Art, the Clinic, and the Political Exercise of Thinking

From 2002-2013, the Museum of Contemporary Art Barcelona (MACBA) brought together professionals from the fields of psychoanalysis, art therapy, and anthropology to provide different services for a variety of groups and individuals in an effort to create new forms of socialization between the museum and the city. In the words of the former director of MACBA’s Public Programs, the intention was “to restore forms of subjective appropriation of artistic methods in processes outside the mainstream and outside the museum” going “beyond the idea of visibility whose paradigm is the exhibition” (Ribalta, 2004, p. 9). This involved removing art from its supposed traditional elitist pedestal, as informed by Benjamin’s and Brecht’s ideas regarding the secularization and proletarianization of the arts (see Benjamin, 1998, 1968; Brecht, 2014; Marxen, 2019, 2018, 2011), and taking art to groups within the community that would not ordinarily visit a contemporary art museum. As such, centering the inevitable connection of the arts with the social and political fields was a priority throughout the project.

MACBA’s project took place at educational centers in Raval, the museum’s neighborhood in Barcelona, focused on teenagers who had been labeled “at risk of social exclusion.” The MACBA project is one of several initiatives I explore in my forthcoming book, The Deinstitutionalizing Art and the Nomadic Museum, to be published later this year by Routledge. The book itself starts with an in-depth description of the art therapeutic device collaboratively developed in the museum context.  I explore the use of art therapy in deinstitutionalization and anti-psychiatry, and their relationship to the arts.

The deinstitutionalization movement in psychiatry was coined by the Italian psychiatrist Franco Basaglia (1924-1980) who achieved the legal abolition of psychiatric hospitals in Italy, starting in the town of Trieste and the Friuli Venezia Giulia region. Deinstitutionalization has been one of several approaches usually collapsed into the term anti-psychiatry. “Closing hospitals” was meant in a literal and legal but also symbolic sense. Yet, in no way did it mean simply releasing people and letting them find their own destiny without any care or support. Rather, the deinstitutionalizing movement argued that hospitals must be replaced by community centers for mental health and wellness. For Basaglia, mental illness was produced by society, and for that reason must also be treated in and by society, as opposed to interning patients in closed wards usually located in the peripheries of cities or beyond (Passos, 2011). For him, the violence of the institution and its social control over poor or lower class people who have less means to defend themselves against oppression was the main focus of his struggle, as was the fight against stigma related to mental illness in society.

For me, the role of artists in retrieving powerful, unruly knowledges is a special interest. Sophisticated examples of such work include, Spanish artist Dora García’s series, Mad Marginal, Ana Longoni and Cloe Masotta’s curation of Argentinian artist and psychoanalyst Oscar Masotta, who stressed the importance of theory in artistic practices, insisting on “the political condition of the exercise of thinking” (Longoni, 2017: 22), and Maurizio Lazzarato together with Angela Melitopoulos, actualizing the thoughts of Tosquelles about institutional therapy. The MACBA’s efforts extended into different spheres, including the publication and dissemination of the work of anti-pedagogue Fernand Deligny (2009) in an effort to question itself “about its institutional practices, its political responsibility, its objective of inquiry in an epoch when art is self-indulging in the denial of its history and its anthropological meaning” (Álvarez de Toledo, 2009, p. 5).  As such, MACBA’s efforts suggested, institutional therapy must be focused in the first place on the critical treatment and analysis of the psychiatric institution itself.  It should facilitate the symbolization of experience through the relational network of institutional or community therapy, wherein collaboration is instituted within and dedicated to both the individual and the collective. Through dialogues with different interlocutors, in steady connection among themselves, the client/patient can find a model to coordinate the fragments of their psychological life, an organization of their thoughts, and empowerment through the active participation in daily life tasks within the institution. Institutional therapy goes clearly beyond psychiatry and embraces the psychological, the social, and the political.

