There
are many varieties of experience of lack, or absence, and many subtle
distinctions between the experience of negation and the negation of experience.
The negation of
anti-psychiatry is complex and embraces several elements defined in
psychoanalysis and philosophy (see: Excursus
on Negation). Sometimes, anti-psychiatric negation disavows or rejects some
aspect of psychiatric theory or practice. For example, institutionalization and
coercive treatment in psychiatric practice were countered by Franco Basaglia’s
anti-psychiatric measures to deinstitutionalize psychiatric patients in Italy
and offer voluntary treatment with truly informed consent and real choices.
At other times,
anti-psychiatry uncovers some masked truths and psychiatry responds with a
negation that confirms the truth of the belief or practice. R.D. Laing and
Jacques Lacan, for example, both rejected Karl Jaspers’ notion of a phenomenological chasm[3] between psychiatrist and psychotic patient, arguing for the accessibility and
intelligibility of psychotic experiences, however complex and laborious, and
their writings are full of such efforts. Psychiatry responded to this negation
of the phenomenological chasm with a series of negations that do not bring us
back to square one and leave us unconvinced. The first negation argues that the
psychotic produces a kind of unintelligible “word salad.” Second, when the
likes of Silvano Arieti[4] in psychoanalytic psychiatry and
Gregory Bateson[5] in
anthropology and family therapy attempted to show that schizophrenic
communication may be meaningful, psychiatry answers that it is too difficult,
time-consuming and ineffective. Third, psychiatry answers that in any case, the
diagnosis is not based on the bizarre content
of thought and speech but the abnormal
form of it, reflecting a biological disease process of the brain. This is
reminiscent of “kettle logic,”
based on Freud’s invocation of the joke about the borrowed kettle whereby the
neighbour, accused of returning a kettle in damaged condition, responds with a
series of incompatible and irrational denials – viz., that he had returned the
kettle undamaged, that it was already damaged anyway, and finally, that he
didn’t borrow it in the first place! Denial, opposition and contradiction are
mixed uncritically in the logic of dream-work, where, as Freud famously
asserted, there is no “No” and the law of non-contradiction is violated.[6]
In a scientific discourse and in the construction of an ethical profession, on
the other hand, we expect rationality even in the face of unreason.
Alienation
is a Negation
[I]t is not accidental that aliené, in French, and alienado, in
Spanish, are older words for the psychotic, and the English “alienist” refers
to a doctor who cares for the insane, the absolutely alienated person.
Living and
fighting in wartime Martinique and Europe, training in medicine and psychiatry
in France, then practicing in France and Algeria, Frantz Fanon confronted even more complex
instances of negation. In the context of colonialism there was a double alienation where the alienation
of the psychiatric patient was compounded by the alienation of colonization.
Fascinating to note that alienation
takes on both a psychiatric and a political dimension and we find in all
European languages the alienation of social and political theory along with the
mental alienation treated by alienists, an older term for psychiatrists.[8]
And just as we can invert psychiatric alienation as a kind of separation from a
“sane” (that is, authentic and healthy) way of living, whereby it can be
understood as an understandable response to an alienating environment, so too
we confront the topsy-turvy logic of colonization imposing foreign medical and
social categories of living to pronounce on the alienation of the locals perceived by aliens (foreigners) and alienists
(psychiatrists). Fanon dissects these forms of alienation with clinical
precision, examining first how the native patients respond to the clinical
situation with a negation of their inmost selves – wearing, in the arresting
image of his first book, “white masks” over their “black skins.”[9]
Fanon then examines with growing political awareness how the alienists
themselves are separated from their patients in spite of their medical tasks
which are at odds with local culture, including and perhaps most painfully in
the case of the alienist who comes from the same culture and by dint of his
training in European medicine and psychiatry, comes to attend to his
countrymen, a situation creating a
negation (the native co-opted by colonizer) of a negation (European
colonization) of a negation (psychiatric alienation).
[1] Cf. François Baudry, “Negation and its vicissitudes in the history
of psychoanalysis: Its particular impact on French psychoanalysis,” Contemporary Psychoanalysis, 1989, 25(3): 501-508.
[3] Karl Jaspers, General Psychopathology (1997).
[6] Jon Mills, ed., Rereading Freud: Psychoanalysis Through Philosophy (2004).
[6] Jon Mills, ed., Rereading Freud: Psychoanalysis Through Philosophy (2004).
[8] Cf. Roland Littlewood and Maurice Lipsedge, Aliens and Alienists: Ethnic Minorities and Psychiatry, 3rd ed. (1997). Joaquim Maria Machado de Assis, a Brazilian mulatto and son of freed slaves, wrote a famous novella about an alienist who applies his ever-growing criteria for mental maladies to more and more of the population until he ends up admitting himself in his own asylum, The Alienist (2012).
[9] Frantz Fanon, Black Skins, White Masks (2008).
