treatment is the exception related to mental disorders, Tso. In the formulation of Tso we are talking about intervention to bring the person back into the social context. The individual exists only when he can express About himself in a social context, he doesn’t exist as a unit. If you do a Tso just to try to cure the person and put him back into the social context, the vaccine somehow has the same meaning, because it allows the protection of the social context.”

The epidemic, as I indicated at the beginning, causes the growth of many mental illnesses, don’t you think there is little interest in this issue?

“Mental health services, which are weak at the moment, should be strengthened: even in cases where they are working well, they are centered around critical illnesses. When the World Health Organization predicts an increase in mental disorders such as anxiety and depression over the next 10-20 years, which will also overtake cardiovascular disease, we cannot help but think about the fact that our social context is not adequately equipped, especially in the area of ​​prevention. of so-called minor ailments which, however, can have an enormous weight on public health.”

January 14, 2022 | 08:03

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