Psichiatria

Orgogliosi di essere pazzi

20130623-000624.jpg UnknownOrgogliosi di essere pazzi di Domenico Fargnoli Mad Pride: a Torino hanno sfilato , a metà giugno, il giorno dopo il Gay Pride i “matti” in un corteo aperto dalla sagoma di Marco Cavallo, il simbolo della “liberazione ” basagliana. Il Mad Pride è stato un calendario di eventi fra cui una rassegna teatrale con ”artisti psichiatrici”.La finalità è stata quella di creare uno scambio fra due realtà (quella dei “normali” e quella dei “folli”) per rivendicare la libertà di vivere il disagio mentale “senza essere emarginati, sedati o rinchiusi”. Obiettivi, con le dovute precisazioni, condivisibili: è giusta la lotta contro la segregazione, l’emarginazione e la stigmatizzazione del malato di mente, contro la sopravvalutazione , ma anche la negazione della sua pericolosità. La volontà di incontro non sempre è capacità di viverlo: dove si trova la “follia”? In quanto realtà mentale quest’ultima non è in uno spazio esterno individuabile. La pazzia è molto più presente negli interstizi della normalità che nelle istituzioni psichiatriche. E’ fuorviante ritenere che la liberazione dalla malattia mentale si limiti alla circolazione di malati etichettati come tali nei viali di una città invece di segregarli in un un manicomio . L’espressione Mad pride inoltre , coniata a calco su Gay pride crea problemi su entrambi i fronti. Gli omosessuali o trasgenders rifiutano infatti la diagnosi per cui non si capisce perchè dovrebbero essere accostati ai malati. I “matti” che si vogliono sentire liberi di esserlo si credono nati in un certo modo, analogamente agli omosessuali , e nessuno potrebbe pretendere di modificare una condizione rivendicata con orgoglio: l’unica cura sarebbe la libertà di essere come si è. Si stabiliscono così equivalenze e si confondono pericolosamente realtà che solo apparentemente sono sovrapponibili. L’idea dell’incontro fra normalità e pazzia non è una novità ma risale alla controcultura degli anni 60-70 del secolo scorso . Recentemente è uscito un romanzo Rehab blues di Adrian Laing quinto figlio, di dieci avuti da quattro donne, di Ronald Laing, famoso “antipsichiatra” Inglese. Il libro è una ricostruzione letteraria di ciò che avveniva nei networks della Philadelphia Association fondata a Londra da Laing e Cooper: persone normali fra cui psichiatri, convivevano in comunità residenziali , con altre affette da patologie mentali anche gravi senza preoccupazioni di ruoli e di gerarchie. In un’ intervista a La stampa Adrian Laing parla del rapporto fra Franco Basaglia ed il padre non particolarmente caloroso, nonostante i punti di contatto.images Come si evince anche dalla biografia che Adrian Laing pubblicò nel 1994 l’esperienza di Kinsdley Hall, la più famosa delle households frequentata dal padre fu un vero disastro. Laing più che la pazzia altrui aveva incontrato la propria: il fallimento del traning analitico alla Tavistock aveva accentuato la sua instabilità psichica e favorito l’abuso di alcool e di tutti i tipi di droghe fra cui l’LSD sperimentato in modo intensivo su se stesso e sui pazienti. Basaglia con la moglie dedicò un libro a “Ronnie”: La maggioranza deviante (1971). Nel titolo veniva riassunto un principio dell’antipsichiatria. Secondo una metafora, suggerita da Laing, se uno stormo di uccelli vola in una direzione e due o tre uccelli volano in senso opposto , solo questi ultimi vanno nel senso giusto : i veri de-vianti sono gli altri. David Cooper intervistato dai Basaglia dice: <<(…)La finalità [dei networks alternativi]consiste nel trovare il modo di integrare la pazzia nella società.(…) se qualcuno “impazzisce” può farlo con sicurezza, senza interferenze psichiatriche>> L’Antipsichiatria basagliana non condivise gli eccessi e le utopie comunitarie di quella inglese ma sviluppò anch’essa una opposizione radicale alla psichiatria come pratica e teoria clinico-scientifica senza intraprendere una ricerca propria ed alternativa. La malattia rimaneva un quid residuale e misterioso dopo l’abbandono delle categorie classiche della schizofrenia e delle psicopatie ritenute astrazioni finalizzate a stigmatizare e difendere la norma sociale. Coerentemente con la sua ideologia religioso-libertaria Laing rompe i ponti con la psichiatria. Dopo la chiusura traumatica di Kindsley Hall nel 1970, Laing ebbe un episodio mistico-autistico da cui non si riprenderà : si recò in India mel 1971. In quello stesso anno Massimo Fagioli scrisse Istinto di Morte e conoscenza, edito l’anno dopo, elaborando una nuova teoria sulla realtà umana che renderà possibile, attraverso una prassi terapeutica collettiva che dura ininterrotta da quasi quarant’anni, la cura della malattia mentale ed il superamento delle tradizionali concezioni psicopatologiche. Laing visse per sei mesi in meditazione con un vecchio saggio che , nudo , si avvogeva nella sua lunghissima capigliatura per riscaldarsi. Lì nacque l’immagine del “guru” immortalata dalla rivista Life che lo ritrasse in una posizione yoga, lì inizia il declino di un personaggio carismatico minato da un subdolo deterioramento mentale. Niente più successi editoriali ma solo citazioni di se stesso e debiti :l’alcool e le droghe intaccavano la salute fisica mentre “Ronnie” portava a fondo la distruzione dell’identità medica e psichiatrica. Proprio colui che aveva sostenuto che la famiglia è alla base della patologia mentale aveva reso le sue un inferno.Uno dei suoi figli morì probabilmente suicida mentre una figlia ebbe un episodio schizofrenico . Due anni prima della morte improvvisa per infarto a sessantadue anni, l’Ordine dei Medici Inglese sospese Laing dall’esercizio della professione per violazioni deontologiche.laBaR_T030 La malattia mentale, di cui alcuni sarebbero orgogliosi. non solo esiste ma ti segue perfino fuori dai manicomi uccidendo subdolamente se non adeguatamente affrontatae e curata . Anche David Cooper morirà a soli 54 anni alcoolizzato. Gli organizzatori del Mad Pride dovrebbero non ripetere passate esperienze e comprendere che ci sono “cattivi maestri” che sulla via dell’incontro con la follia è molto pericoloso seguire.

Interessante testimonianza di un paziente di David Cooper che ci fa comprendere il clima degli anni 60-70 e descrive un modo molto singolare di esercitare la psicoterapia fra camere da letto, bevute e racconti di performances sessuali. In-treatments a confronto è una bazzecola.COOPER2

Far out

It was the 60s and acid was king. It was hip to be mad and cool to be crazy, and twice a week, for four years, David Gale spent an hour with an eminent psychiatrist, trying to get his head around his own personal terrors. Only the shrink was on a trip of his own…

