A Politics of Madness
Francesq TosquellesTRANSLATED BY PERWANA NAZIF
François Tosquelles was a psychoanalyst and psychiatrist of Catalan origin. Taking refuge in France at the end of the Spanish Civil War, he worked from 1940 at the Saint-Alban hospital in Lozère. The text we present here is the complete transcript of a film made in 1989 in the form of an interview with the founder of Institutional Psychotherapy.[1] His life and his work, traversing the madness of history, have radically impacted the history of madness.
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Psychoanalysis is characterized by a requirement to invent. The individual does not remember anything. We let him mess around. We say, “Keep messing around, kid! That’s called association. Here, no one is judging you, you can mess around all you want.” Personally, I call psychiatry déconniatrie [mess-around-atry]. But when the patient messes around, what do I do? In silence or by intervening—but in silence especially—I take my turn messing around. He gives me words, phrases. I listen to his inflections, the articulations, where he puts the accent, or where he lets the accent fall ... like in poetry. I associate it with my own messing around, my own memories, any of my constructions. I am almost falling asleep, he is almost falling asleep. We say to the guy: “Mess around!” But this is not true. He lies down, he wants to be right, he rationalizes, he tells precise stories from reality: “My father this, my mother that....” And he never messes around. On the other hand, I am obliged to mess around in his place. And the messing around I do—based on what he says, and the accent, and the music of what he says, rather than the words—I fill my belly. And then, sometimes, I say to myself: hey there, if I give him this now, a little interpretation.
From 1940, Saint-Alban became the reference point for the movement to transform asylums, then the place for the theoretical and practical development of institutional psychotherapy. Its aim was to treat psychosis, drawing from Freudian thought on individual alienation and Marxist social analysis. Tosquelles joined the antifascist struggle at an early age, before and during the Spanish Civil War, and later joined the French Resistance.
I always had a theory: a psychiatrist, to be a good psychiatrist, must be a foreigner or appear to be a foreigner. So, it’s not coquetry on my part to speak French so badly. The patient—or even the normal guy—must make an effort to understand me; they are obliged to translate and to take an active position toward me.
A man of conviction and practicality, Tosquelles has always avoided the benefits and drawbacks of fame. What would he think of a venture which, against his discretion, could give him some belated publicity?
About your project to make a film about me? I am in agreement. I must be flattered, in a way. But, really, it’s bullshit. Not to say that you’re stupid, not more than me, anyway. But when you try to tell your own story, to write down memories, or explain things, like in clinics for psychiatry or psychoanalysis, what we are evoking, without being radically wrong, is always false, or falsified. I mean that sometimes we emphasize a kind of epic tone, as if we were some extraordinary hero and had escaped thanks to our magical narcissistic power and our spiritual values, or our characterology. And, sometimes, we mention the past in a miserable way. “Fucking life!”—that’s clearer. Hero or zero, in short.
However, it is essential for all to take assessments of their own lives, to make mistakes or deceive others. And the analyst, for his part, is not so naive, to think that when the patient recounts their life, that he has to believe it. He knows very well that it’s distorted, even if they’re being sincere. Sincerity may be the worst vice.
Tosquelles was born in Reus in 1912, 120km south of Barcelona. He was very quickly afflicted by what he considered a constitutional vice: psychiatry. From the age of seven, he went every Sunday with his father to the Pere Mata Institute. This institute for treating madness was run by Professor Mira, a man with great knowledge of European culture, phenomenology, and psychoanalysis. He would have a profound influence on Tosquelles.
At the end of the nineteenth century, Catalonia was already in the process of affirming its nationhood. He grew up in the midst of an intense cultural, social, and political environment; book clubs, workers’ cooperatives, and political meetings with his father. Although the official language was Castilian, he learned everything in Catalan.
I also spoke Castilian, but almost as badly as, or worse than, I speak French now. Like the Arabs. When one lives in an occupied land, one naturally speaks the oppressor’s language, but distorts it. One speaks “petit nègre,” as they say here. Over there, we called it “municipal talk,” because there were Catalan collaborators employed by the Spanish state who, of course, spoke Castilian. So, we imitated those imbeciles, who spoke Castilian so badly.
