Psychiatry Inside Out: Selected Writings Of Franco Basaglia by Franco Basaglia

Psychiatry Inside Out: Selected Writings Of Franco Basaglia Reviews

• 
  Durakov

  Kind of baffled with this one. I'm tempted to say that the Democratic Psychiatry movement was the most sophisticated and impressive of the movements against institutional psychiatry between the 50s-80s. I recently just read Peter Sedgewick's thorough and insightful critique of the main figures of these movements, but very few of his criticisms apply here. The equipe was neither antipsychiatric nor psychiatric, they didn't reduce "mental illness" to biology nor to purely social factors (as did the "labeling theory" sociologists), nor they did not limit their critique to just psychiatry, but extended it to all medicine and even to all technical fields (the provincialism of antipsychiatry was a large part of Sedgewick's criticism).
  
  The book begins with a preface by Franca Ongara Basaglia that touches on the legacy of some of the ideas. Another fault implicit in this section of the text is metatextual: Franca Ongara cowrote most of Franco's texts and was his typist, but the book is attributed to Franco alone. In his book on Basaglia and Democratic Psychiatry, John Foot notes that Franco was perceived by his colleagues at times as a soft authoritarian figure (as in, he ruled through charisma and energy, but denied that he did), and this seems to conform to that representation.
  
  This is followed by a long introduction by Anne Lovell (who was also the co-writer of the magisterial "Psychiatric Society" by the other critical psychiatry married couple from France, Robert and Francois Castel) and Nancy Hughes. These two also wrote introductions to each section that situated the writing in its practical context, which were helpful and solid on their own.
  
  The first section is on the institution. Here Basaglia introduces one of his key concepts: "bracketing illness." He arrived here by way of phenomenology and Husserl. The concept, central to Basaglia's approach to "mental illness" very basically means that one must "bracket the illness," or "suspend one's judgement" about its meaning, cause, course, etc. until the patient's needs can be met and until the patient can be removed from harmful or oppressive situations. Whether this is ever truly possible in a capitalist society remains open in the text, and later on the book Basaglia suggests that he does not really think so. This isn't the same as saying that "mental illness as a myth" a la Szasz (who ends up taking an opposing practical approach of "leave everyone to their own devices"), but rather that we cannot really know, and certainly cannot know while psychiatry is operating as a method of controlling deviancy. That brings one to the next part on deviancy and the growing power of technicians to manipulate ever-expanding populations of "abnormal" people. He sees psychiatry as one force that progressively grows in line with its technical power to manipulate behavior. This is indisputable in the US today, and, in fact, his primary example is "community mental health centers" in the US, which he examines better than 95% of anglophone historians of psychiatry and in fewer pages.
  
  The other major difference between Basaglia and the "antipsychiatrists" is his refusal of a pure subjective or objective position vis-a-vis madness. This stems in part from his Marxist orientation and part from his being influenced by 68' and the Hot Autumn of Italy, influences that are felt very clearly throughout, both theoretically and practically (the open assemblea of the hospitals were borrowed from radicals in 68, and Democratic Psychiatry tried their hardest to make the walls of the asylum permeable and open to radicals and students from these movements). This explains the emphasis on contradiction over definitions: the point here was never to arrive at a coherent account of madness or psychiatry, but to expose the internal contradictions of his position as doctor, of the patient in relation to the social, of the nurses in relation to the patient, so as to "negate the institution." This was a destructive movement using discourses and institutions against themselves. This is also why they rejected the Laingian idea of "working outside the institution" or creating free-standing communes. Basaglia, in an interview with Laing collected here, claims this is impossible because the outside is still inside (there is no outside), so this position is and ideal concealing the reality that it relies on private funds and is really only available to a certain social milieu (usually students, political militants, and their connections). Whether Basaglia's ideas are still possible on the "inside" of the radically complex and decentralized psychiatric and disability system of the US today seems doubtful, but I intend to reflect more on this question.
  
  In addition, interviews between Basaglia and Sartre, reflections on technicity/technology and intellectuals in social movements, and engagements with Foucault's history of madness are all included. This is a wide-ranging book on all the major themes of 60s-80s mental health radicalism, but is, in my view, the most practical and communal (maybe even communistic) take I've read.
  
  One could fault these texts for being circuitous and repetitious at times, for sure. Basaglia likewise oscillates in his style between using careful microscopic nuance and throwing the literary equivalent of dirty bombs. But when you remember that these are truly living texts, that they were written while working 50 hour weeks putting the ideas into practice, you begin to read them less as theoretical corrections to psychiatric critique (although there is also plenty of that) and more as flexible thoughts-in-action responding to the sensitivity of the moment.
• 
  Bradley

  Yep, I know.
• 
  A.

  This book needs to be reprinted.