Colonial Madness: Psychiatry in French North Africa (review)

Combining an intellectual history of clinical practice and scientific theory with a social and cultural history of the institution and experience of psychiatry in a colonial context, Richard Keller’s book is a valuable contribution both to the comparative history of medicine and to the critical history of colonialism, the disciplines, and the durable systems of social power erected at their intersection during the nineteenth and twentieth centuries. Although much of the book inevitably focuses on Algeria, institutions, practitioners, and case histories in Tunisia and Morocco also figure prominently. The relationship of psychiatry in colonial North Africa to the profession in France is also given due attention, with particular reference both to the importance of colonial notions of ethnopsychology in relation to immigration and the degree to which, in psychiatry, the colonial “periphery” in fact became the leading center of developments in the French profession for much of the twentieth century.

The discussion begins with a sensitive exploration of the position of the mentally ill in nineteenth century North Africa, the perception of “Muslim insanity” among European observers, and the tension between the imperatives of “reform” and confinement that framed psychiatrists’ conception of their vocation. Chapters 2, 3, and 4 pursue a detailed institutional and social history of the making of psychiatric knowledge and practice in the Maghreb; they focus on the “Algiers School” of Antoine Porot and the emergence of both innovative mental health and social work programs, on the one hand, and a pernicious conception of “native mentality” on the other. Chapters 5 and 6 shift the focus to consider how the meanings of madness and colonial violence have been explored in literature and film, notably in the texts of Fanon, Kateb, Memmi, and Boudjedra and in recent films by Abdellatif Kechiche and Malek Bensmaïl. A final set of considerations addresses the challenges and innovations of psychiatry in the contemporary Maghreb, the uses of ethnopsychiatry in the contemporary French “global city,” and the reiterated reference to a psychology of suffering in recent public debate on the memory and inheritance of the Algerian war of independence.

This is an ambitious study, navigating between different kinds of evidence and deploying a range of analytical registers to deal with them. The major themes of the study are clearly laid out in the introduction and opening chapter, but subsequent chapters pursue them somewhat unevenly. Keller is most successful in his delineation of the social and institutional history of psychiatry. The abiding tension between humanitarianism and repression that gave the profession a particularly wicked inflection in the colonial world is carefully explored; Keller’s account of a simultaneously progressive and “uncomprehending” science that ends up as an arm of police repression and counterinsurgency warfare is perhaps the book’s greatest contribution in several fields. The discourse analysis in the final two chapters, by contrast, is disappointing: rather than pursuing the nuanced analysis of earlier chapters, Colonial Madness ultimately tends toward replicating a well-worn narrative of pathological Algerian violence born of colonial “dehumanization” and the supposed “impossibility of real subjectivity” (174) among “the colonized.” This attributes to Fanon’s (brilliant but deeply problematic) account a straightforward truth-value that it cannot be held to contain; it also credits colonial discourse with an effective force it never in reality possessed. The qualification that (Fanon’s) “Manichaean world may not be historically ‘accurate’ [sic] but [that the texts considered] reveal how this world was experienced as a historical reality” (189) cannot suffice: a multitude of other experiences are simply expunged in this kind of narrative, which paradoxically, and against the author’s avowed intention, detaches these texts from the more complex conditions of their production.

In chapter 6 the 1990s violence in Algeria is posited as “a renegotiation of the... war of independence” whose origin (sic) is “madness” (194); Algeria’s anguish has been real enough, but this picture is much too simple. This is psychology merely as a rhetorical...