By the end of the Middle Ages, madness had replaced leprosy as the illness that existed on the margins of society. Sebastian Brant’s book Stultifera Navis (Ship of Fools), from 1494, is a symbol of this process. The Ship of Fools wandered the rivers of Europe, and madmen travelled on it to some other world(s). Madness was fascinating because it was a different kind of (forbidden) knowledge related to the end of the world, and Foucault described the ship as a → heterotopia: an inventive space, a reservoir of imagination.
In the 18th century, when ideas based on reason became the primary source of legitimacy, madness was locked away from the rest of the world. In the so-called “great confinement” process of enlightened absolutism, society created a space in which criminals, the poor and the mad were locked up and excluded, kept in a kind of total institution. In the 19th century these houses of confinement were replaced by lunatics’ asylums.
The way madness was treated came under greater scrutiny after the Second World War, and this led to the emergence of antipsychiatry movements in France, the UK, Brazil, Italy, which were linked to other social and political movements of the time. Antipsychiatry is a term coined by R. D. Laing, and it came into use in the 1960s. Another important antipsychiatry or radical psychiatry process took place in the 60s and 70s in Italy, first pioneered by Franco Basaglia in Gorizia and Trieste. But it was only in 1978 that the 180 Act was passed in Italy which finally closed the remaining insane asylums. Antipsychiatry movements did not only aim to close down psychiatric – or total – institutions, but also aimed to carry out a “critique of power knowledge” and of power relations. For example, Basaglia introduced the idea of psychiatry as an apparatus of social control.  As pantxo ramas (aka Francesco Salvini) explained: “It was about breaking apart the institutionalisation of life built through the production of healthcare as a system, and of medicine as knowledge.” It was thus necessary to destroy the place in order to produce another place altogether: with the inmates, with the workers, with the nurses. This is what deinstitutionalisation was about.
However, the aim was not only closing down or changing the institutions, but also producing new subjectivities and new relations among those subjectivities. This was not something new, as it had already been practiced few decades earlier at the La Borde clinic in France – where Felix Guattari was among the staff. The demands of the various antipsychiatry movements differed from country to country, from context to context. In France, for example, in contrast to Italy, those working in institutional psychotherapy tried to subvert the institutions from within. La Borde employed freedom of movement, a critique of professional roles, as well as institutional flexibility. Creativity played a big role in this, being linked with madness. In 1965 Fernand Deligny arrived at La Borde. Deligny created a network of facilities for taking care of children with autism and those “outside of speech”. Especially well known are the drawings, cartographic tracings of gestures, movements, and trajectories of the autistic children in this project. Among other guests at La Borde was a Japanese butoh dancer, Min Tanaka.
To return to Trieste, what they achieved was not only the closing down of asylums but also the establishment of open centres for mental healthcare in public services, as well as cooperatives and the development of mechanisms of economic support. These events in Italy had a strong influence on a group of students and professors of social work in Slovenia, which took the name of The Committee for the Social Protection of Madness in 1988.
Civil society and antipsychiatry movement in Slovenia
In Slovenia, the 1980s were a time of new radical ideas that no longer took the political, social and cultural norms for granted, and which aimed to change the overall socio-political landscape. The main protagonist of these changes was the civil society. In comparison to other Eastern European countries, the concept of civil society in Slovenia had a significantly different starting point: rather than arising from dissidence and opposition, “the civil society against the state”, it represented above all a link among various new social movements (for peace, the environment, and LGBT rights, the antipsychiatry movement, etc.). The idea was thus the creation of institutional structures which were not merely in “opposition” to the existing ones.
The goal of the antipsychiatry movement was deinstitutionalisation (interpreted differently in different contexts, as noted above) – i.e. the closure of the institutions and their substitution with the alternative provision of community services. These ideas had already been articulated in Yugoslavia in the early 1980s. Lepa Mlađenović, an activist/feminist from Belgrade, was one of the organisers of the international conference Alternative to Psychiatry held at the Student Cultural Center in Belgrade in 1982. The conference was attended by numerous guests, such as David Cooper and Felix Guattari, and was very influential as it articulated the idea of psychiatry as an institution of violence and exclusion. However, the goal was not only closing down the institutions, but the entire socio-political transformation of society, and thus establishing new production relations as well as producing new subjectivities, and such aims were part of the general demands of that time in Yugoslavia.
Perhaps more than any other social movement in the 1980s in Yugoslavia, the antipsychiatry movement in Slovenia theorised and put into practice ideas about other/different institutions. Members of the movement called the changes that began occurring in psychiatry “the long march through institutions”. This was an echo of Herbert Marcuse, who when speaking of the student movements of 1968 stated “the strategy of the long march through the institutions actually meant working against the established institutions while working within them”.
The antipsychiatry movement organised two youth-student camps in Hrastovec psychiatric asylum in 1987 and 1988, and one in Ljubljana in 1989. Hrastovec was and probably still is the most known institution of its kind in Slovenia, with almost 700 people living there now. Regardless of the changes in psychiatry and the improvement of the living conditions in psychiatric institutions since the 1980s, the old dictum still holds true in Slovenia: “If you’re mad you get sent to Hrastovec.” Hrastovec is more than an institution, as it is a symbol of a total institution. The building is a castle that was first mentioned in the 15th century. It became a lunatic asylum after the Second World War, when all the castles in Slovenia were nationalised. It is not a coincidence that nearly all psychiatric institutions were located in such buildings, as the formalised and strict architectural order of these represents authority, discipline and control. Disturbing behaviour is sanctioned, life is strictly planned and regulated, and the use of time dictated and organised in timetables. This is the description of a total institution.
