Institutional Psychotherapy

[Editor’s note: this is an addendum to the article ‘Demystifying phenomenological and social psychiatry’ (Isolatarium, 1/2019). Although it is published separately here, it has also been integrated into the aforementioned article]

Commonly considered as conceptional founders of Institutional Psychotherapy (IP) [1] are François Tosquelles, Jean Oury, Hermann Simon, Frantz Fanon and George Canguilhem. Their work built upon the theory of Jacques Lacan, which was later complemented by Félix Guattari and Gilles Deleuze. Many of these individuals were heavily influenced by the experience of occupation during World War Two; of totalitarian oppression on either side of France. Such personal experiences of incarceration engendered the rethinking of institutional confinement within the psychiatric field, which became a central element to IP. Likewise these individuals had a shared conviction that social and psychological problems should be simultaneously broached, and not studied or treated independently. Within the institution this was addressed through a horizontal, radically democratic therapeutic approach. Two important examples are Saint-Alban in southern France, where IP was initially conceptualised, and La Borde Clinic south of Paris — founded by Jean Oury in 1951 and still open today.

Camille Robcis offers an insight into the anti-authoritarian therapeutic practises at Saint-Alban:

‘One of the most important innovations was the Club Paul Bavet. The club was a patient-run cooperative, a sort of union, in charge of organising all the activities within the hospital. Elected and composed of various sub-committees, the club planned meals, theatre and musical performances, sports, parties and field trips — social activities deemed integral to the cure… It also ran the library and the different ergotherapy stations. As one observer noted, the atmosphere at the ‘Club Paul Bavet’ resembled a lively cafe, where everybody discussed all the time… The club was responsible for the publication of a weekly journal called ‘Trait d’Union’ — a collection of texts which could be theoretical, literary, poetic, drawing, recipes, advertisements and letters. The editorial board was composed of patients, who were helped by a few staff members, and the journal was published in the hospital itself by the printing and binding committee. Once again, ‘Trait d’Union’ had both a theoretical and a practical goal: the content was informational, but also philosophically stimulating… The club also coordinated the different activities for the patients that Tosquelles, following Simon, considered foundational to the cure. The work was divided into three categories: agricultural (food picking, working on the land etc.), hospital-related (masonry, carpentry, painting, cooking etc.) and ergotherapy stations (pottery, book-binding, woodwork etc.) … The club, the journal and the activities at Saint Alban were all designed to facilitate the emergence of a horizontal collectivity, a new space of transference (transferential constellation / transversality). Although the patients also received one-on-one psychoanalytic sessions with doctors, they were invited to participate in the general meetings, which had an explicit therapeutic goal [that] were strictly anti-authoritarian.’ [2]


Recommended literature (specific to IP)

Gilles Deleuze, Félix Guattari — Anti-Oedipus (Suhrkamp Verlag, 1977)

Andrew Goffey (2016). “Guattari and transversality. Institutions, analysis and experimentation.” Radical Philosophy, 195, pp. 38-47

Sarah Marks / Katie Joice — Institutional Psychotherapy in France: An Interview with Camille Robcis. Hidden Persuaders blog, 2017

Jean Oury — L’Aliénation (Galilée, Paris, 1982) and Création et schizophrénie (Galilée, Paris, 1989). Note: unfortunately neither of these texts have been translated into English or German

David Reggio and Mauricio Novello (2007). “The hospital is ill: An interview with Jean Oury.” Radical Philosophy, 143, pp. 32-45

Camille Robcis — Disalienation: Philosophy, Politics, and Radical Psychiatry in France. Lecture at ICI Berlin, 23.04.2018

Camille Robcis — The Politics of the Psyche. Lecture at the Center for 21st Century Studies, 10.03.2017


[1] Note: this is an addendum from July 2019 to the original article published in January 2019. As should become apparent, the future TC depicted before (Isolatarium, 4/2018) is probably most closely aligned with the therapeutic model of IP established at Saint-Alban. However, as the author was not aware of Institutional Psychotherapy prior to writing this addendum (further proof of its lacking influence in the english- and german-speaking psychiatric fields), it regrettably does not feature there at all, nor elsewhere in this article. Due to the philosophical depth in the theory underpinning the approach IP, it is difficult to provide a short, concise overview. Again, this is further complicated by the lack of translations of some of the key texts from original French. Thus this should be regarded as a mere introduction, in no way complete
[2] Camille Robcis — The Politics of the Psyche. Lecture at the Center for 21st Century Studies, 10.03.2017 (approx. 43:00 – 46:00)