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2005 – Italy. A young man was found dead in the garage of his house. Extremely poor hygiene conditions were found in the house; several boxes of different drugs (butalbital, diazepam, lorazepam, orphenadrine, dexchlorpheniramine) and piles of garbage were scattered everywhere.

The body was found in a supine position next to the front bumper of his car without evident signs of traumatic lesions, wearing several different layers of clothing, and in a disheveled state. The face was covered in blood and from the oral cavity leaked liquid with a strong alcoholic smell. Inside the house, the walls were covered with writings and drawings, which represented a sort of “diary” narrating the man’s life, thoughts, and feelings.

Fig.1 A young man was found dead in the garage of his house.

Fig.2 Inside the house, the walls were covered with writings and drawings.

One of these writings (see Text 1 below) “described” the sudden death of the woman and indicated that the body had been hidden inside a wardrobe in an upstairs room. With the assistance of the fire brigade, the investigators opened a silicone‐sealed wardrobe, in which they found a totally mummified corpse in a sitting position. Also found inside the wardrobe was the writing Totus Tuus in latin, meaning “Totally Yours.”

The man was identified through his personal identity card. Information derived from the identity card of the woman could not be utilized, hence, DNA examinations were carried out. According to the writings on the walls, the woman would have died of natural causes in 2002, 3 years earlier than the discovery (see Text 1 below).

Fig.3 Extremely poor hygiene conditions at the scene investigation.

Fig.4 Extremely poor hygiene conditions at the scene investigation.

Fig.5 Extremely poor hygiene conditions at the scene investigation.

Fig.6 Several boxes of different drugs.

The police interviewed several neighbors about the behavior and about any possible signs of mental illness. However, nothing significant emerged. The couple had moved in after the death of the woman’s husband in 1997. They were extremely reserved and did not spend time with other people, except for the fact that the man went every month to draw the mother’s pension and drug prescriptions.

The toxicological examination of the man revealed the presence of substances corresponding to the medications which were found inside the house, in particular, butalbital (12 mg/L), diazepam (5 mg/L), alcohol (1.5 g/L), and traces of orphenadrine. The mechanism of death was identified in an acute cardiac failure caused by gastric hemorrhage associate with an overdose of psychotropic drugs and alcohol.

External examination of the mother’s body showed that the characteristics of the tissues and the general conditions were consistent with the time of death stated by the son in one of his wall writings. No traumatic injuries emerged. Autopsy revealed that all the woman’s internal organs had either spontaneously mummified and decomposed. X‐ray study of the body was performed and no traumatic evidence was identified.

Fig.7 The mother and the son.

Fig.8 The body of the mother.

Fig.9 A totally mummified corpse in a sitting position

Fig.10 Autopsy revealed that all the woman’s internal organs had spontaneously mummified and decomposed.

Fig.11 The body had been hidden inside a wardrobe.

The peculiarity of the case lies in the state of the house in which the two bodies were found, especially with regard to several writings the man had left on the walls. Here are translations of two of the writings that the man had painted on the walls. Translated from Italian into English.

Text 1: “When I saw that my mom had died, it was as if I had, too. I absolutely couldn’t accept that she wasn’t there anymore, and the fact I had not noticed, and that I couldn’t have done anything to prevent it or at least be near her when she passed away. I couldn’t accept that the umbilical cord that linked us had been severed. This time I was called upon to be truly born. And I said no. I’m afraid, I am terrified of growing up, I am afraid of living. So I decided to remain in her womb. I embraced her so as to smell her good perfume and not the scent of death. Nobody would ever separate us, my dear mom: together forever. I washed you, I sprinkled talcum powder on your delicate parts, as you did with me. Then I dressed you in clean underwear, with a clean vest that suited you so well. Then I carefully dressed you: first a white blouse, the most elegant I could find. Then I chose a blue dress and shoes of the same color. I would have liked to leave you in your bed, but I knew I would never have been able to go into the room again. I needed daily contact with you and I couldn’t accept that death would corrupt your body, nor could I be a witness to such decay. So I combed your hair, I put face powder on you, and I tried to make your shrine as comfortable as possible, especially at the points where your body would be in contact with the walls, hoping that one day I could open those doors and see you again, relaxed and untouched. But I never had the courage to do so, just contenting myself with calling by and speaking to you daily.”

