By Howard Slater, 15 August 2017
Image: Frantz Fanon Hospital, Bejaia, Algeria 2011

Although close to anti-psychiatry’s diagnosis of the social causes of mental illness, the ‘sociogenic’ approaches of the Black and Asian therapeutic community have been largely overlooked. Their reversal of psychiatry’s individualising techniques, argues Howard Slater, reveals the patient to be western society and its endemic racism which imposes a maddening, monohumanist strait-jacket onto the earth’s majority


‘I’d rather be bright mad

Than dull and well.

My complications me excite,

And contradictions give me breadth and depth:

They are weaknesses which are strengths.’

– Taban Lo Liyong[1]


If, in the absence of certain key translations, the history of anti-psychiatry is incomplete then this incompletion is compounded by the absence of those critiques of psychiatry that come from Black and Asian theorists and practitioners. The contemporary mode of anti-psychiatric historiography is one that links it to the rise of the ’60s counter-culture when a figure like R.D. Laing achieved popularity as much through his media availability as through a series of mass market paperbacks. Perhaps this is why, when pressed to give an explanation of anti-psychiatry, Félix Guattari mischievously replied that is was a literary phenomenon. For many though, Laing and the Philadelphia Association were crucial in inspiring modes and means of politicisation for a ’60s generation that were becoming increasingly alert to micro-political power relations and the rigidity of party political forms. Often recalled is ‘The Dialectics of Liberation’ conference that brought to London an international cavalcade of theorists and activists (from Herbert Marcuse to Stokely Carmichael) and assembled at Camden’s Roundhouse an audience of what seems like a huge swathe of post-beat proto-hippies more familiar with underground poetry magazines than the tenets of International Socialism. However, to a certain degree this counterculture was colour-blind. Outside of Carmichael’s confrontational appearance at the Roundhouse and the coverage given, say, in the pages of the International Times, to Black Power, the Black presence in the ’60s counter-culture was minimal. However, the later founding of the short-lived London Anti-University by members of the Philadelphia Association saw a place on the syllabus for Nigerian playwright and Black Power spokesperson Obi Egbuna and for the American poet and sociologist Calvin Hernton. For some these two, as well as the more ‘in-focus’ Michael De Freitas (Michael X) whose Black House was supported by John Lennon, figure as the almost visible Black representatives in the British counter-culture. However, adopting a parallel approach, it can be discovered that both Egbuna and Hernton had also participated in events organized by the Caribbean Artists Movement which, from 1966-1972, paralleled the British counter-culture to a degree and made its own lasting literary and autonomous political contribution[2].


One strong link between the counter-culture and Caribbean Artists Movement is Calvin Hernton, who from 1965 to 1969 studied with Laing at the ‘Institute of Phenomenological Studies’ in London. One wonders whether the mutual attraction here may have been precipitated by Hernton’s book Sex and Racism that was published in 1965. This book, still shrouded in a net of contentiousness, could well have been titled, after its first chapter, ‘the sexualisation of racism’ and while it is ostensibly a work of sociology it displays, like Laing’s Politics of Experience, a mixture of personal testimony and psychological theory that makes it both frank and insightful. Racism here is not only firmly linked to capitalist exploitation – ‘[racism] is maintained by an economic-political-social system that has made it and still makes it profitable for the majority of white Americans’[3] – but racism, as an ideology constructed over history, is pathologised: ‘like any paranoiac the racist experiences himself as an authentic individual only when he projects his fears onto others and imagines they are attacking him.’[4] Hernton’s explorations of the psycho-dynamics of racism from the sense of self-protective fear imbued in him since childhood (when ‘to look’ could be the forerunner of violent reactions from the whites being ‘looked at’), through to his painful contention that some Black people have a ‘depraved self-concept that centuries of racism have wrought’, Hernton treads both the self-interrogational and ‘sociogenic’ ground of Fanon’s Black Skin, White Masks. While not citing Fanon directly Hernton too is exploring how, under oppressive social conditions, we can, by internalising aspects of capitalist ideology (that, like racism, are everywhere in the ‘culture’), come to oppress ourselves; to model our identities upon hegemonic frames of reference and thus take a role in our own dehumanisation. Key here, as part of the colonisation of the psyche (endocolonialism), would be the repression of singular elements of the self, of our undisordered multiple personalities. As Fanon scholar, Hussein Bulhan, has put it: ‘objective oppression turned into subjective depersonalization.’[5]


To continue with Hernton, Sex and Racism is a book that, in shedding light on the way racism – as a refractive myth, as an ideological construct, as a politically incisive means of maintaining hierarchies of being – has concomitantly come to operate as, in Fanon’s words, a ‘psycho-existential complex’. This comes to foreshadow a little those ways in which psychiatry as it is critiqued by Black and Asian therapists deepens our sensitivity to racism at the same time that it widens an appreciation of the ways ‘anti-psychiatry’ fought psychiatric oppression. Rather than see these developments as ‘ethnic specialisation’, and thus dismissable as a separate discipline, there is much here, albeit free-floating from anti-psychiatric history, that not only adds to the critique of psychiatry, but which is a key component in what David Cooper has called the ‘politicisation of madness’: the opening up of a front of struggle over the means of the production of subjectivity. When a plain speaking Hernton says, ‘the racist is so terrified of himself as an individual that he dares not think of himself or anything as a particular entity. He thinks of himself as a generality […] Likewise, the Negro is not a man but a concept’, he is drawing attention to those modes of categorical alienation, imposed social definitions, that afflict Black and white alike.[6] In terms of Black people still, to this day, being subject to an over-mis-diagnosis of schizophrenia and experiencing a higher rate of compulsory sectioning, what we see is that these generalising categories come to de-personalise the individual; they are a means of producing an ‘image’ of a subject or, as Franco Basaglia suggested, they permit psychiatry to invent patients in the image of its own definitions.[7] So, in their different ways, Hernton and Fanon, in ‘psychologising’ Black experience are extolling a substance of being where it has been denied and pointing up, through their experiential studies of an inter-personal alienation epitomized by racism, the pitfalls that face both Black and white in a ‘becoming human’. This is maybe to say, beyond the generality of concepts, they are interested in ‘particular entities’, in modes of producing ourselves as singularities. It is perhaps such an effort (claiming a substantiality for the ‘self’ beyond a peremptory reification of the ‘subject’) that, to this day, goes some way to marking out people out as ‘mad’.


