By Jakob Jakobsen, 14 November 2013
Image: The fence around the Gorizia Mental Hospital in Italy being dismantled in 1962. Retrieved from RAI Edu 2012
As market logic moulds institutions of learning, treatment and therapy ever more brazenly, co-founder of the Cophenhagen Free University, Jakob Jakobsen, resuscitates some radical histories of deinstitutionalisation, in psychiatry and education, to learn valuable anti-lessons in negation and resistance
In 1962, a group of people at the Gorizia Mental Hospital in northern Italy began dismantling the fence that surrounded the institution. Footage from a documentary by the Italian film-maker Sergio Zavoli shows what appears to be patients and staff cutting and pulling down sections of the high metal fence – a fence built with the clear purpose to both demarcate a specific area of a building and to keep people from getting over it. Significantly, we see the fence that defined the boundary of the hospital being dismantled from inside the compound, and the faces of those pulling each segment of it to the ground express relief, even joy. In Italian, the voiceover of the film describes the action:
In November 1962, the psychiatric team directed by Dr Franco Basaglia opened up the first ward of the hospital and inaugurated a therapeutic community. Hospital life will be regulated by ward assemblies and by general assemblies. The patients are regaining a human and social role, as they get to take care of themselves and their existence through an ongoing communication with the people treating them. Once the prison-like nature of the institution has been abolished, the nature of its ideology can be studied.
Dr Franco Basaglia had been made director of the Gorizia Mental Hospital the previous year. He initiated the demolition of the containment structure devised to keep the patients inside the hospital which had, according to the new director, operated more like a prison camp than a place intended for treatment and care. The fence was not just there for the sake of the patients; it existed to protect society from the insane and insanity. Now the fence was coming down.
Basaglia and his colleagues were important constituent parts of a broader and diverse movement that was developing across Europe in the early 1960s. This movement called for ‘the deinstitutionalisation’ of mental hospitals, as well as other societal institutions characteristic of western industrial societies at the time. When first introduced to the work dynamic at the Gorizia Mental Hospital – determined by a strict and inflexible organisational structure – the cruelty of it had shocked Basaglia. Doctors, nurses, other staff members and patients had fixed and static positions within an extremely hierarchical and authoritarian command structure. The treatment of the patients was characterised by confinement and violence. Basaglia compared the conditions of the patients he met at the hospital to the description of concentration camp conditions he had read about in Primo Levi’s accounts of his bare survival as a prisoner during the Second World War. The patients were robbed of everything including their humanity. Tied down to their beds and induced into medical coma at the doctors’ discretion – they were treated as non-humans, isolated and encaged behind a system of locked doors and high fences that defined the culture of the institution. For Basaglia the institutionalisation he met at the Gorizia Hospital was mirrored by a society that felt obliged to exclude and imprison ‘unproductive’ subjects as a means to protect and stabilise its own social relations and mode of production. In this context, people being institutionalised and undergoing confinement were dispossessed to a degree where nothing was left except their bare life. Basaglia and his group set out to destroy this violent institutional system.
Institutions subtend a mode of production that relates to the specific structure of society, they reproduce society. Institutional modes of production enforce certain hierarchies and reproduce certain subjectivities within these hierarchies: doctor, teacher, student, patient, convict, guard, soldier, commander, judge, policeman, criminal, and so on. Institutions in a capitalist world reproduce capitalist society and capitalist subjectivities. When capital enters a phase characterised by a crisis of accumulation, it is not just followed by a crisis of social reproduction: the crisis of capitalist accumulation and the crisis of social reproduction are two sides of the same coin. This is due to the destructive social consequences of the restructuring of capitalist production that in popular terms is called a crisis, but viewed from the point of view of capital is simply healthy maintenance. The concrete and palpable crisis – the real crisis – is the social crisis of reproduction that is deeply integrated in the readjustment of capitalist production: public spending cuts, and the privatisation (in the widest sense of the word) of health services, welfare, schools, universities, care homes, and so on. The exact relation and the interconnections between production and reproduction are contested questions, especially in the present post-industrial situation where production and reproduction are becoming ever harder to distinguish, but, broadly speaking, institutions are situated on the reproductive side of this balance.