In 1927, at the age of fifteen, Tosquelles began studying medicine. Spain was under royal rule and, from 1921, under the dictatorship of Primo de Rivera. The Catalans could only have been rebels. Catalan political life was driven by fighting this dictatorship. This fragile alliance brought together anarchists from the CNT and the FAI, along with the Catalan-Balearic Communist Federation and its clandestine wing, the BOC (the Workers’ and Peasants’ Bloc), to which Tosquelles belonged, and which was already developing a kind of communism outside of the official PCE [Spanish Communist Party] line.
I was a member of the Catalan-Balearic Federation. Stalin, at one point, sent us a guy, a black man we called Bréa. I will always remember these clandestine official emissaries of Soviet control. He wanted us to go to Madrid and speak in Castilian. This guy wanted us to go to Madrid, make propaganda in Spain—with the monarchy, with the army still in power—and to say “all-power-to-the-soviets.” No republicans, no anarchists, no socialists, nothing. “All power to the soviets.”
So, two or three of us—not the Party, because it wouldn’t have done so officially—wrote to Stalin: “My dear comrade, you are a very important guide, but you understand nothing of what is happening here. In Spain, there are no Soviets. So, to say “all-power-to-the-soviets” is really to justify the military and the king. Stupidity. Worse. Besides, we are not going to speak Castilian because the Castilians are our oppressors. If you want propaganda that sounds like “all-power-to-the-soviets,” you’d have to say “all-power-to-the-peñas.” The Peñas are the cafés, the discussions in cafés, those who wage war in cafés. In the past, when you went to the café, whether in France or Spain, you spent the entire day there; for the most important thing was to work as little as possible. So, as soon as one stops working, one must go to the café. We go there not to get drunk or form parties, but to discuss. There were guys from the right, the center, and the left, and we’d talk for hours about remaking the world.
In 1931, thanks to the Catalan struggle, the Republic was proclaimed in Barcelona before the rest of Spain. 1931–1936 is a period of great popular creativity. Pablo Casals develops his Catalan workers’ concerts. All preconceived ideas and hierarchies are questioned.
In 1935, Tosquelles was already a psychiatrist at the Pere Mata Institute in Reus when he contributes to founding POUM, the Workers’ Party of Marxist Unification, which was the only party to denounce the Moscow trials. Many refugees fleeing Nazism joined. The Falcon Hotel, on las Ramblas, was the POUM headquarters. It would later become a prison for its militants. From 1931, the psychoanalysts leaving Berlin and Central Europe come to settle in Barcelona.
We forgot the little Vienna that was Barcelona between 1931 and 1936. I pay homage here to Professor Mira and to the ensemble of psychiatrists and psychoanalysts from the most diverse schools that the paranoid anxieties embodied by Nazism brought to this city: Szandor Reminger, Landsberg, Strauss, Brachfeld, and others.
Among these émigrés, Tosquelles met, welcomed, and protected the one who would soon become, despite the language barrier, his psychoanalyst: Szandor Reminger.
In 1933, I caught an ear infection, and my analyst came to visit me. One day, my father came as well. He was introduced to my analyst and he says something like this:
—How can you analyze my son, when you speak Catalan and Spanish so badly?
My analyst responds:
—You only need to be in Barcelona for fifteen days to understand half of Catalan.
—Half? my father says. I know very well that you men of Central Europe have a gift for languages, but I didn’t know you were that good.
—Yes, half, continues my analyst, because every two words the Catalans say “me cago en Deu’” [goddamn] or “mierda” [shit]. So you only need to understand these two words to know half of Catalan.
It took me a while to say to my analyst that I owed a lot to this extra-analytical meeting. For it was there that I realized that what counts is not so much what the patient says, but the cut and the sequence. Putting a period—mierda—or a semi-colon—me cago en Deu—was to mark the sequence. What is interesting is to listen to the sequences of this music; and the words between them do not matter. Not bad!
In 1936, the civil war broke out. Tosquelles joined the POUM antifascist militia and left for the Aragon front. He was 24 years old. All his ideas were put to the test by fire. Very quickly the POUM became the Communist Party’s preferred target, which was entirely dependent upon Moscow. From 1937, many of its militants were killed or imprisoned. The war takes on a surrealist quality.