Image: Carlos William’s new diagnosis post-1968; another African-American male’s clearly altered diagnosis from ‘Psychiatry Personality with Psychosis’ to ‘Schizophrenia’. Image from Jonathan M. Metzl, 'The Protest Psychosis'.


Whilst Hernton, in the novel Scarecrow, went on to fictionalise aspects of Sex and Racism and set them against a backdrop drawn from his ’60s experiences in London, his novel seems not to have had the same exposure to historians of anti-psychiatry as that of Clancy Sigal’s Zone of the Interior (based upon the latter’s experiences at the Philadelphia Association’s Kingsley Hall project.) As with Sigal’s novel, Hernton also bases a character upon Laing. In Scarecrow he is called Dr Yas and is described as ‘an existentialist psychiatrist specializing in schizophrenia.’ Here we can draw a line of remote contact between the Philadelphia Association and Frantz Fanon as Fanon, like Laing, also studied the phenomenologist and existentialist philosophies of Jean Paul Sartre. Laing, along with Cooper, had written a summary of Sartre’s Critique of Dialectical Reason and Fanon is reported to have greeted Sartre’s book with a similar enthusiasm which, after correspondence and meetings, led to Sartre writing the preface to Fanon’s Wretched of the Earth. However, despite this link, Fanon’s work is only infrequently mentioned in the Anglo-Saxon anti-psychiatry literature. Phil Brown, in one of the rare appraisals that surfaced in anti-psychiatry’s heyday, describes Fanon as a ‘psycho-political’ writer and chooses, in a short note, to focus on the ‘Colonial War and Mental Disorders’ chapter of Fanon’s last book. Phil Brown here offers that Fanon ‘could not allow for a separate system of psychology which did not deal with economics, politics, sociology etc. And it is precisely this compartmentalization, which mystifies the obvious realities of people with problems, that Fanon breaks down.’[8] Indeed, just as anti-psychiatry in general introduces the circumscribed discipline of an individualising psychiatry to micro social fluxes so too, Fanon, in some of the last words he ever wrote, opens up politics to the complexities of subjectivity and the refractive-warping of ‘selves’ when master discourses and their underlying racist geneaology can shape even our unconscious experiences (endocolonialism).


As we still await the collection and publication of Fanon’s clinical papers (which Bulhan glosses as Fanon’s ongoing effort to articulate the ‘relations between individual travails and the prevailing social order’[9]) it is difficult to get a more complete picture of Fanon’s clinical practice as a politically committed psychiatrist. However, one thing that Fanon biographers have mentioned and which links Fanon to an aspect of anti-psychiatry is that, in 1952, he had a position at St Alban and worked with Francois Tosquelles. Tosquelles was a left-republican exile from Spain and the hospital at St Alban (described as an anti-fascist community and cultural haven during WWII) became identified with what, in France, was called ‘institutional psychotherapy’. Alice Cherki describes St Alban in terms that are very reminiscent of an aspect of anti-psychiatry: ‘The method at Saint Alban […] was premised on a communal arrangement in which the sane and the insane lived together as caregivers and boarders […] Madness was probed in light of its close tie to social and/or cultural alienation. The psychiatric institution was itself subject to inquiry and evaluation.’[10] Rather than see Fanon as overtly influenced by his time at St Alban, or as someone mimetically shaped by Tosquelles, Cherki, in mentioning Fanon’s prior position as an intern at Saint-Yile Hospital, depicts Fanon as someone militantly pre-disposed to what came to be known as anti-psychiatry: ‘For him, a psychiatrist was first and foremost a therapist […] He was absolutely intolerant of prison guard behaviors in his medical staff. He was unsparing towards anyone who failed to consider the mentally ill as subjects.’[11] Fanon’s practice then, as it continued at Blida-Joinville hospital in Algiers and at Charles Nicolle hospital in Tunis, was one that was both critical of the racist presuppositions of psychiatry as well as one that, from this premise, developed a psychiatric approach informed by what, in Black Skin, White Masks he called ‘sociogeny’; an approach, developed more as a practice than a theory, that gave credence to the socio-historical factors that inform mental suffering.


Before looking into ‘sociogeny’, it is as well to turn to the last chapter of Wretched of The Earth in which Fanon, after presenting a series of case studies which are as much interpreted in terms of colonial oppression as by the usual reified medical modes of psychiatric thinking, takes to task (one could say exposes) the then current mode of thinking in Algerian Psychiatry. In order to explain the violence of colonial resistance both to themselves and their paymasters, French psychiatrists such as Professor Porot would not only entertain new diagnostic categories such as ‘homicidal melancholia’, but literally dehumanise the entire North African populace: ‘The native of North Africa, whose superior and cortical activities are only slightly developed, is a primitive creature whose life, essentially vegetative and instinctive, is above all regulated by his diencephalon.’[12] Whilst Porot’s paper was first published in 1939 Fanon is disturbed that it still, in his day, featured prominently on the syllabus of the Algerian School of Psychiatry. The path to sadistic eugenics which Porot’s paper treads is, in psychiatry, a long unfurling one (e.g. the forced sterilisation of mental patients) and for Fanon these ‘behaviourist’ dangers were epitomised in his day by a study carried out in 1954 by Dr A. Carothers which had the backing of the World Health Organisation. From this study Fanon chooses to cite the following: ‘The African makes very little use of his frontal lobes. All the particularities of African psychiatry can be put down to frontal laziness.’[13] What Fanon reveals here is psychiatry as something more than a mode of social control; it appears as a crude articulation of white supremacy – a means of justifying colonial occupation by using ‘science’ as a vehicle for racial beliefs that de-socialised and de-individualised African peoples.


