Even though I haven’t met Dr. Matsa in person, I feel as if we have known each other for long. When I was starting my specialization in Child Psychiatry, Dr. Matsa was already at the front line of sociopolitical struggle for the reformation of Mental Health in Greece. She was a protagonist in the field of Detoxification. She was an activist and a writer.
Her writings involve action. They record creative action along with ideas and arguments.
This is something you come across in this book as well.
She writes: “The spark for writing this book, which encapsulates decades of clinical observation, came in the spring of 2012 when ministers Loverdos and Chrysochoides ordered the exposure of drug-addicted, HIV positive women. A political act of extreme barbarity.”
Maybe it is that K. Matsa, as a therapist, witnessed with empathy many of the feelings of Shame and Humiliation in various addicted women (including one of these exposed women). These are the experiences she presents in a brief and comprehensive manner.
They are all women because, as she states, “…although shame affects both sexes… today's androcratic society, with its amplified social stereotypes against women due to the crisis, represses and stigmatizes addicted women even more”.
At the same time K.M. analyses thoroughly the Psychodynamic of Shame, always shedding light on the connection of the “inner”, the “in-between” and the “outer”. Through this she attempts to make a distinction between Shame and Guilt. This does not seem always possible, even though she describes Shame as a feeling that is created mainly in the process of relating with the Other — something that I think connects Shame more than guilt to the Greek cultural tradition in which the ‘Other’ is the community that defines the feelings about the self.
She insists on the social causes of mental dysfunction and dysphoria, something that often has to be supported against the dominant tendency for “medicalization” and/or psychological interpretation.
This book is an attempt at resisting the dangerously spreading sociopolitical barbarity which affects our lives.
Yet it is also a book about feelings, central among which is the feeling of Shame: a feeling that, depending on its intensity or its use, might have either a castigative or a protective effect.
What is it that determines this vital fluctuation?
Elaborating on the above, K.M. follows a path which includes aspects from the Systemic Perspective. Thus she leads us from the ‘personal’ to the ‘inter-personal’ and from there to the ‘collective-social’ aspect. The reverse course, which starts from the social process of control through the wish for power of the dominative minority, is what designates Shame as a feeling that castigates, disorganizes and paralyzes human beings. Functions that facilitate domination and social control through the withdrawal of every potentially active citizen from political or social action.
But K.M. has a suggestion for the reversal of this disorganizing process that affects these women. A suggestion that more or less constitutes a statement about a way of living. This is addressed to everyone because it embodies human values such as solidarity, sharing dysphoria through verbalization and trust in the human capability for active formulation of the social terms of existence.
The context in which she tries to bring this statement into reality –on the level of therapeutic action– is the therapeutic unit for addictions called 18 ΑΝΟ.
She writes: “...in order to positively reevaluate her identity she has to deny the old evaluating systems that stigmatize and humiliate. She must embrace and actively support new values, new ideals. She has to participate, in any way she decides, in the collective struggle against humiliating violence... It’s the only way she can calm down the storm inside her. The restructuring of identity presupposes the active establishment of new dialectic relations between psychological and social processes. We should not detract the social dimension from individual history.”
The book ends with a presentation of the therapeutic exploitation of Drama Therapy by Stavros Kevopoulos and Angela Kalozimi, colleagues of K.M. at 18 ANO, and with the appendix by Savas Michail, who highlights the political and social components of Shame.
In short, I think this is a book that promotes faith in an active personal stance that serves Life versus a passive stance that leads to symbolic, or even real, deaths.