Professional Profile - Dr Mario Marrone

I trained as a medical doctor in the city of Rosario (Argentina). Medicine was intertwined with psychoanalytic psychology. As a medical student I joined a study group on psychosomatic medicine of which Dr. Isaac Abecasis was a distinguished pioneer. I also started my first personal analysis.

In the early years of my medical career I gained experience in pathology (doing biopsies). Initially, I worked in Rosario (Argentina) at the Carrasco Hospital and later in psychiatry. I also learned to play violin and cello and formed the Rosario Chamber Orchestra. In Rosario I worked as a psychiatrist in various hospitals. I also trained in social psychology and psychodrama and had my first experience at the receiving end of psychoanalytic psychotherapy.

I have always been interested in psychodrama. Psychodrama is a method of group psychotherapy developed by Jacob Moreno (1889-1974). Issues are not only discussed but also enacted like in a theatre. Some enactments can be very moving and artistic. Certainly, psychodrama is a powerful therapeutic tool. Throughout the years I attended workshops conducted by famous psychodramatists from different countries (including Anne Ancelin Schützenberger, Marcia Karp, Hernán Kesselman, Gretel Leutz, Zerka Moreno, Jaime Rojas Bermudez and Monica Zuretti to name just a few).

Over the years, I have directed psychodrama groups with mixed clinical populations as well as psychotics in hospitals. As I have said earlier, I have also run a group in Milan (Italy) with a steady membership over a period of 8 years, in which I combined a group analytic model with psychodrama, dance and other forms of creative expression and bodily techniques.

In the late 1970`s I visited therapeutic communities and psychiatric hospitals in Spain, Italy and Switzerland. I became particularly interested in a movement called “Democratic Psychiatry” which was pioneered by Franco Basaglia in Italia. The purpose of this movement was to minimize the social stigma, social isolation and disempowerment that people diagnosed as mentally ill suffered, by promoting progressive reforms

Later, I was lucky enough to work in Shenley Hospital (now closed) which at the time was a very progressive psychiatric hospital. It was designed on a villa system where patients were housed in small homely units spread on a beautiful parkland environment. Each villa had its own treatment modality and type of patients: admission, in-patient psychotherapy, etc. Psychoanalytic psychotherapy, family therapy and psychodrama were part of the repertoire of therapeutic interventions. Some villas were run as therapeutic communities.

As a Shenley doctor, I had to practice general medicine (since I had to carry out a medical assessment on every admission and act as a general practitioner every time an in-patient fell ill) but also gained experience in the fields of general acute psychiatry, psychosis, psychogeriatrics (including dementia), forensic psychiatry, personality disorders as well as individual, group, couple and family therapy and home visits. There was no area of adult psychiatry in which I had not been involved in that context. Shenley had a culture of team work and patients were meticulously discussed in interdisciplinary staff meetings.

While working in Shenley, I was given time to attend training sessions in psychotherapy at the Tavistock Clinic and take the Qualifying Course at the Institute of Group Analysis. In Britain, the Institute of Group Analysis is the main provider of training for group therapists in the UK. I was fortunate to have Malcolm Pines, Robin Skynner and Dennis Brown as some of my teachers. As part of my training I was a patient in a twice-weekly therapy group conducted by Lionel Kreeger. I also participated in large group sessions, conducted by Pat de Mare (1916 – 2008)), the founder of this method. These are groups formed by more than 25 members. I have also run large groups myself in hospital settings and in group analytic workshops. I have also gained experience working with several families together ("multifamily therapy" or "interfamily therapy").

While attending seminars at the Tavistock Clinic, I met John Bowlby (1907 - 1990). Subsequently I had weekly supervision with him for a period of ten years. John Bowlby, a British psychiatrist and psychoanalyst, developed attachment theory. Briefly, attachment theory is an emerging paradigm within psychoanalysis that underlines the fundamental role that close and durable relationships (particularly between parents and children) have in personality development and emotional life. Bowlby concluded that the infant and young child should experience a warm, intimate, and continuous relationship with his parents (or permanent parental substitutes) in which to find satisfaction and enjoyment, and that not to do so may have negative, significant and irreversible consequences for the individual’s future mental health.

Soon after qualifying as a group analyst, I started my training in psychoanalysis at the Institute of Psychoanalysis in London.  I am registered with the British Psychoanalytic Council and comply with its ethical guidelines as well as Continuous Professional Development requirements.

Together with Tirril; Harris and other colleagues, I founded the International Attachment Network (IAN), an organization aiming at promoting knowledge about attachment theory and the journal Attachment and Human Development:

I also represented IAN in the Committee in charge of the Concerted Programme on Mental Health Promotion for Children Aged 0-to-6 organized by Mental Health Europe in association with the European Union. We met in Brussels. For me that was a great opportunity to learn the principles and methodology of mental health promotion from experts like Clemens Hosman of Nijmegen(The Netherlands). I am currently a member of the Spanish Association of Infant Mental Health (ASMI).

While working at Shenley Hospital, I started developing my private practice in London. Eventually, I left the hospital to devote my time and energy to do individual work and occasionally see couples or run group therapy workshops. I have also worked in Milan and Alicante.

I trained in psychoanalysis according to the principle that proper analysis is done on the basis of five sessions a week, Monday to Friday. During my training I had to have personal analysis five sessions a week and treat two patients under supervision also five sessions a week. Some analysts used to say that no treatment less than five sessions a week could be called “psychoanalysis”. However, few patients have the time and money to hold such intensive therapies over a long period of time. I do not believe that such orthodoxy can be sustained in the present socio-economical circumstances. Therefore, technical modifications resulting in less demanding requirements for the patient are necessary. However, the pecuniary investment of having long-term intensive therapy can be rewarding. Patrick Casement, one of my supervisors, used to say “a good therapy pays at itself”. In fact, in the course of therapy and as a result of it many patients improve the way they organize their finances or increase their earning capacity.

Currently I mainly offer telephone and SKYPE sessions to patients who live far away from my home town. This is a valid form of psychotherapy, recognized as such by the International Psychoanalytic Association.

Following Bowlby, I see therapy as a safe and confidential space where a secure relationship between patient and therapist can be promoted and developed. This safe space acts as a platform from where it may be possible to explore the patient’s attachment history and current relationships (including the relationship with the therapist). Warmth, empathy and connectivity are important elements of the therapeutic relationship.