Francois Ferrero: The Geneva 1980's psychiatry crisis: Psychiatry an Antipsychiatry 

Introduction

        The starting point for this project was a question Thomas Ban asked me a few years ago about the events that took place in Geneva in June 1980 when he was there working at the World Health Organization. Stimulated by his curiosity and enthusiasm, I began to search for documents to try to reconstruct the story, leaving little room for my own memories. At first, I relied solely on written sources, without taking sides, which gave this text a bit of a journalistic investigation. A first version was published on the INHN website and, in view of the interest it aroused, the project of making it into a book gradually became possible.

        How is it possible to explain that a tragic event, however far from being exceptional - the death of a patient in a psychiatric hospital - led to such consequences on psychiatry, influencing as well politics and academics? To try to answer this question, several hypotheses will be formulated/proposed based on certain political and social characteristics of Switzerland and more particularly of Geneva, a city whose psychiatric history had already been marked by several crises.

        Although this work focuses specifically on Geneva’s psychiatry in the late ‘70s and early ‘80s, it is necessary to refer to the situation in a few other countries, thus to remind that the difficulties encountered by psychiatry at the time were found practically everywhere. The prevailing climate was characterized by the radical questioning of the social order and by the rejection of any hierarchy as indicated by the famous slogan, Il est interdit d’interdire. How could Geneva psychiatry not have been carried away sooner or later by such a questioning of the organization of society? How could it have avoided responding to criticism and a rethinking of its practices after years of stability that it undoubtedly owed to the personality of a charismatic director?

        Even before 1968, many books radically questioning psychiatry had met with exceptional success, and some are still considered "classics." Examples include Ronald D. Laing's The Divided Self (1960); Asylums by Erving Goffman (1961); The Myth of Mental Illness by Thomas Szasz (1960-1961); Histoire de la folie à l'âge classique by Michel Foucault (1st ed. 1964, English translation, Madness and Civilization, 1965); or L'Istituzione Negata by Franco Basaglia (1968, English translation, Refusing the Institution, 1968).

        In Europe, the most radical protest developed in Italy with the adoption of the "Law 180" which led to the closure of asylums. In Germany, antipsychiatric protest was sometimes taken to the extreme and highly politicized forms focused on the issue of treatments by Electroconvulsive Therapy (ECT).

        In France, where the 1968 movement originated, the undisputed "patron" of university psychiatry was Jean Delay, archetype of the "Mandarins" in the eyes of the protesters, and his authority was suddenly questioned. Driss Moussaoui, who was an intern in his department, referred to this episode as a "thunderclap in a blue sky" (Moussaoui 2002). By May ‘68, the chaos was indescribable.

        A motley crowd of more than 500 protesters invaded Delay's ward and office, with plans to release patients considered prisoners, victims of the system. After long discussions, a psychiatrist, Lucien Bonnafé, managed to convince the crowd to return the next day and, finally, this assault was abandoned. However, the Clinique des Maladies Mentales et de l'Encéphale, which was the beacon of Francophone psychiatry, did not survive these events. The Clinic was subsequently divided into a dozen services and, two years later, due to his health, Jean Delay resigned.

        Other services were also occupied, such as that of Georges Daumézon in Sainte-Anne, and in the sector of the 13th arrondissement of Paris, yet at the forefront of a new psychiatry, even the seminary of Jacques Lacan was disrupted - the antipsychiatry challenge did not differentiate between theoretical models. Among countless demands, three of them concerned the organization of psychiatry: the first called for the separation of psychiatry from neurology, which was done the following year; the second called for a reform of the training curriculum, which was also carried out; and the third required the exit of psychiatry from medicine, which, fortunately, was not followed up.

References:

Basaglia F. L’Istituzione Negata. Turin: Einaudi; 1968.

Foucault M. Histoire de la Folie à l’Age Classique. Paris: Plon; 1961. (English translation: Richard H. Madness and Civilization. New York, Vintage; 1988.)

Gofman E. Asylums. New York: Anchor Doubleday; 1961.

Moussaoui D. A Biography of Jean Delay. Amsterdam: Excerpta Medica; 2002.

Laing RD. The Divided Self. Harmondsworth: Penguin; 1960.

Szasz T. The Myth of Mental Illness. New York: Harper & Row; 1961.

October 28, 2021