When campaigning psychiatrist Suman Fernando offered up race as a ‘biological myth that is very much a social reality’ we are reminded of the way that psychiatry has been lobotomised by this myth to the degree of coming up with its own prejudicial diagnoses. The infamous coining of the pathology of ‘drapetomania’, a drive for freedom that figured as an explanation as to why Black slaves wanted to flee the plantation, is, like Fanon’s taking Octave Mannoni to task for his ‘discovery’ of a ‘dependency complex’ in Black Africans, a point in case. Maybe this ‘drapetomania’, when taken seriously as something other than just insane nonsense, reveals how Suman Fernando could quietly offer, 130 years after ‘drapetomania’ was coined, that ‘psychiatry has got drawn into the social oppression of Black people.’[14] In the UK such social oppression, aided and abetted by the pseudo-objectivity of psychiatry, can be testified to by the ongoing over-diagnosis of schizophrenia in the Black community, by the scandals of deaths in custody of those wrongfully arrested as well as the high incidence of Black and Asian people being committed to ‘Educationally Subnormal Schools’ in the 1970s (and today being streamed-out into Pupil Referral Units[15]). So, a cursory look at why a diagnostic label like drapetomania came into existence shows up underlying trends in psychiatry’s social oppression of Black people. One point is the utter denial of the social reality of the plantation system as an epicentre of ‘forced labour’, another is the complete denial of the runaway slaves’ subjective desire, yet another is the use of scientistic rationality as an ideologically driven conceptual screen; as ‘objective’ justification for that very oppression. All this, of course, as with Porot and Carothers and the liberal pitfalls of ‘ethno-psychiatry’, amounts to a process of dehumanisation that obliterates the very being of people. As Fanon put it in his letter of resignation from Blida-Joinville: ‘If psychiatry is the medical technique that enables man no longer to be a stranger to his own environment, I owe it to myself to affirm that the Arab, permanently an alien in his own country, lives in a state of absolute depersonalization.’[16]


That categorisation creates objects is such that it makes living beings into specimens and it groups specimens into generalities that, as objectifications, become not just easier to assess and control (without the mess of sentient desiring-singularity) but become, in their DSM-patented obviousness, in their predicative closure, not worth communicating with, not worth saving and not worth mourning. The master categories, then, with their inbuilt occlusion of particularities, with their ‘bracketing-out’ of sensitivity, come to almost take control of our means of social perception as they sift through and filter out abnormalities and idiosyncrasies so as to provide us with a ‘stimulus shield’ wherefrom we can deny our singularity and refuse to even entertain producing ourselves as what Sylvia Wynter calls ‘uniquely hybrid living beings’.[17] Indeed, these categories, allowed a history and a narrative accretion when many humans have been denied theirs, become over-determining and life threatening when, in the psychiatric context, they become ‘methods of evaluation’ and ‘treatment’ that establish power relations by means of racial beliefs that go back centuries. As Race and Culture progresses Fernando becomes cutting in his appraisal: ‘The way of working in psychiatry, in particular the diagnostic process, is conducive to the application of racism in a scientific guise.’[18] It would seem, then, that the combination of what Fernando refers to as ‘ethnocentric arrogance’ and ‘dynamic conservatism’ have no more provoked psychiatry into auto-reflection than any other institution in which psychiatry is entwined (the criminal justice and educational systems). Indeed, the embeddedness of racism in these institutions as a kind of unconscious discrimination epistemologically and behaviourally ‘written’ into their very structures, as a kind of perpetuation of the illusion of racial pre-eminence, is just as much a matter of warding-off the contamination and disorder of subjective hybridity (‘madness’) as it is a blind defence against any recognition of the foundational violence of Western States.


Maybe such illusion and blindness are intertwined in that the violence meted out to the other as a non-being both precedes and precipitates the knee-jerk categorisations that come to exclude some from humanity and give everlasting warranty to ‘white right’ and the profit motive. Just as categories are formed out of a culture’s need to understand itself, preserve its own ‘self-image’, to establish itself as permanently valid, this operation of delineating and taxonomising also relies for its success on defining itself against something ‘other’. Just as Hussein Bulhan has castigated this very process in terms of western psychiatric research honing its terms and definitions in relation to the cultures of Africa,[19] so too difference is used by western rationality to set the ideal standard of its normality at the same time that it deems as archaic the singularising traces of the culture of the ‘other’. Fernando, whilst not necessarily drawing our attention to the economic advantages of such taxonomising (not just in terms of the neatness of bought ledger accounts but in a righteous excuse for genocide and land grab), refers to Carl Linnaeus who, in the mid-18th century, in a manner more akin to the procedures of natural history, classified human beings in a hierarchy based on skin colour. There are, too, controversies over texts by the revered Enlightenment philosophers Kant and Hegel, that have been brought to light as tributary to the Western ideological thrust to justify colonialism: Africans have an inferior brain size, they are innately lazy, they have a lower mental capacity, they represent the ‘dark continent’ of the unconscious. Fernando cites an 1895 study that, despite giving Afro-American people a high score on the speed of sensory perception, was rationalised away as being an indication of a deficiency in powers of reflection. Whilst the foregoing is hardly a thorough investigation of the scientific and philosophical justifications for colonial racism it is enough, at present, to indicate in what kind of soil the roots of psychiatry lie and to indicate further – as biological reductionism and the demotion to ‘natural history’ of Black and Asian peoples suggest – that this had economic and ‘moral’ advantages for Western colonialism. With ‘natural science emerging as an essential feature of the capitalist mode of production’,[20] the mass exploitation of Black and Asian peoples could not only be justified (the slave and coolie as a kind of ‘natural’ raw material), but consciences need not be pricked and a kind of liberal-illusory innocence about some being excluded from the human species could prevail.


Image: A Thorazine advertisement from the 1970s shockingly depicted the tool of the 'primitive' to illustrate the claim that (only) psychiatric medications controlled psychotic agitation. From 'The Protest Psychosis'.


