Hospitality is a subject one associates with evocative, imaginary atmospheres: just think of the people we receive in our homes, of the people we mix with and of the hospitality we extend to our nearest and dearest.

The same atmospheres are summoned up when we remember having been someone’s guest, possibly a stranger or a foreigner; when we were welcomed into a new place, by new people in a new place, and when we remember too how we were greeted and the quality of the hospitality.

There is much I could say on the subject, but that is not what I want to talk about.

I should like instead to talk about the theme of hospitality in the clinical work of a psychiatrist like myself at a Centre that styles itself an “Institute for psychiatric rehabilitation”, as written on the sign at the beginning of the Viale (Avenue) San Giovanni di Dio in San Colombano al Lambro --  something that probably sounds like a proclamation or a promise to any approaching stranger.

What comes to my mind are the words of Don Giussani when he speaks of what he terms a pathology of inhospitableness that seems to prevail in modern society and how the point of departure in hospitality (as well as its major objective) is the acceptance of oneself. “Our first mission is with ourselves”, he tells us, a motto designed to underline how the difficulties one encounters in accepting oneself, with all one’s own weaknesses and frailties, are instrumental in teaching us acceptance of another person: if we cannot accept ourselves, we cannot be truly accepted by others.

So that leads to the real question: How can a sick person receive true hospitality if we do not recognize and accept our own problems and frailties.

“Well, crazy people are crazy”, some people will reply in a sort of reassuring tautology. There is nothing that can be done. Their illness is chronic. Permanent.” But what I see here is a chronic disease caused by the attitude of the physician or the caregiver: a disease becomes chronic when it is considered as such by the person who should be working to avoid it. To use technical jargon, when a patient is considered as chronic by a therapist and is no longer seen as a guest, then he or she is automatically consigned to continuing regression. No further  investment is made in him, he is not allowed, as Brother Gennaro would say, to live inside his time, and his words will be ignored. The caregiver will no longer consider that he exists and the only important thing at that point will be to make sure that he does not make trouble.

So thus we end up with what Umberto Galimberti called the “Troublesome Guest “in a book about nihilism addressed to today’s youth in which he says that “what is necessary is to make sure that we are aware of this guest’s presence and to look him directly in the eyes”, because nihilism means “there are no answers to the whys” and that “the highest values no longer have any meaning”.

One way to deal with this kind of attitude could be to provide more space for the mentally ill, not only in terms of a physical or structural space but in terms, too, of a mental space: and this becomes possible only when genuine Hospitality is practiced. What I mean by mental hospitality is the capacity to create a space in one’s own mind that can play host to all the facets of the character of a sick person, whether positive or negative, and assume a neutral and non-judgmental attitude.  In this way (although, admittedly, this has yet to be seen) others may be able to deal more successfully with their emotions, even the more painful, convoluted and destructive ones.

The best way to guarantee the existence of such a space is very simple, and that is to make a concrete effort to really be there for the patient. This is what I would describe as the true ethics of psychiatry and consequently of those who work in this field: our responsibility is to find a way to open ourselves to the vitality of the patient and not to his illness, to work towards the creation of a dialogue and a relationship, something that is difficult and challenging but certainly therapeutic.

And to conclude, I would like to quote the great American historian, Howard Zinn, who wrote the story of his country by focusing on those who are often left out of official histories:  the poor, the slaves, and the indigenous peoples: “It is not necessary to take part in great, heroic actions in order to participate in a process of change. Small acts, when multiplied by millions of people, can themselves transform the world….”