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  • Madness and Automation: On Institutionalization
  • Phoebe Sengers

Institutionalization, October 11–18, 1991. What happened?

The week was bizarre, inexplicable, intense. The week had a story, the story of a breakdown, a story whose breakdown delineates the workings of the psychiatric machine. This machine, operating on a streaming in/out flow of people, is not only institutional but institutionalizing; its inputs become institutionalized. It works where it breaks down; “The social machine’s limit is not attrition, but rather its misfirings; it can operate only by fits and starts, by grinding and breaking down, in spasms of minor explosions” (Anti-Oedipus 151). The breakdown of its patients is reflected onto the ward; in its case, however, breaking down is productive and creates the institutional moment. Understanding that experience of institutionalization, making it explainable, means reading that story and following its lines of flight. What results is a patchwork narrative, neither coherent nor choosy about its sources. The aim is not purity of form, but an answer to “What happened?” that respects the complexity of the institutional moment and a diversity of viewpoints on that moment. Nevertheless, from this patchwork emerges an effective understanding of social machines in general and the possibilities for agency even at the moment of subjugation; the narrative of this singularity leads to a general strategy for escape from totalization based on the postulates of machinic analysis.

What Happened

In the middle of September, I started to get depressed. By the middle of October, things had progressed to the point that I could no longer function: I couldn’t read or write and was having trouble walking. I went to see a counselor and told him, ‘I think I need to go to the hospital.’ He took me to Western Psychiatric Institute and Clinic.1

The fastest way into and out of theorizing about insanity is to state that people are labeled insane if they fail to correspond to social norms. Such a statement fails to take into account the experience of many mental patients who have committed themselves or of people who are seeking treatment outside the institutionalized stream. For these people the experience of being “crazy”—schizophrenic, depressed, or anxious, to follow the clinical classification—is routed through feelings of misery and, often, physical symptoms like an inability to concentrate, insomnia, or involuntary movement. This is not to deny that these physical symptoms bear the mark of the social formation (“[I]t is a founding fact—that the organs be hewn into the socius, and that the flows run over its surface” [Anti-Oedipus] 149). It is only to state that insanity and institutionalization are more complicated than a mere labeling on the part of a social organization. Insanity is something experienced both from the individual and from the social point of view.

I do not pretend to be able to (re)present the real institutionalization, the real experiences of mental patients. Instead, I want to consider the period of institutionalization as a moment where two flows come into contact with each other: that of the institution, with its labels and categories, ready to take in new input, and that of the individual, who leaves his or her everyday life to become, for a while, a more-or-less functioning member of the social community under the auspices of the ward. Corresponding to these two flows there are two points of view or modes of representation of the conjunctural period to be considered, that of the institution and that of the patient.

For the institution, any particular institutionalization is just a moment in its history, though each of these moments is in the strictest sense essential—the institution really only consists of the sum of these institutionalizations. For the individual, ripped from his or her normal existence and deprived of his or her accustomed social context, the commitment is a traumatic event, but one that is not constitutive—in most cases, the institutionalization will last only a moment in the scale of their lives. The meeting of the institution and the patient is a point of conjunction of the paths of two very different social machines. Here, I would like to consider the dis- and conjunctions...

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