Psychoanalysis and Severe Handicap: The Hand in the Cap

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The book The Hand in the Cap introduces an original look on handicap, a look aiming at capturing the subjectivity, no matter how weak or uncertain it may be, of the ill Other. In this light the work of operators can become an invaluable support to the creation of the self, a crucial help to self-narration, and a valid contribution to making one's way through the entangled intricacies of language.The text falls into six chapters, which elegantly and accurately lead us into the core of the problem tackled. Focusing on the difficulties implied by the recognition of the ill Other and the acceptance of the otherness, Villa attacks those cultural policies which set autonomy and integration as absolute objectives to be achieved in the work on handicap. Instead, the author highlights the need of a path aiming at the structuring of the individuality of the disabled and at the molding of their subjectivity, starting from the subject's peculiarities. This is the only way for the disabled to find his place in the world to fit in.But how could we do it? The author envisages the possibility of replacing the repetition of trite models with creative solutions and of developing new strategies for intervention on handicap, which may finally focus on transcription, that is to say the original rewording of experience, and on laughter, seen as the faithful companion of unexpected events.This is a book that combines years of clinical practice with a solid theoretical reflection on the world of handicap. It will be a valuable support to the work of social operators but, also and above all, a reflection for everyone on the suffering of the human life.

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Chapter One

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CHAPTER ONE

Good morning, Doctor Villa, meeting you is such a pleasure.” Katia, a woman in her late thirties suffering from Down's syndrome, walks up to me as I step into the SEC(a socio-educational centre, i.e., a recreation centre for the disabled and handicapped) in order to collect a book which has been left there for me as a present. Katia knows my name, I think, on account of my interviews with the staff in her department, who have probably told her about my visit. I can see her make her way towards me, holding out her hand to shake mine, a broad smile lighting up her face. She is happy: she glows with enthusiasm. She seems to be fully absorbed by the action she is going to perform. She walks steadily towards her goal. I shake her hand and greet her warmly. Then suddenly, like a shadow of that action, the gesture evaporates. I would like to go on and exchange a few words, but Katia's emotion has gone, not because it has lost its force, rather because simply—no matter how painful that adverb may sound—the interview has come to a close, imploding on itself, like fireworks falling back to the spot on earth from which they were fired. Her emotion is like lightning, which is followed by darkness. It is like a sudden light, so quick that it disappears instantaneously, leaving no trace in memory. It is an explosion, leaving no time to raise your head to the sky. I stand there, petrified. I can see no marks of inhibition on Katia's face. Her smile has gone, her action has consumed her intention. Her intention has resolved itself into her action. I can do nothing but take my leave of Katia, who affectionately says goodbye, ignoring my embarrassment, which forces me to stand still for a few seconds as I watch her walk away. Perhaps, I wonder, the question of severe handicap starts here, round this dead end, round this lack of communication, digging a chasm between the so-called normal consciousness and the disabled, a gap which no psychology can ever bridge with either good feelings or good will.

 

Chapter Two

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CHAPTER TWO

Monica is not Katia. Her syndrome is different. It was caused by some mental damage which was noticed right after she was born. Her parents got into a crisis and the discovery of their daughter's handicap brought them to the brink of separation. What was it that kept them together? And most of all, how? When I talked to Monica's brothers, all of them grown-ups with children of their own, I managed to reconstruct the development of an intense and mostly unvoiced tension, of a grudge that both parents had borne all their lives. Monica was the last of three children, the first two being “normal”. Probably she just happened to be like that, as people usually say under these circumstances—to not acknowledge the subtle implications that bind desire to sexuality in the acting outs that evade the control of consciousness. Her mother and father had been elderly. They would have accepted her no matter how she was: they were both very religious and she was seen as a gift from God. Or, maybe, from some kind of chance they would never dare to question. She had two older brothers. She was going to be cuddled by the whole family, to be their baby, their doll. Who would not compete to take care of her, to be with her, to pamper her? But her handicap ruined it all, it destroyed all illusions. Like a stone violently thrown against a lavishly decorated Christmas shop window.

