Applied Psychology OPUS

Identity, Therapy, and Womanhood: Humanity in the Mafia

Grace Anzalone

“Tom, don't let anybody kid you. It's all personal, every bit of business. Every piece of shit every man has to eat every day of his life is personal. They call it business. OK. But it's personal as hell. You know where I learned that from? The Don. My old man. The Godfather."

― Mario Puzo, The Godfather

Since the debut of The Godfather in 1972, American film and television has rhapsodized and romanticized the Italian Mafia. As the Mafia in America has dwindled in the past few decades, media glorification of mobsters has only risen, with some of the most-watched films and TV shows centering around the Italian Mafia in particular (DeStefano, 2006). The Mafia captures the American public’s attention in part because the actions of its members are beyond comprehension. Although the organization’s base values of loyalty, family, and justice are some that many Americans hold dear, what makes the Mafia so fascinating - and horrifying - is the ends its members will go to in order to achieve their goals. Thus, there remains a clear duality in the American public’s perception of the Mafia: a vision of base and ignoble criminals who cannot be redeemed, and a vision of good and fair heroes who bring justice to an otherwise unjust political system.   

Although the American media has glorified the Mafia in books, film, and TV shows, the reality is much different. What most Americans know as the Mafia or simply “the mob” is really La Cosa Nostra, the Sicilian body of organized crime that arrived in America during the great wave of southern Italian immigration (Guglielmo & Salerno, 2003). “Cosa Nostra” is Italian for “our thing,” and this seemingly simple title underscores two of the most central philosophies of the organization: collectiveness and secrecy. La Cosa Nostra imbues its members with a collective mentality and requires unquestioned commitment and dedication, a value underscored by calling each clan a Family. Because La Cosa Nostra originated as an alternative system of justice in the face of a corrupt and tyrannical Sicilian government (Dickie, 2005), it places the highest value on silence and is decidedly mistrustful of any governmental authority. Likewise, the organization is highly hierarchal and centralized, so that every member has a distinct rank and purpose. This cultural environment and set of strict social norms, however, ultimately serves to achieve money, power, and security for the group. 

The primacy of silence and secrecy in Mafia culture make clinical attention and research extremely difficult in this population. Although some sociologists have investigated the machine-like organizational structure of the organization, they have largely ignored the human nature of the Mafiosi. Although they operate within extraordinarily dangerous circumstances and under extreme psychological pressure, the Mafiosi, their wives, and their children have distinctly human ways of coping with these stresses and forming identity in their environment. Although literature examining personal and interpersonal forces in La Cosa Nostra is scarce, it is a topic that deserves much attention moving forward. In order to understand the phenomenon of the Mafia itself, it becomes necessary to develop a much richer understanding the forces that make each member inclined to conform. 

This review will adopt a clinical psychological lens in order to investigate how individuals cope with their own and their relatives’ Mafia involvement. The goal of this review is not to sympathize with those who commit acts of violence, but to bring the phenomenon of the Mafia to life. It hopes to shift the focus from the glorified hero and feared criminals portrayed in the media to human beings operating within a particular cultural environment. In particular, this review has three research questions: 1) How do Mafiosi men view themselves and their identities? 2) What are some clinical perspectives on the psychotherapeutic treatment of individuals connected to the Mafia? 3) What is the role of women in such an explicitly male-dominated system?

The Mafioso Identity

In order to penetrate the inner psychic workings of the average Mafia member, one must first examine how he reconciles his membership in La Cosa Nostra with his individual sense of self. Each individual brought up in the traditional Cosa Nostra structure draws his identity from the organization’s mission. Members are born into an environment that stresses a collective mentality from a young age, teaching them to rely almost exclusively on the “full” family unit for support (i.e., the Cosa Nostra Family to which he or his family belongs, in addition to blood relationships). Because of this mentality, members of the Cosa Nostra community are inseparable from the context of the Family and community to which they belong (Lo Verso & Lo Coco, 2004), and this group identification becomes an indelible part of their identity.

Although this strong group identity may initially provide a rationalization for individuals who commit violent crimes, it is also a mechanism that directly benefits the Mafia itself. Dino (2012) points to the Cosa Nostra family as the provider of identity, and explains that the organization often actively discourages individuality in order to strengthen its own interests. Being unable to gain a sense of personal worth from their own life, Mafia members are entirely reliant upon the organization to provide social and psychological support. In this way, the member can feel virtually incapable of acting against the will of the group; besides facing possibly fatal repercussions, the feelings of failure and worthlessness that come with defiance seem even worse.

