Journal of Psychological Abnormalities

In Italy, as in other industrialized countries, the younger generation are struggling with many factors that are making their social and emotional status increasingly difficult to maintain. The difficulty of finding a job – and thus an income that makes them self-sufficient – leads young people to feel frustrated, even humiliated. The housing shortage makes it difficult for them to plan for their future and leave home, impeding their pursuit of autonomy and freedom of experience. In addition, the collapse of many certainties and moral values is bringing about a crisis of moral values and ideals. Indeed, the crisis of moral values is a crucial factor in the general sense of loss and loneliness among young people today. With public institutions already perceived as distant from the real lives of citizens and unable to solve urgent social problems, young people appear ever more isolated. In the ten years from 2001 to 2010, Italy had the lowest economic growth of all EU countries, with an average annual increase in Gross Domestic Product (GDP) of only 0.2%, compared to 1.1% in the Eurozone as a whole.

The trend in household consumption has been affected by the decline in purchasing power, which fell by 3.1% in 2009, and then again by 0.6% in 2010. There has also been a progressive reduction in the rate of savings, which is now the lowest of the major Eurozone economies. Young people (18-29 years) have been the most severely affected by the economic recession, with a loss of 482,000 jobs in the period 2009-2010. The employment rate dropped from 49.7 to 47.7% between 2004 and 2008, and has since declined further. In 2010 there were 2.1 million people aged between 15 and 29 defined as Not in Education Employment or Training (NEET) [1].

This figure is much higher than the previous year’s total of 134,000, and amounts to 22.1% of the population in this age group, a proportion much higher than in other European countries. One third of those classified as NEET are unemployed, one third is not available for work for some reason and one third belongs to a “grey area”. The vast majority of these young people (including 80% of the NEET males in Southern Italy) show an interest in participating in the labour market, but are unemployed or inactive despite being available for work.

In 87.5% of cases, NEET males live with their family of origin. 450,000 women belonging to this category are wives or mothers, and many of them describe themselves as “housewives”. Just over half of those classified as NEET living with parents come from the working classes, compared to 30% of students and 42% of people in work. Having considered the economic statistics for 2010 provided by ISTAT (the Italian National Institute for Statistics), we can now make some observations in the social sphere [1].

In this paragraph we present data of various kinds that provide an overview of the difficulties facing young people in Italy today: a) 800,000 young people aged between 15 and 24 suffer from depression; b) Suicide is the leading cause of death among people aged 15 to 25 (5 per 100,000 between 10 and 25 years, 8% of deaths in this age group); c) 32% of young people mostly spend their free time watching television, 28% listening to the radio, 16% surfing on the Internet, 11% talking or playing with their mobile phones; d) It is estimated that 5% of high school students drop out of school; e) It is now estimated that 1 out of 4 young workers begin their professional experience with casual or poorly-defined jobs [2,3].

The Italian Academy of Matrimonial Lawyers (AMI), involved in the protection of individuals, minors and families, has published a study carried out with the participation of major Italian research institutes and professional associations [4]. The study shows that crimes committed by minors in Italy have not increased since 1992, but have undergone a transformation. The most frequent offence among juvenile offenders is now bullying, against which adequate steps have not yet been taken, partly due to the indifference of many families, who are ambivalent towards the education of their children or even complicit in their crimes. The desire to imitate adult behaviour among boys, a growing phenomenon, has had a primary role in the increase in sexual offences committed by 14-year-olds, especially when acting in a group. The growing frequency of such behaviour among minors from all social classes and all areas of Italy means that it is now considered part of the educational process.

Sexuality is seen as a way of playing at being an adult, and frequently leads to abuse of weaker subjects. The juvenile justice system responsible for dealing with such offences is unable to provide an effective response: the combination of the high number of trials, the limited number of judges and the failure of social services in many instances has led to the current emergency. In addition, there is no doubt that the high number of separations and divorces has added to the spread of distress among children [5,6].

Today many young people are struggling to develop a life plan from a succession of fragmentary experiences, without being able to make sense of their existence. In addition, in modern society, young people are being increasingly influenced by today’s consumer culture, as well as being the target of advertising that can be highly disturbing [7].

