Living with Madness: Experimental Asylums in Poststructuralist France

By the time Foucault published History of Madness in 1961, recounting in detail “the great confinement” that excluded madness from society through banishment or internment, an informal network of leftist intellectuals had created a loosely affiliated group of experimental mental health institutions that imagined the asylum differently. Foucault’s book was especially well received by these intrepid clinicians, who had been inspired by Catalan psychiatrist François Tosquelles, a reader of Lacan, renegade Marxist, and antifascist militant. Obliged to emigrate after the 1936–39 Spanish civil war along with thousands of other Spanish leftists, Tosquelles wound up in a French refugee camp, where he set up a psychiatric service for his fellow exiles and their caretakers. The Spanish republican refugees who escaped from the French camps during World War II formed the backbone of the Resistance in southwestern France. Tosquelles was rescued from his camp by two psychiatrists from the Saint Alban hospital. In this remote rural institution, he found a mix of psychoanalysis, communism, surrealism, and the French Resistance. Whereas most psychiatric hospitals still resembled prisons, Saint Alban had opened up the asylum, encouraging meaningful human encounters among patients, staff, and clandestine residents. This more open asylum continued to provide patients and resistance fighters alike with the shelter and care denoted by the original meaning of the term. “I prefer the word ‘asylum’ to ‘psychiatric hospital,’” declares Tosquelles, explaining that “asylum means that someone can take refuge there, or can be made to take refuge there” (n.p.). Saint Alban was one of the few French psychiatric hospitals that lost none of its patients to the famine and neglect that killed forty thousand mental patients during the German occupation (Polack 2011). Whereas the prisonlike hospitals described by Foucault were designed to protect society from the patients, the experimental asylum of Saint Alban protected its patients from society.

The postwar movement that created new experimental asylums inspired by Saint Alban came to be known as Institutional Psychotherapy. Tosquelles and his followers pioneered methods for treating psychiatric inpatients using the techniques of psychoanalysis. Grounded equally in Freud and Marx, they analyzed not only the patients but also and, just as important, they analyzed the institution itself, including its social and political contexts. Born of the Spanish Civil War, then nurtured during the Resistance, Institutional Psychotherapy spread through leftist youth movements (F. Guattari 1998, 7). Jean Oury, the Lacanian analyst who founded the La Borde clinic where Félix Guattari worked throughout his adult life, followed his brother Fernand Oury into the youth hostel movement, where he encountered plenty of Trotskyists and anarchists, in addition to French Communist Party members. Already a committed leftist, Jean Oury arrived at Saint Alban in 1947. He describes Tosquelles as having “an extraordinary political conscience” (2010, 14–15). Prior to emigrating from Spain, Tosquelles had organized a Marxist party critical of Stalin and the Spanish Communist Party.

It was through the youth hostel network that the Ourys met both Félix Guattari and Fernand Deligny. The latter stayed at La Borde intermittently between 1963 and 1967. Emmanuelle Guattari was born in 1964 and grew up on the grounds of La Borde. The three books under discussion in this essay—Emmanuelle Guattari’s I, Little Asylum, Félix Guattari’s Psychoanalysis and Transversality, and Fernand Deligny’s The Arachnean—intersect at La Borde, which served as an incubator of Institutional Psychotherapy. All three books recount the experience of caregivers and patients living together in asylums that refused the segregation techniques that Foucault described in his study of “the great confinement.”

When Oury joined the staff at Saint Alban just after World War II, instead of the typical psychiatric hospital that “retained a carceral, internment-like structure,” he found a hospital that had been “humanized.” Patients were no longer confined to their own isolated cells. They had access to shared living spaces. The transformation had been brought about by doctors and nurses, some of whom had been prisoners of war and a few of whom had been in concentration camps. Oury defines Institutional Psychotherapy as a resistance to anything resembling concentration...