 

Chapter Three

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CHAPTER THREE

An institution is an institution: the term must always be thought of in the singular. Every institution is specific, and different from any other. This is also true of its history, the people who work within it, its task, its atmosphere, and so on. At least in this case it is obvious that, as Minkowski pointed out, a hundred mad people do not form a society, so a hundred disabled people will not form an institution. An institution in the broadest meaning of the word will be formed by the “normal”. “Normal” people organise it, structure it, decide how it is going to work.

Socio-sanitary institutions can be defined according to two essential paradigms. The first concerns space. This kind of institution usually ends up being equated to the place it occupies, as if its function were embodied by the space it is expressed in. Its activity is mostly of a sedentary, custodian-like nature. The care of the patients attending it does not really consist in proper therapy. The second paradigm is that of time. This kind of institution legitimates its existence in terms of time-based practices, both on a psychological and on a strictly therapeutic level. Time provides meaning to the institution itself: this is a place the subject enters in order to get out of it—sooner or later. The subject does not stay there, as happens with the first type.

 

Chapter Four

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CHAPTER FOUR

The attention we have paid to the topic of intelligence now enables us to introduce another, strongly connected, topic. In fact, if we consider intelligence in its relationship with the manifestations that disability sometimes sensationally underscores, it consequently becomes practically impossible to seperate it out from the more complex issue of the handicapped person's subjectivity. The seriousness of the intellectual impairment ends up heavily conditioning it, for it indelibly marks both its content and its forms of expression. The “normal” person's impulse to hurriedly close the circle is strong, and sometimes cannot be restrained, as if it were a matter of simply registering an equation. The minus in their intelligence refers to, or, more banally, redoubles in, a minus in subjectivity. The former refers to the latter, and vice versa.

However, if the connection between intelligence and subjectivity appears, especially on certain levels, to be undeniable, it is, in my view, quite risky to confuse intelligence with subjectivity. The seriousness of handicap certainly forces us to preserve differences and to cultivate distinctions in order to contrast the homologating devastation that the sick Other forces onto the handicapped person. Far from looking like the signs of a speculation that is actually an end in itself, they look more like traces of the fact that it is possible to maintain concern for the very issue of the disabled person; the return of an attention that forces “normal” people to constantly think of others as being related to their own alterity.

 

Chapter Five

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CHAPTER FIVE

T he attention we have tried to pay to the differences within the pathology of disability now brings us to reflect on the clinical cases that appear more enigmatic and, in certain aspects, more difficult to manage. In particular, we are referring to the cases where unease and subjective inadequacy end up manifesting themselves as autism or psychosis. For the sake of precision, we must add that in the latter case we are talking about a particularly severe psychosis that has been developing since the subject's childhood and which has decisively invalidated their relational attitude, their ability to act autonomously or to perform relatively basic tasks without any external help. Both autism and psychosis, when their pathological level is so severe, highlight the core of the subject's trouble. In most cases, the adhesiveness of certain manners related to other handicaps is replaced by a totally opposed behaviour. The subject can neither “see” themselves as they are reflected in the mirror, nor get lost in other people's images. They often seem lost, distant, sucked away by an otherness they themselves are unable to reach. They are insensitive to the grip of everyday life, even in its most trivial implications. Françoise Dolto describes them as a Martian in their own household. Oliver Sacks, a clever and curious neurologist, expresses more or less the same opinion.

 

Chapter Six

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CHAPTER SIX

The “normal” person's attention and interlocution are the conditions for the acknowledgment of the moments when the disabled person's creative act occurs. They are crucial both in perceiving and recognising the specific value of such acts, and in preventing those acts, which on certain occasions, manifest themselves as the subject's invention, from being reduced to mere stereotype, to expected, mechanical behaviour which makes the disabled person appear an eccentric, a caricature of herself. So, what can be acknowledged as a creative act in situations which involve severe handicap?

From a temporal point of view, we could, in some way, define it as an unforeseen, unusual act, living on the contingency it supports: a happy, extemporaneous intuition.

From the point of view of its origin, it can be an act stemming from an implicit thought that has not been saturated by the sick Other or by the requests of others or by parasitical dependency on other people's imagination. The creative act is the true proof of a subjectivity that resists the devastation of handicap and of everything that is associated with it. It determines difference; it creates, albeit just for an instant, the flash of a difference which is almost imperceptible but, at the same time, irreducible to what alienates the subject in a mortiferous, passivising way.

 

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