The law of the surreal unfolding of war is that there is always the unexpected, the unforeseen; that is to say, something which cannot necessarily be understood by science. Science is a behavioral disorder for some people who become obsessed with it; they want to control everything through science. War is uncontrollable. But, as the surrealists would say, exquisite corpses appear, that is to say the unexpected, free association, which are not pure fancy, they are more real than the real.
But let’s talk about war. I insist on the fact that this was not just any war, but a civil war. Civil war, unlike the war of one nation against another, has to do with the non-homogeneity of the self. Each of us is made up of pieces placed against each other, with paradoxical unions and discontinuities. Personality is not made up of a “bloc.” In that case, it becomes a statue.
What did I do in Aragon? I did not have very many patients; I avoided having patients sent two hundred kilometers away from the front line. Instead, I treated them where things began, less than fifteen kilometers away, according to a principle that may bear some resemblance to sector policy. If you send a war neurotic 150 kilometers from the front line, you make it a chronic case. You can only treat him near the family where the troubles occurred.
Instead of curing these patients who did not really exist there, I developed a habit of treating the doctors so that these guys would lose their fear and, most especially, something more important than fear. Civil wars induce a change of perspective on the world. Doctors usually have, at the back of their minds, the stability of the bourgeois world. They are petit or haute bourgeoisie who want to live alone, make money, and be erudite. However, in a civil war, like ours, the doctor had to admit a change in worldview; he had to admit that the client determines the clientele, and that he is not all-powerful. So, I took care of psychotherapy for normal men to avoid crises. You can’t do psychiatry in the sector or in a hospital if you maintain a bourgeois and individualistic ideology. A good citizen is incapable of doing psychiatry. Psychiatry involves an anti-culture, which is to say a culture that has a perspective other than that of the subject. Its nature is of no matter. This is what I learned in those early years.
Professor Mira obtained, against the advice of the Communist Party, the maintenance of the army’s psychiatric services and the organization of the sectors, both at the front and the rear. Tosquelles was named chief physician of the army’s psychiatric services. He was sent to the southern front, stretching from Valencia to Alméria, passing through Madrid. He set up a therapy community in Almodóvar del Campo and organized the recruitment of caregivers, avoiding the inclusion of psychiatrists, who he believed actually had a fear of madness.
As I had to make a selection for the army, the first thing I did was to choose for myself. Charity begins at home. I chose lawyers who were afraid of going to war but had never treated a madman, painters, literary scholars, prostitutes. Seriously! I threatened to close the brothels (already illegal, but remained open nearly everywhere), unless there were three or four prostitutes who knew the men well, and who preferred to become nurses—on the condition that they didn’t sleep with the patients. I guaranteed that the brothels would not be closed, so long as we could send them soldiers. The brothels became annexes to psychiatric services. Some of these prostitutes converted themselves into heaven-sent nurses. It’s extraordinary, no? As they knew that everyone was mad, through their experience with men—including men that frequent prostitutes—their professional training was quick. In a month, a prostitute, a lawyer or priest became someone extraordinary.
Thus, all my activities have been establishing the sector and therapeutic communities, working with local politicians, with those who represented some power in the country. That’s sector activity!
March 1939 saw the fall of the Spanish Republic. Tosquelles thus attempts to flee Andalusia. He is able to get to France thanks to a network set up by his wife, Hélène.
When I entered France, I was sure that we could do good psychiatry. Not a theoretical certainty, but practical certainty.
He joined the Septfonds camp, one of the many concentration camps set up by the French administration to house the four-hundred-and-fifty-thousand Spanish refugees. Conditions were atrocious; many died of hunger, or different illnesses, others from suicide. Tosquelles created a psychiatry service there.
In this service, too, it was all very comical. Once again, there were political militants, painters, guitarists ... there was only one psychiatric nurse; the others were all normal people. This was very efficient, and I created a service. I think this was one of the places where I did my best psychiatry, in this concentration camp, in the mud. It was magnificent. And on the other hand, it was used to assist escapes ... stories like that.
It is often overlooked that the Spanish republicans who escaped the camps provided the backbone of the resistance throughout the southwest of France.
Tosquelles arrives at Saint-Alban. Refugees were added to the mix of patients and illegal immigrants who found a place of welcome and camaraderie there. Among them were Tzara, Eluard, Canguilhem, Matarasso, Bardach ... and others. Although he was a chief physician and already famous in his own country, the administration only grants this foreigner the position and pay of an assistant nurse. In these extremely precarious conditions, Tosquelles embarks on the transformation of the hospital.