Another risk factor is the growing use and abuse of addictive substances (e.g. tobacco, alcohol, cocaine) in a context of inadequate or non-existent social policies and preventive information. Indeed, the educational difficulties many students encounter need to be highlighted. Many children leave school early and many more are forced to repeat an academic year if they do not make the grade, especially in the early years of secondary school, risking early social exclusion [8,9].

A further problem, as evidenced by research, is the fragility of the family unit and the fragmentation of local communities. Traditional mutual help relationships among neighbours, by which individual problems were shared by the community and thus mitigated if not actually solved, seem to have all but disappeared. This frequently means young people have nobody who will listen to them and no significant adult figures to turn to.

All young people, regardless of their family or educational background, especially in the pre-adolescent and adolescent period, may experience the kind of problems described above. However, the discomfort also affects young adults (25-30 years). Educators should regularly ask themselves whether their children are experiencing hard times which require their attention. Studies of psychopathology and developmental epidemiology are trying to identify the main risk factors, i.e. those elements that herald, promote or signal distress. Although these risk factors are not the cause, they may shed light on distress as a multi-factorial phenomenon. Studies also highlight the protective factors that help to prevent or mitigate a situation of distress or “dangerous behaviour. First and foremost of these is the identification of individual vulnerability and family difficulties, especially the fragility of the social context in which the young person lives. In addition, young people must be helped to develop social relationship skills, since by relating to others such as their friends and adults, they may recover the capacity to make sense of their experiences and plan and build their future. It is through relationships with others that young people can regain their desire for challenges and understand the need to aim high. They also need to rediscover the pleasure of companionship, which means travel, adventure, challenge, and initiative. In helping young people to rebuild their capacity for relationships, the role of the adults who deal with them is crucial [10,11].

In the 1980s, Western capitalism promised a palliative to the discomforts of contemporary life: the idolatry of consumption and momentary gratification. The cure did not promise to defeat human misery, but only to erase the bitterness of everyday experience, exploiting the human instinct for improvement, however superficial [12].

The term nihilism indicates the absence of an ultimate aim that guides the course of one’s life. Therefore it is a philosophical position based on the meaninglessness of all experience. Such a doctrine corresponds to behaviours that deny the possibility of reaching a higher goal. Somewhat controversially, it affirms – or at least implies – that substantial improvement is impossible or meaningless, and only appearance counts. In its more common meaning, nihilism is a conception according to which reality is inevitably destined to decline into nothingness. Or, from an ethical point of view, there is no ultimate aim guiding the course of events and human life. Since humans are limited and this limit is experienced every day in death and its painful anticipation, they are forced to consider that nothingness is the true meaning of existence. The nihilist thus excludes the possibility that humans ever experience objective and universal truth.

The long decline of Italian political and social life provides a good opportunity to reflect on the nature and depth of nihilism as it pertains to the forms and ideals of the era we live in. Silvio Berlusconi, who has dominated Italian political life for nearly twenty years, represents the most perfect case to date of the reduction of reality to a simulacrum, a culture inspired by trashy television, which “progressive” figures have taught us to celebrate as a sign – and even a means – of liberation and progress. Berlusconi represents the fulfilment of the dream of Italian society which, in the late 1980s, saw its emancipation in the triumph of low-brow entertainment characterised by charming and beautiful personalities, implausibly ever-joyful and playful, freeing the viewers from any confrontation with the truth existing outside television’s hall of mirrors.

The posters of Coca-Cola bottles and Campbell’s tomato soup cans seen in galleries and museums confirm that even art is now the reflection of consumerism [13], but the Berlusconi phenomenon goes way beyond this. Having done so much to form and influence the social and political aspirations of the Italian people, his media empire now represents their living embodiment, their existential and aesthetic fulfilment: a freak-show in which television glorifies the most banal, prosaic aspects of our existence.

This “neo-nihilism” deeply affects the feelings of young people, confuses their thoughts, perspectives and horizons and destroys their souls, replacing their more healthy passions with worthless idols. Families are alarmed and the schools do not know what to do. As for politics, it has become no more than a meaningless parade of personalities, with participation in the electoral process apparently of no more interest or significance than voting for the best act on the X-Factor! The only institution taking an interest in young people is the market, which sees them merely as consumers of entertainment and material goods. The consequence of course is that they end up consuming their own lives. Their unease is not so much psychological as cultural. The remedies developed by Western culture, both religious and scientific, appear so ineffective that all that is left to counteract the current tendencies is philosophical reasoning, which seeks to ensure cultural progress by proposing powerful concepts, ideals and values.