I had a 10 o’clock appointment with my psychotherapist at Primrose Hill. When I got there, he was naked in the kitchen. He was dandling a naked baby and telling me that he had been up all night fucking a South American woman. The baby belonged to Roy, one of Cooper’s patients. Roy and Cooper would go out in Roy’s VW camper van and pick up chicks and fuck them. Roy’s wife had a leg brace from poliomyelitis. But the South American woman was not a pick-up, she was the girlfriend of another patient of Cooper’s. This guy had jumped under a tube train two days ago. His father had been a butcher. Cooper said the guy had grown up watching meat being chopped and fantasised that his father was chopping him up. Apparently the train had cut him very neatly in two. Cooper said that in the moment of his death, the guy had achieved something he had been craving all his life: to be treated with respect by his father.I wasn’t sure whether my session had begun. For a start, we weren’t in the right room, but then formalities of this sort had been observed only sporadically in the past few months. I thought what I ought to think was that all this wildness was good for me. I was reluctant to admit that, in fact, I simply felt uncomfortable.That was 1970. Throughout the year, the eminent psychiatrist David Cooper had also been engaged on an entirely coherent project, one that would challenge the very basis of civilisation. The publication of his book The Death Of The Family in 1971 would confirm that, despite the author’s apparent waywardness, a powerful and visionary mind had been at work, on a profoundly unsettling text. The book, published by Penguin, was both lucid and elliptical, containing a coruscating attack on a hallowed institution.As the book’s title suggests, Cooper felt that the family was over. He described it as “that system which obscurely filters out most of our experience and then deprives our acts of any genuine spontaneity”. It was a merciless space in which its victims were petrified, dehumanised and systematically stripped of their critical faculties. Far from maintaining the sanity of its members, the family drove them mad. “The family,” asserted Cooper, “since it cannot bear doubt about itself and its capacity to engender ‘mental health’ and ‘correct attitudes’, destroys doubt as a possibility in each of its members.” What the family teaches, Cooper declared, is that “one is not enough to exist in the world on one’s own”. This leads to a passivity that submits to invasion. The invaders are, of course, members of the family. If one reacts to this too noticeably, perhaps by becoming paranoid, one of the family’s most insidious protectors will intercede to defend the family against the autonomy of its members. Its name is psychiatry.Cooper and his colleague, Ronald Laing, were the champions of anti-psychiatry. In the widely read books that they produced in the 60s and 70s, they not only laid waste to complacent notions about the nature of madness and badness but articulated an impulse that lay beneath the dope and love beads of the era’s stereotype. The anti-psychiatrists saw that some of the participants in the decade of love and revolution were caught up in a determined attempt to deconstitute reality. At a personal level, this entailed finding out just how mad you could sanely be. The anti-psychiatrists offered a context and an itinerary.On the last page of The Death Of The Family is a passage I find rather engaging. “There was once a young man who until the age of nine had longed for his father to chastise him. One day, at long last, his father actually raised his hand with the intention of hitting his son’s backside. As he did this, the father landed a backsider on the face of his voyeuristic wife.” Cooper gets the details wrong – I was 11, not nine, and it wasn’t my backside my dad was aiming at, it was my head. We were sitting at the breakfast table. As he drew his hand back, my father inadvertently slapped my mother in the teeth and she cried, “Ernest! Don’t you dare hit him so hard!” He lowered his hand. I think my version – the authentic version – is better.My father was a biochemist at Cambridge. On Sunday evenings when I was a little boy, he would take me to his laboratory to watch him “sow the bugs”, that is, smear bacteria on to a nutrient gel so that they would grow overnight into colonies large enough to experiment with on Monday mornings. My father was, and continues to be, a gentle man. He never hit me, despite snapping just that once back in the 50s. By the time I reached my teens, however, I had decided that his world of precise measurement and endlessly repeated experiments was the pits. It would be another 20 years before I realised he had dedicated his career to a quest for the Secret Of Life. As a teenager, however, I convinced myself that I must cut my ties with this suffocating life and head off in the direction suggested by Elvis and later confirmed by Jack Kerouac.The 60s began in 1962, when I was 18. By 1963, I was having trouble with the new freedoms. Suddenly you could do anything you wanted. I took this as a fiat: you should want to do Anything. At times this felt quite onerous. My friends and I had recently become members of the Beat Generation. Sure, we were white, middle-class boys living at home with our parents, but there was every possibility we might become White Negroes. These were figures conjured by Norman Mailer, whom we had seen talking on black-and-white television. White Negroes, Mailer had said, were a new phenomenon, American existentialists who had divorced themselves from society “to set out on that uncharted journey into the rebellious imperatives of the self”. The white bohemians had found jazz in certain quarters of certain cities and there they had come face to face with “the Negro”. In this bebop moment, “the hipster became a fact in American life”. Far out.Crucial to the maturation of the emerging beatnik was the regular inhalation of pot. I should say that, in those days, the word “pot” was very cool, like “digital”. That it now sounds like something your uncle would say is because we are uncles now. In addition to unlocking the synaesthesia of the inner cinema, the cannabinoids bestowed the gift of Transparency. This was really quite something. With Transparency, you could think about your life, or the society in which you lived, or the values you had absorbed, and you could see right through them. Some years later, it would become appropriate to say this was a form of deconstruction, but that hadn’t been invented yet. There was a difference, however: you didn’t have to be clever to deconstruct in this manner, you just had to be stoned. Truths were made apparent, they were not worked out.So I saw through it all. Saw it for the charade it was. Saw its falseness. Unfortunately, I also saw through myself. My falseness. In the summer of 1963, I holidayed with some fellow beatniks in Ibiza, where bulk purchase of pot was a routine affair. This was when the inner and the outer first became confused. Every night we would roll big spliffs without tobacco and laugh for hours with fuzzy, bloodshot eyes. My girlfriend, Maureen, was with me. I realised I could hear a sort of dull whine. I glanced across the room at where my mother was sitting. But my mother wasn’t on holiday with us. You wouldn’t bring your mother. As I gazed at her, the flesh of her face flowed and reformed. It was Maureen. Crikey. To say the least. I’d read a Penguin on Freud, so I had a notion of what might be going on. That night in bed with Maureen, we had dynamite stoned sex and afterwards I lay for hours, enveloped in a streaming, twittering miasma of bright, fragmented faces, figures and cartoon creatures. Something had shifted. Back home, I carried on smoking. I noticed that my experience was becoming less social, more self-absorbed. My fellow angel-headed hipsters would be bellowing delightedly or bowing their heads to some sounds, but I would fall silent and uneasy. When I glanced at them and caught their eye, I would look away, lest they saw through my eyes into my mind, where 20 years of composure were starting to unravel. So unsettling did these paranoid episodes become that I decided to stop smoking pot. It might all have ended there, had it not been for the arrival of acid. In those days, doses were big. None of your namby-pamby little tabs for the 60s pioneers, thank you. It was 500 mikes and say goodbye to your backside. Within 20 minutes I was orbiting the sun, suffused with an elation that permeated every electric molecule of my being. I saw the centre, I extended to the outermost reaches of space, I was the hum of the dynamo. And this lasts for eight hours, I thought. Too much. With that thought, the thing turned over. I fell from Eden into the most hellish place I’ve been to in 57 years. The room disappeared. I saw my father’s disembodied head, it flowed into the face of a bulldog, blood oozed from its eyes, nose and mouth, it shuddered and became a vagina, my mother’s head emerged from it. I buried my face in the pillow. But this wasn’t a close-your-eyes thing. You couldn’t get away. Eyes open, eyes closed – no difference. I had lost the world. For eight or nine hours, I writhed in total hallucinated horror. I had lost the world. I had lost David. He was down on the bed somewhere and I was out in madness. There was a door marked “David” that I had closed behind me. The LSD might wear off, but I would not be able to find that door again. I would be out here for ever. Wherever I looked, there would be rippling horror and paralysing fear. For ever. You had to take acid. I took it eight more times and it was hellish. I took it because that’s what you did. You had to break through. Go mad, get out the other side, then really start living. I couldn’t seem to get there. I came to the conclusion I was full of terrifying things. There was another Penguin: The Divided Self by RD Laing. Everyone was reading it. Ronnie Laing said that madness arose in a maddening society. That it was a response to an impossible situation. It was not something to be avoided, it was an essential journey which the therapist must facilitate for the patient so that the patient could emerge whole and healthy on the far side. Madness, then, was a trip. When the book came out in 1965, it was the new rock’n’roll. Innumerable young people who were not mad suddenly wanted to be, it sounded so fascinating and ennobling. The new psychiatry would transform patients into revolutionaries and visionaries. So I wasn’t so fucked up. I had embarked on an important trip, but had lost my nerve before getting to the destination. I rang Laing and made an appointment. He came to the door of his Great Wimpole Street practice in jeans and a brown suede jacket. Jeans – that’s cool. We talked about my propensity for fear and horror, and Laing said he would refer me to his colleague, David Cooper. I said, “Does he use LSD?”, meaning, “Does he give it to his patients?” Laing said, “Yes, I’m pretty sure David Cooper has taken LSD.” Cooper was born in Cape Town in 1931. He studied medicine at Cape Town University, then left South Africa at the age of 24 and worked in a number of London hospitals. Before taking up private practice, he had presided over Villa 21, a radical treatment unit for schizophrenics, set in the grounds of a larger, mainstream psychiatric hospital. Both Laing and Cooper inclined to a Marxist social analysis. Laing had the more contemplative disposition, while Cooper was actively engaged in the revolutionary applications. Both sought to develop an existential therapy that would enable the patient to acquire an autonomy that did not depend upon the mad reason of the world. I went to see Cooper twice a week for four years. We started off in Harley Street in 1966. Unlike Laing, Cooper wore a suit. He was a tubby man with a shiny face and a warm, deep voice. His book, Psychiatry And Anti-psychiatry, introduced a key element of the anti-psychiatric position, that there should be no distinction made between doctor and patient. The patient could even treat the doctor and this would be therapeutically most salutary. Such a notion, given the nature of my own anxieties, struck me as rather academic. Besides, Cooper seemed reassuringly sane. For at least a year, my therapy went well. Cooper was kindly, jolly and wise. I began to learn about projection and to acquire perspective on my fears. Although I was aware of his revolutionary reputation, there were still times when his pronouncements surprised me. On one occasion, he told me a story that may have been designed to dissolve some of the awe that made me feel very much like a patient. As a young man, Cooper had met Jean-Paul Sartre in Paris. The great philosopher proved to be surprisingly approachable, with a marvellous knack of making his admirers feel respected and interesting. That night, Cooper told me, he dreamed that he fucked Sartre up the arse. As the 60s began to generate heat, I found myself running with a fast crowd. I had moved into a flat near the Royal College of Art, where I attended the film school. I shared the flat with some close friends from Cambridge, including Syd Barrett, who was busy becoming a rock star with Pink Floyd. A few hundred yards down the street, our preternaturally cool friend Nigel was running the hipster equivalent of an arty salon. Between our place and his, there passed the cream of London alternative society – poets, painters, film-makers, charlatans, activists, bores and self-styled visionaries. It was a good time for name-dropping: how could I forget the time at Nigel’s when I came across Allen Ginsberg asleep on a divan with a tiny white kitten on his bare chest? And wasn’t that Mick Jagger visible through the fumes? Look, there’s Nigel’s postcard from William Burroughs, who looks forward to meeting Nigel when next he visits London! As the decade took shape, Cooper abandoned his baggy suit and let his hair grow. As it moved in a Marxian manner towards his shoulders, he took to wearing a black polo-neck sweater and black corduroys. An unflinching rigour compels me to disclose that my therapist also sported a large gold medallion, worn outside his woolly. He left Harley Street and moved to a house off Caledonian Road. Ever benign and gentle in therapeutic sessions, Cooper started getting himself in the papers for his violent views. At the Dialectics of Liberation Conference, held in the Roundhouse in 1967, he declared that he yearned for the day when “the compassionate chatter of machine guns” might be heard in the streets of north London. This was duly recorded in the evening paper, but they missed the bit right at the end of his speech when he said, “If there is anyone here prepared to die for the Revolution, see me afterwards.” The consulting room in Caledonian Road was painted purple – the colour perceived by infants in utero. Cooper had placed a placard over the fireplace. It bore a quote by Raoul Vaneigem, an impressive situationist writer who had emerged in Paris in 1968: “He who speaks of revolution without living it in their daily life speaks with a corpse in his mouth.” So far, so good. I assumed that therapy had to be like this. These were revolutionary times, after all, and I was keen to keep abreast. I was proud of my therapist. Worlds were going to collapse and he was equipping me for life after death. But he disturbed me in ways that seemed to have no redeeming side. One day in the purple room, he came in, slumped in his armchair and told me he had just been making love to his partner, a feminist writer. “I live within her orgasms,” he intoned. “Hmm,” I said, nodding. Clearly he had told me something remarkable – you could live within someone’s orgasms. But, you know … Underlying my discomfort was a fundamental confusion that had come into focus as the 60s progressed: it was considered desirable to have a childlike openness to experience, while at the same time evincing a world-weary, omniscient cool. You’d think I might have been able to relinquish this double bind in an actual therapy session, but although my therapist’s frankness continued to upset me, I kept mum. So to speak. Cooper had been off sick and I’d missed some sessions. When we met again, he had moved to Primrose Hill and I learned what he’d really been up to. My therapist told me he had been sitting in his kitchen. The bell rings and a dark, beautiful woman asks if she can come in and drop acid with him. Soon they are making love on his bed overlooking the park. As the acid washes in, Cooper and the beautiful woman leave their bodies and assume astral forms, which are radiant and blue. The astral lovers hover above the bed, making divine congress. Then Cooper sees a tunnel – dark, abyssal, falling away before him. He drops down and down, picking up speed.He sees a pale blue disc hurtling towards him. Suddenly he finds himself in… nothing. Not an empty place, but a place of no place, a place beyond spatial ideas. He is suffused with feelings of love. In the distance he sees a low green hill against an azure sky. Standing on the hill is a young boy, his hands outstretched. Falling from the sky, into the boy’s hands, is manna. Cooper knows then that we are about to enter a new age. In this age, all institutions will transform into anti-institutions. The power of the state will be overturned as the powerful realise they are interchangeable with the powerless. An era of harshness will be supplanted. When he came back to his body, Cooper understood that this tearing, heavy world was going to dissolve and, in that knowing, was overcome with relief and sadness. He cried all day for five days. He told me this. What can you say? You’re supposed to be the patient, for God’s sake. Do you really want your shrink to be so fascinating? No, you don’t. You want him to be reserved, poised in an attentive reverie. You don’t want to know about his trips or his girlfriend’s orgasms. But isn’t that rather pusillanimous of you? I couldn’t tell. The next time I went to Primrose Hill was the night after Cooper had been fucking the dead patient’s girlfriend. He had done this, he said, because in her extremity, this was the language that would console her. He said to me, “Perhaps she’d like to sleep with you, David.” This was the sort of thing he said. As well as being naked in the kitchen at Primrose Hill, Cooper had his leg in plaster to the hip. This was because he had fallen down the stairs when pissed. We went next door to the consulting room: Cooper’s bedroom. Before the session began, he gave me a fiver, then fell on the bed. Would I go to the off-licence and buy him a bottle of whisky? When I got back, he opened the bottle and offered me some. In those days it was not cool to drink alcohol and I didn’t like whisky anyway, so I took half an inch in a plastic cup. Cooper grasped the bottle and upended it into his mouth. When he had finished, there were a couple of inches left. With difficulty, he rolled across the bed and put the arm of his Philips record player on a track of an album, What Have They Done To My Song, Ma? by Melanie. As she sang out in her tragic American Piaf style, Cooper started to weep. He wept loudly throughout the track and when it was finished, he played it again and wept again. He did this over and over while I sat and watched. After an hour, I decided the session must be over, so I said, “I’d better be going.” He did not seem to hear me. I told myself that my therapist wept because of the melancholy that attends enlightenment. To see the world in its blind, leaden pain had made him heavy-hearted. I’m sure if I’d asked him, he would have said that to be so heavy-hearted is to apply a dreadful stress to one’s heart. His heart attack came a few months later. The doctors told him to stop drinking and smoking and taking drugs if he wanted to live more than four months. They gave him drugs of their own, though, seven sorts. These made his hands tremble and purple blisters rise on the backs of his fingers. I was sitting on the divan talking about my problems. Cooper was smoking, holding a roll-up in his blistered hand. His head was bent in an attentive reverie. I thought I could smell smoke, but not tobacco smoke. “David?” He didn’t seem to hear. “David?” Smoke seemed to be rising from his chair. Surely he couldn’t be sleeping… Surely the chair… I jumped up. “David!” He groaned and raised his head groggily. “David – the chair’s on fire!” He mumbled and struggled to his feet. Smoke billowed from a small inferno in the chair’s horsehair stuffing. Cooper had dropped his roll-up. I dragged out a clot of glowing material, stamped on it, then doused the chair with water. It would be neat to finish there, to say that the patient had saved the analyst, thereby bringing a great circularity and symmetry to the anti-psychiatric process. But while writing this, I remembered that it was not my last session. It took one more to convince me that my analysis was doing more harm than good. I went to see Cooper in a flat in West Hampstead. He was lying on a bed staring emptily past me in a drunken trance. He seemed not to see me. As if I were transparent. I didn’t know what to say. Minutes passed as I looked at him and looked away. Then I said, “I must go.” Then I left and never went back. I said to myself, “It’s fucking me up more staying than going.” In the dedication page of The Death Of The Family, David Cooper wrote, “During the end of the writing of this book against the family, I went through a profound spiritual and bodily crisis that amounted to the death and rebirth experience that I speak of in these pages.” The crisis found its peak in his mystical LSD experience with the dark woman and seemed to endure until 1986 when he died of chronic alcoholism. It was so very hip to be mad in those days; a beatific craziness was to be worn like Tommy Hilfiger. This helped make the 60s exhilarating and revolutionary, while producing a credulous generation intoxicated by relativism. For many, this condition proved impossible to shake off and paved the way for the fog of New Age vagueness, energised by consumerism, that seems to be going global. The extraordinary energy released over 30 years ago has contributed to the state of affairs in which we now have magazines about feng shui and our avant gardists can be identified by the Nike swoosh tattooed on their calves. These days, madness is to be avoided at all costs – it is neither big nor clever. The energy invested in suppressing madness and chaos sometimes erupts, though. It can produce hysterical displays, such as the Dead Diana festival or the Portsmouth Paedophile rampage. David Cooper knew very well the price to be paid for such a denial and used his own being as a guinea pig for purgation. While the benefits of his wisdom seemed not to avail him personally, it is hard to forget one of his favourite maxims, frequently delivered with a wry chuckle: “If you’re going to go mad, then do it discreetly.” David Gale is writing his autobiography. His website can be found at www.iamdavidgale.com.