Cultural critic, Sylvia Wynter, in re-working Darwin and his ‘natural selection’ theses, speaks of this exclusion as an epistemological and economically justified ‘dysselection’ of parts of humanity from a full belonging to what, in a characteristically compacted phrasing, she calls the ‘single homogenized descriptive statement that is based on the figure of the West’s liberal monohumanist Man.’[21] This figure, an overrepresented mythic and ‘storied’ construction, as much a work of ideological ‘fiction’ for Wynter, is the figure around which notions of ‘normality’ still subsist. One way to counter this, to bring to light what Foucault refers to as ‘the system of limits and exclusions which we practice without realising it’,[22] is for Wynter to return to and build upon Fanon’s concept of ‘sociogeny’ which he coined as a progressive complement to the already extant biological and psychiatric terms of phylogeny and ontogeny. The mining of this Fanonian concept has been as much developed by Wynter and other Fanon scholars as it was by Fanon himself and is indicative of the need, constantly highlighted by Black and Asian therapeutic commentators, to introduce a socio-historic dimension into psychiatry.[23] In Fanon’s case Cherki refers to his psychotherapeutic method at Blida-Joinville hospital as one of ‘socio-therapy’. She reports that he aimed to ‘construct a new social arena… an open space to help reveal the evolution of a given life.’[24] For Fernando, the problems of retaining just the ‘phylogeny’ and ‘ontogeny’ elements in psychiatry is that it aids the location of ‘mental disorder’ solely within the individual, rendering them subject to ‘dysselecting’ pathological categories and therefrom to modes of psychiatric misdiagnosis and neglect. For Fernando the ‘social context in which illness occurred was largely disregarded and notions of illness being caused by relations within a social group did not enter psychiatry’.[25] This is to call, as Fanon did, for a ‘socio-diagnostic’ approach which, as Wynter suggests, saw Fanon move in his thinking from the family as the immediate social setting to the ‘overall cultural constellation’ which, of course in both Fanon and Fernando’s case, would reveal the role of racism and Black peoples’ being expected to ‘live inside the white man’s generalisations.’[26]


Wynter’s exploration of ‘sociogeny’ has a further implication in that it signifies for her a space of articulation, an enunciative space that can link life experiences and psychical dynamism to the production of subjectivity. In the words of Walter Mingolo, glossing Wynter, this ‘sociogenesis’ “uncovers the differential workings of power” and these differentials, it could be said, can be part and parcel of what anti-psychiatry approaches as the 'politicisation of madness': the recognition of such 'differentials' are often accompanied by traumatic ‘in-breaks’ of the Real as in the case of Fanon's discovery of his 'Blackness' in Europe of the 40s or Remi Kapo's descriptions of his arrival to Britain from Nigeria in the 60s. These ‘differentials’, when seen in a therapeutic space informed by ‘sociogeny’, can come to figure as components of singularity (“nuanced particularities” in the words of Spillers) that could illustrate how individuation takes place against a socio-historical backdrop. In terms of the life stories of (traumatised) subjects, then, these particularities of difference, could come no longer to render subjects up to examination, diagnosis and to being personifications of category. So, just as Fanon offered that ‘for the Black man historical and economic realities come into the picture’[27] so, too, Wynter offers that our 'mode of being human' is always socialised and cannot be explained solely in the preferred terms of orthodox psychiatry: phylogeny and ontogeny. This corresponds to those passages in Fernando’s book in which he outlines new approaches to psychiatry wherein 'rapport' entails a loosening of professional roles and a ‘person-centred’ approach (more akin to a therapeutic setting than a medico-psychiatric one) that, as a ‘new social arena’ can encourage those suffering to articulate the particularities of their 'mode of being human.' Cherki reports that Fanon encouraged such an open communication at Blida-Joinville and mentions how he built up rapport with patients and in several instances would stay up all night and lend his ear.[28] Hospitable approaches like these, could be seen, in Cherki’s words, as relating to the unconscious of another as a ‘repository of the trace effects of culture and history’ and not just as the battleground of Oedipal conflicts. According to Bulhan, for Fanon, one of these new social arenas was the ‘day clinic’. Fanon established just such an alternative to psychiatric internment at the Charles Nicolle hospital in Tunisia and, in his last published article offered that one of the advantages of a day clinic would be that it kept the patient in maximal contact with his exterior social milieu and that ‘the true milieu for sociotherapy is concrete society itself.’[29]


We could offer here that such a 'sociogenic’ approach is especially upheld by Black and Asian practitioners as it is they that recognise the social alienation of Black and Asian people who, as personifications of racial categories, come from the outset to suffer from the enmaddening 'stereotype threat' institutionalised in psychiatry. Such ‘personifications’ are maybe a factor in Fanon’s coining the term ‘sociogeny’ as this additional approach would, ironically, in filling in the wider (extra-European) socio-historical factors, entail an individuation that has been denied to those subject to ‘the white man’s generalisations.’ One of these generalisations is depicted by Fernando in his often returned to discussion of 'somatisation'. This hangover from the mind/body split of Cartesianism that becomes the psyche/soma split of psychiatry has it that Black people, unable to distinguish thought and feeling, would prefer to somatise their psychical 'symptoms' into physical ones. For a psychiatry devoid of a sociogenic approach this ‘somatisation’ came to be considered as a ‘dissonance of communication’ that led to Black people being seen as unsuitable for the ‘talking cure’ of therapy. However, perhaps this ‘dissonance’ should rather be seen as the refusal of a ‘loaded’ form of (therapeutic) communication in that a reticence to be classified as a categorical representation of race – to be everyone and no one – would both render ‘somatisation’ a safer response in the short term at the same time as, in a psychiatric diagnostic reality that shortcuts sociogeny, act as a warning that only a de-differentiating mode of communication could be entered into. In other words, ‘somatisation’ in this instance, is more a symptomatic outgrowth of a racist society that cannot accept differing modes of expression rather than an individual avoidance of psychical problems. In blatant contradiction to the ‘somatisation’ thesis Fernando refers to a study carried out in the early ’80s in Birmingham by Aggrey Burke when the response rate to the offer of therapy in the Black community rose by 100% after the ‘socially protective factor’ of Burke and his teams’ Blackness become known.[30]