The Artists Without Works: A Guided Tour Around Nothing
Performer: Michelangelo Miccolis
Spanish Pavilion 54th Venice Biennale
Private Collection
© Dora Garcia

Dora García intensively researched the deinstitutionalization and anti-psychiatry movements. In this context, the video The Deviant Majority (2010) is the first of her Mad Marginal series (initiated 2009) and is inspired by Franco and Franca Basaglia’s eponymous book (1971/2014). García adds “from Basaglia to Brazil” because Basaglia’s work was the base for psychiatric reform in Brazil, where at that time the deinstitutionalization movements coincided with protests against the military dictatorship fought by psychiatrists, psychoanalysts, artists, and other activists (Passos, 2011; see also Fusar-Poli, Bruno, Machado-de Sousa, & Crippa, 2009). García (2010) draws from anti-psychiatry and deinstitutionalization practices as a prism for examining marginality as a potential creative position. She also deepens into “the concepts of the mainstream and counterculture, anti-institutional movements, and the notion of outsider art” (p. 11). Regarding the latter, she reflects that “[a] term such as ‘outsider art’ deserves some reflection. Outside of what? Obviously the term ‘outsider’ implies exclusion, exclusion from something” (p. 18).

The video formed part of the Spanish Pavilion titled The Inadequate at the 2011 Venice Biennale. The artist offered spectators movements through different continents and art projects, such as the theater group Academy of Madness in Trieste, the Theater of the Oppressed in Brazil, and the Italian imprisonment publishing cooperative Sensibili alle foglie [trans. “Sensitive to pages”; a play on words with follie: madness]. Simultaneously, Dora García invited the visitors for an open route around references to Basaglia, the SPK (Socialist Patients Collective), Deligny, Goffman, Joyce, Artaud, and others. The “inadequation” represented different positions: independent, underground, dissident, unofficial, marginal, and exiled (García, 2018, p. 99). Visitors were purposely deprived of the clarifying limits of the interpretative armor of an exhibition and “had to assimilate by themselves this strange assembly of bodies and voices” (Beard, 2018, p. 87).

The art therapy program with adolescents under the auspices of MACBA shared similarities with the principals of deinstitutionalization. With the help of the museum, a much-appreciated service was established for participants that went beyond psychiatry and medication. Dora García participated with this artwork, related research, and her thoughts in the MACBA seminar Alleged Opposites. On the Public Sphere, Art, and the Clinic (Marxen and Rodríguez, 2012). This seminar concluded the art therapeutic and psychoanalytical MACBA practices mentioned above.  In the seminar’s discussion, we drew links between Dora García’s work and the importance of a critical vision of psychiatry, psychology, and therapy. The ideas and concepts of the representatives of the Sociology of Deviance and Labeling Approach, like Becker and Goffman, are present in her work, as are the thoughts of Foucault.

Since his very beginnings, institutional therapy initiator Francesc Tosquelles (1912-1994) had actively employed theater activities, including psychodrama, and other art forms into his psychiatric practice both in his hometown Reus, Catalonia, and Saint-Alban, France. He frequently mentioned “ergotherapy stations” such as pottery, book printing and binding, and wood workshop. He intended to change patients’ forced inactivity due to confinement into an “active therapy” in the form of workshops (Robcis, 2016).  Tosquelles (1972) offered interesting reflection on using art with children with severe mental disabilities. As typical for institutional therapy, he considered the art space as an extension of the body into the social and the painting as an exteriorization of the body. The setting must allow for the free expression of the conscious or unconscious desires of participants. The presence of the group members as well as the facilitator allowed for a certain socialization of desire. He stressed the discovery of the other and the social. 

In La Borde, where Tosquelles’ followers Jean Oury and Felix Guattari extended Institutional therapy, theater and art activities were frequently organized. Guattari (2006, p. 82, 79) had stressed the importance of the arts to create space for liberating subjectivities. The arts are able to “unframe” dominant discourses, to “rupture senses, forms, and significations” both in the personal and social field, being the two permanently entangled. Through decoding and deterritorializing, the arts can work as desiring machines (Deleuze & Guattari, 1972/2009). Constantly overthrowing their own current forms, the arts “untool” current forms of social life, of definitions of being together. Both new subjects and social positions are created, substantiating “a critical cultural analysis, a reason for one’s existence” (Larsen, 2006, p. 172). 

