The Italian psychologist Roberta Milanese (Genoa, 54 years old) is one of the main exponents and popularizers of brief strategic psychotherapy, born in the 1950s in Palo Alto, California, with Paul Watzlawick, and imported into Italy in the 1980s by Giorgio Nardone, in the so-called Arezzo school. Milanese, who knows how to explain complex conflicts in a fun and understandable way, he has made his work known in books that have become bestsellers in their sector in Italy, and in Spain they have been published by Herder, such as The deceptive fear of not being up to par or the last one, Going. An emotion that must be tamed (and ridden).
Milanese teaches clinical masters and training courses (on November 15th he will have one in Barcelona), and also consults for companies, artists or athletes. The conversation takes place in his studio in Milan, through whose door he has already seen thousands of people enter with all kinds of problems, but the most surprising thing is that he then saw them leave solved in a short time. The interesting thing about this therapy is its speed. He assures you that a few sessions are enough.
Ask. What is Brief Strategic Psychotherapy?
Answer. We focus on the present, we don’t look for causes in the past, which are usually hypothetical, reconstructive or, even if they were true, we can’t go back and change it. It focuses on the here and now, on the person’s situation at this moment. We use small tasks, things for people to do or think about between sessions, and produce rapid change. Most ailments can be treated quickly.
Q. They want the patient to feel something that pushes them to change.
R. Yes, most approaches focus on understanding people: if I understand, I change. But in most cases it’s not that we can’t figure out what we should do, but rather that we can’t do it. If I’m in a relationship that isn’t working, maybe I know I should leave, but being able to do that is another thing. We then work with a reverse process, to generate a corrective emotional experience. Neuroscience confirms this sequence: the transition from the cortex to the limbic system, from the rational to the emotional part, is much more resistant to change than the opposite. It works better to move from below, from emotions.
Q. These tasks are like little games that unlock situations.
R. Yes, we use non-ordinary logic. For example, if I have anxiety, the more I try to control it, the more it flares up. We use a paradoxical technique called “the worst fantasy,” half an hour a day in which people voluntarily try to generate as much anxiety as possible. Because the more I try to generate anxiety, the more I inhibit it. This is how non-ordinary logic comes into play.
Q. Another paradox is that the patient comes to you to change something, but at the same time does not want to do it.
R. Yes, resistance to change is a characteristic of all living things, from the amoeba to us. Change is tiring, it’s scary. Strategic therapy is based on dialogue, tuning into the person’s perception and seeing their reality from another point of view. If you simply told someone “do this” and they did it, anyone could do it.
Q. There are already those who ask artificial intelligence for advice.
R. Yes, I’m horrified, because there was already a great tendency towards relational inability and personal fragility. Sometimes I even enjoy asking him things. He knows a lot, but he doesn’t understand.
Q. And he has no emotions.
R. Obviously, but he simulates it very well. If someone wants to be treated well, talk to the artificial intelligence, you can insult him, he never gets angry, he is obedient. It’s a terrible drift.
Q. In his work he explores the current obsession with being aware of the judgment of others.
R. Yes, there is an epidemic of insecurity, of fear of not being good enough. It is the result of the era of performance in which we live. We must shine in everything, even when we have children, and social networks amplify this, everyone can judge us. And we also have a totally distorted perception of other people’s lives. They are always in heavenly places and eat wonderful things. A world where everyone is perfect and I’m not.
Q. You talk about how you have to observe your feelings, be in them. For example, you need to deal with pain, not pretend it doesn’t exist.
R. Yes, pain is like a physical wound. The healing time of the wound is not up to me. I can only prevent her from getting infected and protect her. Then it has its time, a month, a year. But we live in a phobic society: there must be no pain, it interferes with productivity, we must move forward. With Covid I saw a 60-year-old woman whose husband had died. Three months had passed and he didn’t feel like going out in the evening, but his daughter also thought he needed treatment. And here another problem arises: the latest edition of the DSM-5, the most used diagnostic manual in the world, says that with a series of symptoms, such as crying, not being able to eat, sleeping badly, for more than 15 days, we are talking about depression and we are candidates for psychotropic drugs. First it was two years, then two months and now 15 days. There is a diagnostic drift that does not take into account that I am not pathologically depressed, I am in mourning, and more than an antidepressant I will need the closeness of my loved ones to cry. Now we can no longer afford it and we need psychotropic drugs. Normality is pathologized.
Q. Take a pill and everything goes away.
R. Yes, it happens with overweight too. I don’t have to force myself, better yet, I’m not even responsible. This is another theme: responsibility, which is not a question of guilt, if I have a disorder it is not my fault. But how I relate to the disorder is my responsibility, I have the power to change something. Otherwise, I become a victim of the situation.
Q. There is an escapism from reality and responsibility. Have you seen an evolution in recent years?
R. Yes, first there were more phobias, then we entered the era of controlling everything, now we are in the era of judging others. I also see more and more addiction to mobile devices. And it’s not like before, only social networks are now coils (short network videos), and the whole issue of dopaminergic stimulation associated with rapid stimuli, with a permanent emotional apathy effect. And the television series! If there is anything that has the effect of a drug, and they do it deliberately, it is the series.
Q. People swallow them for hours.
R. In a series there are spikes of dopamine, which leave you hungry, and a film has a beginning and an end, it doesn’t leave you nostalgic. There are people who think all day about what will happen to the characters in a series. We don’t even live our lives anymore.