Of course, this lack of personal identity comes at a price to the individual. Identity, especially in the male Mafia brain, is very fragile, as it hinges on an organization that systematically commits violent crime and perverts family values. Although Mafia value codes stress dedication to one’s family, this dedication serves primarily to maintain a foundation in the Mafioso’s life so that he can approach his work with a clear head. The extreme hierarchal nature of the Cosa Nostra highlights this lack of depth in relationships; a lowly ranking clan member is not permitted to voice dissent, which can severely undermine his sense of self-efficacy (Di Maria & Lo Verso, 2007). Family relationships, although intrinsically valuable to both the group and the person, are characterized less by love than necessity.

Although the interpersonal dynamics of Mafia relationships help members to function without a strong personal identity, the fragility of their inner world is especially apparent when group membership is removed. Members who have either lost favor or choose to leave La Cosa Nostra are routinely plagued with psychosomatic symptoms, often become socially isolated, and may become filled with guilt about the criminal acts they have committed (Lo Verso & Lo Coco, 2004). Although there are very few examinations of Mafia or ex-Mafia samples in the literature, existing clinical observations (Fabj, 2013) have reported incredibly high rates of suicide, depression, and isolation.

Clinical Perspectives on Treating the Mafia

Through an examination of the few existing clinical interviews with Mafia members and their families, researchers and practitioners can gain some insight into the human side of a phenomenon that seems inherently inhumane. Mafia members sometimes seek out psychotherapy when they choose to leave the organization, are no longer allowed to be members, or are incarcerated (Fabj, 2013; Lo Verso & Lo Coco, 2004). Although the authors emphasize that trends in psychotherapy cannot necessarily be generalized to all criminals or even all mob members, existing studies have noted that their results were striking in their consistency and commonality among Mafioso patients. Although psychotherapeutic gains were moderately small in Mafiosi (Fabj, 2013), examining them in this setting allowed significant insight into their individual mental states and the group itself.

Lo Verso and Lo Coco (2004) explain the initial appeal that involvement in the Cosa Nostra has to potential members. Ex-members report that they viewed the Mafia from a young age as a way to obtain pride, money, and prestige. They also noted that past members consistently returned to the explanation that the weakness of the Sicilian government created an opening for the respected, family-made, “honorable” criminal. Family cements each clan to create a united organization that punishes disloyalty with death, and ingrains this, as well as a hatred for the police and need for masculine traits, from a young age (Fabj, 2013). Once he has become successfully initiated, the Mafia member starts to lose his ability to differentiate between his own likes, goals, and enemies, and those of his Cosa Nostra family.

In addition, clinical interviews have shown that the morality of Mafia members is almost nonexistent. Not only did they not experience guilt for crimes including murder, but few could recall feeling afraid at any time (Lo Verso & Lo Coco, 2004). Besides the continual thirst for money and power, members repressed other emotions (e.g., love, shame, sexual desire) until they decided to leave the Mafia. Likewise, guilt-laden dreams, whether about betraying one’s family or committing acts of violence, emerged only after cooperating with the police and renouncing membership (Fabj, 2013). Research suggests that the removal of group identity removes the primary tool by which members used to cope; without a greater sense of purpose, the machine-like unfeeling is removed and gives way to guilt, confusion, and psychic turmoil (Lo Verso & Lo Coco, 2004).

Although therapeutic gains were observed in some Mafiosi, rarely did members ever return to an average level of psychological health. Still, significant gains were made during the course of psychotherapy in about 25% of members. Interestingly, many of the members who benefited from psychotherapy were devoutly associated with a religion (Fabj, 2013). More often, however, Mafiosi’s therapy was often slow-moving, difficult for the therapist, and frequently futile. Although the examination of clinical work sometimes showed significant change and progress, there are great obstacles to therapeutic progress in this population (Lo Verso & Lo Coco, 2004). Even highly trained psychotherapists can face issues (e.g., fears of their own safety, moral disgust) that can impede hope for recovery or even a stable psyche. Still, psychotherapeutic work with members of this unique culture gives us significant insight into the true operation of La Cosa Nostra.

Therapeutic gains were significantly higher in Mafia members’ spouses and children. Although some aspects of Mafia life seemed to permanently desensitize a large portion of ex-members, “typical” morality and individual identity is much more observable in relatives (Di Maria & Lo Verso, 2007). Likewise, less directly involved relatives were shown to have more productive relationship with therapists, as the therapists could better empathize with their situation without directing any blame or fear toward the patient (Lo Coco & Lo Verso, 2007).

The Role of Women in the Mafia


Limited research of therapy with females associated with the Mafia indicates that although the Cosa Nostra is explicitly male run and dominated, women hold a deceptively important role. Women are involved in the keeping of secrets, thus seemingly hold the keys to the centrality of the Mafia’s mission (Di Maria & Lo Verso, 2007). Officially, women exist to procreate, seal family alliances, and keep quiet whatever secrets they know. Research points out that this traditional conception of women’s role in the Mafia underestimates their involvement. Women are the ultimate symbol of family, which is the central unit of identity in the Mafia. Although women associated with the Mafia are often exploited and dominated, marriage and motherhood brings about the woman’s crucial role in advancing the the organization’s mission.