Brother Beast: A Personal Memoir of David Cooper1Stephen Ticktin
With the death of David Cooper some six weeks ago in Paris, the ‘antipsychiatry’ movement, which began in England in the 60s lost one of its greatest inspirations. He died at home (a small flat in the 15th arrondissement) from a sudden heart attack, in the presence of Marine Zecca, the woman with whom he lived and worked, and who had been his greatest support for the past ten years. Besides Marine, he left behind him a wife and three children, a number of published books, and many friends, colleagues, and admirers (myself included) who will miss him greatly. But his greatest legacy was his determination to struggle against the oppression and orthodoxies of his time — political, philosophical, religious, and, most of all psychiatric. As he stated in the ‘forewarning’ of his penultimate book The Language of Madness:

“There is no hope There is only permanent struggle That is our hope That is a first sentence In the language of madness”.

David will probably be best remembered here in England as the champion in the 60’s and early 70’s of ‘antipsychiatry’, a word he, himself, coined in 1966. The term referred to that movement which began by challenging the medical concepts and practices of the modern psychiatric system — in particular the notion of mental illness itself — and looked for alternative ways of understanding human experience and behaviour and responding to human distress. David himself was instrumental, in 1962, in setting up a very radical venture, within the context of the NHS, at Shenley Hospital, which became known as Villa 21. This was a separate unit in which many young people, who had been diagnosed ‘schizophrenic’, were allowed to live without the interference of potentially harmful drugs, electroshock, or other organic therapies. The unit was run on egalitarian lines, and there was a deliberate attempt to abolish the traditional hierarchy between doctor and patient. Attentive non-interference was the ideal that was aimed for. At about the same time, in 1965, David, along with R.D. Laing, Aaron Esterson and four other like-minded individuals founded the Philadelphia Association, a registered charity that was eventually to set up a number of houses in the Greater London community where people in distress could go and live as an alternative to the traditional psychiatric hospital. He continued his involvement with the latter association until 1971 when he left England (early 1972) for Argentina. I first met David at this particular juncture of his life. He was en route to Argentina. He had been invited to participate in a week-long conference on ‘madness’ by the Health Advisory Service of our university (Toronto, Canada). I was a third-year medical student at the time and was supposed to be attending seminars in obstetrics and gynecology. However a ‘Madness Conference’ and a chance to meet David could not be passed by so easily, and so I attended the whole event. I had already read several of his books (as well as a few by his colleague R.D. Laing) and his existential Marxist writings both excited and catapulted me out of my more mechanical Freudian orientation. David soon appeared in full splendour. He was a large, wildlooking man with long golden locks and a huge red beard. He was dressed in black garb and had a big llamaskin coat of the same non-colour that lent him a beast-like quality. (Ironically, later on, I discovered that he often used the word ‘beast’ as a term or endearment!). But his blue eyes were very gentle and he spoke in a soft voice. And he was extremely thoughtful. One had the impression, almost immediately, of being in the presence of an exceptionally deep and beautiful man. When it came his turn to speak, he started by introducing me and saying that I would play a song. We had met only three hours previously, and, at that time, he had heard me playing my guitar. He had then asked me if I would play something at the debate and I agreed. I chose Bob Dylan’s ‘Ballad of a Thin Man’ (There’s something happening here but you don’t know what it is do you Mr.Jones). It set the tone for what David wanted to say, I didn’t realise it, at the time, but this was actually the beginning of a pattern that would repeat itself many times over as we travelled together, over the next few years, from one country to the next, with me playing a song and David speaking. He spoke most bravely that first time. He was inebriated and initially addressed that English-speaking audience in French, thinking that he was in the province of Quebec. He made it clear that he had left England, left the Philadelphia Association, and was no longer collaborating with Laing and Co. The latter, he said, was on a spiritual trip. He, David, was on a political one. At one point in the debate he actually left the podium and sat in the audience — I believe to underscore the idea that in the field of ‘madness’. (He used to say, often, at that time, that ‘schizophrenia’ did not exist but ‘madness’ did), there were no experts, and that one needed to remain sceptical of the so-called ‘science’ of psychiatry. I thought for all his appearance as a ‘guru’ that he showed a tremendous humility and compassion and it was these qualities in him which struck me the most. One woman in the audience summed up the whole experience in a nutshell: “He has a heart of gold” she said. Over the next three to four years I spent quite a bit of time with David, culminating in our sharing a flat for a year in Crouch End, London (1974). It was to prove to be his last year in England. He had returned from his sojourn in Argentina a few months earlier, and when I joined him I found him to be in a state of complete despair. He was drinking heavily and had virtually severed all his links with his former colleagues in the Philadelphia and Arbors Associations. Although he saw his family from time to time, relations were tense. It seemed that Laing and his followers had embarked on a course of exploring and utilising various therapies of the mind, body, and spirit, whereas David, in spite of a brief period in private practice in Harley Street in the late 60’s had, by this time renounced the latter occupation, primarily for political reasons. He was wont to say at the time that there were no personal problems only political ones. So we lived frugally during this period, and I acted, in a funny sort of way, as the intermediary between David and the outside world, answering telephone calls and letters, and arranging interviews and conference meetings when desired. His income came mainly from the royalties on his already published books and from an advance on his next one (this was eventually to become The Language of Madness). But he couldn’t write. It seemed that the English soil which had produced a burst of creativity in the 60’s had suddenly run dry. Some new spark was needed.

Brother Beast: A Personal Memoir of David Cooper1Stephen Ticktin…continued from page one
It cam from a somewhat unexpected quarter in September of that year. A meeting was being organised in Portugal to see if it might be possible to form a European network of alternatives to psychiatry. David was invited to speak. I accompanied him and it proved wonderful in the next few weeks to meet so many comrades from all over the continent who were struggling, in their own way, against psychiatric oppression. We were introduced to Franco Basglia, whose extroverted personality, and ‘democratic psychiatry’ contrasted so much with David’s personal reserve and ‘anti-psychiatry’. Also Robert Castel, the Parisian sociologist, who had just published a book entitled Le Psychoanalysme which consisted of a radical critique of psychoanalysis. Two very nice French sociology students, Nicole and Dominique (who eventually became long-standing friends) urged David to come and live in Paris. They promised him opportunities of work. After some persuasion on my part we drove back to Paris with them to begin the contact. There we met Felix Guattarri and Gilles Deleuze who had together written a cause celebre the year before entitled L’Anti-oedipe (Anti-Oedipus). David commented to me at the time that he thought Gilles Deleuze, in particular, to be extremely intelligent.The Portugal conference eventually proved to be the forerunner of the meeting in Brussels in Jan/75 which launched The International Network Of Alternatives To Psychiatry (Resseau Alternatif A La Psychiatrie). Mony Elkaim, a very congenial and energetic Belgian psychiatrist offered to act as a co-ordinating secretary. The developments in Italian psychiatry were seen to be very much in the forefront of things –David decided to move to Paris, and at that point I decided to return to Canada. I was virtually penniless and still not fully qualified as a doctor. I was sad to leave David. The year we had spent together meant a great deal to me — living and travelling together. But I felt that he was now embarking on a new (and, as it turned out, last) phase of his life, and he needed to make a fresh start. I was glad to have acted as part of the bridge which ultimately got him from England to France.About six months later he wrote to me in Canada (I had by now started my psychiatric training), saying that he had met a wonderful woman, had fallen deeply in love with her, and was experiencing a ‘joie de vivre’, the likes of which he had not known for years. I was so glad for him. The woman turned out to be Marine Zecca, at the time a young psychology student. They lived, loved, and worked together in Paris for the remainder of David’s life. When I returned to England in 1978 as a qualified physician I embarked on a course of studies with the Philadelphia Association and, at the same time, completed my psychiatric training. I got in the habit of visiting David once a year, and although I enjoyed seeing him very much, I knew little, in detail, of his last years in France. In the first few years he completed the manuscript he’d been working on when I left him. This was eventually published as The Language of Madness.It was a refreshing and most readable book and reflected the new experiences and thoughts he’d had while living on the continent. It seemed that he’d moved on dialectically from ‘anti-psychiatry’ to what he called ‘non-psychiatry’. In addition, he taught for a while at the University of Vincennes. He gave seminars, wrote articles and pamphlets, and introductions to other people’s books. He continued his activity in the International Network, and attended their annual meetings. For the past six years, he and Marine had been involved in a research project looking into the health needs of people in France, Italy and North Africa. His next book, which he was working on with Marine just prior to his death, was to incorporate the results of their investigations, as well as new developments in his own thinking during that time. As well, several years ago, along with Jacques Derrida, and several others, he helped set up The International College of Philosophy. I remember meeting David in Brussels in May/82 at a meeting of the International Network (it was as a result of this meeting that The British Network of Alternatives to Psychiatry was formed). It seemed to me, at that time, that France suited his consciousness much more so than England,although he commented to me that the problem with Paris was that it had too many artists and too many intellectuals. But, ironically enough, his own prodigious mind required that sort of soil. Each year I would watch his library grow, and, at the end, the small flat was literally walled with books. As much as he hated to admit it, David was himself a First World intellectual. And again, ironically, France seemed to have tempered his political outlook. The revolutionary rhetoric of the 60’s and early 70’s gradually evanesced (before this his letters would usually begin ‘Dear Beast’ and end ‘For Love and Revolutions’), and he spoke, in his last years, in a much more moderate way of practical reforms and concrete situations or work. In the English-speaking world there has been little written about David in the past ten years. An article in “Openmind” several years ago by Ron Lacey is the only thing that immediately springs to mind. His books are getting progressively more difficult to find in the commercial bookstores. When his name came up in the psychiatric circles I moved in there was usually one consultant or another making some derogatory comment to the effect that he was ‘mad’ or ‘psychotic’. This annoyed me very much as I knew him not to be. He once told me that each of the books he wrote seemed to coincide with something he’d left behind. With Psychiatry and Anti-psychiatry it was Shenly Hospital and the British NHS. With The Death of the Family it was his own nuclear family. With the Grammar of Living it was England for Argentina; and with The Language of-Madness it was England for France. It now seems that with his last book (still to be titled and published), he has left the world and all of us behind. But he will be remembered, for his spirit is still very much with us, and he will be missed for both his intellectual achievements and the person that he was.

