‘Disalienation’: Book Review

Frances Williams reviews Disalienation: Politics, Philosophy, and Radical Psychiatry in Post-war France (University of Chicago Press, 2021) by Camille Robcis.

The title of Camille Robcis’ book, Disalienation, presents an intriguing paradox: a positive state of mind and social-being, framed as double-negative. The sub-title further promises an exploration of ‘politics, philosophy and radical psychiatry in Postwar-France’, making it clear that this hopeful proposition was forged out of a very dark history. ‘From 1940 to 1945, during the German occupation of France, forty thousand patients died in French psychiatric hospitals,’ (1) the book begins. 

Robcis situates alienation – feelings of being estranged, trapped or isolated – as an affect acutely felt amongst doctors and thinkers who survived the war as refugees and resistance fighters. The ‘policy of extermination that the Nazi State promoted’ was one ‘the Vichy regime silently endorsed’, she notes, with resonance for our own Alt-right age. Robcis admits to finding fresh impetus for her study through recent events (she finished writing in 2020). ’One of my goals is to… read institutional psychotherapy as a political theory, an attempt to envision a political imaginary that can still be useful today’ (10). This is a prospect she lets hang in the reader’s mind, returning to it only at the very end of her book.

The central journey charted here is the rise and fall of institutional psychotherapy – a model of psychiatric treatment developed by Francois Tosquelles, a psychiatrist who fled from Catalonia to Vichy France. Intent on saving the lives of neglected patients housed at an asylum in Saint Alban, he mobilises not only provision of food, but re-casts the institution as a laboratory of political invention. Robcis charts the journey of institutional psychotherapy (or socialthérapie as it was also termed) as a set of practices applied across sites and decades, but primarily fought for – and over – amongst influential men. She lightly brushes over their status as such: ‘Mostly male and mostly white,’ they ‘often failed to question some obvious hierarchies around gender and race’ (9).

Her own interest in gathering these radicals together in this way arrives out of her understanding of shared approaches spawning both ‘incredibly visionary and progressive analysis’ alongside ‘remarkably conservative and retrograde positions’ (9). Her aim is to test potentials of the past (recorded as historian) with those that might be present in the present (as contemporary theorist), contributing to ‘historiographical and theoretical discussions’ alike. She describes how Francois Tosquelles, Franz Fanon, Felix Guattari and Michel Foucault supported each other to test new models and methods of clinical practice, the ground work out of which theory could develop. She borrows an image from Walter Benjamin to organise these personalities, ‘a constellation’, that gives a ‘spatial arrangement without an origin or endpoint in which certain links and connections can come to light or be obscured, depending on the observers viewpoint’ (13).

Tosquelles is posited as the ‘decisive figure’ in that he played a ‘key role in the dialogue between psychoanalysis and psychiatry in 20th century France’ (16). It was his experience of political organisation during the Spanish Civil war (1936-39) that convinced him that politics and psychiatry could work together to ‘disalienate’ and ‘disoccupy’ minds as he attempted to bring together readings of Marx with those of Freud. Whilst involved in anarchist politics in fascist Spain, he became interested in ‘promoting decentralisation, self-management and solidarity within the confines of the asylum’ (19). The problem with institutions was not that they existed, but that they had become ‘concentrationalist – authoritarian, hierarchical, oppressive and stagnant’ (12). Tosquelles (re)conceived the ‘institution as space of exchange’ in direct repudiation of the internment camp whose psychic and physical harms he also experienced directly. In this way, ‘it was possible to remain institutional while critical’ (6). 

Tosquelles went about the re-arrangement of this asylum quite literally – taking down walls between cells – buoyed by the writings of Jacques Lacan which suggested that the internal divisions within the patients’ psyches might likewise be freed. As one volunteer who tore down the walls of the compound recalls, the ‘Liberation of the territory was also the liberation of the asylum’ (39). In this way, an alternate ‘revolutionary horizon’ was opened-up, a state of social and political ‘disalienation’ made a ‘possible and reachable goal’ (11). Those who came to visit and work at Saint-Alban were energised in the belief that institutions could be subject to ongoing processes of being ‘rethought, reworked and remapped’ by those who inhabited them, a working model suspicious of ‘doctrinal purity and theoretical a prioris’ (12). Experimentation and adaption were seen as key to success with no particular creative or social activity seen as therapeutic, per se, so much as an investment of ‘affective economic and social value’ discovered jointly with others, with staff cast as co-revivers of the ‘symbolic dimension of life’ (44).

Franz Fanon’s contribution to theories of self are charted by way of his experience of racism and colonialism, social orders that rendered whole populations ‘alien’ in their ‘own country’ (48). Robcis shows how Fanon tested the Saint-Alban model out in a series of institutional contexts across North Africa. A Muslim men’s section of an institution in Tangiers, for example, refused an initial offer of Western films and parties, preferring to set-up a cafe space where they played dominos amongst themselves. ‘We forgot that such approaches must be preceded by a persistent, real and concrete interrogation into the organismic base of an indigenous society’, Fanon observed, on beginning the task of ‘de-colonising’ institutional therapy through developing alternate ’models, schemas, examples’ that could help to disalienate and reconstruct the post colonial social’(71).