However, Fernando outlines for us a damaging psychiatric assumption that, it is hoped, has by now been laid to rest by Burke’s work in Birmingham and New Cross. This is, following on from an upholding of the somatisation thesis, the assumption that Black people are considered to be ‘linguistically underdeveloped’ and unable to fully develop an emotional vocabulary. Of course such myths as these – entailing as they do a rationalistic view of ‘somatic experience of feelings [...] as deviancy’[31] and an upholding of the psyche/soma split – is a grossly restrictive assumption about all human subjects. It is a rejection of 'differentials' and a reduction of the psyche to not just language per se, but to western scientific language. And yet, as if to lend itself to the hybridising scope of Wynter’s take on sociogeny, Cherki described Fanon as being ‘interested in all registers of mental illness and nodes between the somatic and the mental.’ She goes on: ‘these patients, he argued, were their pain and incapable of functioning in a linguistic register that exacts specifity.’[32] This may seem to be upholding the somatisation thesis, but Cherki's use of the word ‘exacting’ here is, I feel, not to be taken as Fanon’s refusal to communicate at a deeper more self-probing level but as his wariness of psychiatry’s commanding demand for a ‘specifity’ that fits the diagnostic categories. This would, again, highlight a psychiatric blindspot in that failure to meet the ‘exacting specifities’ would not only disqualify a person from ‘treatment’ but would devalue other means of expression. Fanon, Cherki notes, was interested in ‘muscular tension’ and ‘trance dance’ as viable means of expressing the pain of being, and this is what differentiates him from an exclusively western (logos-centric approach) and, furthermore, girds him to anti-psychiatric approaches that refuted the basis of the ‘somatisation’ thesis in the split of psyche from soma. Whether this thesis still has currency (and it may well do in the terms of what’s called ‘acting out’) is perhaps a question to ask especially when one considers that there still exists a taboo on just what can be articulated (both intra and inter psychically). This taboo, in itself, hinders our being able to form ‘singular’ languages (be they verbal or non-verbal, lexical or gestural) through which to express the limbo of psychical-fluxes that often underpin mental suffering.


The overdiagnosis of schizophrenia is another consistent element in the history of racist psychiatry and one wonders whether the more controversial ‘de-medicalising’ elements of anti-psychiatry in rejecting the diagnostic categories of the medical model were on to something in that to ‘focus on distress’ (the being in its pain) rather than pathology (the body as ill), is to have the time to accompany another’s experience as it is unburdened rather than medicate it into silence. It is to relate to the complexities of a ‘hybrid being’ rather than a ‘normal’ individual psychiatrically defined in terms as a non-differentiated and equilibrated identity. To wield the category of ‘schizophrenia’, then, whatever its deep and complex etiology, is to send another person into social exile; is to, in some senses, exclude them from an ‘open communication’ to the same degree as they, after fruitless efforts, exclude themselves. Such self-exclusion and withdrawal may very well be exacerbated for Black and Asian people in that, even beyond any cultural sensitivity that psychiatry can muster, there still lies what Wynter refers to as ‘the empirically institutionalised ultimate symbolic death subhuman status of the Negro population as a whole.’[33] This is to say, turning the tables and ‘diagnosing’ Western racism, that the ‘psycho-existential’ complex of race can carry a murderous sociopathic intent. There is little wonder then, that for some, when faced with this intimately felt ‘pathology’ and its global ramifications, that mistrust can become an internalised hostility that can turn its violent feelings inwards as much as outwards. What comes to light, as many anti-psychiatrists came to imply, is that such diagnoses as schizophrenia are, maybe, more accurately depicting modes of alienation, modes of social and psychic alienation – an alienation from self and society that undoubtedly has a ‘sociogenic’ aspect at the same time as it is an aspect of what Hortense Spillers, adding to our take-up of Wynter’s ‘hybrid selves’, has called ‘interior inter-subjectivity’. Spillers defines this as ‘a locus at which self-interrogation takes place […] Its operations are torque-like to the extent that they throw certainty and dogma […] into doubt.’[34] Hearing voices and responding to them, suddenly hitting yourself, rambling on and on in a monologue or withdrawing into silence in a posture of complete exhaustion, etc. being traumatised to the degree of no longer being able to relate to your peers because of a perceived (but nonetheless real) absence of shared experiences and redacted empathy. All these are markers of what Fanon termed ‘existential deviance’, which could be related to both as a psychic torque – a forceful twisting (into pre-made definitions of the square hole Real) – that can be very painful (psychologically disturbing) and, yet crucially, an opening towards hybridity.