I arrived in Saint-Alban on January 6, 1940.
Before talking about this period, I would like to say a few words on the cultural and ideological situation of French people in relation to postwar Spain. As in, French people who were members or not (it’s the same) of the Communist Party—that is to say, average French people. In my opinion, they all carried significant guilt over France’s non-intervention in the Spanish Civil War. They realized, after the fact, that if the French government or workers had supported the Republic, if they had transformed the Popular Front movement into a revolutionary movement—and not a demand for paid vacations—the whole history of the world would have unfolded differently. But, it’s like Cleopatra’s nose; things are as they are. Most French people, especially those that hold freedom as an ideal, felt very guilty about the events of the war. At Saint-Alban, for example, Eluard, Bonnafé, Cordes, Chambrun, and many others who were members of the Communist Party, behaved with me as if they were guilty. They assuaged themselves by helping me.
This collective French social guilt over the Spanish Revolution was very important; I benefited from it. Everyone helped me. Like yourself ... you came and said to me: “My poor Tosquelles, how much you have suffered! We must help you! You must regain your footing back into life. Don’t get depressed because you lost the war. One lost, ten found!
Paul Eluard stayed for some time at Saint-Alban.
Eluard, he was an angel, the weaver of words. He knitted words all day long because he was cold. Eluard was a cold little boy and his mother had to wrap him in warm cloths. For him, words were clothing. He wrapped himself in warm words.
A poem by Paul Eluard from the collection Souvenirs de la maison des fous [Memories of the madhouse] written in Saint-Alban during the Resistance:
This cemetery here, born by the moon
Between two waves of black sky
This cemetery, archipelago of memory
Lives on mad wind and a spirit in ruin.
Three hundred graves lay on the earth barren
For three hundred dead masked in earth
Crosses without name, bodies’ dearth
The earth is dead, man falls away.
The forgotten ones take leave of the prison,
Robed in absence and barefooted
Having nothing more to be hoped for
The forgotten all die in this prison.
Their cemetery a place without reason.
In advance of Lucien Bonnafé’s arrival, who was named head doctor in 1943, the hospital became an open space for encounter and confrontation. Psychoanalysis, communism, and surrealism, during the Pétain years, sustained nearly constant meetings. At night, while waiting for visitors or an arms airdrop, organizing care for the wounded or preparing underground newspapers, these meetings were developing the asylum’s world, which was already concerned with “curing life.” This was the Society of Gévaudan, named after the infamous and invincible beast.
There can be no resistance except against the oppressor. As long as there is no barrier, a more or less violent obstacle, we do not recognize the bullshit of normal life, which runs similarly to stagnant water. So, we organize modes of diversion and resistance simply in order to live. Of course, the Resistance is situated as a political fact after the war in 1940. I mean, after the defeat. If there had been no defeat, there would have been no revival of Saint-Alban. The Resistance at Saint-Alban is the confluence of various stories and people.
I was already a foreigner at Saint-Alban, a peasant of the Danube. But it was the Resistance which, beyond any diversity necessitated by the patients, produced the heterogeneity of the community, that of the caregivers, who were in many respects soignants-soignés [cared-for-caregivers].
The nuns, long separated from the world, are caught in the web of a society overturned by war. They nurse wounded resistance fighters.
I had two specialties: turning communists into communists and nuns into nuns. Because most Catholics are not actually Catholic. I have nothing against being Catholic or communist. I am against those claiming to be communists when they are radical socialists or public servants; and against the nuns who believe they are nuns when they are only officials of the church.
Part of my job has consisted of converting people into what they really are, beyond their appearance, beyond what they believe they are, and their ideal self.
The patients themselves were confronted with the reality of the war and knew the Resistance fighters were hiding on the third floor of the castle.
They were hidden like them! Asylum is the right word! I much prefer the term “asylum” to “psychiatric hospital.” We do not know what this means, psychiatric hospital. Asylum means someone can take refuge there or is forced to become a refugee there. Gentis said that everyone carries the walls of the asylum within themselves. It is like a protective gap, Melanie Klein’s “splitting.” Thus, the walls protected the patients from the harms of society.