There are structural similarities and interconnections between various forms of institutional production within education, health, law and order, urban planning, etc. The struggles catalysed within these institutions under the crises of capital can be related to, and are ultimately taking place along similar historical fault lines. That is why I think there is much to learn from the struggles within mental and educational institutions in the 1960s and the struggles going on today within institutional social reproduction, significantly within the educational field, the restructuring of which I have been following for some time. What has especially drawn my attention are the most radical currents within this struggle in the 1960s, the anti-institutional movement that fought for the dismantlement and ultimate destruction of the outdated and violent institutions of their times. Theirs was not a call for reform; they considered the only way ahead was to leave these sites of social reproduction altogether and, through experimentation and improvisation, open the way towards the formation of truly democratic and new institutional structures.
Deinstitutionalisation: Two Experiments
In a speech at the 1964 First International Congress of Social Psychiatry in London, Basaglia quoted from the 1925 manifesto of the revolutionary surrealists to attack the directors and doctors working in mental institutions and their relationship to patients:
Tomorrow morning, at visiting time, when without any lexicon you try to communicate with these men, you will be able to remember and recognise that, in comparison with them, you are superior in only one way: force.
The title of Basaglia’s speech was ‘The destruction of the mental hospital as a place of institutionalisation: thoughts caused by personal experience with the open-door system and part-time service’. By dismantling the fence around of the hospital in 1962, Basaglia hoped to initiate the process of developing a new lexicon of madness. Acknowledging the many unknowns of deinstitutionalisation, the development of the missing lexicon highlighted by the surrealists could only be developed through an experimental process: the fragile, stuttering language implied in not knowing what would happen when the fences of the hospital were taken down.
For Basaglia the culture he met at the hospital in Gorizia wasn’t only a manifestation of the violence of a sovereign state, it was also the manifestation of the violence of a class society. The dismantling of the fence was in this sense also an attack on a society that had created ‘two distinct kinds of psychiatry’, one for the poor and one for the rich. The patients confined within the hospital were mainly of a less privileged background. In his analysis Basaglia situated the institution in an intersection between Marx’s class society and Foucault’s disciplinary society.
Across Europe during the early 1960s, the movement for deinstitutionalisation unfolded in diverse ways. By 1962, one year after Basaglia’s takeover in Gorizia, some particularly radical initiatives came to light: one in Scotland, where Dr Maxwell Jones was director of the Dingleton Mental Hospital, and another in England at the Shenley Mental Hospital, where Dr David Cooper had established Villa 21. The Dingleton Hospital had implemented an open-door policy for more than a decade. This, combined with Maxwell Jones’ goal of integrating care into the wider community, opened new perspectives. Basaglia and his colleagues were aware of these strategies and were discussing Jones’ texts on community care. The initial step was to take down the fence and open the locked doors and gates of the mental hospital. The next step was to dismantle the authoritarian command structure that had until then regulated the patients and ensured their confinement. For Jones, the authoritarian command structure of the mental hospital was not only reproduced in relationships with patients, but on all levels of the institution. This culture had to be challenged and changed. He believed it was necessary to develop new structures and routines of decision-making capable of transforming the way agency worked on every organisational level. Jones proposed a committee structure for doctors, nurses and other staff with high degrees of autonomy in relation to his own position as hospital director. At Shenley Mental Hospital, David Cooper’s method for Villa 21 was more improvised and directly anti-authoritarian. Here, doctors and nurses were asked to take off their white uniforms, and decisions were made in daily community meetings that included all patients and ward staff.