So one can well wonder whether the label ‘schizophrenia’ (which, with its oft mentioned ‘verbosity’ and made-up-languages, seems to contradict the ‘somatisation’ thesis) is a label that doesn’t illustrate mainstream psychiatry’s sophistication and scientific credibility but, on the contrary, is an indictor of the paucity of its theory of the subject and of the concomitant drugging-away of psychical experience. The existentialist incursion into psychiatry, shared by Laing, Cooper and Basaglia, seems to have been treading along the ‘sociogenic’ pathway and indeed, in the writing of Black and Asian intellectuals we find much that explores this ‘existential deviance’ as not so much encouraging those suffering to make the ‘voyage’ of repatriation (as trans-cultural psychiatrist Philip Rack once suggested) as, after Fanon, to humanely accompany the suffering in their effort of ‘dis-alienation’.[35] Whilst this could become the subject matter of a book in itself, it is as well to revisit once more W.B. Du Bois’s notion of ‘double consciousness’ as this is seemingly synonymous with popular notions of ‘schizophrenia’ (a split personality). Reams have been written about Du Bois’s phrase which Spiller glosses as Du Bois bringing into expression a consciousness of the ‘Western context and the cut from it that African personality inscribed.’[36] What we have here is almost a permission from Du Bois to relate to our experience as not necessarily a unified whole, to be excited by complications and contradictions that, as poet Taban Lo Liyong wrote, give ‘breadth and depth’. Such breadth and depth offers up the psyche itself as a ‘social arena’ that is not necessarily sequential and unified, but, as Freud long ago suggested, dynamical and plural (we are our own ‘other’). This enables Wynter, in drawing a parallel between Du Bois and Fanon, to say that both of them had a ‘reflexly experienced consciousness of normalacy and abnormality.’[37] So, what we can stumble on here is that the ‘normal’ subject of western psychiatry is as mythic as its so-called opposite and that chasing after this ‘ego-ideal’ of a contradiction-free normality is, to cite Bulhan again, ‘subjectively depersonalizing’ and it is so in that it seems to warn against any processes of singularisation from coming into being. Rendering any ‘self interrogation’, any relation to the dynamism of the psyche, to a kind of ‘madness’ or ‘abnormality’, is to deny the social reality and real sociality of our ‘interior inter-subjectivity’. This latter is a key component of Fanon’s sociogeny which Bulhan, in describing Fanon’s psychotherapeutic practice, draws out as the ‘real, dynamic and active society in the heart of the patient.’[38] Is it this that becomes more pronounced in those deemed suffering from ‘schzophrenia’? If so, it is not so much that ‘schizophrenia’ is a pathology as the outcome of a societal repression that rewards the silencing of our ‘plural self’ and allocates it next to no enunciative space at all.


The absence of such an autonomous enunciative space, which is something that anti-psychiatric practice and the therapeutic community movement tried to provide, is as much a result of psychiatry dealing with mental disturbance as an ‘illness’ understandable only by medical specialists as it is of a wider social need to institutionalise and thus control contradictions. So, when Fanon spoke of giving time and space to the ‘evolution of a given life’ he points towards a Black and Asian critique of psychiatry and its ‘present state’ symptomology. As previously mentioned, critiques from this direction urge that not just social but historical factors be taken into account in any approach to mental suffering. In the Black and Asian experience this has been more readily taken up as both a means of widening ‘diagnosis’ and as an avenue of therapeutic practice. The need for this has been summed-up well by Alice Cherki: ‘any political system that severs individuals from their history and memory, that assigns them trumped up origins, forbids them to express the complexity of their identity and identifications.’[39] This complexity, the psychical flux of singularity and hybridity of being, can be found in expanding out an individual’s experience in the present moment (surface level behavioural symptoms) into an examination of the way that historical factors have shaped and warped their subjectivity. In the altered terms of many Black and Asian therapists this entails turning the diagnosis onto Western Society and its institutions through taking into account slavery and colonialism as ‘etiological’ factors and, in terms of the transmission of affect between generations, a taking seriously of collectively felt trauma. Aggrey Burke, in the article cited above, reiterates this deeper historical component of subjectivity when he writes, at the outset of his article, ‘that the introduction of the inhumane and brutal system of African slavery and the difficulties encountered by subsequent generations in overcoming (or recovering) from this tragic set of circumstances’[40] has, in being transmitted from generation to generation, the cumulative effect of an inevitable ‘existential deviance’ that predisposes some Black and Asian people to disidentify with ‘the very being of being human as it is incarnated in its globally hegemonic western bourgeois tradition.’[41] This is exacerbated by the fact that the occlusion of this history, the forced expropriation of wealth that occurred in the creation of Western States, is disavowed from the West’s view of itself which goes on to construct screen memories as mythic history: that the feted Abolitionists were prime movers in later colonial moves and that compensation to former slave owners ranks as both a ‘bank bailout’ and a capital injection to the Industrial Revolution are conveniently aired and then forgotten. So, we could add that the role of history in any ‘sociogeny’ is also a form of ‘self-discovery’, of singularising against a collective backdrop, that the encouragement to discover the ongoing ramifications of this history, and indeed, to seek therapeutic succour in collective counter histories, is to place the suffering (of inter-generational exploitation) inside a wider context that can, in itself, take on the dimensions of an enunciative space.[42]


Such an enunciative space, with room given over to existential deviance and to a historically inflected sociogenic approach, is a key aspect in any ‘politicisation of madness.’ The Black and Asian experience of a ‘negating’ psychiatry (in which even Black and Asian psychiatrists seem to suffer) renders such a politicisation intelligible as a politics militating against how subjects are produced as both individual and fixed. As Stuart Hall offered back in the ’80s: ‘Identity is formed at the unstable point where the “unspeakable” stories of subjectivity meet the narratives of history.’ [43] Such an instability could proffer what Alice Cherki described as a process of ‘restoring the tragic’ and may very well have the effect of overwhelming identity (identification mediated by categories) through the power of the ‘unspeakable’ and the traumas of particular histories that have never been narrated and the shared pasts that have rarely, in the psychiatric realm, been regarded as collective. Indeed, just as Hall’s statement carries with it a perhaps unintended sense of ‘madness’ (the ‘unstable point’), so too do some of the pathological diagnoses of psychiatry scare us away from a more fearless reappropriation of the production of subjectivity: schizophrenia may be one such, hysteria another, the oedipal complex yet another, but, foremost may very well be the notion of multiple personality disorder. So, when Spillers speaks of ‘interior inter-subjectivity’ or of the ‘layered histories of a multiform past’ it seems to me to be in the spirit of acknowledging that ‘collectives’ are contained within us psychically and these can have the effect of both driving us mad (the hauntings of involuntary memory) and offering an opening to our becoming ‘uniquely hybrid beings’. As Wynter has suggested: ‘If humans are conceptualized as hybrid beings. You can no longer classify human individuals, as well as human groups, as naturally selected and naturally dysselected beings.’[44] While this very well may be the case and while many of the writers cited in his article are articulating a common push to get beyond the presumptions that are fed by categorical (racially diagnostic) thinking and are singing along with Fanon’s lyrical urge ‘to try to set afoot a new man (sic)’, there is still much to do in politicising madness, in continuing with the urgent task of re-appropriating the manifold ways in which we are produced and deformed as ‘seriously unfinished’ subjects amidst the sociopathic social relations of a ‘Cro-Magnon’ capitalism.