Hélène Tosquelles arrived in Saint-Alban after crossing the Pyrenees alone with her first child [Marie-Rose]. Saint-Alban was one of few psychiatric hospitals, if not the only, in France that did not experience famine, the “soft extermination” which killed over thirty-thousand[2] mental patients during the war.
As Jean Oury remarks, the question of survival was entirely didactic.The patients, nurses, and even the accountants and doctors fought against hunger, leaving the hospital and going to the peasants to collect butter and turnips in exchange for labor.
We connected the patients with the outside, not to wage war, but to trade on the black market. We organized presentations on mushrooms to teach them how to forage. Because there were food cards for tuberculosis patients, we came up with a tuberculosis service. When a guy started to show signs of a deficiency, he was promptly diagnosed with tuberculosis. There exists a whole series of contingencies which, ultimately, means that war comes at the right time ... as does the Resistance.
In 1940, Saint-Alban was a miserable, dirty, and overpopulated place. The patients rarely leave the hospital. Twenty caretakers and a few nuns are responsible for monitoring and survival.
The first paradox: it is in the dilapidated asylum in a neglected region where institutional psychotherapy will develop. The gamble, deemed impossible, was to treat psychotics with psychoanalytic means. There was no couch, no contract imposed by words. And where they found themselves in numbers was in hospitals and other places of seclusion and segregation.
The second rupture: the hospital secretes its own symptoms, confining patients and staff in a chronic pathology. It is the hospital that urgently needs to be treated. Tear down the walls, remove the bars, open the locks. This is still not enough. Analysis is required, but above all is the fight against hierarchy, habits, and corporatism.
“Nothing comes only from the self,” everything led to meetings. Everyone must be consulted, everyone can decide. It wasn’t just a concern for democracy, but the gradual conquest of discourse, a mutual learning of respect. The patients must be heavily involved in the conditions of their stay and care, in their rights of exchange, expression and movement.
The third principle: the permanent revolution. The work is never finished when transforming an establishment of care into an institution and a care team into a collective. It is the constant development of material and social means, of the conscious and unconscious conditions of psychotherapy. This does not come from doctors or specialists alone, but from a complex arrangement where patients themselves have an essential role.
Man is the type that goes from one space to another. He cannot always stay in the same place. That is to say, man is always a pilgrim, the type that is always going elsewhere. The important thing is the trajectory.
The Club was a place where people leaving the various hospital wards could meet up and establish relations with the unfamiliar, the unusual, and, at times, the surprising. From that moment on, their statements and actions would not be fixed by the internal life of their ward; the important thing was to free oneself from the fatal characterological oppression of the head of the ward! Ultimately, a psychiatrist does nothing but make everyone a prisoner of the particular psychopathology of their character. That is why—as we say at La Borde—there must be freedom to roam, to go from one place to the other. Without this wandering, this “the right to wander”—as Gentis once claimed—we cannot speak of the Rights of Man. The first right of man is the right to wander.
The Club was a place where wanderers could meet, a place for the practice and theorizing of wandering, rupture, and deconstruction-reconstruction. We must first separate ourselves from somewhere in order to go elsewhere, differentiate ourselves in order to meet others, elements, or things.... The Club is an autonomous system, if we want to use a certain language. Autonomy is exercised and put into practice there. The most important site of collective psychotherapy in the hospital was the publication of the newspaper. The newspaper was called Le Trait d’Union [The Hyphen].
An editorial committee session of the newspaper was filmed by Mario Ruspoli in a film dedicated to the Saint-Alban experience: Images de la folie[3] [A Look at Madness]. A patient speaks: “Do you have the poem I gave you? I will read it, if you’d like. It is called La victoire de Samothrace [The Victory of Samothrace]. That’s why they said I was crazy.
She breaks the blue. Seeing her,
it is difficult to believe that she came
about the hand of man.
Not that man is incapable of the admirable,
yet—I do not know from where I hold
this certainty—there is something of her
that eclipses the work of man. A line,
a thread, a light withdraws from her, returns
and illuminates her. She is not created, she creates.
Not one would claim
the mountain of Sainte-Victoire, where Cézanne
let wander his admirable gaze,
was his work.
But the victory of Samothrace, she,
could only come from the hands of the Gods.