For Basaglia there was no space for reform; the ultimate aim of the institutional experiments he and his colleagues had initiated was the destruction of mental hospitals all together. In the 1968 book L’istituzione negata (The Institution Negated), Basaglia and his group criticised Maxwell Jones for working only towards a reform of the system. This would just be ‘a belated adaption of modalities of social control of pathological behaviour to the methods of production perfected over the last 40 years by sociologists and technicians of mass communication’ and eventually integrating the mentally ill into the ‘ideal of the panorganisation of neocapitalist society’. The critique by Basaglia and his colleagues was based on their suspicion of institutional reform as a mere vehicle for the renewal of the system. For them, reform would in the end only reproduce institutional power and, thus, class power in a different way. A system where disciplinary violence is substituted by more flexible and transformative modes of control would basically maintain the institution at the intersection of class society and disciplinary society. A reform scheme means a broader social control takes over where the restricted discipline of confinement left off, shifting the visible borders while reaffirming the same repressive logic. Gilles Deleuze describes the potential problems of this historical transition from a disciplinarian social model to one of control in his well known text ‘Postscript to the Society of Control’ (1990):
in the crisis of the hospital as environment of enclosure, neighborhood clinics, hospices, and day care could at first express new freedom, but they could participate as well in mechanisms of control that are equal to the harshest of confinements. There is no need to fear or hope, but only to look for new weapons.1
Image: With the Lex 180 the provincial psychiatric hospital in Gorizia was closed. Today, clusters of old beds and chairs can be seen close to the remains of the old hospital. Photo by Valentina Mosetti, October 2010
Basaglia and his colleagues’ push for deinstitutionalisation in Italy led to a fundamental redefinition of mental care and institutional control on a national level through the legal measures known as Lex 180, also sometimes called Lex Basaglia, introduced in 1978. This law saw all the traditional large scale disciplinarian mental hospitals abolished and closed down. Gorizia Mental Hospital was also closed down, though Basaglia had already left a decade earlier. The dismantling of the mental institutions implied and realised a change of focus from the care of societal fears to the care of subjectivities suffering from mental distress. This was Basaglia’s intention. The state-sanctioned confinement of specific ‘unproductive’ bodies was being lifted. The fortified borderline between the previously locked away lives of emarginati (the excluded), as Bagsalia called them, and societal production was slowly being erased. Now that the fence had come down, mental suffering had to become a recognised state and current within society and not only attached to specific bodies that as a consequence were put away.
It is significant that in Zavoli’s film the patients at the Gorizia hospital were pushing the fences out into the surrounding world and society, returning the fence to the society that had put it up in the first place. The (formerly) institutionalised non-humans were entering society, they would again become social beings. The unstable experience of madness would no longer be caged behind locked doors and high fences, it would become a part of the social body’s collective experience and by this challenge its conception of production and productivity. The movement of deinstitutionalisation, unlocking doors and cutting down fences, made a parallel push towards the integration of the formerly institutionalised non-humans into everyday social life constituted by a new communication and exchange of experiences. So called ‘therapeutic communities’ were developing both inside the remains of formerly sealed-off institutions as well as beyond them, through the setting up of day centres and smaller care homes. These emerging communities were part of a process of inventing and introducing new terms for the lexicon of madness into the fabric of society.
Villa 21 was developed in parallel to the dismantling of the hospital in Gorizia; Cooper was also breaking down structures of separation and moving towards the creation of the context for a therapeutic community in the form of an insular villa inside the massive Shenley Mental Hospital. With 2–3,000 patients at Shenley, Villa 21 became an experimental zone through the negation of the hosting institution that surrounded the building. The hierarchies between staff and patients were made increasingly porous, and to a large degree, broken down. In their plain clothing, doctors and nurses were asked to step back from learned procedures of intervention, surveillance and control. Instead of tying patients to beds or locking them up behind closed doors, a fluid and communal ‘everyday’ was developed. Although they could not always avoid friction or conflict, this community of patients and staff operated as an experimental social space for the organic articulation of a new language.
Each day at Villa 21 was organised between scheduled and spontaneous group assemblies. The key gathering was the daily community meeting, which ran from 9.45–10.30 each morning. This movement towards communitarian care and mutual support also included programmed group therapy. The new culture also encouraged patients and staff to establish self-organised and spontaneous groups ‘at any time of the day or night around some particular issue – anything from discussion of a television programme to attempts to deal with disturbing acting-out on the part of some patient.’ But for Cooper, the ultimate goal was still, as he wrote in his 1967 book, Psychiatry and Anti-Psychiatry, to ‘step out of the mental hospital into the community.’