Modern philosophers, such as Friedrich Nietzsche first and Zygmunt Bauman later, had already foreseen the crisis of the human condition and had become aware of the limitations that generate that “liquid life” in which there seems to be no fixed points, in which everything changes very fast, too fast. We are still learning how to deal with such a situation, and in the meantime reality has already changed; the situation is different, and our tools quickly become inadequate or, as we say today, “obsolete”. Everything is mixed, whether we like it or not, and looks different from how it used to. We are caught between optimism and despair; between the delusion of omnipotence (treated in Nietzschean terms in plays dating back to the ancient Greeks) and the limits of daily existence.

Idolatry, or the equation of a non-identity reflected in the ‘perfect search for a personal identity’, is the illusion of a perfect noncorrespondence with reality. The consequences in many cases are dependent personality disorder or symptoms of schizoid and paranoid psychosis, and inappropriate attitudes that are completely unrelated to the social reality the person lives in. The more idolatry grows, the more they ensnare the personality and take possession of its material existence [14].

People living in industrialized societies can express their identity by mixing different styles, for example in clothing, culture, food, music, technology and lifestyles, imported from all over the planet. This is certainly preferable to the poverty of developing countries, whose peoples have never been allowed to choose a way of life, their destiny having been assigned in advance. However, as a form of freedom it is restricted, superficial and ultimately precarious, since the fate of all peoples, rich and poor, depends on the vagaries of that mother of all idols, the global economic system.

Adolescent distress should not be simply ascribed to acute individual and existential problems. The role of socio-economic factors – and the relationships between them – in causing dangerous behaviour and intensifying borderline conditions also needs to be taken into account. Social marginalisation can be the result of economic variables such as the lack of job security and unemployment but environmental factors also play their part: poor-quality housing (frequently concentrated in specific areas), urban blight and the lack of attractive places for young people to meet all generate a social-familial context that is loaded with anxiety and frustration and frequently aggression. In cultural terms, the intensification of cultural diversity causes marginalisation and leads to violent reactions. Socially, in a complex society the terms of reference can change rapidly: action prevails over thought, having over being, and personal gratification over the quality of relationships. As a consequence, processes of socialisation and identification become increasingly difficult.

Psychological and relational factors also come into play. The transition from childhood to adulthood is always characterised by mental suffering resulting from a struggle between the desire to move forward and the desire to remain a child. The solitude of adolescents is also triggered by the loosening of ties with the people who have educated them and brought them up, due to the difficulty of maintaining relationships with them and to the pervasive conflict between generations.

The distress arising from the growing process appears to be not so much an illness as a series of behaviours stemming from the inability of the adolescent to adapt, including running away from home, suicide, sexual frustration, drug addiction, violence and crime. This failure to adapt is a widespread form of distress: a momentary inability to accomplish the developmental tasks associated with that age. There are four recurring causes: the limited attention paid by the family to the personality of the adolescent; the low propensity of parents to accept their children’s choices, whatever their age; the failure to give young people tasks that entail greater responsibility in the family; the lack of motivational guidance from adults. The inability of adolescents to adapt, finding it difficult to respect social norms and assume responsibility, can have severe consequences. 10% of adolescents are at least tempted to commit acts of hooliganism. The desire for transgression increases significantly when the relationship between parents and children is not satisfactory. The tendency to be overprotective and authoritarian and a lack of involvement are a breeding ground for transgressive and reckless gestures. Theft may be frequent, though not necessarily habitual; its meaning depends on the reasons that drive the young person to steal. Young people have a pronounced tendency to challenge the adult world and its rules. Regarding theft the challenge is aimed not just at adults, but at themselves, in the sense that the criminal act is a sort of test of their capacity to break the rules. In terms of violence, the rise in aggressive gestures may be caused by the considerable influence of the mass media. In the most fragile subjects violence becomes a way of overcoming their own weakness or distress. Violence means using the physical language of the body to manifest one’s social distress and vent one’s existential difficulties on others. Suicide attempts are a cry for help in a situation of great difficulty; they serve to draw the attention of adults to a problem and to demand changes in the relationships between the child and others, and the message is frequently aimed at the individual’s parents. The gesture has a strong relational meaning, but at the same time it is loaded with aggression and the assignment of blame. Depression can lead to mental states of solitude and desperation that may have serious consequences. In a fragile state, an objectively insignificant event can trigger an acute crisis in the young person. Obscene language is an “affectless” way of expressing one’s sexuality that is also part of the search for one’s sexual identity. Used by adolescents among their peers it is simply a form of slang, whereas with their parents or other adults it is a manifestation of distress and suffering. Anorexia and bulimia are eating disorders that show distress above all in girls. The former is characterised by a refusal to eat, acute loss of weight and the disappearance of the menstrual cycle. Bulimia entails the consumption of large quantities of food in an impulsive, rapid and disorderly way, followed by vomiting. Such behaviours are caused by unresolved affective and existential issues that create solitude and suffering and lead to an exaggerated desire for attention, with behaviours that are often antithetical to what they seek to achieve.