Howard Slater <howard.slater AT> is a writer and researcher based in London. This essay is the third in a series of texts on ‘antipsychiatry’ published across Mute and Datacide magazines.



[1] Taban Lo Liyong, ‘Normalcy, Normalcy, I Detest Thee!’ in Frantz Fanon’s Uneven Ribs, Heinemannn 1971.

[2] See Anne Walmsley, The Caribbean Artists Movement 1966-1972, New Beacon Books 1992.

[3] Calvin Hernton, Sex and Racism, Paladin 1973, p.150.

[4] ibid, p.106.

[5] Hussein Abdilahi Bulhan, ‘Fanon: The Revolutionary Psychiatrist’, Race & Class Vol. 21 No.3 (1986). Hortense Spillers makes a succinct poetry from Fanon when she speaks of ‘masks of self-negation’. See See Hortense J. Spillers: ‘All the Things You Could Be By Now If Sigmund Freud’s Wife Was Your Mother’, Critical Inquiry, Vol.22 No.4 (Summer 1996), p.117.

[6] Hernton, op cit, p.99. Hortense Spillers in posing questions of racism asks whether it is ‘our deadliest abstraction [..] our most non material actuality […] our deadliest fiction’. See Spillers, ibid, p.78.

[7] See Alex Jenner, ‘F. Basaglia – Democratic Psychiatrist’, in Asylum Vol. 1 No.1 (1986), p.4.

[8] Phil Brown, ‘Notes on Fanon’, in The Radical Therapist, Ballantine Books, 1971, p.276. In his paper ‘Fanon’s Letter’ Fillipo Mennozi has drawn attention to the influence that Fanon had upon Franco Basaglia. See Interventions Vol.17, No.3 (2015). I have not been able to afford access to this paper.

[9] Hussein Abdilahi Bulhan, Fanon and the Psychiatry of Oppression, Plenum Press, 1985, p.240.

[10] Alice Cherki, Frantz Fanon: A Portrait, Cornell University Press, 2000, p.17. For more on Institutional Psychotherapy see Félix Guattari, Psychoanalysis and Transversality, Semiotext(e) 2015. Guattari: ‘One could not consider psychotherapeutic treatment for the seriously ill without taking the analysis of institutions into account’, ibid, p. 61.

[11] Ibid, p.225 f.n.26. Cherki asks the question as to whether Fanon could be seen as a forerunner of ‘anti-psychiatry’. She answers in the negative, but in so doing perhaps addresses just one facet of ‘anti-psychiatry’: ‘Fanon did not think that the cause of mental illness was purely or directly political. The idea that there would be no schizophrenia, delirium or even neuroses under different political conditions was not one he entertained’, ibid, p.210.

[12] Frantz Fanon, Wretched of the Earth, Penguin 1997, p.243.

[13] Fanon, op cit, p.244. Fanon mentions further that Dr. Carothers, in this 1954 ‘study’, draws a likeness between a normal African and a lobotomized European. The infamous Carothers crops up again in ‘Psychiatry and the Corporate State’ by the Black Health Workers and Patients Group. See Race & Class, Vol.25 No.2 (1983).

[14] Suman Fernando, Race And Culture In Psychiatry, Tavistock/Routledge 1988, p.122. This book by Fernando marks the reprise of a form of ‘Fanonian’ anti-psychiatry in the 1980s through which psychiatry’s less than auspicious history is taken to task from the Black and Asian perspective.

[15] The Black Parents Movement led a campaign against E.S.N. schools from the mid ’70s. Active in this group was John la Rose and others associated with the Caribbean Arts Movement as well as education-activist Gus John. Writing almost 30 years after Fernando, Aggrey Burke reiterates this disturbing historical continuity: ‘Marked over-representations of African Caribbean clients are found on locked wards of mental hospitals, on special hospitals for the dangerous; in prison facilities, and among patients held by the police on emergency sections of the Mental Health Act’. See ‘A Cautionary Tale of a Stigmatised Minority’ in Criminal Justice Matters No.101, 2015.

[16] Frantz Fanon, ‘Letter to the Resident Minister (1956)’ in Towards the African Revolution, Grove Press 1967, p.53.

[17] Sylvia Wynter, On Being Human as Praxis, ed. Katherine McKittrick, Duke University Press 2015, p.17.

[18] Fernando, op cit, p.130.

[19] See Hussein Abdilahi Bulhan, ‘Psychological Research in Africa: Genesis and Function’, in Race and Class Vol. 22, No.1 (1981). Bulhan cites H. Reuning and W. Wortly as outlining, in the journal Psychologia Africana, one of the benefits of such ‘ethno-psychiatric’ research as “studying earlier stages of intellectual endeavor [… ] will lead to a clarification of what is intelligence.”

[20] See R.Lewontin, S.Rose and L.Kamin, ‘Bourgeois Ideology and the Origins of Biological Determinism’ in Race and Class, Vol. 24. No.1 (1982). It is apposite to mention here the theories of Theodore W.Allen that seem, rightly or wrongly, to pinpoint the origins of racism (seen as ‘the invention of the white race’) to the Bacon Rebellion of 1667. This Rebellion, in a Virginian settler colony, saw a multi-racial worker response to exploitation, that Allen contends, precipitated the establishment of ‘the white race as a social-control formation’ through turning to African slaves as a labour resource and instituting a series of laws (between 1680 and 1723) that privileged white workers. See Theodore W. Allen, ‘Class Struggle & The Origins of Racial Slavery’ (1975) at

[21] Wynter ibid p.23. Ashis Nandy offers this as ‘the exclusive universality imputed to most systems of modern scientific knowledge’. See Ashis Nandy, The Savage Freud, Princeton University Press 1999, p.110. The subtitle to Nandy’s book provides an interesting parallel to Wynter’s notion of the hybridity of being in that he speaks of ‘possible and retrievable selves.’

[22] Michel Foucault, ‘Ritual of Exclusion’, in Foucault Live, Semiotexte(e) 1996, p.73.

