Football Therapy tackles schizophrenia

If you drove past on the autostrada, and briefly looked down at this little football game in the Bufalotta suburb of Rome, you might not notice any difference to a normal match.

It's when you get down on the touchlines that you discover the truth: half of the players are schizophrenics. This is the Gabbiano club, a side conceived and brought together by a psychiatrist, as a startling and successful form of psychiatric therapy.

Mauro Rafaelli is the man responsible for the original concept behind Gabbiano. Taking a breather from the game, he likes to play alongside his patients, he comes over to tell the story.

"The notion of Football Therapy first struck me, 14 years ago, when I was in a Rome hospital. I was treating one of the patients you can see out there - Alessandro. I was injecting his legs, and I realised they were notably muscular, like an athlete. So I asked him if he had ever played sport, and he said 'Yes - football.'"

This revelation gave Mauro a crucial insight. He could reconnect the patients with their happy and healthy childhoods, by getting them to kick a ball around, and even play proper matches.

Encountering opposition
In its early days, Mauro's Football Therapy encountered real opposition - not just on the pitch. Managers of sports grounds didn't want schizophrenics hanging around their changing rooms. Some claimed that the patients might attack bystanders.

The psychologists persuaded the powers-that-be that such fears were baseless. Since then the concept has blossomed. Now there are 50 different teams of psychiatric patients right across Italy who take part inchampionships and tournaments. And the reason everyone has changed their attitude is quite simple: Football Therapy seems to work.

Mauro points at Alessandro again: a tall gangly player who looks slightly like Zinedine Zidane.

"Before we got him into football, Sandro was truly sick. He was suffering with wild hallucinations, and hearing many voices. But most of these symptoms have been ameliorated with football."

The second half is about to begin. Before the restart, Mauro calls over some other patients. We meet Luca Denei, an ex-security guard. Ten years ago, he tells us, he was virtually catatonic from severe depression. Now he's married, got four daughters, and he's just started a course at Rome University.

Naturally, football is not a total cure. Another player, 41-year-old Benedetto Quirino, attests to this. He comes from a wealthy and cultured background, he speaks very good English, and was himself, ironically, a psychology graduate. He believes he has greatly benefited from Rafaelli's revolutionary therapy. But he remains very disturbed: one of the most afflicted schizophrenics here in Bufalotta.

Overcoming the illness
Benedetto tries to tell us about his condition. But his attention span breaks. Then he appears to hear voices in his head - he is mumbling to someone else, quite invisible to onlookers. Tics agitate his intelligent face. You can see the anxiety under the smile.

It is heart-wrenching. And it gives a profound insight into the sheer courage people must discover in themselves, to tackle an illness as debilitating as schizophrenia. In the end Benedetto wanders over to the dug-out, muttering away. But when he gets back into the game the transformation is complete. He is running around like anyone else, calling for the ball, whacking a tasty volley at goal.

"When you run out on the pitch, the voices stop," he explains. "Your opponent is no longer inside you, he has come out and you can dribble round him and beat him."

Another doctor joins us. Santo Rullo works in Villa Letizia, a Therapeutic Residential Community on the outskirts of the Italian capital. Along with Mauro, Santo was one of the creators of Football Therapy.

He elaborates on the curative process.

"A football team is a social group, each individual has a role, everyone has a social place; rules and relationships are all-important. So when an isolated and excluded person joins a team, it teaches them to live in, and with, the larger community. That's why it is important that doctors play with the patients, so there is no division between the supposedly normal and the abnormal."

The doctors, Santo says, don't only use football in their therapy, they still use anti-psychotic drugs, like any modern clinician; but they have discovered that, when they employ Football Therapy, the patients require less medication.

"This is very important," says Santo, "Because the drugs we usually give schizophrenics essentially mimic Parkinson's disease. These powerful drugs block the brain and the body, they reduce mobility, whereas football unlocks people, and gives them energy. Fifty per cent of our patients need fewer drugs after playing."

He wipes his face with a towel - it's a warm day for winter - then he adds: "Another great advantage of soccer therapy is that the players increase their endorphin levels - the happy hormone that makes you feel good after exercise. Many disabling mental conditions, like depression, are linked with reduced endorphins."

The game has ended. The reds have won, despite a spirited fight back from the whites. For the after-match celebrations, we all repair to a nearby, slightly rundown part of Rome, the port area where Alessandro grew up.

The story of a schizophrenic
We join Sandro and his mum in their small but cosy apartment. As Sandro showers down, his mum tells her son's life-story. Sandro was a perfectly ordinary, rather handsome young Italian man. He was working as a bodyguard for the Italian president. But the stress of carrying a gun, and worrying about assassination attempts, catalysed a latent psychosis in Alessandro.

As his mother puts it: "Suddenly he was talking to himself, talking to the TV. He lost his job. He had terrible mood-swings. I wanted to know if he was faking so I got a guitar and smashed it over his head. He wasn't faking, he just sat there. A few days later he ran out of the house and my other son had to call the police. Sandro was restrained. And that's when it all began."

Sandro returns. He opens a bottle of wine.

"I like to think that my mum was my first medication," he said. "I guess football was my second. Football worked for me because it helped me escape the prison of madness. Lots of people with my illness have died violently, they have accidents, or they kill themselves. And I was heading the same way: I was very mad. It was as if I was exploding, with all the millions of voices."

The moment is tense. His mum touches his shoulder; he goes on. "But then I started playing football, and I started to manage things. The weird thing is, the opposite team became the voices in my head, they embodied the voices, and that helped me. Because it made them real. And then I could cope."

The doorbell goes: Mauro the psychologist joins us. And then a second bottle of wine is opened, and the family laughter gets louder. There's a sense of celebration in the air. And no wonder. For people like Sandro, just getting through another day is a minor but important triumph.

A bit like winning a football match.