In the face of all this, what educative strategies should be followed? In the past, educational approaches were founded on the concept of duty and often inculcated feelings of guilt from the very start. Punishment became the corrective response of adults in order to modify bad behaviour, but it cannot be a useful corrective for those who do not feel guilty. “Social morality” is based not so much on the sense of duty as on parents’ “expectations” from their children; the effective deterrent against erroneous behaviour is thus the sense of “shame” towards oneself and others. This position is dangerous in that it easily triggers the “children’s vendetta”, which will show itself sooner or later. In contrast, it is more time consuming but more productive to focus on the quality of relationships [15-17]. A basic, solid trust in others can help adolescents to overcome their existential crises, whatever they may be.

From the Nihilism of Young People to Psychosocial Research

The way of life of today generates suffering and a flight from reality. It drives young people into a sort of maniacal hyperactivity, a desire to experience anything and everything in order to escape the pain and emptiness of thought [18].

The various dangerous behaviours such as drug and alcohol abuse and car or motorbike racing on public roads derive from this hyperactivity, this flight from reality. They may be interpreted as manifestations of distress arising from daily life, in which the development of a young person’s personality can be arrested, preventing them from becoming adults and condemning them to an endless search for “kicks” – immediate gratification based on their instincts. Emotionally, everything becomes an undifferentiated mass and there seems to be no point to anything. This is a form of nihilism of which young people are not directly aware; it generates a huge existential vacuum and strips life itself of any meaning. Confused and deprived of any values, the adolescent neglects authentic interpersonal relations and takes the road of social deviance and dangerous behaviours [19].

Lastly, studies and research in this field are methodologically hindered by the difficulty of measuring and comparing psychological disorders in young people in order to highlight any increase or reduction over time. Reasons for this include the following:

a) The classification of psychological and psychiatric disorders by means of tools created specifically for this purpose (such as the Diagnostic and Statistical Manual of Mental Disorders – DSM IV & V) is not always conducted in the proper manner;

b) Quantitative assessment of the symptoms often depends on the attitudes and communication skills of the young patients and on the professional skill of the psychologist/doctor;

c) The consumption of psychiatric medication depends, just like any product, on purchasing power, on marketing and on the legislation regulating its availability on prescription or otherwise, which varies from country to country.

Nevertheless, psychiatrists, psychologists and educationalists have observed a clear rise during adolescence of developmental disorders including autism, anxiety, eating disorders and affective disorders. Data also point to increases in suicides and depression.

Lastly, an article published in “The Economist” [20] examines the way in which psychiatric diagnostic classifications are changing in response to the publication of the updated Diagnostic and Statistical Manual of Mental Disorders (DSM-V) in 2013. The article highlights possible conflicts of interest among psychiatrists and pharmaceutical companies, who provide substantial funding for research relating to the content of the DSM). A study by Cosgrove et al. [21] examined the economic links between the psychiatrists responsible for revising the DSM IV and the pharmaceutical industry. The authors showed that that 56% of the psychiatrists participating in the workgroup drawing up the DSM had one or more financial links with the pharmaceutical industry. 100% of the psychiatrists involved in the workgroups focusing on “Mood Disorders” and “Schizophrenia and other Psychotic Disorders” had links of this kind, but also 81% of those on the panel for “Anxiety Disorders” and 83% of those on the panel for “Eating Disorders”.