[23] Such a ‘denial of the social’ is a constant criticism of psychoanalytical discourse and practice and we could mention a slow ‘evolution’ in this direction over the Twentieth Century that has been aided by theorists roughly contemporaneous to Fanon such as W.R.Bion and S.H.Foulkes and their group therapeutic practices as well as developments in feminist psychoanalysis and social-psychiatry. These latter emanate from a viewpoint similarly skeptical of a Freudian bio-centricism that, as with the individualizing tendencies of psychiatry, denies the social factors that have an influence on subjective dynamics. Interestingly, but not to play the precedent-game, in a 1931 paper Foulkes speaks of a ‘sociogenetic (historical) mode’. See S.H. Foulkes, Selected Papers: Psychoanalysis and Group Analysis, Karnac 1990, p.81.

[24] Cherki, ibid, p.66.

[25] Fernando, ibid, p17.

[26] Remi Kapo, A Savage Culture, Quartet 1981, p.58. Elsewhere in Kapo’s memoir he describes being ‘framed into unimportance by whites,’ adding that ‘they didn’t even know how to change their myths about us’, ibid, p.12. There is a sense, then, that such generalisations as ‘race’ become embodied as social imaginary significations (c.f. Fernando’s ‘biological myths’) and from this, as Hortense Spillers offers, they become ‘reified in personality’, ibid, p.80.

[27] Frantz Fanon, Black Skin, White Masks, Paladin 1973, p.114.

[28] This is a rarely explicated aspect of anti-psychiatry in that what seems patently obvious and habitual to some is seen as subversive and boundary breaking by others. This willingness (of not just ‘professionals’) to be with and listen patiently is seen in many scenes in Peter Robinson’s film, Asylum (1972) as well as in Alan King’s Warrendale (1967). During his stay at Blida-Joinville (1953-1956) we see Fanon introducing many innovations associated with the ‘open communication’ tenor of anti-psychiatry: bi-weekly meetings, a weekly open forum, a newspaper entitled Notre Journal and an open (day) clinic. See Cherki, ibid, pp.67-68.

[29] Bulhan, Frantz Fanon and the Psychology of the Oppressed, ibid, p.244. Bulhan notes that at Charles Nicolle Hospital a ‘team of patients was put to work to demolish the prison-like cells. The bars, the straitjackets, the handcuffs, and all instruments of incarceration and oppression were removed.’ Through the filter of the European ‘anti-psychiatry’ of the 60s, Fanon’s approach seems much more like a precursor to the de-institutionalising efforts of Franco Basaglia and Psichiatria Democratica than the ‘Institutional Psychotherapy’ of St Alban. Indeed, Bulhan cites extracts from Fanon’s penultimate clinical paper in which Fanon criticizes Tosquelles and the ‘inert neo-society’ approach of Institutional Psychotherapy. This theoretical conflict was played out a little in a 1968 Franco-Italian meeting held at Courchevel.

[30] Fernando, op cit, p.82. Fernando also notes Burke’s involvement in therapeutically assisting the families and surviving victims of those murdered by racists in the January 1981 New Cross fire.

[31] Fernando, op cit, p.140.

[32] Cherki, ibid, p.17.

[33] Wynter, ibid, p.59. The ongoing chain of Black assassinations and high levels of penal incarceration in the USA, the hounding of Muslims as ‘terrorists’ and the ‘prevent strategy’ in the UK surely attest to this.

[34] Spillers, ibid, p.84. This phrase (‘interior-inter-subjectivity’) has resonance with Marx’s notion of the “individual existence as communal being”, and echoes down through the years as René Girard’s ‘interdividual’, Deleuze and Guarrati’s ‘dividual’ and Simondon’s ‘transindividual’ etc. We should note also, in the field of radical psychiatry, the book edited by John Rowan and Mick Cooper, The Plural Self (1999) and that by Na’im Akbar entitled The Community of Self (1985).

[35] It is small wonder that mainstream psychiatry seems to have avoided the term ‘alienation’ as it leads very quickly to Marxist notions of alienation and from there it propels the sociogenic approach in the direction of the capitalist mode of human relations as being more or less the institution of inhumanity. See David Cooper, ‘Mental Alienation and Social Alienation’ in Recherches, December 1968. This article, written in French, has been translated by the author.

[36] Spillers, ibid, p.109

[37] Wynter, ibid, p.52.

[38] Bulhan, ibid p.248.

[39] Cherki p.205.

[40] Burke, ibid. See also Barbara Fletchman-Smith, Transcending The Legacies of Slavery: A Psychoanalytical View, Karnac Books, 2011. In a chapter entitled ‘Slavery and Psychological Trauma’, Fletchman-Smith offers “In accepting slavery the individual comes to thinking that he is regulated by something external with a sadistic power. It is the opposite of feelings oneself free to become self-regulating. It is a mental condition that is still very prevalent today.” ibid, p.16.

[41] Wynter, op cit. Such an ‘existential deviance’ as it comes to expression as a militant disidentification and counter power did not pass unrecognized by the psychiatric establishment. As Jonathan Metzl has shown, the 60s Black power uprising coincided with a change in the diagnostic criteria of schizophrenia from a ‘disease’ associated with those of an ‘artistic’ temperament to something more akin to what was dubbed as a ‘protest psychosis’. See Jonathan Metzl, The Protest Psychosis: How Schizophrenia Became a Black Disease, Beacon Press, 2009.

[42] See for instance Power Writers and the Struggle Against Slavery, compiled and edited by Tower Hamlets African and Caribbean Mental Health Project, Black History Committee, Hansib/THACMHO, 2005. In an article entitled ‘Thirty Years Speaking Out – The Many Voices of Survivors’ Andrew Roberts cites THACMHO: ‘We must go back and reclaim our past so we can move forward. Health is found through history as identity is restored.’ See Asylum, Vol. 23, No.2 (2016).

[43] Stuart Hall, ‘Minimal Selves’,1987,

[44] Sylvia Wynter, ibid, p.17.