Image: Lorraine Bracco, James Gandolfini in "The Sopranos"
AP
Life may be imitating art as increasingly anxious Italian mob bosses seek therapy from a select group of therapists, just like TV mob boss Tony Soprano (played by James Gandolfini in the HBO series "The Sopranos").
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updated 11/8/2010 8:36:26 AM ET 2010-11-08T13:36:26

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. Absolutely 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 from his head and the imaginary blotches popping up all over his arms.

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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 ratting, wives left frigid by rigid codes of loyalty. In exclusive interviews with The Associated Press, granted on condition that the identities of the mobsters not be revealed in line with doctor-patient confidentiality, the doctors offered rare insights into the secretive, increasingly strung-out world of Italy's centuries-old criminal organizations.

Quattrone, a neuropsychiatrist, treated his jailed patient, a member of the criminal organization 'Ndrangheta, 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 organized crime families wrestling with self-doubt, unsure they are cut out to take their fathers' and grandfathers' place in the bloody, vengeful world of the mob.

'If my father knows I come here, he'll kill us'
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," said Lo Verso. "A mafioso is paranoid about everything" — trusting the mafia code of silence ("omerta") more than the medical code of 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 sometimes the mobsters themselves.

Quattrone, the head of neuropsychiatry at a Reggio Calabria hospital, was once summoned to an apartment building in an upscale neighborhood. An elevator, with no buttons and an armored door, led from the garage straight to an apartment with windows shuttered tight.

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In the sprawling master bedroom, complete with inlaid swimming pool, 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 everything he needed to know.

"We understood each other," Quattrone said. "She was oppressed in her role as a mafioso's wife."

Diagnosis? Existential loneliness.

The wife was depressed because she could hardly ever get out of the house — and had a driver and a car with tinted windows on the rare times she did. The psychiatrist prescribed anti-depressants and checked up on her for the next few months.

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

A masters in Mafia psychology
Lo Verso teaches at Palermo's University of Studies, which will soon offer a masters course in mafia psychology, the first of its kind. The therapists draw psychological profiles from treatment of mobsters and their relatives, turncoat testimony in courtrooms, lawyers' dealings with mafia clients, and countless pages of intercepted conversations between bosses that wind up in indictments.

Group therapy sessions conducted in prison also provide fodder for Lo Verso's research.

At group talk in Reggio Calabria's maximum-security San Pietro Prison, inmates turned up perfectly groomed — doused in cologne, hair neatly combed, nattily dressed — and sat in armchairs arranged in a circle, recalled Paolo Pratico, a Calabrian psychologist who organized three sessions.

The prisoners showed eagerness to earn "good conduct" points toward early release. But to the man, they refused to admit the 'ndrangheta even existed. Rather, they insisted they were victims of a miscarriage of justice. If the mafia doesn't exist, they argued, how could they be convicted of mafia association?

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Many mobsters stay silent when Quattrone visits them in prison. A few complain of nightmares. They see "terrifying" images, but not of the people they've killed. One jailed mobster's sleep was haunted by thoughts of his terminally ill 12-year-old daughter.

"I can't sleep because I hear the voice of my daughter," the mobster lamented. "It's not fair that I can't see her. I can't accept that."

No 'crises of conscience' for most mobsters
Sociologist Alessandra Dino, who has interviewed wives of Cosa Nostra turncoats and pored over transcripts of turncoat testimony to prosecutors, believes few mobsters have "crises of conscience."

"They have a mechanism of neutrality, where deviance equals normality," said Dino, who teaches at Palermo's university. "Murder becomes philanthropic because it is somehow related to helping the group they belong to."

Lo Verso said he has concluded that "the mafioso identifies himself totally with Cosa Nostra, which is his family. He has no individuality."

The therapist recalled a woman who was leaving her Cosa Nostra husband. She came to him for a psychiatric evaluation in a bid to gain custody of the couple's children. The woman, in her 40s, was beautiful, elegantly dressed and accompanied by her lover.

The pair would go away to romantic hotels for the weekend and sleep in the same bed. The man would undress and get sexually aroused, but the woman kept her clothes on and never showed any sign of sexual excitement.

She had the Mafia hardwired inside her, Lo Verso concluded — noting that, like many Mafia wives, she was the daughter of a mob boss, well familiar with Cosa Nostra's code that the wife never betrays the husband. In short, she remained married to the mob — all the more striking because she suspected her husband of having a hand in her father's slaying.

Quattrone said over the last decade or two, he has seen a slight shift, from mobsters who wouldn't have anything to do with psychologists to those who will consult them if they think the problem can somehow be "masked" as a physical illness.

A 'ndrangheta family from the Calabrian countryside came to Quattrone after their young daughter started having panic attacks. "She can't have a mental illness, she has to have a physical problem," the girl's mother and brother told him.

Quattrone ran a battery of tests, and did find an unrelated physical ailment.

"The family was very happy to hear she had something. ... Because if it's a mental illness, the family risks being seen as untrustworthy."

Alberto Cisterna, a prosecutor in the national anti-Mafia office in Rome, is a Calabrian whose schoolmates included future 'ndrangheta bosses. He is fascinated by the growing body of psychological studies of mobsters, since "psychology figures a lot" in persuading a boss to turn over evidence.

In the rugged Aspromonte mountains of Calabria, Cisterna said, paramilitary police go out every night looking for fugitive mobsters, often in their families' farmhouses.

"You don't go looking for them at high noon, you go at 4 a.m.," Cisterna said in an interview. "The kids are bundled up in blankets and put in the street ... Everything in the house gets turned upside down."

After repeated raids, Cisterna said, "the wife will either begin to hate the state, or they'll hate their husband who subjects them to this."

In Taurianova, a 'ndrangheta stronghold, students at a vocational high school discussed how the crime syndicate affects their lives. Daniela, a soft-spoken 16-year-old from the nearby town of Rizziconi, talked about a childhood friend, the son of lawyer now in prison on charges of murder and of belonging to the 'ndrangheta.

The boy often asks her to go to his house and keep him and his mother company.

"Sometimes he cries and cries and says, 'I don't want to end up like my father,'" Daniela said.

Copyright 2010 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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