The Committee for the Social Protection of Madness sprang out of the second camp in Hrastovec. Initially, it was a group campaigning for the rights of the mental health users and against the wrongs of the institutions. In their founding manifesto they wrote: “Hrastovec is the dumping ground of Slovenian psychiatry and society. Society disposes of people from the margins it no longer wants in its midst by depositing them far away, so they can no longer be seen or heard.” The group managed to raise some degree of public awareness of the problem of total institutions, of confinement and exclusion, and its members went on to organise help and support in the community. But the important thing was the movement not only problematised madness, but society’s attitude to it. Madness, they wrote, was a creative principle and a driving force, and should be protected as such. Their → slogan was: “Being called a lunatic should become a compliment!” It was thus not by chance that the Ship of Fools was one of the symbols of the movement in Slovenia, as well as an artistic happening on the Ljubljanica River organised in 1989. The happening attempted to symbolically bring madness back to the city from which it had been expelled. The slogan was: “What we do not see does not exist”.
The Committee also emphasised the “development of cultural production” – with the aim of searching for various forms of madness. They organised cultural events such as theatrical, circus, and dance performances in the psychiatric institutions, in Ljubljana and Maribor, as well as at demonstrations, where the motto was: “We do not want a madhouse, we want a civil society.” Vito Flaker, one of the main protagonists of the movement, stated that the people from psychiatric institutions started to chant: “We want freedom!”
Art and madness
Artists have always been fascinated by madness, and the antipsychiatry movements worked to stimulate the artistic expression of their “patients” as a kind of therapeutic process. Franco Rotelli, one of the key players of the psychiatric reforms in Italy, said “we ought to have a therapeutic practice, artists, culture, poets, painters, cinema operators, journalists, inventors of life, young people, jobs, parties, playing, words, spaces, machines, resources, intelligence, multiple subjects, and the meeting of all of these.”
During the First World War André Breton had been assigned to work in a psychiatric hospital, and those experiences strongly influenced his work (such as the First Manifesto of Surrealism in 1924), and Jean Dubuffet’s fascination with the art of mentally ill (art brut) is also notable. At the Degenerate Art exhibition in Munich in 1937, the slogan “Madness becomes method!” was written on the wall.
However, there is an exceptional case with regard to the relationship between mental illness and artistic creation that happened in Brazil, a context quite different from Europe. Kaira Cabañas said this was because “in Europe art of the mad refreshed and expanded the formal vocabulary of modernist art, while in Brazil art of the mad was regularly exhibited in the space of modernist museums.” In 1933 the artist Flavio de Carvalho organised an exhibition titled Month of Children and the Mad in São Paulo. Nise da Silveira, a Jungian psychiatrist working in Rio de Janeiro, developed a form of occupational therapy within a psychiatric hospital in the 1940s where the patients engaged with art, music, dance, and theatre. She also established within the institution the Museu de Imagens do Inconsciente, with the purpose of preserving the works produced by patients and using them for educational purposes. Bispo do Rosário, one of the most well-known patients and today an internationally recognised artist, spent 50 years in the institution. The writings of Mário Pedrosa gave great visibility to the museum, and he called the art there arte virgem, or “virgin art”. Mário Pedrosa was very much influenced by this museum and the works it contained, and in 1978 actually proposed that the new MAM RJ (Museum of Modern Art, Rio de Janeiro) would consist of five independent yet organic museums, the so-called Museum of Origins that would include a Museum of the Indian, of the Unconscious (Mad), Modern Art, Black People, and Folk Art.
Figure 143: “Deinstitutionalisation of Madness”, The Politicisation of Friendship, exhibition view, 1 July – 5 October 2014, Museum of Contemporary Art Metelkova, +MSUM. Courtesy of Moderna galerija.
However, in our local context it was not until recently that the connections among the antipsychiatry movement, art institutions and their → constituent practices became a subject of deliberation. The Politicisation of → Friendship in Moderna galerija (+MSUM) in 2014 included a project dedicated to the antipsychiatry movement, where the “users”, activists, and social workers acted together with the curators to select materials for a kind of “didactic exhibition” about the history of the movement and the lives of mental health users, which included photographs, films, diaries, letters and notes. The idea was to find some → common points between the movement and the processes of deinstitutionalisation and other changes that have been taking place in both psychiatric and art institutions. There was thus a consideration of the meaning of creativity, and the commonalities between artistic creativity and madness. (Figure 143)
What can we learn from the antipsychiatry movement today? First, as Basaglia made clear, one movement’s struggle cannot remain isolated and only within a specific field or context. Second, new institutions must be established to serve a subject who is no longer in equilibrium with the institution but is, by definition, in a state of non-equilibrium. This is the basis of The Invented Institution text written by Franco Rotelli. Institutions, as he said, should always be invented and never given (here there is a similarity with the idea of “Monster Institutions”). This means that any progressive institution should constantly reflect on how it operates. Third: to repeat the questions after Deleuze, if the institution is useful, then useful for whom? For all those who have needs? Or just for a few? Or only for those who control the institution?
Finally, we should not forget that many total institutions still exist, such as refugee camps and detention centres for asylum seekers, so when we discuss other institutions we should also bear in mind these places.