Psychiatry an offer Italian mobsters can refuse

REGGIO CALABRIA, Italy - The mafia boss was having a dreadful time dealing with loss. But he wasn't struggling with the loss of lives, or even the loss of his freedom.

"Doc, it's my hair," the mobster from the 'ndrangheta crime syndicate confessed to his psychiatrist in jail. "I'm afraid of losing my hair.

"And look at these spots on my arm. See them?" he half-pleaded as he rolled up a sleeve and thrust out his arm.

"But your hair is fine. And there aren't any spots," Dr. Gabriele Quattrone tried to reassure his patient, who had tied himself into a knot of anxiety over the hair he believed to be falling out and the imaginary blotches popping up all over his arms.

Quattrone is one of a tiny corps of psychotherapists who have treated Italian organized crime bosses or their family members. Patients include dons haunted by nightmares, turncoats tormented after informing, wives left frigid by rigid codes of loyalty.

In exclusive interviews with The Associated Press, granted on condition that the mobsters' identities not be revealed, in line with doctor-patient confidentiality, the doctors offered insights into the secretive, increasingly strung-out world of Italy's centuries-old criminal organizations. Quattrone, a neuropsychiatrist, treated his jailed 'ndrangheta patient with tranquilizers and made some attempts at nurturing introspection.

"It's the stress of 20 years of being a fugitive, of going on trial," he told the man, a top boss in Reggio Calabria, the toe of Italy's boot.

"Yeah, I'm stressed, all right. I'm stressed because I'm innocent," the boss retorted.

These are indeed tense times for Italy's mobsters.

A growing police crackdown and a rebellion among businessmen expected to pay protection money have left some sons of crime families wrestling with self-doubt, unsure they are cut out to take their fathers' and grandfathers' place in the vengeful world of the mob.

But seeking help is risky business: Among mobsters, visiting a psychologist is a weakness you can pay for with your life. Palermo psychologist Girolamo Lo Verso recalled the case of a mobster's son who told another therapist at a public mental health facility: "If my father knows I come here, he'll kill us."

"If you're a Mafioso and you're anxious, you're not trustworthy and you have to be eliminated," Lo Verso said. "A Mafioso is paranoid about everything" - trusting omertà, the code of silence, more than patient confidentiality.

The state's war on organized crime has put hundreds of bosses behind bars, sometimes for decades, sorely testing the mental health of spouses, children and the mobsters themselves.

Quattrone, the head of neuropsychiatry at a Reggio Calabria hospital, was once summoned to an apartment building in an upscale neighborhood.

In the sprawling master bedroom lay the mafia boss' severely depressed wife. Doctor and patient looked into each other's eyes. The husband's presence made communication hard, but the woman's gaze told Quattrone all he needed to know.

"We understood each other," Quattrone said. "She was oppressed in her role as a Mafioso's wife." Diagnosis? Existential loneliness.

Quattrone scoffed at the notion her husband would ever consider psychotherapy himself. As fictional mob boss Tony Soprano put it to his therapist in "The Sopranos": "I understand therapy as a concept. But in my world it does not go down."