An incandescent self-exploration: Ambiguities and unconscious logic in Day of Wrath (Vredens Dag), directed by Carl Theodor Dreyer (Denmark 1943).

The author examines the paradoxical dramatic dynamics of the Dreyer's masterpiece, according the Matte Blanco's theoretical model, as a tormented path of self awareness that consists in a progressive immersion in the unconscious. Anne, the young wife of an old Lutheran pastor, marginally involved in the witchcraft trial of a friend of her mother (now dead, but suspected to be a sorceress as well), falls in love for his son-in-law, leaving the child-wife position held so far. It's a new very strong vital drive for Anne, to which she adds the belief to own the magic powers of the witches: the ability to evoke the living and the dead, kill with thought and communicate through dreams. All the emotions are at an infinite level of intensity. Nevertheless, after she's left by her lover and after her husband's wished-upon death, the protagonist confesses her presumed witchcraft before the husband's coffin and, in the derangement of ambiguities, affective contradictions and shift of position, she attains a sort of mystic epiphany (significantly represented by the flow of filmic images): maybe a contact with the deepest layer of the mind where, according to MatteBlanco, the symmetrization is total.

M by Fritz Lang (Germany, 1931) Phenomenology of Evil: a serial killer and his social group.

In 1931 an unknown murderer of little girls (Peter Lorre) is terrorizing the city of Berlin. We see him entice a new victim, the little Elsie Beckmann, who is coming home from school: whistling a tune by Grieg, he buys her a balloon from a blind beggar. When her corpse is discovered, the police undertake a major mobilization aimed at seeking the serial killer in the criminal underworld; meanwhile, the ever more terrified population starts to see the dangerous murderer in everyone. Since the roundups and incursions into the seediest parts of town disturb the gangsters' activities, the leaders of organized crime, headed by Schränker (Gustav Gründgens), take it upon themselves also to hunt down the solitary child-killer, engaging the community of beggars. Every corner of the city is catalogued and sifted by the dual activity of the police and the gangsters. The 'monster', a former psychiatric patient, mild and harmless in manner, is finally tracked down via two parallel routes: the clue of a cigarette packet enables Inspector Lohmann (Otto Wernicke) to track down the serial killer's address, while the blind beggar recognizes the whistled tune. The murderer is identified by a 'slap' from a young criminal which leaves an M marked in chalk on a shoulder of the man's overcoat. Thus he is caught and undergoes a kind of trial at the hands of the gangsters who tie him up in order to lynch him, but they are interrupted by the arrival of the forces of law and order.

Existential crises in two religious patients: Vicissitudes of faith and the emergence of the true self.

The authors present two clinical cases involving an existential crisis which led the patients to lose what had been the foundation in their lives, their faith. Although the therapeutic settings differ--the first patient had a few psychotherapy sessions following a psychotic episode with a mystical background, while the second was in the final stage of analytic treatment - the authors highlight how in both clinical cases a loss of faith becomes a total and urgent crisis of the Self. The fracture which ensues seems to generate an intense engagement of the body which, paradoxically during a loss of faith, induces an experience of ecstasy of the kind that has traditionally been reported. In the first case the experience of ecstasy was lived first-hand by the patient who thereafter redefined the psychotic breakdown as a "moment of truth"; whereas the second patient, through a deep projective identification, induces an eerie countertransferential feeling of 'metaphysical' shortfall in the agnostic psychoanalyst, triggering bewilderment, physical discomfort and awe in him. In both cases the authors believe that the notable somatic involvement may be correlated to a potentially profound and unprecedented contact with the True Self.

The Sweet Hereafter by Atom Egoyan: extreme loss and psychic survival.

In a small mountain community of British Columbia a school bus swerves off the road, causing the death of 14 children. Mitchell Stephens, a New York lawyer, immediately enters the fray with the idea of instigating a large-scale lawsuit to obtain compensation for the victims, making contact with each of the parents who had lost children in the accident. Many are persuaded to join his cause. The lawyer, bombarded by phone calls from his daughter, a drug addict, even turns to Dolores Driscoll, the bus driver, who survived the accident. The latter, however, with the support of her paraplegic husband, refuses to become involved in the lawsuit. Another character who is vigorously opposed to the collective cause is Billy Ansel, a garage owner who had already lost his beloved wife and witnesses the death of his two children from the pick-up truck in which he is following the school bus. Among the survivors there is, finally, the 14 year-old Nicole Burnell, who had dreamt of becoming a folk singer and now finds herself paralysed from the waist down. Nicole is initially persuaded by the lawyer and by her parents--in particular by her father Sam, with whom she has had an incestuous relationship--to testify in favour the party seeking compensation, but when she steps into the witness box, realizing that such legal action was misguided, she offers a 'false' account of the accident, invalidating the case. Two years after the tragedy of the school bus, Mitchell Stephens bumps into Allison, a friend of his daughter's, on an airplane and ends up revealing to her some of his painful experiences.

Making diagnoses in psychiatric clinical practice: the point of view of the psychotherapeutic attitude.

Using a "psychotherapeutic attitude", as a criterion and measure of the psychiatrist's involvement in clinical relationship (with the "trial identification" according to Fliess), some phenomenological and epistemological considerations are offered about diagnostic assessments, as a synchronous and diachronous recognising process. Inspired by Gehlen's notion of "exoneration" (i.e., the reducing and focusing of the perceptive experience as applied to the wealth of the perceptible), this paper examines how the mind of a skilled diagnostician might work. Three levels are explored: firstly, "the symbolic perception", where perceptive/ emotional data derived by "trial identification" and worked through during one's professional experience, automatically selects wide fields of allusions (e.g., in the psychopathological prefigurations, suggested by the "contact"); then, we consider the "exoneration" of scientific hypothesis, which allows the psychiatrist to give a scientifically recognisable form to the first diagnostic outlines gathered in the interpersonal communication; and thirdly, the holistic reflection is examined, which returns the doctor's focus to the patient's individual problems, after going through different and, at times, very high inference levels. It is not a question of phases, but of varyingly interwoven moments in the mind of the skillful clinician, which are based on the dialectics of identification/separation.

Current factors affecting the choice of psychiatry as a specialty: an Italian study.

OBJECTIVE: This study examined the differential impact of factors hypothesized to affect the choice of psychiatry as a specialty in Italy. METHOD: A 38-item Likert-type questionnaire about factors that potentially affect the choice of a career in psychiatry was administered to 97 Italian medical school graduates sitting for an admission examination to psychiatric residencies and to 82 colleagues sitting for an admission examination to an internal medicine residency. The two groups' ratings on the questionnaire items were compared. RESULTS: Response rates were 49.5% and 45.1%, respectively, for the psychiatry and the internal medicine groups. Future psychiatrists did not differ from future internists in sociodemographic characteristics. They rated 13 factors on the questionnaire more positively than did their colleagues who were pursuing internal medicine, and many had chosen psychiatry very early (40% had done so before medical school). Some of the more positively rated factors were experience with mental illness either personally or by a relative or close friend, efficacy of psychiatric treatments, the degree to which psychiatric practice is perceived to be evidence based, research opportunities, and curiosity about the topic of "madness." CONCLUSIONS: Findings confirm earlier work in North American samples showing a substantial cross-cultural consistency in motives for choosing psychiatry as a discipline. A strong, early interest and curiosity among these students, often present in the premedical and preclerkship years, suggests some benefit in targeting this group for recruitment.