Rodríguez (2015 and her letter for Dora García ’s artwork Exile, 2013) had already related the MACBA devices to Tosquelles’ work, precisely considering said devices as its clinical extension. Referring to Pierre Délion, the legacy of Tosquelles should not be conceptualized as either intra nor extra-hospitalarian, but rather as a practice of unlocking the alienated subjects while at the same time providing the possibility of a rearticulation with their socio-cultural historical and present context. And that is precisely what happened in the work with the adolescents at the museum: The project consisted of the creation of the necessary conditions (Winnicott’s ‘potential space’) for subjective work aimed at maintaining the capacity for symbolization (Marxen and Rodríguez 2012; Marxen, 2018, 2016, 2011; Sajnani, Marxen, and Zarate, 2017). The main objective was to create and maintain spaces of freedom, as opposed to promoting dynamics of normalization, functionalism, and dominant subjectification (in the sense of Foucault 2001, 1983; Rolnik 2001; Deleuze and Parnet 1987). At the same time, responses that differed from those the participants were usually given in institutional contexts, as were the experiences of the adolescents when written off by their schools and society more generally as total academic and social failures, as well as carriers of ADHD (Marxen and Greteman, 2019). By not following these discourses, a subjective rearticulation with their social context was made possible.  

Dora García
La verità è rivoluzionaria, Trieste, 2009
© Dora Garcia

Works Cited and Additional Resources

Álvarez de Toledo, S. (2009). Introducción. In F. Deligny, Permitir, trazar, ver (pp. 5-13). Barcelona, Spain: MACBA.

Baldiz, M. (2017). La anti-psiquiatría. Ajoblanco, 1, 78-80.

Basaglia, F., & Basaglia, F. (1971/2014). La maggioranza deviante. Milan, Italy: Baldini Castoldi. (Original work published 1971)

Beard, D. (2018). Entre la institución y la acampada. In D. García, Segunda vez. Que siempre es la primera (exh. cat.) (pp. 80-93). Madrid, Spain: MNCARS.

Benjamin, W. (1998). Understanding Brecht. London, UK: Verso.

Benjamin, W. (1968). The work of art in the age of mechanical reproduction. In H. Arendt (Ed.), Illuminations: Essays and reflections (pp. 217–251). New York, NY: Schocken Books.

Brecht, B. (2014). Brecht on theatre. London, UK: Bloomsbury Academic.

Caló, S. (2019). ‘Can an institution be militant?’ In Prospections (Ed.), Metabolic rifts. A reader (pp. 115-131). Lisbon, Portugal and Berlin, Germany: Atlas Projectos.

Carrington, L. (1972/2017). Down below. New York, NY: New York Review Books. (Original work published 1972)

Deleuze, G., & Guattari, F. (1972/2009). Anti-Oedipus. Capitalism and schizophrenia. London, UK: Penguin Books. (Original work published 1972)

Deleuze, G., & Parnet, C. (1987). Dialogues. New York, NY: Columbia University Press.

Deligny, F. (2009). Permitir, trazar, ver. Barcelona, Spain: MACBA.

Fernández Polanco, A., & Pradel, A. (2015). A conversation with Suely Rolnik. Re-visiones, #5. Retrieved from: http://www.re-visiones.net/index.php/RE-VISIONES/article/view/50 [Accessed 20 December 2019].

Foot, J. (2015). Taking over the asylum: Critical psychiatry, Franco Basaglia and social struggle. Verso Blog. Retrieved from: https://www.versobooks.com/blogs/2271-taking-over-the-asylum-critical-psychiatry-franco-basaglia-and-social-struggle-by-john-foot [Accessed 20 December 2019].

Foucault, M. (2014). Truth telling, wrong doing. Chicago, IL: University of Chicago Press.

Foucault, M. (2001). Dits et écrits. Vol. II. Paris, France: Gallimard. [English version: (1998). Ethics: Subjectivity and truth. New York, NY: The New Press].

Foucault, M. (1983). The subject and power. In H. Dreyfus, & P. Rabinov (Eds.), Michel Foucault: Beyond structuralism and hermeneutics (pp. 208–226). Chicago, IL: The University of Chicago Press.