In 1965, Cooper and his colleagues in the Philadelphia Association took the step through the establishment of Kingsley Hall in Bow, East London. This groundbreaking move towards the building of an anti-institution – or more specifically, the anti-hospital – was one of the first attempts to organise a therapeutic community independent of any official body. In fact, Kingsley Hall was seen as a space for the reinvention of the hospital as the negation of itself. Many of the psychiatrists involved – Dr R.D. Laing, Dr Joseph Berke, Dr Leon Redler and Dr Morton Schatzman – moved into the building alongside those who felt the need to live in a self-organising therapeutic community. An everyday setting was sought in an impoverished neighbourhood of London in opposition to the convention that mental hospitals should be located out of sight and in the city outskirts. Therefore this inner city neighbourhood, Bow, became the setting for the experiment of not only deinstitionalisation, but also despecialisation. Medical professionals had to rethink their profession as doctors. And those suffering from mental distress who sought refuge at Kingsley Hall also had to despecialise in relation to their former roles as patients. The kind of ‘everyday’ that emerged through this setup has been a source of debate ever since, but in hindsight there is little disagreement that this was an experiment with a revolutionary perspective. The language of madness is a social and political relation that Kingsley Hall challenged through social struggle and experimental negation.
From Anti-Hospital to Antiuniversity
In 1965, Dr Joseph Berke moved into Kingsley Hall after arriving from New York, where he had been involved in setting up the Free University of New York. As soon as he arrived Berke recognised Kingsley Hall as an educational anti-institution, and to him, it was already a free university. Berke organised Saturday lectures on politics and culture, drawing especially on his links to the countercultural scene in London, as well as the group of political theorists around the New Left Review. In November 1965, Berke invited key cultural and political agents from London to a meeting at Kingsley Hall to discuss setting up the Free University of London. This meeting was organised in collaboration with the visual artist and underground publisher Jeff Nuttall. The Free University of London did not finally materialise at Kingsley Hall due to objections on the grounds that it would shift the focus from its main activity as a therapeutic community. For Berke the educational aspect was central to the therapeutic community, as it could potentially open up the anti-institution to a broader social reality. As he saw it, the therapeutic community was a learning community and vice versa.
Following this insight, the group of psychiatrists began applying and expanding the organisational and institutional experiences of the anti-hospital to the university, or the anti-university. This initiative had already begun to take shape at the 1967 International Dialectics of Liberation Congress, organised under the auspices of the Institute of Phenomenological Studies. Although some initial free university activities were already informally taking place at Kingsley Hall, in 1968 Berke and his colleagues established a separate educational initiative as an anti-university. On 12 February 1968, the Antiuniversity of London opened its doors at 48 Rivington Street in East London, in a building cheaply rented from the Bertrand Russell Peace Association. It was basically structured like the Free University of New York but also drew on experiences from Kingsley Hall and the other anti-hospitals that the group of psychiatrists had been involved with since 1962. As Berke told me in a recent interview, ‘In the process of making an institution we deinstitutionalised ourselves.’
The first catalogue of the Antiuniversity of London offered more than 30 courses on a diverse field of topics. A group of tutors affiliated with the New Left Review ran classes in political theory and revolutionary movements. Avant-garde artists such as John Latham, Gustav Metzger, Anne Lockswood and Cornelius Cardew taught courses that consisted of collective and practical experimentation through the making of artistic work. A group of poets and writers including John Keys and Lee Harwood offered anti-courses in poetry. The founding group of psychiatrists and psychoanalysts – David Cooper, Leon Redler, Joseph Berke and Juliet Mitchell – taught courses that covered aspects of psychiatry and experimental therapy along the lines of their critical social perspective. Black Power, experimental drugs, printmaking and underground media were also topics of learning. Alexander Trocchi offered a course with the title ‘Invisible Insurrection’, which referenced his 1962 text on the founding of a spontaneous university. The poet Ed Dorn declared simply in his course blurb that he would ‘be ready to talk to anyone who wants to talk to me’.