My memories of R.D. Laing

Written for International Journal of Psychotherapy, special issue, 2011 Personal recollections of Ronnie Laing EMMY VAN DEURZEN Abstract: This is a very personal account of contact with R.D. Laing and some of the spin-offs of his work into the Philadelphia Association / Arbours Association and anti-psychiatry movement in the 1970s by one of the founders of Existential Psychotherapy in the UK. Key Words: R.D. Laing, personal memories, reflections, existential psychotherapy. I came to the UK in 1977, from France, where I used to work as a clinical psychologist and existential therapist in psychiatric hospitals (though my first training was as a philosopher) in order to work with R.D. Laing.  Reading The Divided Self and The Politics of Experience (in French), around 1971, had deeply affected me personally and had impacted greatly on the work I did with psychiatric patients.321436_10152420401250261_1581471229_n I had sought out the Arbours Association[i] therapists when they spoke at a conference in Milan in 1975 and had come over to visit the Arbours Association to see whether it might be of interest to work with the group, and also with R.D. Laing in his Philadelphia Association (PA)[ii]. My ex-husband Jean-Pierre Fabre (a psychiatrist) and myself were promptly invited by Joseph Berke and Morton Schatzmann[iii] to come over to work with the Arbours Association in London, and we accepted their invitation. We moved into an Arbours community house in South London in October 1977 and contributed to the work at the Arbours crisis centre as well.  I also started teaching existential therapy on the Arbours training programme, when it emerged that such teaching was not happening, as the Arbours training programme was almost totally based in neo-Kleinian theory at that time.  We set up some meetings with Ronnie Laing, with Paul and Carol Zeal, with Francis Huxley, and some others. We started attending some seminars with the P.A. too. But we got the impression from what people told us, and from what we observed for ourselves, that the Philadelphia Association was very run down by then. Several P.A. colleagues warned us not to get too involved, as it was crumbling and had become a ‘toxic’ organization, and Ronnie himself seemed to be in very bad shape.  It was also a great disappointment to find that the P.A. was focusing many of its seminars on French psychoanalysis.  Since Jean-Pierre and I had both been trained in this way of working for many years in France, and had been fighting the hegemony of Lacanian thinking, and had indeed specifically come to England to get away from all of that, it was rather ironic to be faced with rather poorly formulated French psychoanalytic thinking in the place where we had hoped to connect up with the existential tradition we were interested in.  My idea that, coming to the UK, would allow us to work directly with existential therapy, quickly turned out to be illusory and I began to realize that I would actually have to create what I had hoped to find ready-made. Not surprisingly, from the start, my relationship with Ronnie was not a very good one.  He certainly at this stage did not like to engage with the critique that I was formulating.  It seemed to me that he did not like to be on an equal level with colleagues, and was certainly not very interested in hearing about the rather revolutionary psychiatric and therapeutic work that J-P and I had been involved with in France.  Ronnie, it was clear to me, expected to be treated as a guru, and I was certainly not looking for a guru, but for a fair and frank exchange.  I remember him shouting at me one day on the phone that he was, “f…ing R.D. Laing and my husband and myself were just some f…ing psychiatrists from France”. With hindsight, it occurs to me that he may have wrongly assumed that we wanted to bring in more French psychoanalysis into the PA. Nothing could have been further from the truth.  But his attitude was so haughty, disdainful and rejecting that I decided to steer clear of him as much as possible. I gave it one more shot by attending his infamous lecture on ‘The Politics of Helplessness’ at the Round House, in early 1978, but I found it appallingly prepared, extremely poor in theoretical or practical contents, and completely uninspiring.  I was shocked by the way the P.A. trainees were made to sit at his feet, on stage.  I knew then for certain that this scene was not for me and that Laing’s work could not truly inform psychotherapeutic practice, but would only lead to un-productive adoration. Ronnie himself seemed burnt out by his own fame and I made a mental note never to let myself become famous, or too enamored with my own ideas or my own importance.  Fame, I knew from observing him, corrupts as badly as power or money. Too much light shining on you, blinds you and weakens you. What still sticks in my mind to this day is the story that he told at that conference of two climbers, tied to each other by ropes as they climbed a steep mountain slope, until one of them fell into a precipice, from which the other was unable to hoist him to safety.  The question he asked his public was, ‘When do you decide to cut the rope?’  I was shocked by his metaphor for psychotherapy and knew instinctively that this was the wrong question, and a completely wrong image to use. My inner protest against his fatalism and his personal helplessness spurred me on to formulate a much more structured form of existential therapy that could enable others to think for themselves and find their own path, be it with some support. Of course, living in an Arbours therapeutic community, I was only too aware of the impossibility of ‘saving’ other people in such a context, especially if one had to be apologetic about being a ‘therapist’, instead of just being a co-resident. It seemed obvious to me that, going out on a hazardous journey into madness without a compass, a map and some decent safety equipment and sensible planning, was mad indeed and could only lead to accidents. But I carried on with this anti-psychiatric[iv] journey for a little longer yet, to make quite sure it really was the wrong path, and that I wasn’t just being dismissive and arrogant about it. I also felt I had more to learn from the people I lived with.  It was through talking with them, and by studying and teaching the philosophical writings of my favourite existential authors, that I began to formulate my own ideas in a systematic way from this point onwards.  One could say that my disenchantment with Ronnie catapulted me into my own writing, and released me to be creative in my own right. I carried on seeing Leon Redler for therapy in one of the P.A. communities for a while in 1978, but soon decided to leave the Arbours and the P.A., and in April 1978 went to California to visit various mental health projects and to do some training at the Esalen Institute. Upon my return I got re-involved with the Arbours community in a different capacity, continued teaching for the Arbours training programme and became a supervisor to the trainees. I also, somewhat to my shame, was part of the Laing/Rogers encounter in the London Hilton Hotel in September 1978 and was one of Ronnie’s therapists, in the great rebirthing event on the dance-floor of the Hilton hotel. After that I decided that enough was enough and preferred to continue developing my own work, and I took a job with Antioch University’s London-based MA (Master’s degree) in Humanistic Psychology, which was quite tied in with the P.A.  I still attended occasional P.A. meetings and had many students who were in placement either with the P.A., or the Arbours.  I also did some yoga-based work with Mel Huxley, and Arthur and Janet Balaskas, around the time my son was born (February 1981). In fact, the night my son was born (more or less exactly thirty years ago at the time of this writing) Janet was going between the Royal Free, where she was my birthing partner and Ronnie’s house in Belsize Park, where she was helping him through a rough time during his marriage break down.  I think this was a final confirmation for me that he was losing it and that – in some way – the future of existential therapy was in my hands. I set up the first Masters degree programme based on existential therapy for Antioch University in 1982 and then moved this to Regent’s College, London in 1985, where it grew into an entire school of psychotherapy. During those years of very hard work, raising my young family and establishing a new therapeutic approach at the same time, I lost touch with the Arbours Association, the P.A. and Ronnie Laing. I only really got back in touch properly with Ronnie around the time that I decided to set up the Society for Existential Analysis.  This was in 1987, on the strength of me just having completed my first book on Existential Psychotherapy (Existential Counselling and Psychotherapy in Practice, which was to be published by Sage in 1988) and, of which I sent him an early copy.  He was much mellowed by that time and I was pleasantly surprised to find that we could talk sensibly about setting up a body for existential therapists to heal the splits between PA, Arbours and the Regent’s College-based programmes. I think Ronnie was quite impressed by what I had been able to achieve at Regent’s College and we discussed various ways in which he might be involved in it.  But he did not want to come to the founding meeting of the Society for Existential Analysis and sent John Heaton instead, who kindly proposed me as first chair of the Society, which was duly created together with the Journal Existential Analysis. I had promised Ronnie that though our first conference would be about existential analysis; the second would be about his contribution to psychotherapy and would be entitle ‘Demystifying Therapy’.  So, John Heaton and I gave the keynote talks at the first SEA conference in 1988 and Ronnie was nowhere to be seen, but fully expected to be the star turn at the second conference.  He was very keen that this second conference should be a platform for him to present some new ideas of his own about his way of doing therapy.  I believed that he was actually interested in rising to the challenge that I had put to him to formulate an existential therapy that could be taught to others.  But, in the middle of the process of us putting together the programme for that second SEA conference, he tragically died, in August 1989.  It was a big shock. The Society members immediately decided that the conference that we had been planning should be about Ronnie Laing and his work, even so, and Adrian Laing, his lawyer son, agreed to be our keynote speaker.  Adrian gave a rather bracing and somewhat harsh paper about his father and this caused quite a stir. I think that for me, this was the end of any remaining attachment to Laingian theory and I wrote a paper arguing how much Laing had misunderstood the whole philosophical notion of ontological anxiety. This was later published in my book, Paradox and Passion in Psychotherapy.[v] I am afraid that my recollection of Laing’s work has continued to be more about the ‘shadows’ that he created than about the light that his early work shone on my own life and that of many others.  I came to the UK because of his work: no doubt about it.  But instead of finding a flourishing existential scene, I found a chaotic situation where those who needed help were being plunged into confusion, rather than into elucidation and enlightenment.  The great myth of the breakdown leading to a breakthrough had been shown to be just that: a myth! So, I decided I could do better than that, and worked extremely hard to create the therapy that I had hoped to find in the UK, when I immigrated here in the seventies.  I would like to think that my work, in good Laingian tradition, speaks for truth and enables people to find truth where confusion reigned, previously.  I know for certain, that creating the Regent’s College[vi] courses and subsequently, and perhaps more importantly, the New School of Psychotherapy and Counselling[vii], has allowed existential psychotherapy to become established as a formal, and now well recognized, tradition in the UK (see my book: Everyday Mysteries[viii]). There are now thousands of people in the UK, who have had a structured and formal training in this approach, up to doctoral level.  Many countries in the rest of Europe have also created existential training courses on this same model, especially through the work that Digby Tantam, myself and colleagues from other European countries have done in creating the European-funded, online, Septimus courses[ix] in a dozen European countries.  Indeed, there is now a sweeping movement in this existential therapeutic direction all over the world. \As I lecture on each continent, I find enthusiasm and dedication to philosophical therapy everywhere.  There is something about the approach that allows for a cross-cultural non-doctrinaire take on the world and this is what liberates people to face our global and often paradoxical realities. I think Laing’s work was so popular because it drew on this philosophy of liberation and connected directly with people’s sense of alienation.  His early work will continue to be of much interest to many people over the next decades for that reason and he certainly figures prominently on New School syllabi. But it wasn’t Laing’s work, on its own, that created the movement of existential therapy.  In terms of actual psychotherapeutic method, his work stopped short of providing any practical guidance for trainees or clients, leaving people to turn to now outdated concepts from psychoanalysis or rebirthing instead. I feel that the hard and ongoing work that many of us have done in creating existential psychotherapy as a distinct approach in the UK will have a much bigger impact and longer lasting effect in the long run.  But this is a slow and carefully built impact, and not the flashy, fame-driven bolt of lightning that were the ideas of R.D. Laing. It is the discipline of philosophy that now carries the approach, rather than the emotional passion of one person. Whilst this is every bit as inspirational as were Laing’s words, it takes a lot longer to absorb, fully understand, and apply.  Ultimately, it has more therapeutic value and dynamism, as it is not based in wishful thinking, but in reality.  While this form of existential therapy is in many ways a testimony to Laing’s brilliant ideas, it unfortunately owes very little to him directly. Author: Emmy van Deurzen is Principal of the New School of Psychotherapy and Counselling in London, where she runs several masters and doctoral programmes in existential therapy and counselling psychology, jointly with Middlesex University.  She is the author of ten books on existential therapy. E-mail: emmy@nspc.org.uk Endnotes:


[iii] Joseph Berke & Morton Schatzman – colleagues of R.D. Laing at Kingsley Hall and founders of the Arbours Association.
[iv] The movement that started in the UK around the work of R.D. Laing and David Cooper was sometimes known as the ‘anti-psychiatry’ movement: http://en.wikipedia.org/wiki/Anti-psychiatry
[v] van Deurzen, E. (1998). Paradox and Passion in Psychotherapy: An existential approach to therapy and counselling. Oxford: Wiley-Blackwell.
[vi] Regent’s College: http://www.regents.ac.uk
[vii] New School for Psychotherapy & Counselling: http://www.nspc.org.uk
[viii] van Deurzen, E. (2000). Everyday Mysteries: Existential Dimensions ofPsychotherapy.  Hove: Routledge.
[ix] SEPTIMUS (Strengthening European Psychotherapy Training through Innovative Methods and Unification of Standards) courses: see http://www.europsyche.org/contents/13120
05 NOV–08 JAN 2011 MARY BARNES In 1965 radical psychiatrist R.D. Laing co-founded an experimental therapeutic community at Kingsley Hall in Bow, East London. Presenting herself on the brink of a serious mental breakdown, Mary Barnes (1923-2001) was Kingsley Hall’s first resident. Under the guidance of Laing and his colleagueJoseph Berke, Barnes underwent a near total behavioral regression. Refusing to eat, dress or wash, she was in her own words “going down.” Around this time she produced her first artwork – a pair of black breasts painted on the wall of her room in her own shit. Focusing principally on her time at Kingsley Hall (1965-70), Mary Barnes presents painting, drawing, sculpture and writing produced by Barnes alongside an extensive archive of documents, films, audio recordings and photographs relating to her work and the legacy of R.D. Laing’s thought. Accompanying the main exhibition will be a cycle of films. These include Abraham Segal’s Coleurs Folie(1986) and Asylum (1972) Produced and Directed by Peter Robinson. (Asylum by permission of Surveillance Films).

by Mary Barnes and Joseph Berkes Other Press, 2002 Review by Tony O’Brien, M.Phil on Feb 24th 2005 Mary Barnes’ autobiography is one of the frankest and most literal accounts of madness you are likely to read. From her description of her early family life to the sometimes tediously detailed description of her day to day experience of regression into psychosis, Barnes spares herself and the reader little. Interspersed with sections by her therapist, Joseph Berkes, and with new epilogues added since the publication of the 1971 edition, the book spans the entire period of Barnes’ life until her death in 2001. Barnes’ story is not simply an autobiography, but a first-person account (two if you include Berkes’) of a tumultuous time in British psychiatry. The asylum era had faltered under the weight of internal critique, public distrust, and the seemingly limitless capacity of society to consign the mentally ill to institutions. New theories of mental illness, especially schizophrenia, were emerging. In particular, psychoanalytically oriented theorists were looking at the role of the family in schizophrenia. Thus Barnes’ personal life history followed a path toward, and then away from the mainstream of British psychiatry. Barnes begins with the ironic comment: ‘My family was abnormally nice’. From there she recalls a childhood under the austere gaze of her mother, and her struggle to live with the conflicts carried into her adult life. She recounts early experiences of her reaction to her mother’s pregnancies, and her sense of rejection, displacement and rage. Trained as a nurse, and for a time employed teaching nursing, Barnes’ life does not show the trajectory of adolescent role failure often considered to characterize schizophrenia. Her conversion to Catholicism showed a concern with questions of meaning that were later to assume almost mystical proportions. According to her account Barnes achieved considerable success professionally, but remained troubled by self doubt and at times delusional ideas about herself, her family, and her effects on the world around her. These led to hospital admissions and intervention with the standard treatments of the time, ECT and chlorpromazine. When she met R.D Laing her life changed, and it is here that the biography takes on and additional social and historical interest. In 1965 Barnes entered Kingsley Hall, a therapeutic community set up by antipsychiatrists Laing and Esterson. The mood was radical; the techniques primitive and untried. Laing considered psychosis to be a healing experience which, fully experienced would bring about its own resolution. Laing was the enfant terrible of British psychiatry in the 1960s. His somewhat precocious The Divided Self set out what he saw as the basis for an alternative scientific account of schizophrenia, that of schizophrenia as an indicator of pathological family interaction. Kingsley Hall was the crucible in which Laing’s ideas would be tested. Barnes would become one of Laing’s ambassadors; a voyager into the depths of psychosis, who would emerge to explain its mysteries to those who would listen. A lot of people listened. Kingsley Hall, during the time of Mary Barnes residency, became a magnet for radical thinkers in psychiatry. Visitors included Fritz Perls and Loren Mosher. As mainstream resistance to Laing’s ideas became more entrenched, his critique took on an explicit political dimension through his identification with concerns of emancipation and liberation, rather than merely the alleviation of distress. 49389458According to Berkes’ account, doctors working at Kingsley Hall were exhorted to drop their medical persona, and instead engage with their clients as one human being to another. There seems to be little that is problematic about such an attitude. Many doctors of the day, especially those who were psychoanalytically trained, would probably have agreed that the relationship between doctor and patient is the prime ingredient of psychiatric care. Michael Balint’s 1957 The Doctor, his Patient and the Illness certainly took such ideas seriously in applying them to general medicine. However it is not entirely clear that Laing and others were prepared to abandon the status arising from their background as doctors. Their role as therapists appears in large part derived from their medical authority, augmented by a considerable dose of personal charisma. At one point in Berkes’ therapy with Mary Barnes, Berkes lashed out in frustration at Barnes’ childish demands, bloodying her nose. What is notable about his response is his consternation at finding himself thinking in terms of the ethical framework of medicine. He is later relieved that Barnes thanked him for the assault and said “she loved me more than ever”. As she emerged from the cocoon of psychosis Barnes’ discovered a talent for art. She became a productive and respected painter, not merely in the ‘art of the insane’ tradition, but in her own right, as an artist of the unconscious. The book contains several reproductions of her work, and they certainly have evocative power. One painting, ‘The resurrection’ seems clearly modelled on Munch’s The Scream, but the embryo-like figure suggests the idea of rebirth which was a cornerstone of Laingian therapy. Roman Catholic iconography is strongly represented in her art, with the fingerpainted works on Peter, the Nativity, and The Blinding of Paul having a primal quality in both the colors and the interpretations of their themes. Two Accounts of a Journey through Madness is at times a slow read. There is little evidence of professional editing, which may be a reflection of the Barnes’ view that madness speaks directly, and should not be filtered through objective the frames of reference for the convenience of others. Whatever the reason for its publication in this form, the authentic voice of Barnes contributes in large measure to the book’s appeal. While there are passages in which the tone of her writing is prosaic, there are others that show the poetic sensitivity that inspired her art. Her view of herself is that: ‘Much of me was twisted and buried, and turned in on itself, like a tangled skein of wool, to which the end had been lost.’ (p. 13). Mary Barnes was never cured. Perhaps she was never ill. She lived a productive, fulfilled life, albeit one interrupted by her admissions to hospital and her sponsored descents into psychosis at Kingsley Hall. She contemplated death with equanimity. It is hard to imagine the events of her life being repeated. That is not to say that psychiatry has been reformed by the lessons of the antipsychiatrists. If anything, the ideological position of biological psychiatrists has been strengthened, rather than weakened over the past few decades. Psychiatry, especially State psychiatry, has redrawn its boundaries, and is now less concerned with dysfunctional families, and more with using narrow diagnostic criteria to limit access to services. It is not at all clear that Laing’s radicalism has made an enduring, independent contribution to psychiatry. His focus on understanding the experience distress is part of an interpersonal tradition that predates Kingsley Hall, reaching back to Tuke and other practitioners of moral therapy. Kingsley Hall folded in 1970, and so was never able to provide the sort of sustained programs of intervention that might have tested Laing’s theories more fully In the years after Kingsley Hall Laing never recaptured the status he enjoyed as a counter culture figure. A biography is a story of a life. While Barnes’ book, especially the chapters by Berke, provides a critique of mainstream psychiatry, it is as biography that the book is most successful. From the intensely subjective descriptions of her childhood experiences, to the frank and at times naively honest recollections of her adulthood, Barnes’ account is direct and compelling account of one woman’s life. http://youtu.be/13s9oLvb-Bg

JERVIS E IL CONVEGNO SU BASAGLIA (1 – L’esperienza di Gorizia)

– 16 GENNAIO 2013PUBBLICATO IN: PERSONAGGI

Basagia e Jervis ISi è tenuto a Roma il 30/11/2012 e il 1/12/2012 un convegno organizzato dall’ARPCI (Scuola di Specializzazione e Formazione in Psicoterapia Cognitivo-Interpersonale), dal titolo “Attualità del pensiero di Basaglia”, che ha visto la partecipazione di eminenti psichiatri per la maggior parte affluenti nell’area storica di “Psichiatria democratica”, continuatori del pensiero basagliano. Ottimo convegno, ben organizzato anche nel numero contenuto che ha consentito di respirare un’atmosfera gradevole e familiare. In una delle tante relazioni è stato citato il nome di Jervis accennando in modo solo tangenziale ad alcuni dissidi e divergenze con lo stesso Basaglia che, con la pubblicazione de “ Il buon rieducatore” di Jervis, hanno segnato il definitivo distacco. Alla fine degli interventi prendo la parola, presentandomi innanzitutto come uno psicoterapeuta che aveva avuto dei rapporti di supervisione quasi ventennali con Jervis e che nelle discussioni avute sull’argomento dopo la pubblicazione del suo penultimo libro “La razionalità negata” scritto in collaborazione con Corbelllini, oltre alla polemica psichiatria-antipsichiatria, emergeva anche una figura di Basaglia in realtà poco democratica, piuttosto accentratrice e autoritaria, incapace negli ultimi anni di gestire una “notorietà” che forse lui stesso non s’aspettava; pur riconoscendo allo stesso Basaglia lo spirito di una mente illuminata che aveva dato vita ad una grande e importante riforma della psichiatria del tempo.

Che certe polemiche tra Jervis e l’area basagliana di “Psichiatria democratica” esistessero da tempo era cosa nota e che non si fossero mai sopite del tutto ha trovato ampia conferma proprio dopo la pubblicazione de “La razionalità negata” che le ha acerbamente disseppellite, rimettendo evidentemente il “dito sulla piaga” di un nervo scoperto. Non mi aspettavo certo sviolinate d’amore verso Jervis, ma quello che dalle loro risposte mi ha colpito è stato l’eccessivo livore, rabbia e rancore contro di lui; non è uscita fuori la fatidica parola ma il senso intuibile era quello di essere considerato un “traditore” della causa, l’unico vero “sabotatore“ dell’esperienza idilliaca di Gorizia. Come già accennato, gli attacchi sono stati portati particolarmente al libro di Jervis “Il buon rieducatore”(1977) che a detta dei relatori (sui cui nomi preferisco tacere) ha segnato anche una frattura personale con Basaglia, e manco a dirlo al già citato Jervis-Corbellini “La razionalità negata. Psichiatria e antipsichiatria in Italia” (2008). Gli attacchi che hanno sfiorato anche il cattivo gusto del pettegolezzo e perfino della denigrazione inventata contro Basaglia, mi hanno fortemente insospettito come se ci fosse nei confronti di Johnny il sentimento ambivalente di chi, mentre rimprovera implacabilmente, vive la cocente delusione dell’abbandono. Le parole di uno dei relatori risuonavano, infatti, come un monito nostalgico di rimprovero per non essere lì in mezzo a loro (magari lo potesse, aggiungo io!), riconoscendogli quell’immensa cultura che li avrebbe certamente aiutati.