Foucault, M. (1961/2006). The History of madness. New York, NY: Routledge. (Original work published 1961)

Fusar-Poli, P., Bruno, D. Machado-de Sousa, JP., & Crippa, J. (2009). Franco Basaglia (1924-1980): Three decades (1979-2009) as a bridge between the Italian and Brazilian mental health reform. International Journal of Social Psychiatry, 57(1), 100-103. DOI: https://doi.org/10.1177/0020764009344145.

García, D. (2018). Segunda vez. Que siempre es la primera (exh. cat.). Madrid, Spain: MNCARS.

García, D. (2011). Mad Marginal. Cahier 2. L’inadeguato. Lo inadecuado. The inadequate. Berlin, Germany: Sternberg Press; Trieste, Italy: Fondazione Galleria Civica di Trento and Mousse Publishing.

García, D. (2010). Mad Marginal Cahier #1. From Basaglia to Brazil. Berlin, Germany: Sternberg Press; Trieste, Italy: Fondazione Galleria Civica di Trento and Mousse Publishing.

García Canclini, N. (2014). Art beyond Itself. Anthropology for a society without a story line. Durham, NC: Duke University Press.

Goffman, E. (1961). Asylums. Essays on the social situation of mental patients and other inmates. New York, NY: Anchor Books/Random House.

Guattari, F. (2006). Chaosmosis: An ethico-aesthetic paradigm. In C. Bishop (Ed.), Participation (pp. 79-82). London, UK: Whitechapel Gallery and Cambridge, MA: MIT Press.

Hochmann, J. (2015). Les antipsychiatres. Une histoire. Paris, France: Odile Jacob.

Holmes, B. (2006). The artistic device, or, the articulation of collective speech. Ephemera 6 (4): 411-432.

Kleinman, A. (1991). What is a psychiatric diagnosis? In A. Kleinman, Rethinking psychiatry: From cultural category to personal experience (pp. 5-17). New York, NY: Simon and Schuster.

Lacan, JJ. (1977). The Seminar. Book XI. The four fundamental concepts of psychoanalysis. London, UK: Hogarth Press and Institute of Psycho-Analysis.

Larsen, (2006). Social aesthetics. In C. Bishop (Ed.), Participation (pp. 172-183). London, UK: Whitechapel Gallery and Cambridge, MA: MIT Press.

Longoni, A. (Ed.). (2017). Oscar Masotta. Revolución en el arte. Buenos Aires, Argentina: Mansalva.

Mannoni, O. (1973). The anti-psychiatric movement(s). International Social Science Journal, XXV(4), 489-503.

Marxen, E. (2019). Transforming traditions: Walter Benjamin, art, and art therapy. In R. Hougham, S. Pitruzzella, & H. Wengrower (Eds.), Traditions in transition: New articulations in the arts therapies (pp. 251-271). London, UK: Ecarte (European Consortium of the Arts Therapies).

Marxen, E. (2018). Artistic practices and the artistic dispositif – A critical review. Antípoda. Journal of Anthropology and Archeology, 33, 37-60. 

Marxen, E. (2011). Diálogos entre arte y terapia. Del ‘arte psicótico’ al desarrollo de la arteterapia y sus aplicaciones [Dialogues between art and therapy. From ‘psychotic art’ to the development of art therapy and its applications]. Barcelona, Spain: Gedisa.

Marxen, E. & Greteman, A. (2019). Ingesting power. RECIE. Electronic Cientific Review of Educational Research, 4 (2), 875-886.

Marxen, E., & Rodríguez, M. (2012). Alleged opposites: On the public sphere, art and the clinic. Research working group. Retrieved from: http://www.macba.cat/en/alleged-opposites.

Meyers, T. (2014). Jean Oury and Clinique de La Borde: A conversation with Camille Robcis. Retrieved from Somatosphere Web site: http://somatosphere.net/2014/06/jean-oury-and-clinique-de-la-borde-a-conversation-with-camille-robcis.html [Accessed 20 December 2019].