The Antiuniversity of London consisted of a very short and explosive process of deinstitutionalisation. The main educational project of the Antiuniversity became, almost from the start, to structure and restructure itself continuously. Many of the people who had lived or were living at Kingsley Hall joined classes with students from the London School of Economics as well as the other official universities across London. Artists and dropouts from the countercultural scene supplemented the group that signed up and more than 200 participants enrolled for the first quarter. This proved to be an explosive mix of students in terms of social experiences and revolutionary aspirations, which broadened the community and sustained its aims of collectively constructing the Antiuniversity. As an open-ended process that integrated deinstitutionalisation and despecialisation, the notion of ‘teachers’ and ‘students’ (and whatever other social roles that came to mind) were continuously contested.
The second Antiuniversity catalogue introduced a series of meetings called the ‘Counter University’. These focused on the development and operation of the Antiuniversity itself. In May 1968, the group held its first assembly and distributed a flyer with the heading ‘You and the Anti-U’, which continued the debate around the organisational issues that had been challenged since the first days at the Antiuniversity. It stated:
These past four months have proved that an antiuniversity can survive – it can even grow. The question is in what direction? We feel it is necessary to depass our birth and commit ourselves to a new community development. Any organisation which wishes to be meaningful, not only to the world outside but more importantly, to its self, must re-examine itself at each step. To do otherwise is a symptom of death.
The three main questions on the agenda were the student-teacher relationship, decision making power within the organisation and the level of communication and exchange between courses. The flyer also called for an end to the distinctions between ‘students’, ‘teachers’ and ‘administrators’.
Image: Chairs at the Antiuniversity, 1968. (BBC News report 1968, retrieved from youtube.com 2012)
The process of pushing for a deinstitutionalisation of the Antiuniversity eventually led to a slow erasure of its original structure; the project dissolved into surrounding social organisations and vice versa. In spring 1968, the Antiuniversity had turned into a commune where many of the students integrated living, learning, education and the everyday in one space. The course structure was dismantled, and by 1968 the building in Shoreditch had been given up. An announcement was made in the underground paper International Times (IT) with a rather cryptic but telling ‘message from nowhere’: ‘The Antiuniversity is dead. Long live the Antiuniversity!’ After leaving the building at Rivington Street in August, meetings continued to take place in private homes and pubs around London, coordinated through a phone line and advertisements in IT.
Through its process of deinstitutionalisation and despecialisation, the Antiuniversity of London shifted from a rather centralised structure to an almost invisible self-organising anti-anti-university that occurred whenever and wherever. The last trace of the Antiuniversity I have found is a 1971 advertisement in IT for a weekend workshop on poetry and philosophy. In principle, the Antiuniversity continues today, whenever people meet and share critical knowledge and revolution in their everyday. The act of convening doesn’t even need to be acknowledged as such.
Leaving and Learning
These radical strategies of deinstitutionalisation could be applied to a contemporary institutional context. Recently, a friend of mine showed me images from the widespread student protests that have gone on in Chile since 2011. The anger and frustration expressed by students arises from the social and economic exclusion brought about by years of increasingly neoliberal privatisation policies within the educational system. From this, a two-tier educational system has developed: one for the rich and one for the poor. These protests are not due to a recent wave of privatisation as seen in Europe; the Chilean educational system has been heavily privatised for decades, especially through the targeted attack on public education during the Pinochet dictatorship. Instead, these protesters fight against the consequences of privatisation. They demand free education for all.
Privatisation of education in Chile and elsewhere has far-reaching social consequences. On a general level, universities are becoming increasingly privatised and corporatised as wildly branching industries that serve economic interests not only in relation to the education of the students, but also in relation to research, student credit services, workforce qualifications and urban development. All this is still mediated by a state that facilitates and supports a free-market dynamic inherent to its development. The consequences are felt by students in their daily life: their social futures are being privatised as they become increasingly responsible, on an individual level, for the socioeconomic sustainability of their education in terms of employability in the labour market and management of the debts imposed by university fees.
Privatisation in Chile has occurred on all levels – not just in the area of higher education. In high school, students also fight against the capitalisation of education and degeneration of public institutions. The images I was shown were from high school occupations, mostly in Santiago, where pupils had fortified the fences of their schools with chairs from classrooms. The images depict chairs toppled upside down so that legs become spikes to make the already heavy metal fences look even more threatening. It is as if they are warding off any menace of the outside world that wants to storm the compounds of the schools – a desperate attempt to avoid the total abolition of public education. Other images show how chairs are used by university students to build barricades to hinder access of the authorities into the occupied educational institutions.