Text 2: “The body of my mother is upstairs. Please be careful when you open the wardrobe, as she’s got over her head an image of the Virgin fastened with a weak nail, if it were to fall it can harm her. My body, if the devil will catch me, will be in the room above the one of my mother. But God don’t want me. I’ve tried to kill myself again and again, but a miraculous intervention saved my life. The same as, thanks to the celestial light of God and the divine strength of the Holy Virgin, with the help of my guardian angel, I won the Devil’s assaults for fifteen times, defeating him at the end. Jesus saved me and he let me understand that, walking a difficult path, but always enlightened by his light, thanks to my repentance, my expiation and the redention of my sins, I will ascend to his and I will become an instrument in His

Fig.12 From a psychoanalytic point of view, the state of the house and the writings suggest an extreme effort to deny the man’s feelings of loss and his anxieties of abandonment.

Fig.13 The writings and drawings represented a sort of “diary” narrating the man’s life, thoughts, and feelings.

Text 1 attests to the man’s inability to develop an individual identity when he was a child and the failure of the separation‐individualization process. The impossibility to complete the developmental process, and the fusion with the internal image of the archaic(very old or old-fashioned) mother, is characterized by the overwhelming presence of womb fantasies that impair the man’s capacity to accept his mother’s death and the need to live his life as a separate individual with his own identity.

Text 2 describes a “mystic” experience, from which emerge ambivalence, some drifting in respect of the reality test and suicidal experiences. However, it is not possible to define clearly the presence of hallucinations or delusions.

Fig.14 The writings and drawings represented a sort of “diary” narrating the man’s life, thoughts, and feelings.

Fig.15 According to the writings on the walls, the woman would have died of natural causes in 2002, 3 years earlier than the discovery.

In another writing, the subject feels “responsible” toward the community in which he lived, begging “pardon, piety and mercy,” in a mixture of guilt, expiation, ruin, and misery. On the whole, from the analysis of the different writings, no evident formal thought disorder seemed to emerge. Some highly hysterized and structured delusional ideas surface, although the presence of delusional beliefs cannot be clearly identified.

The affective picture is dominated by a deeply depressed mood with guilt, ruin, indignity, and devaluation themes. Some obsessive traits are suggested by the way the house was kept and by the way the man compulsively wrote on the walls and the feelings of despair, abandonment, and guilt, which may be hint of a depressive mood.

Fig.16 The writings show the existence of a perverse mother–son bond, a relationship characterized by exclusivity and dependence, ambiguity and ambivalence.

Fig.17 A police officer inspects the writings on the walls.

The lack of data pertaining to the social retirement and the environmental condition suggest a type of life retired and disorganized, whereas the fact that every month the man went to draw the mother’s pension and her medications, although she was already dead, may be hint of a manipulative and finalistic approach.

One of the paintings on the walls was a replica of the famous painting The Scream by artist Edvard Munch.

From a psychoanalytic point of view, the state of the house and the writings suggest an extreme effort to deny the man’s feelings of loss and his anxieties of abandonment, in an attempt to keep a depressive core at bay (the garbage is kept inside the house, i.e., inside the sick Self, which the subject tries to “anesthetize” through the excessive intake of drugs), the denial of the loss being due to the failure of the splitting and projecting capacity; the persecutor remains inside the Self and is kept at bay through compulsive praying, which becomes a sort of rite of exorcism. But, the persecutor is also inside the symbiotic couple and is projected outward to become an exterior persecutor, fostering the man’s paranoid fantasies and his retreat inside the house.

Fig.19 A drawing on the wall and writing inside the wardrobe meaning “Totally Yours.”

Fig.18 A police officer inspects the writings on the walls.

The writings show the existence of a perverse mother–son bond, a relationship characterized by exclusivity and dependence, ambiguity and ambivalence, expressing the son’s fantasy of fusion with his mother. This symbiotic fixation seemed to be at the root of the son’s development of a pathological personality, in which obsessive compulsive and apparent dependent traits were connected with an altered perception of the self.

The trauma of loss impacted dramatically on this pathological organization; the mother’s death shattered as a crystal the man’s personality, deconstructing the fragile symbiotic Ego, which cannot imagine any survival on its own: “On the 10th of November 2002 I found my mother dead… When I saw that it was as if I died… I could not accept the umbilical cord to be cut. This time I had to be really born. I said no. I’m afraid of being born, I’m afraid of growing up, I’m scared of living hence I decided to stay in her womb… .”

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