Il convegno è poi scivolato verso altri temi. Tornando a casa, ruminavo tra me e me su quanto accaduto e per quanto potessi essere stato io a somministrare la pastura non riuscivo a digerire il pasto indigesto. Mi sono preso la briga di andare a riprendere “Il buon rieducatore” dove nel primo capitolo intitolato proprio “Il buon rieducatore” c’è, oltre che una piacevole autobiografia fino a quel momento, anche un ottimo resoconto dell’esperienza di Gorizia. Il primo capitolo che vale come lunga introduzione data dicembre 1976, quando lui è già a Reggio Emilia a dirigere i Centri d’igiene mentale, mentre il libro viene edito nel 1977. Questo è quanto scrive Jervis su Basaglia:

Quanto alla mia carriera, avevo chiesto e ottenuto da Basaglia il suo formale e personale impegno che, nel caso l’equipe goriziana si fosse sciolta o trasferita io sarei stato il primo tra i suoi collaboratori a cui egli avrebbe trovato dignitosa sistemazione altrove (…) Rispetto a come si presentavano gli altri direttori di istituti universitari e manicomiali italiani, si misurava subito una netta differenza di qualità. Egli proveniva da una ricca famiglia veneziana, e traeva dalla sua origine aristocratica e alto borghese doti di gusto, cultura, spregiudicatezza, attitudine al comando, disprezzo per gli eufemismi e per le piccolezze quotidiane. Leggeva, e a quanto mi disse i suoi autori preferiti erano Pirandello e Sartre; amava molto occuparsi di mobili antichi, era un antifascista e progressista; inoltre, era un uomo simpatico, e viveva in una splendida casa con due figli e una moglie bella e intelligente, Franca Ongaro, che gli faceva da segretaria e lo aiutava a scrivere gli articoli. Infine era ambizioso e sembrava aver fatto di Gorizia lo scopo della sua vita…Con una rabbia e un coraggio di cui credo nessun altro sarebbe stato capace in Italia in quegli anni, in una situazione locale culturalmente e politicamente sfavorevole, aveva deciso di farne un’esperienza pilota. Aveva mantenuto rapporti molto stretti col suo vecchio professore che andava a trovarlo a Padova tutte le settimane, ma si considerava, ed era un outsider; e se da un lato il modello a cui Gorizia si riferiva era quello delle comunità terapeutiche britanniche (che Basaglia aveva visitato), da un altro lato era chiaro che si era trattato sin dall’inizio di un’esperienza dotata di caratteristiche originali. Di fatto Gorizia finì per essere qualcosa di più di una copia di modelli stranieri: divenne un tentativo di detecnicizzare e depsichiatrizzare il rinnovamento manicomiale; fu un luogo di elaborazione di importanti proposte politiche e culturali; e infine assunse una importanza centrale per il rinnovamento della psichiatria istituzionale italiana dopo il 1967”. (Jervis “Il buon rieducatore”,1977, pp.19-20)Una descrizione molto simile si ritrova anche in Jervis-Corbellini “La razionalità negata. Psichiatria e antipsichiatria in Italia”, 2008, pp.82-83.

E ancora sulla personalità di Basaglia e i rapporti tra i membri del gruppo goriziano:

Basaglia richiedeva ai suoi collaboratori una adesione incondizionata, e non tollerava facili dissensi teorici e di linea, che tendeva a vivere drammaticamente come attacchi personali. Prima del mio arrivo, il gruppo dei medici allora intorno a Basaglia aveva conosciuto liti, scismi, espulsioni ed emarginazioni; mi resi conto rapidamente che anche nel gruppo attuale vi erano competitività e malumori che appesantivano molto il lavoro. E il lavoro era di per se molto, e pesante, sia come ore che come impegno: io tra l’altro ero tenuto a fare, in quanti medico di sezione, frequentissimi turni di guardia, di 24 o (nei fine settimana) di 48 ore, da cui erano invece esentati sia il direttore che i primari(…) “L’istituzione negata” fu, almeno secondo l’impressione che mi fece allora, una mescolanza quasi inestricabile di esaltazione comunitaristica e “antiautoritaria” e di attenzione critica ai problemi politici e culturali in gioco. I lavori di elaborazione collettiva di quel libro segnarono l’inizio della spaccatura dell’equipe e di una serie di dissensi che, apparentemente legati a rivalità ed esacerbate ambizioni personali, nascondevano invece profonde differenze di linea, e quindi divergenze di scelte operative, Dopo il maggio ’68, a Gorizia come altrove la spaccatura divenne drammatica e irreversibile.”(Jervis “Il buon rieducatore”, 1977, pp. 20-22).

Ancora su Basaglia e i rapporti col gruppo:

Da anni Basaglia parlava di lasciare Gorizia (già nel ’66 e’67 pareva che avesse la possibilità di andare a lavorare prima a Ravenna e poi a Bologna). Nel ’68 si sommarono a questo la sua delusione per i dissensi sempre più profondi che dividevano tra loro vari membri dell’equipe, e lui dall’equipe; e la convinzione che l’esperienza goriziana fosse ormai giunta a un punto massimo di sviluppo: in pratica, a un punto morto. Retrospettivamente, sono ora portato a credere che avesse più ragione di quanto non pensassi a quell’epoca: è possibile che l’esperienza goriziana avrebbe avuto la possibilità di progredire ulteriormente, oltre la fase volontaristica dell’ ”ospedale aperto”, solo se all’interno dell’equipe si fosse cessato di ignorare la necessità di un confronto con problemi tecnico-scientifici di tipo più specificamente psichiatrico, come quelli di natura psicoanalitica, o attinenti alle dinamiche di gruppo; oppure se l’istituzione avesse avuto la possibilità di aprirsi all’esterno, di legarsi ai problemi della popolazione locale, di portare “nel territorio” le contraddizioni, i problemi che venivano gestiti invece esclusivamente all’interno delle sue mura. Dall’altro lato, almeno per quanto riguarda quest’ultimo punto, la situazione politica locale e l’ostilità dell’amministrazione provinciale, avrebbero reso difficile, se non quasi impossibile, un sistematico “lavoro all’esterno”: però né allora né, credo, in seguito Basaglia dimostrò interesse per le istanze di base e per la politica “dal basso”, per cui non ritenne che questo costituisse un possibile terreno operativi (…) Un episodio fu indicativo, ed emblematico del clima che si era creato. Quando all’epoca scrissi per i “Quaderni piacentini” un articolo di denuncia sul caso Braibanti-Sanfratello in cui criticavo due cattedratici e ospedalieri di psichiatria fra i più reazionari (Rossini di Modena e Trabucchi di Verona) Basaglia pretese che censurassi il mio scritto o addirittura che, a cause di quelle critiche contro i suoi colleghi, io non lo pubblicassi; alla fine acconsentì solo perché mi impuntai, ma a condizione che al posto del mio nome usassi uno pseudonimo. Così feci con imbarazzo, e firmai con un altro nome. In quella circostanza misurai la mia dipendenza oggettiva, istituzionale (ma in parte anche psicologica) dal direttore dell’ospedale: malgrado il clima informale, amichevole e solidale, e malgrado il sentirci “tutti nella stessa barca” (e in parte proprio per questo) la direzione di Basaglia era sostanzialmente autoritaria. Erano a quell’epoca sempre scontri interni: per motivi di disciplina di gruppo, in cui credevo, e di solidarietà, evitai sempre finché rimasi a Gorizia, e anche per vari anni in seguito, di partecipare o anche di far trapelare all’esterno queste divergenze (che erano sempre, in ultima analisi, profonde divergenze politiche ed anche etiche) e di provocare un confronto pubblico sulle differenze d’impostazione e di linea che esistevano fra il mio operare, quello di Basaglia, e quello degli altri membri dell’equipe. Il fatto di non aver reso pubblici i dissensi, e di non aver confrontato apertamente fin dall’inizio le nostre rispettive posizioni con gli ambienti della sinistra e con tutti coloro che guardavano con simpatia all’esperienza goriziana fu indubbiamente un grave errore politico, che produsse confusioni e danni…Del resto moltissimi del vasto pubblico non volevano sentir parlare di dissensi di linea né di diversità di condotta: il gruppo goriziano fu idealizzato dai suoi simpatizzanti come politicamente omogeneo (cosa che invece non fu mai) o venne identificato con formule “antipsichiatriche” più o meno semplicistiche. Del resto credo che il pubblico avesse tutte le ragioni per non voler sentir parlare di dissensi, dal momento che questi ultimi sembravano riconducibili solo a beghe personali”.(Jervis “ Il buon rieducatore,1977,pp. 23-25). L’episodio che si riferisce al caso Braibanti-Sanfratello è riportato con maggiori dettagli anche in Jervis-Corbellini “La razionalità negata. Pschiatria e antipsichiatria in Italia”, 2008, pag.114.

Questo è quanto scrive Jervis verso la fine dell’esperienza goriziana:

“ Ma vorrei tornare ai fatti di quell’epoca, cioè all’estate del ’68. La tesi di Basaglia non era solo che l’esperienza di Gorizia fosse finita (e già su questo punto il resto dell’equipe non era d’accordo) ma altresì (per usare un’espressione che ripeteva spesso) occorresse “riconsegnare Gorizia agli psichiatri”: cioè andarsene tutti, e trasformare di nuovo l’ospedale aperto in ospedale chiuso, chiamando a gestirlo un direttore tradizionalista e medici conservatori; e cercare di far carriera altrove (…) ma egli si scontrò soprattutto con l’opposizione di Pirella. Con molti buoni argomenti e molta fermezza, Pirella dichiarò che non contestava affatto a Basaglia il diritto di lasciare Gorizia se lo desiderava: ma che riteneva giusto, anche per i ricoverati e gli infermieri , che l’esperienza continuasse. In quanto membro più anziano e di più alto grado dell’equipe se la sentiva di assumere la direzione dell’ospedale, lavorare con altri, andare avanti. Su questo contrasto io persi una buona occasione per dimostrarmi quel gran nemico dell’opportunismo, che spesso lasciavo intendere di essere: trovavo che Pirella aveva ragione ma all’inizio non lo dissi con chiarezza, per non rovinarmi definitivamente i rapporti con Basaglia. (Ciò non mi servì neppure, perché ne aveva più che abbastanza della mia collaborazione, tanto che mi impedì di occupare un posto messo a concorso nel manicomio di Parma, e mi disse chiaro e tondo che per il mio futuro professionale e di lavoro vedessi di arrangiarmi. Quanto a lui , ammaestrato dall’esperienza, per il suo futuro sarebbe stato attento a scegliersi collaboratori “più giovani e più di buon carattere”). La direzione di Gorizia fu dunque presa da Pirella, con cui rimasi a lavorare. Però Basaglia non digerì molto bene l’idea che esistesse una “Gorizia senza Basaglia”. In Italia e anche nel mondo si sparse a quell’epoca la voce, totalmente falsa, secondo cui egli era stato costretto ad andarsene per l’opposizione degli ambienti politici retrivi o per persecuzioni giudiziarie, tanto che l’esperienza goriziana pareva fosse finita nella repressione; e non riuscii mai a capire fino a che punto Basaglia stesso contribuisse a fabbricare e propagare queste dicerie. Quando nell’autunno del ’69, ormai stabilitomi a Reggio Emilia, ottenni udienza dal ministro della Sanità (a quell’epoca, Ripamonti) per avere il riconoscimento ministeriale dell’attività appena iniziata dei Centri di igiene mentale di Reggio, fui interrogato con molta cortesia e simpatia sulla sorte dell’esperienza goriziana: il ministro mi chiese se a Gorizia vi erano grosse difficoltà, e se proprio non poteva fare qualcosa, anche finanziariamente; risposi che non solo l’esperienza non aveva fatto passi indietro, ma stava procedendo, ora soprattutto grazie agli sforzi di Pirella e Casagrande, e che un suo aiuto sarebbe stato molto importante, forse decisivo. Il ministro parve imbarazzato; poi mi disse che era disorientato, perché Basaglia in persona gli aveva risposto poco tempo prima che l’esperienza di Gorizia era “del tutto chiusa e conclusa”, e che non era proprio il caso di aiutarla. In seguito i rapporti tra Basaglia e Pirella migliorarono sensibilmente, e fra gran parte dell’equipe goriziana si cementarono nuovi accordi. Io non rivelai mai l’episodio del ministro.” (Jervis“ Il buon rieducatore”,1977, pp.25-26).