Another reason to be circumspect about treating adolescent distress as a purely medical issue is the fact that – as the Economist article points out – “the brain is a complex organ and the causes of its disorders remain poorly understood”; though progress is being made, psychiatry is still fundamentally symptom-based. It should also be borne in mind that the “pharmacological solution” to young people’s developmental problems is already the subject of intense debate [22,23] and we should not be tempted to look for “quick fixes” – pharmacological or otherwise – to what are extremely important and complex issues.

Transactional Analysis (TA) is a psychological theory formulated in the 1960s by a group of psychoanalysts founded by the American psychiatrist Eric Berne [24]. Their most able mouthpiece was perhaps Thomas Harris.

TA is a major psychological approach in terms of its theoretical depth and its breadth of application. As a theory of the personality it provides a portrait of how psychologically structured we are by using a model that helps us to understand how we work and how we express our personality in terms of behaviour.

TA makes it possible to understand how the current life plans of adults originate in childhood, and how inadequate or harmful childhood strategies continue to be replicated in adult lives. More precisely, the term ‘Transaction’ refers to any exchange between two or more persons: a dialogue is a transaction, as is an exchange of gestures of affection. In tackling certain situations, people tend to stick to a “script”, continuously replicating their childhood experiences as operational strategies, even though at times they prove to be selfdestructive or harmful. Indeed, people tend to follow paths they have already travelled in order to feel safe, limiting the possibility of divergent thought that might find solutions to problems old and new. Transactional Analysis is thus a psychological theory that studies the individual in the environment in which he or lives, via their behaviour [25].

The aim of this theory of the personality is to study the behaviours of subjects in relation to each other, to understand the reasons why at times they suffer and to identify the most sui strategies for avoiding suffering and for living in harmony to the greatest possible degree.

This theoretical approach makes it possible to clearly grasp the intra-psychic and social dynamics of the problematic situations of adolescents, providing an interpretative framework of the “person” as a “being in relation to others”. TA can help find solutions for people who are willing to learn and grow, as well as for educators, parents and teachers who are willing to participate in the educational relationship in terms of awareness and setting realistic goals [26]. TA aims to provide an effective tool of analysis and self-analysis of interpersonal relationships, and can facilitate awareness of both the self and others [27].

Politically, the social impact of the problem is tackled in Italy with reference to European norms. The first Italian Law was the 328/00, known as the Bassanini Law [28] (November 8, 2000, framework law for the implementation of the integrated system of intervention and social services).

Italian law establishes the principle of subsidiarity, which entails joint strategies and cooperation between agencies and public and private organizations playing various roles with regard to the same social issues. This has opened up lines of communication between public and private entities which recognize the importance of the role of the voluntary sector (article 118 of the Italian Constitution). The voluntary sector in Italy is represented by associations of a private nature but aimed at the production of goods and services for the public or the masses, for example social cooperatives. This line of thinking could already be seen in Italy in the policies for children and adolescents arising from the application of the “Turco-Napolitano Law” [29] (D. Leg. 286 of 25 July 1998), which envisaged the participation of voluntary associations that act in society in the planning of social policies. For youth policy, that is for young people aged 16-30, it was necessary to look to EU legislation [30], specifically the European Commission’s White Paper of 21 November 2001 – A new impetus for European youth. This text provides an effective guide for EU member states for establishing measures for the younger generation based on open coordination between political institutions. It is innovative in that the possibility exists for young people to participate in the definition of policies that directly concern them, as well as evaluating and redesigning those policies where necessary. To promote youth participation in local public life, there must be cultural respect for young people and some element of fun and pleasure in social life. However, there is little evidence of these principles being implemented in Italy. Indeed, Italy is one of the few countries in the EU in which:

• Youth policy has not yet been defined at the central level;

• There is no central institution to address and coordinate youth policy;

• There is no national youth agency.

In this context, local governments still do not have a national or regional point of reference. “Youth projects”, the “Informagiovani” youth social interaction centres, Consultative Committees and Forums all begin and develop at random and almost always as a result of cooperation between voluntary associations and local authorities. These new organizations based on mixed public/private partnerships which create innovative and experimental projects may produce results of real importance at the local level.