Art brut is the spontaneous production by the patients. Most often, it is something they make alone. When I arrived at Saint-Alban, Forestier, who all knew, had already invented this. At the time, although there was a wall around the hospital, the doors were completely open once a week. The peasants on their way to the fair would cross through the doors with their cows so as to not tire themselves. Forestier made his boats, his little marshals, and put up a display on the path. Passing through, the people of Lozère would exchange a pack of cigarettes or a few cents for his works. They bought his art brut. It is important to transform this art into commodity. In what has erroneously been named socialization, it is necessary to go beyond exhibitionism in order to encounter the other. It’s not so bad to exhibit yourself. I’m doing it right now; I’m happy because it allows me to meet you.
In La fête prisonnière [Captive Feast], directed by Mario Ruspoli at the Saint-Alban hospital, a patient walks around the annual ball saying: I have no one in the world. I am alone. Perhaps, I am a little mad, if you will. But I wonder if mad people really exist, if mental illnesses are everywhere. I do not think so. They are perhaps forgotten by the world, abandoned by all.
When we walk through the world, what counts is not your head, but your feet! You must know where to put your feet. They are the great readers of the map of the world, of geography. It is not on your head that you walk! The feet are the site of what becomes dynamic energy. That’s why mothers tickle the feet first. It’s about standing up, distributing the energy, which lets you go somewhere. But it is with the feet you go, not the head!
The experience of Saint-Alban suggests the impression that the private life of caregivers must merge with their professional life. Does institutional psychotherapy prescribe living with the insane?
You know, it’s like love stories. There are those short acts of love that last a lifetime. You have to live with patients; but it is not because we stay in the psychiatric hospital day and night that we live with patients. I live with them all the time, I live in them, they live in me. My first patients still live in me. Perhaps the best way to live with them is to separate oneself from them.
At Saint-Alban, there was not a single agitated patient in 1950, despite not using any anti-agitation medication. We took care of the réseau [network]. Unfortunately, between 1950 and 1960, they discovered what are called tranquilizers, or something like that. From that moment on, psychiatrists said: “Great! We no longer need to need to worry about the relations, about narcissism or eroticism”—of the net, so to speak. “Just give them the pill.” They willingly fell into the trap. They were happy: “Now, thanks to this, we can have relationships with the patient’s ‘person’ and we will be able to talk like at school: ‘Go right, go left, go up!’” ... In the end, it was shepherding with a stick.
After Saint-Alban, institutional psychotherapy found its way into a number of public and private establishments. Among these diverse care and research centers, mainly focused on the treatment of psychoses, La Borde clinic, with Jean Oury and Félix Guattari, was undoubtedly, for Tosquelles, the place which followed it best.
It’s strange but in France I became a celebrated Frenchman, Knight of the Order of Public Health or whatever.... And back home, in Spain, where I would have been killed, I became an Illustrious Son. French, but Illustrious Son of Reus. The same guys who would have killed me decorated me. If I moved there, they’d beat the shit out of me. I never claimed a return to Reus. If I have had some success, it is because I am a foreign Catalan. I have already said that one always needs to be foreign. Now, I am a foreigner in Catalonia. This is why I am effective.
I grieve far more for the loss of Saint-Alban than my taking leave of Catalonia or Spain. My parents are buried in Saint-Alban. I’m not in favor of honoring or erecting graves ... but the destruction of the Saint-Alban cemetery and the disappearance of the living dead of my father, my mother, and my aunt in Saint-Alban pains my hearts. And yet, this allows me to perfectly admit that we can talk about Saint-Alban and institutional therapeutics as if I never existed.
A quotation from François Tosquelles:
“We believed, until 1914 more or less, in the healing effects of consciousness. It was said that the subject had to become conscious of their unconscious problems, which was unknown to themselves. As soon as the truth was formulated, the suffering would disappear. By 1930, Freud was disillusioned with this idea. As for myself, if I had to prophesy, I would imagine that the proletariat could stay with the unconscious, and not with raising consciousness.”
[1] Transcription from François Tosquelles: A Politics of Madness (1989) shot by François Pain, Danielle Sivadon and Jean Claude-Pollack in the journal Chimères—Fall 1991, no. 13.
[2] Translator’s note: a more accurate estimate is over forty-thousand deaths (as stated in the film and mis-transcribed in Chimères).
[3] T.N: The correct title for Mario Ruspoli’s film is Regard sur la folie (1962).