Eviterei di commentare oltre misura questi passi (sarebbe fin troppo facile!), mi limito a dire che sulla scia dell’atteggiamento umano-scientifico profondamente antidogmatico che proprio Jervis ci ha insegnato, quanto riportato non va certamente preso (anche da coloro che lo hanno amato) come l’oro colato della “verità”, ma sicuramente come l’ ”esperienza” umana e professionale dello stesso Jervis che risulta però profondamente “diversa” da quanto riportato al convegno. Anche nel prossimo articolo continueremo a parlare del convegno, ma centrato di più sul tema psichiatria-antipsichiatria.

BIBLIOGRAFIA

-G.Jervis “Il buon rieducatore”, Feltrinelli, Milano, 1977

-G.Corbellini- G.Jervis” La razionalità negataPsichiatria e antipsichiatria in Italia, Bollati Boringhieri, Torino, 2008

JERVIS E IL CONVEGNO SU BASAGLIA (2 – L’antipsichiatria)

– 28 GENNAIO 2013PUBBLICATO IN: PERSONAGGI

Franco BasagliaL’ultimo capitolo de  ”Il buon rieducatore” s’intitola il “Mito dell’antipschiatria”. Qui sono già evidenti le “differenze” con la cosiddetta antipsichiatria da cui Jervis intende prendere le distanze, non solo dal punto di vista tecnico-scientifico, ma più profondamente dal punto di vista politico. Vediamo cosa scrive in proposito:

Nel campo della psichiatria, ai contestatori del ’68 è stata fatta bere, in un bicchiere verniciato di facili slogan, la ricetta borghese di una psichiatria magicamente liberata da problemi di autorità, digeribilissima perché priva di problemi tecnici, risolutrice di oppressioni, emarginazioni e violenze. Con fatica, ci si va oggi finalmente accorgendo che lo spirito permissivo, tipicamente borghese, non è la stessa cosa che la lotta antiautoritaria; che nella nostra società non si dà educazione senza sgradevoli problemi di metodi e di autorità (con i quali occorre fare i conti); che il problema del manicomio non sta tutto “dentro” quelle mura ma in primo luogo “fuori” di esse; e che se è vero che la malattia mentale non esiste in quanto malattia, cioè nel senso medico, questo non significa che non esistano persone con gravi problemi psicologici, e bisognose d’aiuto; né che non esistano molti individui, che lo stato borghese non può certo rinunciare in quanto tale a rinchiudere, controllare, reprimere, condizionare, prevenire, assistere in modo specializzato, con metodi man mano più efficaci.

Le cose si fanno man mano più chiare: e, passata l’epoca della mistificazione permissiva, il potere torna a mostrare il suo vero volto… …Uno degli equivoci più comuni, ma oggi ormai in piena crisi, riguarda ancora il mito di una psichiatria “antiistituzionale”: cioè che si pretende capace di negare il proprio carattere repressivo nel momento in cui corregge, o abolisce, gli aspetti più oppressivi del manicomio. Questo errore, particolarmente diffuso in Italia, arriva a scambiare il riformismo istituzionale (cioè l’elaborazione, o per meglio dire l’importazione, di più moderne forme organizzative dell’assistenza psichiatrica pubblica) per un progetto politico dotato in qualche modo di virtù eversive… …Ma per lo più, ciò che si indica come antipsichiatria non vuole avere nulla a che fare col riformismo psichiatrico. L’antipsichiatria vuole essere caso mai la negazione di questo riformismo: non la negazione del manicomio, ma la negazione della psichiatria. Questo orientamento implica non solo la critica al vecchio concetto di malattia mentale, ma anche la critica all’idea della follia come qualcosa da curare; implica la confutazione della definizione di disturbo mentale, e la tendenziale rivalutazione della devianza “psichiatrica” e della follia.

In questo senso l’antipsichiatria vive piuttosto come tendenza, orientamento culturale, fermento critico, che come realtà pratica. Questa tendenza critica nasce in buona parte dall’interno stesso della psichiatria, e da alcune correnti della sociologia, mentre per altri versi è espressione (come si è accennato all’inizio di questo scritto) di contraddizioni e bisogni politici. Si tratta però di una tendenza dotata di caratteristiche vaghe e contraddittorie. Il concetto di antipsichiatria è andato rivelando, col passare degli anni, una sua imbarazzante carica velleitaria: da un lato si è man mano chiarito che all’atto pratico l’antipsichiatria era ancora psichiatria, mentre da un altro lato essa sfumava nel cielo degli equivoci scientifici.  (Jervis “Il buon rieducatore”1977, pp. 133-137). (Sull’antipsichiatria su veda anche Corbellini-Jervis “La razionalità negata. Psichiatria e antipsichiatria in Italia”, 2008, pp. 60-81).

Vediamo cosa scriveva nel “Manuale critico di psichiatria” del 1975:

Le conseguenze, nel manicomio, sono molto più gravi: ma le cause stanno fuori dalle sue mura. Così, è soprattutto fuori da quelle mura che si formano le strutture si potere e gli schemi di comportamento che (talora degradati e poco riconoscibili) regolano i rapporti anche all’interno dell’istituto di ricovero. Il manicomio rende talora evidenti alcuni aspetti dell’oppressione e dell’ipocrisia che costituiscono l’infrastruttura del vivere sociale nel capitalismo: ma non ne spiega né l’oppressione né l’ipocrisia. Il manicomio non spiega né i perché di se stesso, né tanto meno quelli della società esterna: al contrario, è la struttura sociale che causa e spiega il manicomio. Così, è in rapporto alla lotta di classe, e nell’ambito dei temi che studenti, operai, tecnici elaborano e fanno propri nelle proprie rivendicazioni sociali e nella vita quotidiana, che si organizzano le lotte contro le cause del disagio psichico e contro la sua gestione repressiva. Il collegamento della classe operaia con le forze che si battono all’interno dell’istituzione costituisce allora una premessa possibile per la trasformazione reale di quest’ultima. (Jervis “Manuale critico di psichiatria”, 1975, pag. 118).

E ancora su psichiatria, antipsichiatria e lotta rivoluzionaria:

Non saranno né gli operatori né gli amministratori a “liberare la psichiatria”: e un a psichiatria “alternativa” e “contro il sistema” in fin dei conti non è mai esistita. La psichiatria resta nella nostra società, e resterà fin tanto che una società è divisa in classi, essenzialmente uno degli strumenti di repressione e di integrazione di cui dispone lo stato, e quindi la classe al potere, per gestire i propri privilegi. Lo stato non vi può rinunciare: non può rinunciare a disporre delle carceri, e così non rinuncia a gestire i manicomi e le strutture equivalenti, o i servizi psichiatrici in genere. Per ora le cose non possono essere diverse: la psichiatria non potrà essere restituita a una funzione solo terapeutica, cioè non potrà essere “liberata”, se non in una società senza classi. Ma forse a quel momento anche le contraddizioni sociali che dominano l’insorgenza dei disturbi mentali saranno attenuate o scomparse” (Jervis “Manuale critico di psichiatria”, 1975, pp. 138-139).

Dopo l’esperienza di Gorizia, imboccando questa strada, Jervis s’avvierà dal 1969 a dirigere dall’ ”esterno” del manicomio i Centri d’igiene mentale distribuiti nel territorio di Reggio Emilia.jervis2 Vediamo a distanza di qualche anno (rispetto a quando scrive) la posizione di Basaglia (riespressa al convegno) in riferimento alla malattia, alla follia e al manicomio; posizione i cui semi erano già contenuti nell’esperienza goriziana, definitivamente fioriti a Trieste (dove Basaglia andò a dirigere l’ospedale psichiatrico di zona), i cui frutti animarono lo spirito della “Legge 180”, emendata in quegli anni.

La follia è una condizione umana. In noi la follia esiste ed è presente come lo è la ragione. Il problema è che la società, per dirsi civile, dovrebbe accettare tanto la ragione quanto la follia, invece incarica una scienza, la psichiatria, per tradurre la follia in malattia allo scopo di eliminarla. Il manicomio ha qui la sua ragion d’essere che è poi quella di far diventare razionale l’irrazionale. Quando qualcuno è folle ed entra in manicomio smette di essere folle per trasformarsi in malato. Diventa razionale in quanto malato.” (F. Basaglia “Conferenze brasiliane” (1979), Raffaello Cortina, Milano, 2000, pag. 34)

Riassumendo, dobbiamo innanzitutto contestualizzare questo excursus in quegli anni animati da forti fermenti politici della contestazione di sinistra, dal mito della rivoluzione e dalla lotta di classe. Infatti, a ben vedere, le due posizioni hanno almeno un punto di vista politico comune: il disturbo psicologico-psichiatrico viene (almeno in parte) interpretato come espressione storica delle contraddizioni del sociale; ma da questo punto di vista le posizioni divergono. Quella basagliana antipsichiatrica potrebbe riassumersi così: “Se la malattia, gli stessi psichiatri e soprattutto l’istituzione manicomiale rappresentano le contraddizioni di una società oppressiva e violenta, chiudere i manicomi, sciogliere i matti e mandare a casa gli psichiatri, rappresenta l’atto consapevole e volontario che interrompe la cinghia di trasmissione di tali contraddizioni”. Discorso che apparentemente non fa una grinza. Mentre il discorso di Jervis di quegli anni potrebbe risuonare più o meno così: “Se la malattia, la psichiatria e l’esistenza dello stesso manicomio trovano origine nelle contraddizioni del sociale, è proprio nella trasformazione politica del sociale che c’è la chiave di volta, mentre invocare ad una psichiatria “libertaria” o “antiistituzionale” oltre che risuonare mistificatorio, si rivela un semplice “esorcismo politico” che lascia le cose intatte, sia nel senso della responsabilità psichiatrica della “gestione” del disturbo (che s’impone comunque!), sia nel senso della sua “produzione” che continuerà a proliferare fin tanto che non si andrà alla radice del male”.

Potrà sembrar strano ma stando agli scritti di quel tempo, Jervis scavalca politicamente a sinistra la posizione basagliana, pur essendo improntata, questa, ad un riformismo radicale della psichiatria italiana; ciò che gli varrà spesso, fin dai tempi di Gorizia, la critica per un eccessivo intellettualismo di sinistra, ancorato su posizioni estremiste. Adesso, rileggendo questi scritti, mi viene da sorridere quando sento ancora parlare di Jervis come “traditore” del mandato e del ruolo sociale della psichiatria, “rinnegatore” della valenza sociale del disturbo mentale. E’ vero che successivamente Jervis abbandonerà le posizioni massimaliste e prenderà le distanze sia dalla teoria marxista intesa come prassi rivoluzionaria e dottrina della liberazione sia dall’interpretazione univoca del disturbo mentale in chiave esclusivamente sociale, ma ciò che è importante sottolineare qui è che la frattura con “Psichiatria Democratica” si era già consumata nel decennio degli anni ‘70 e molto poco sull’interpretazione “scientifico-psichiatrica” della malattia mentale e della sua cura (questioni ancora “in fieri”), ma proprio sull’interpretazione “politica” della sua origine e della sua gestione; interpretazione che vedeva in Jervis uno psichiatra fervidamente impegnato sul fronte politico-sociale e per niente la figura di un freddo psichiatra scientista e antisociale come vorrebbero quelle critiche che sbagliano clamorosamente i tempi della loro enunciazione! Per chi avesse ancora dei dubbi su quanto fosse politicizzato lo psichiatra Jervis di quei tempi può andarsi a (ri)leggere il capitolo “La normalità e la sua critica” in Jervis “Manuale critico di psichiatria”, 1975, pp. 194-225.