Image: Chairs attached to a school fence, signifying the school is en toma (occupied), Chile 2011. Retrieved from http://treychile2011.wordpress.com, 2012
The images of Chilean student protests have made me reflect on how institutions are always organising our bodies, making them stay behind fences; making them sit in certain positions on chairs in the auditorium; making them get out of bed and go to school in the mornings; keeping them fixed and confined in the straitjacket inside the mental institution; this is the way institutions are constantly moulding and remoulding our bodies throughout our lives. What we see in recent developments – which has become evident as students have reacted across the globe, in Montreal, in Santiago, in Cali, in London – is a more subtle but still uniform treatment of bodies defined by the interests of capital. The biopolitical moulding of bodies integrated with a crude sorting mechanism determined by economic powers and class has become an increasingly transparent and evident worldwide process. What was formerly a part of social reproduction has become an important aspect of capitalist production, turning it into an expanding site of accumulation. This is perhaps the main structural change from the institutional landscape of the 1960s. There is nothing surprising to this, but yet more people, even within the middle class bracket, are feeling the innate sorting mechanisms imposed by the institutional production of today as they enter the educational system.
In stating that there were two kinds of psychiatry – one for the rich and one for the poor, Dr. Franco Basaglia foresaw today’s biggest issue in education. At the time, he rejected any demands for reform, and his analysis led to a call for ‘The Destruction of the Mental Hospital as a place for institutionalisation’. Joseph Berke’s analysis of the state-sanctioned university, which led to the establishment of London’s Antiuniversity was radically similar:
The schools and universities are dead. They must be destroyed and rebuilt in our own terms. These sentiments reflect the growing belief of students and teachers all over Europe and the United States as they strip aside the academic pretensions from their ‘institutions of higher learning’ and see them for what they are – rigid training schools for the operation and expansion of reactionary government, business, and military bureaucracies.
Admittedly, it is difficult to compare the socioeconomic contexts of 1960s UK and Italy with the present conditions of the globalised economy. One could question what the subsequent deinstitutionalisation of the mental hospitals across the western world has led to, beyond offering the neoliberal ideologists of the 1980s an easy way to cut down public expenses on mental health. But on an institutional level, one could also ask what present day corporate educational institutions are doing to our bodies and by extension, to society, and whether there are any good arguments that back a struggle for the reform of an increasingly coercive, exploitative and class-based educational system? By attending present day neoliberal schools we reproduce a system that is not offering anything other than the discipline of the market. Already in the Wages for Students campaign of the mid-1970s in the US, this role of the university as an integral part of the assembly line of the capitalist factory was pointed out. In the Wages for Student pamphlet of 1975 it is put as follows:
Like all capitalistic institutions, schools are factories. Grading and tracking are ways of measuring our productivity within the school-factory. Not only are we trained to take our future ‘position in society’ but we are also being programmed to go to our ‘proper place’. The school-factory is an essential step in the selection process that will send some to sweep the streets and some to supervise the sweepers.
Maybe it is time to push for deinstitutionalisation once more in the radical sense of the concept that Basaglia and Berke put into practice. An ‘education against education’ that strives for student controlled learning communities to be developed elsewhere constituting a radical pedagogy towards a new social reality – or an anti-pedagogy, to be more precise. The reversed use of chairs as a means to obstruct the reproduction of an evermore corporate educational system is a start, but perhaps it is time simply to leave these institutions altogether.
Jakob Jakobsen <jakobhjakobsen AT gmail.com> is a visual artist living in London. In collaboration with vaticanochico and Common Notions, he is currently editing a republication of the ‘Wages for Students’ pamphlet (forthcoming in 2014). A research blog on the Antiuniversity of London can be found at antihistory.org
1Gilles Deleuze, ‘Postscript on the Societies of Control’, October, Vol.59 (Winter, 1992), pp.3-7.
Jakob Jakobsens’s exhibition ANTIKNOW opens 28 November. A pedagogical theatre of unlearning and the limits of knowledge’ at Flat Time House, Peckham (http://www.flattimeho.org.uk/)