P. 76, Fig. 3.2 Postcard of the Château de La Borde © Public Domain

Chapter three focusses on the experimental institution of ‘La Borde’ housed in a former Chateau in the Loire. Owned by Jean Oury – who authored a book entitled ‘institutional pedagogy’- it was run by Felix Guattari, under whose direction it became a ‘site of pilgrimage’ (77) for French intellectuals in the ‘60s and ‘70s (as well as artists, writers and filmmakers). Robcis positions La Borde as a spin-off of Saint-Alban developed in a very different context – a period when the immediate threat was ‘no longer one of historical fascism’, but rather its persistence as the ‘love of power’: ‘Our desire for the very thing that dominates and exploits us’ (78). The working model adopted here – known as ‘the grid’ – revolved around shared work, flat organisational models and copious meetings. A micro-society was fostered which generated its own cultural references, ethical code, system of governance and pedagogical impetus, intent not on ‘molding existing subjectivities but producing new ones’ (81).

Robcis gives a subtle account of La Borde’s treatment of psychosis, one which drew heavily on Lacan’s ideas of ‘anti-oedipal politics’.  The ‘trick’ of institutional psychotherapy as described by Oury, was to offer ‘partial responsibilities’ through the ‘dispersal and association of transference’ (86). Thus collective responsibilities that could better give patients new orientations, referents, and foster the desire and will to live. The complex inter-play that developed between the ideas of Lacan and Oury (and by proxy, Freud,) is one that Robcis lays out carefully, at pains to consider the attitudinal dispositions of these characters as they jointly build distinction through discussion of the structures of authority set out by way of Lacan’s concept of the nom-du-pere (name of the father).

P. 126, Fig. 4.2 May ’68 Poster: “Bourgeois Medicine Does Not Heal, It Repairs Workers” © Beinecke Rare Book and Manuscript Library, Yale University

The constellation implodes leading-up to the May ‘68 uprisings, a moment when a concerted movement challenging authority was ignited and mobilized – albeit cast by Guattari as an ‘abortive revolution’ (89). From being mistaken as a form of anti-psychiatry, institute psychotherapy found itself forced to defend its psychiatric premise against the charges made by Michael Foucault through his History of Madness (published in 1961). Always more skeptical of the potentials allowed by institutional psychotherapy, Foucault’s theory of power identified alienation more as ‘an effect rather than a cause’:

‘Instead of beginning with a pre-established definition of the “abnormal” as a “pure state” and defining illness as the pathological behaviour of the abnormal and alienation as the alteration of personality resulting from this process,’ Foucault argued that ‘classical pathology needed to “reverse the order of things”; begin with alienation as the original situation, to then understand illness, and finally arrive at the definition of the abnormal’ (118).

In composing this narrative arc, Robcis feels in total command of her archival material. But what stands out is her articulation of the mediums and agencies that served to propel concepts in unison, while others were overshadowed and eclipsed. As a non-specialist, I was swept along by her ability to make clear, nuanced argument amid richly-textured contexts. The last chapter presents a thrilling account of how Foucault made parts of his own history disappear (though downplaying the extent to which he was once entangled amongst Saint Alban’s ideas-figures). Photographs and illustrations add to the sense of ideas being made manifest in material form – through architecture, posters, letters and artworks – as well as embodied by doctors and patients through their densely-woven (dis)associations. 

Ultimately, Robcis refuses to a take sides on institutional therapy, ‘neither a hagiography nor a repudiation’ (149). Her text is both forensic and capacious enough to allow contemporary readers to engage with it on their own terms. She amply succeeds in underlining the point that any understanding of fascism cannot be ahistorical, however ‘haunted’ our own age currently appears. ’Infused’ is the verb she used to describe this process of saturation whereby political and affective commitments join and give life to one another, across spaces and times (147). This dynamic approach marks this book out from others that take a more detached stance on what French Theoryis and how it can be understood – it is far more relational, playful and in sync with the spirit of her protagonists (and less ‘French’ too). She carries the point, taken from Tosquelles, that psychic manifestations do not result from single causes, but are in ‘constant interaction’ with social factors. Perhaps, finally then, this is also a feminist re-reading of fallen ‘heroes’, one that exposes the extent of mutual inter-dependencies. Robcis shows how these men’s legacies might persist in new form by way of their limitation. Indeed, especially so. 

Dr Frances Williams completed her PhD – a study of the field of ‘Arts in Health’ in relation to devolution and place – at Manchester Metropolitan University (Williams, 2019). She will teach on related topics for a new MA at Wrexham Glyndwr University, North Wales. Follow Frances on Twitter @francespushkin. 

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