Su questo punto è lecito muovere una nota critica allo stesso Jervis, dal momento che per quanto legittimamente possa aver revisionato alcune sue idee (tutti hanno il diritto di farlo nel corso della propria vita), sembra essersi mostrato dimentico negli ultimi venti anni, su quanto scriveva negli anni ’70: ma per affermare la “differenza” del presente col passato non c’è bisogno di rimescolare troppo il passato nel tentativo di renderlo più coerente col nuovo presente. A conti fatti e facilmente col senno di poi, ritengo che dobbiamo essere tutti grati a Basaglia per il suo coraggio e lo spirito innovatore dimostrato in quegli anni difficili: il muro divisorio preso a simbolo rassicurante della città dei sani rispetto a quella dei folli doveva essere abbattuto, e l’interno manicomiale ridotto a lazzaretto dei derelitti, ghetto degli esclusi e pattumiera dei rottami sociali, definitivamente chiuso! (Anch’io, nel 1975, allora studente di psicologia ai primi anni, visitai l’orrendo manicomio di Trapani, dove feci anche un breve tirocinio). La Legge 180 ha significato il fiore all’occhiello della psichiatria italiana e siamo, con vanto, l’unico paese al mondo che ha chiuso con un intervento legislativo l’istituzione manicomiale. Lo stesso Jervis, a distanza di tanti anni, riconoscerà l’importanza della Legge 180, nonostante tutte le sue pecche e i suoi vuoti applicativi (Corbellini-Jervis ”La razionalità negata. Psichiatria e antipsichiatria in Italia”, 2000, pag. 169). In merito a ciò, bisogna rilevare che la Legge 180 è risultata “molle” e “imprecisa” negli aspetti applicativi della gestione del disturbo psichiatrico distribuito sul territorio (e questo anche Basaglia lo sapeva benissimo!), ma soprattutto ha lasciato inevasa la domanda sull’origine e sulla natura del disturbo stesso: chi pensava che la malattia (ma anche la stessa follia in senso basagliano) fosse solo figlia del manicomio e che bastava demagogicamente chiuderlo per farla sparire, si è dovuto amaramente ricredere.

Oggi non si può dire che la “follia”, la “malattia” e il “disturbo mentale” non continuino a prodursi, nonostante lo splendore della 180. Riguardo a queste ultime considerazioni, ho sentito riecheggiare nel convegno categorie esplicative un po’ vecchiotte che finivano, ancora una volta, per appiattire il disturbo psichiatrico sui rapporti sociali finendo in una lettura troppo semplicisticamente sociologica dei problemi. Che il disturbo psicologico-psichiatrico nasca dalle trame dei rapporti sociali (a partire da quelle familiari) è cosa indubbiamente vera; ma che sia “solo” la duplicazione reificata di queste, appare superficiale, riduttivo e perfino banale. In merito a questa miopia eziologica pongo tre elementari considerazioni che idealmente rivolgo agli esponenti del convegno:

1) Se l’origine è solo sociale, come mai nella stessa città, nello stesso quartiere, in un’ipotetica famiglia disastrata, due fratelli coetanei (che quindi vivono contemporaneamente il parossismo di certe situazioni) prendono strade completamente diverse: uno quello della delinquenza organizzata, l’altro quella dell’entrata in seminario per diventare prete? Ammettere l’esistenza di un sia pur rudimentale “psichismo” tra il biologico e il sociale appare così strano? Non è forse quell’elaborazione “soggettiva” e “personale” degli stessi stimoli che fa la differenza tra gli uomini sani o disturbati che siano e non la riproduzione imbalsamata del “reale” tout-court?

2) Gli psichiatri dell’area democratica trovano una radice storica nell’ideologia d’ispirazione marxista (anche se ormai il mito della rivoluzione è finito per tutti!) e coerentemente con ciò del disturbo psichiatrico ne danno una lettura massimalista in termini di “materialismo sociale” dei rapporti. Questo tipo di materialismo non li spaventa! Mentre invece li spaventa un materialismo d’altro tipo: non solo quello più rozzo tradizionalmente organicista, ma anche quello più raffinato biologico-genetico e neuropsicologico dei disturbi… perchè?! Come se il materialismo sociale lasciasse inalterata la “coscienza” (cosa che invece non è), mentre invece quello biologistico la facesse sparire del tutto (e anche questo non è vero). Siamo animali dotati di un’intelligenza superiore (così si dice) e perciò condannati a vivere nell’ ”Io coscienziale” (buono, cattivo, vero o falso che sia) e non nelle cellule dei nostri organi interni; non ci sarà scienza al mondo che potrà sostituirsi alla coscienza per il semplice motivo che la scienza è un “processo” d’accertamento della verità, la coscienza è il “luogo” ed anche il “tempo” ontologico dell’esistenza che riguarda tutta la specie umana senza nessuna distinzione di età, sesso, razza, religione o cultura. Ma se la costruzione della struttura coscienziale è sovradeterminata da un’infinità di fattori biologici, genetici, organici, emotivi, affettivi, storico-sociali, situazionali, perché mai dovrebbe vedere proprio nella scienza, che studia questi fattori, la sua antagonista? Semmai la scienza potrebbe farsi ancella per la costruzione di un sapere coscienziale più accorto e oculato, capace di vaccinare quel “luogo” da inganni e facili illusioni.

3) Se tali psichiatri vedono con molto sospetto l’approccio biologista e organicista in materia, allora perché fanno un uso sistematico e tanto disinvolto degli psicofarmaci? E’ stato fatto rilevare proprio da un relatore, la profonda differenza di trattamento tra uno psicoanalista classico che tradizionalmente non usa i farmaci, da quello di uno psichiatrico democratico che invece ne fa largo uso.

Queste linee di tendenza sono riaffiorate quando la discussione è scivolata sul trattamento dei disturbi dello spettro autistico, polemica importata dalla Francia e proseguita in Italia tra lo stesso Corbellini e lo psicoanalista lacaniano Di Ciaccia (io stesso ho ascoltato, tempo fa, una trasmissione radiofonica sull’argomento tra i due protagonisti): se la sindrome autistica sia possibile curarla con un approccio tipicamente psicoanalitico oppure facendo ricorso a tecniche neuro-cognitive. Anche qui la riluttanza verso ogni tecnica neuro-cognitiva e bio-psicologica si è fatta sentire; ma è ormai risaputo che la sindrome autistica ha radici bio-genetiche (non è un caso che la stragrande maggioranza dei bambini autistici sia di sesso maschile), che incidenza clinica di cura potrà mai avere il “sapere psicoanalitico” sull’autismo? ( a meno che uno faccia delle cose chiamandole con un altro nome). E’ come domandarsi se i D.S.A. (disturbi specifici d’apprendimento) possano trovar giovamento con qualche buona chiacchierata da un buon psicologo o se a un tubercolotico possa giovare una bella passeggiata in un bosco a respirare aria pura… certamente sì!

Ma altrettanto certamente questo non lo cura dalla sua tubercolosi! Come ho fatto rilevare al convegno, ritengo che la psicoanalisi, ponendosi tra psicologia e filosofia, rimanga un’ermeneutica della liberazione della “soggettività” che qualche volta riesce bene, altre volte meno, ma non debba trovare la sua antagonista dirimpettaia nelle neuroscienze, né ingelosirsi dei suoi progressi, anzi rallegrarsene, eventualmente. Ogni tanto i due percorsi paralleli possono anche incrociarsi e all’occorrenza infiocchettare un nodo comune, ma poi ripartire per la propria strada, evitando sterili quanto inutili contrapposizioni.

Finisce qui il mio resoconto  sul convegno, ringrazio tutti gli organizzatori per la loro totale dedizione agli aspetti logistici, i relatori per la passione con cui  hanno esposto i loro  contributi comunque pregevoli e mi congedo con  affetto da tutti i lettori, immaginando che in mezzo a loro ci sia anche il “nostro” stimato GIOVANNINO (mio e di Francesco)… …che abbia letto anche lui gli articoli e che con  sobrio calore mi dica “Ti ringrazio!”, ma fermandosi lì, senza lasciar trapelare emozioni più profonde.

BIBLIOGRAFIA:

F. Basaglia “Conferenze brasiliane” (1979), Raffaello Cortina, Milano, 2000

G. Corbellini-G. Jervis ”La razionalità negata. Psichiatria e antipsichiatria in Italia”, Bollati Boringhieri, Torino, 2008

G. Jervis ”Il buon rieducatore”, Feltrinelli, Milano, 1977

G. Jervis “Manuale critico di psichiatria”, Feltrinelli, Milano, 1975

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Una risposta a "Orgogliosi di essere pazzi"

  1. Andrea ha detto:

    In realtà il Mad Pride e il Gay Pride sono più collegati di quanto si creda . Gli omosessuali sino a pochissimo tempo fa sono stati considerati malati mentali in quanto devianti dalla norma sociale , e l’eliminazione dell’omosessualità dal Dsm è avvenuta proprio grazie alla “pressione” delle organizzazioni antipsichiatriche e LGBT che da sempre hanno collaborato . Nessun psichiatra tradizionale in passato ha mai considerato l’omosessualità come un’orientamento normale , solo chi apparteneva al movimento antipsichiatrico . Lo stesso Freud , che è un precursore della psicologia e antipsichiatria progressista ( Fromm, Cooper , Basaglia ecc ) considerava l’omosessualità come un disturbo sessuale e psicologico . Se non ci fosse stata l’antipsichiatria a quest’ora l’omosessualità ( ma pure l’epilessia e addiritura l’introversione ) sarebbe ancora considerata malattia mentale .

    Per quanto riguarda i “cattivi maestri” il discorso fatto nell’articolo è un pò troppo demagogico . La maggioranza dei protagonisti del 68 e delle contestazioni erano “cattivi maestri” , drogati , alcoolizati , morti giovanissimi , e se proprio la vogliamo dire tutta anche i grandi della psicologia non erano tanto a posto : Freud come ben si sa era cocainomane e oltre ad essere drogato aveva disturbi mentali e negli ultimi anni della sua vita era diventato sempre più narcicista e con manie di grandezza . Se poi si vuole parlare delle maggiori figure del movimento omosessuale pensiamo a Mario Mieli , l’icona omosessuale più importante e fondamentale italiana , a cui sono dedicati tutti i più importanti circoli omosessuali , che praticava e esaltava tutte le parafilie ( compresa la corprofagia e la necrofilia ) , negava l’esistenza dei generi ( maschio e femmina) e delle personalità e sosteneva che bisognava rovesciare e distruggere il concetto di normalità ed essere orgogliosi di essere “anormali” e “deviati” , oppure bizzari , matti (queer) , ed è da lì che nasce il Gay Pride , dall’esaltazione di tutto ciò che è , o è considerato, bizzarro , anormale , deviante , malato , in una parola queer come segno di trasgressione e rifiuto e sfida alla società dei “normali” allo stesso tempo . Un’altra icona omosessuale e non a caso tra i fondatori dell’antipsichiatria è Foucault , noto pr essere molto critico verso il concetto di “normalità” . Inoltre c’è da dire che la maggioranza degli psichiatri antibasagliani e favorevoli alla riapertura dei manicomi sono tutti , come si direbbe oggi , “omofobi” , basti pensare a Francesco Bruno . Comunque in definitiva le motivazioni che stanno dietro al Mad Pride sono le stesse del Gay Pride o viceversa , ciò in sè è un fatto neutro ,ma comunque non bisogna dimenticare che l’omosessualismo è sempre stato inconciliabile con la psichiatria tradizionale e critico verso i concetti di “normalità” e “devianza” imposti dalla società . Mi scuso per il kilometrico commento , ma spero che il discorso si sia capito . Saluti

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