Montejo Alonso, FJ. (2013). En un lugar de la Mancha… Francesc Tosquelles y Max Hodnan, creadores de las primeras comunidades terapéuticas durante la guerra civil española. XIV Congreso Virtual de Psiquiatria.com. Interpsiquis 2013. Retrieved from: https://psiquiatria.com/bibliopsiquis/en-un-lugar-de-la-mancha-francesc-tosquelles-y-max-hodann-creadores-de-las-primeras-comunidades-terapeuticas-durante-la-guerra-civil-espanola [Accessed 20 December 2019].

Mouffe, C. (2012). Alfredo Jaar: The artist as organic intellectual. In A. Jaar. The way it is. An aesthetics of resistance (pp. 264-281). Berlin, Germany: RealismusStudio of NGBK, New Society for Visual Arts.

Negri, T. (2017). Marx and Foucault. Malden, MA: Polity Press.

Robcis, C. (2016). François Tosquelles and the psychiatric revolution in postwar France. Constellations, 23(2), 212-222. DOI: 10.1111/1467-8675.12223

Rodríguez, M. (2015). Esquizofrenias y otros hechos de lenguaje. De la clínica analítica del MACBA (2002-2013). Madrid, Spain: Brumaria

Roll. C. (2011). Carmen Roll. In D. Garcia, The world according to Dora García (pp. 6-15). Berlin, Germany: Argobooks.

Rolnik, S. (2001). ¿El arte cura? [Does the art cure?]. Barcelona, Spain: Macba.

Oury, J., Guattari, F., & Tosquelles, F. (1985). Pratique de l’Institutionnel et politique [Practice of the institutional and political]. Vigneux, France: Matrice Editions.

Passos, E. (2011). Eduardo Passos. In D. Garcia, The world according to Dora García (pp. 45-50). Berlin, Germany: Argobooks.

Ribalta, J. (2004). Mediation and construction of publics. The MACBA experience. Retrieved from: http://www.republicart.net/disc/institution/ribalta01_en.htm [Accessed 20 December 2019].

Sajnani, N., Marxen, E., & Zarate, R.  (2017). Critical perspectives in the arts therapies: Response/ability across a continuum of practice. The Arts in Psychotherapy, 54, 28–37. https://doi.org/10.1016/j.aip.2017.01.007

Sartre, JP. (1960/2004). The critique of the dialectical reason. London, UK: Verso. (Original work published 1960) 

SPK (Sozialistisches Patienten Kollektiv). (1972/2013). Aus Krankheit eine Waffe machen. Munich, Germany: TriKont-Verlag. (Unofficial translation into English: Anonymous [2013]. Turn Illness into a Weapon. Retrieved from:  https://www.indybay.org/uploads/2013/11/14/turn_illness_into_a_weapon.pdf [Accessed 20 December 2019]. 

Szasz, T. (1961). The myth of mental illness. New York, NY: Harper.

Taussig, M. (1992). Reification and the consciousness of the patient. In M. Taussig. The nervous system (pp. 83-109). New York, NY: Routledge.

Thys, E. (2015). Psychogenocide. Psychiatrie, kunst en massamoord onder de nazi’s. Antwerpen, Belgium: EPO.

Tosquelles, F. (2014). L’enseignement de la folie. Paris, France: Dunod.

Tosquelles, F. (2001). Préface. In J. Oury, Psychiatrie et psychothérapie institutionnelle (p. 11-20). Lecques, France: Les éditions du Champ social. 

Tosquelles, F. (1972). La pràctica del maternatge terapèutic en els deficients mentals profunds. Barcelona, Spain: Nova Terra.

Eva Marxen, assistant professor, School of the Art Institute of Chicago, is a medical anthropologist (PhD and DEA), art therapist (M.A.), and psychoanalytical psychotherapist (M.A.). She is the author of Dialogues between Art and Therapy: From “Psychotic Art” to the Development of Art Therapy and Its Applications (Gedisa, Barcelona, 2011). Her next book, Deinstitutionalizing Art of the Nomadic Museum, will be published by Routledge in 2020.

Leave a Reply

Your email address will not be published. Required fields are marked *