The power of the maternal figure is both direct and indirect. Directly, mothers have the opportunity to condone and enforce family and Mafia values in their sons, often excusing them from acts of violence at a young age. A weak, or perhaps just uncommitted mother may not further the Mafia’s message and thus not successfully create the “we” identity in her son. Without the loyalty, commitment, and biased moral judgment of the maternal figure, the organization’s familial glue can fall apart. Thus, Mafia mothers are empowered victims and hold a unique and important role in the furtherance of the organization (Di Maria & Lo Verso, 2007).

Women in the Mafia also exert their influence on the Cosa Nostra beyond motherhood. Although crimes committed by females are often a simple noted exception in the male-dominated literature on crime, research suggests that women are systematically excluded from both judicial consequences and widespread visibility (Dino, 2012). Likewise, although the Cosa Nostra and laypersons alike often view female involvement in crime as a novelty or freak act, the lower frequency of female committed crimes is likely due to social factors, not genetic or ingrained ones (Dino, 2012). Underlining the civil belief that women are incapable of taking responsibility for their own actions, indictment rates between male and female criminals are vastly different. It may be possible that this belief comes from the strongly imbued Sicilian patriarchy of male husbands, fathers, judges, and politicians (Dino, 2012). It may not be that females are necessarily unable or disinterested in criminal activity, but rather that their role is downplayed both inside and outside of the Cosa Nostra, and any interest in “masculine” business becomes insignificant (Di Maria & Lo Verso, 2007).

Mafia-associated women are often assigned traditional roles that form various archetypes in the Cosa Nostra world. These roles are based around the role of wife and mother, educator, and central socializer of values. Furthermore, religious functions are often assigned to women, to present a public face and perhaps confuse law enforcement. Lastly, it is often the wifely duty to legitimize the male’s authority through reinforcing family ties and power structure (Di Maria & Lo Verso, 2007). Female deviation from these traditional roles is often ignored and thus removed from visibility, which could partially explain their tendency to be under-represented in the Mafia.

Because Mafia culture assigns silence as a duty to females, the full extent of her influence is hard to ascertain. To deal with female diversity, male members seek to make the female influence invisible, and thus less influential. If the group is perceived as an all-male enterprise, it continues to be an all-male enterprise. Although expectations of a male-dominated structure assuredly discourage women from participating, Dino (2012) points out a new role of the ‘today’ woman of the Cosa Nostra. While still rooted in traditional family ties, the modern female involves herself in the organization through her own abilities in order to fulfill it’s mission. Still, men in the Mafia are fully controlling the amount of visibility modern women receive, which allows the Cosa Nostra to maintain the level of female influence that it deems acceptable (Dino, 2012).

An understanding of how the Mafia treats women provides yet another window into the Mafia mentality and identity. Wives, mothers, and especially active members of the organization are represented, and often misrepresented by the male-run Mafia. Women’s evolving yet stagnant role highlights the fact that women are often marginalized and underestimated in the Cosa Nostra because the mission requires that “foreigners,” in this case, women, be assigned traditional roles and, even when committing a crime or being useful, are rarely acknowledged for it (Dino, 2012). Certain archetypes of women are permitted while others are scorned, and those who do not fit into a traditional role are dealt with as insane or unworthy to accept responsibility for a crime they committed (Di Maria & Lo Verso, 2007).

Women and men represent opposing forces in the Sicilian organized crime world. Although men are of course the controllers, their mission is supported less by their individual worth as strong leaders or intimidating bosses, and more by group manipulation, partially promulgated by women (Di Maria & Lo Verso, 2007). The identity of Mafiosi seems to rely almost exclusively on manipulating another resource, be it emotional normalcy, the family unit, or denying women exposure to keep the exclusivity and structure of the group.


DeStefano, G. (2007). An offer we can’t refuse: The Mafia in the mind of America. New York: Faber & Faber.

Dickie, J. (2005). Cosa Nostra: A history of the Sicilian Mafia. New York: Palgrave Macmillan.

Di Maria, F., & Lo Verso, G. (2007). Women and the Mafia: [female roles in organized crime structures]. New York: Springer.

Dino, A. (2007). Women and the Mafia: [female roles in organized crime structures]. Miami, FL: Miami University Libraries.

Fabj, V. (1998). Intolerance, forgiveness, and promise in the rhetoric of conversion: Italian women defy the Mafia. The Quarterly Journal of Speech 84(2), 190-208.

Guglielmo, J., & Salerno, S. (2003). Are Italians white? How race is made in America. New York: Routledge.

Lo Verso, G., & Lo Coco, G. (2004). Working with patients involved in theMafia. Psychoanalytic Psychology 21(2), 171-82.