The problems of the NEET category of young people are a wake-up call for European national governments with respect to the social and political marginalization of young people. According to the Euro found report of 2011[31] a large percentage of young people are disillusioned with politics, which threatens to delegitimize democratic systems in European societies. The report shows that only 64% of NEET youth would cast their vote in the general election, less than the percentage of the EET group (75%), i.e. their peers who work, study or attend training courses. In addition, the NEET group are less interested in political participation and the percentage of those who are members of a political party is much lower than that of the young EET group, 1.6% versus 3.9% respectively. Finally, NEET participation in social activities is low: only 26% of respondents said they belonged to a public social organization versus 46% of their EET peers. Finally, the Euro found report estimated the total economic cost of the non-participation of NEET youth in the labour market in 26 member countries of the EU to be over 150 billion euros per year, about 3 billion euros a week. Italy has the worst record, with economic costs surpassing 32 billion, followed jointly by France and the UK (22 billion and 18 billion respectively). In terms of percentage of GDP, the greatest cost is paid by Greece and Bulgaria, which exceed 3%, while in Italy the cost is more than 2%.

According to the same report, the inclusion in the labour market of 10% of the NEET population would save Europe more than 15 billion euros and that figure would rise to 20 billion with 20% of the NEET population in work.

The aim of this presentation is to promote the sense of responsibility which adult society must assume in its dealings with young people who are in difficulty in terms of distress and lack of moral judgement.

It is necessary to develop cultural and psychological models in primary and middle schools based on Transactional Analysis that make it possible to identify the ‘distorted fantasies’ of the childhood ego [26] and the ‘erroneous convictions’ of parents that can cause young people to feel a “fear of being inadequate” (generally speaking a fear of failure or a fear of losing the object they desire), which is manifested in symptoms of anxiety and an inability to function socially.

Educators and parents must seek to develop in young people an ethical conscience that will promote self-regulation of their conduct and thus act as a safeguard of liberty and legality. The notion of planning for one’s future is directly linked to the sense of responsibility that is required in order for life to be lived and shared with other people, and this can only be inculcated by adults who take the time to build solid, trusting relationships with the young people in their charge. It should be stressed that this is not primarily a question of medicine; psychiatrists, psychologists and pharmacologists have a role to play in many cases, but any recourse to doctors and drugs must take account of the huge financial interest of the pharmaceutical companies, our relatively limited knowledge of how the brain functions and the need to distinguish strictly medical issues from broader social considerations.

In a consumption-oriented society based on mere appearance, the time and the attention that must be devoted to educating young people and students increases in proportion to the limitations and inadequacy of the available tools. While this consideration is assumed to apply to developed countries in general, it seems to be especially valid in the Italian context, where an entire generation has been subject to the baleful influence of an unscrupulous media empire. Even before Berlusconi became Prime Minister this empire was subject to barely any attempt at regulation by the state, in terms of either content or its dominant market position. Consistently seeking to appeal to the lowest common denominator, it has replaced all values with the illusory concepts of “glamour” and “entertainment”. In this media-generated universe, the only criteria by which a person is ever judged are celebrity, monetary wealth and physical attractiveness, however these may be acquired. While no-one would claim that Berlusconi deliberately set out to ruin young people, it should be obvious that the relentless promotion and reinforcement of such a message, which intensified after Berlusconi acquired control over the state-run TV networks in 1994, was bound to have consequences in the long term.

Today more than ever Italy needs to focus on the younger generations, who are the real strategic asset for growth. No change is possible without their contribution [32,33]. As well as focusing on the family and familial relationships, it is essential to initiate a program of improvement and renewal of the Italian educational system. Italy has one of the most serious problems with students dropping out of school in Europe, with large numbers of young people leaving school without a qualification.

Study parameters useful for monitoring this complex phenomenon, which has consequences in terms of both psychological distress and physical violence, include: a) monitoring of the rate of unemployment among 18 to 29 year-olds, b) monitoring of the number of young people in the NEET category, and c) implementation of projects designed to inculcate a culture of respect for the law, responsible citizenship and opposition to organised crime. These indicators, recorded every six months by ISTAT (the Italian National Institute for Statistics) can assist and inform youth policies in Italy.

The country needs bold policies and measurable goals, since the roots of the future are here. Italy strongly needs to implement a robust network of relationships between institutions, culture, economy, ecology and local communities.

The author would like to thank George Metcalf for his help in translating and editing this manuscript.