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The Italian psychiatrist who ended the age of the mental asylum

As John Foot makes clear in his fascinating account of the life and times of Franco Basaglia, Italy’s “anti-institutional” movement did not deny the existence of mental illness.

In 1961, my aunt was diagnosed with “schizophrenia in obsessional personality” and sectioned at the Hill End psychiatric hospital in St Albans, Hertfordshire – a Victorian-era institution that combined insulin-coma shock therapy with straitjackets and other forms of patient coercion. At the time, she was a student at the Royal College of Art under Professor Carel Weight, the “Alfred Hitchcock of British painting”, whose expressionist paintings transfigured the streets of London into fear-ridden landscapes of suburban apocalypse. Weight was not alone in regarding his student’s psychiatric treatment as “barbarous”. Her life was a void place, rattling with pills and pervaded by a sense of powerlessness.

Franco Basaglia, the Italian psychiatrist whose pioneering reforms led to the closure in the late 1970s and early 1980s of Italy’s manicomi (“madhouses”), apparently met my aunt in Florence, where she lived briefly before her breakdown. Shortly afterwards, in 1961, Basaglia took over an institution in Gorizia, near the Yugoslav border, and transformed it into a “therapeutic community”, where patients were fed, clothed, washed and accorded human dignity. In Italy, this was nothing short of a revolution. Power was handed over, in part, to the patients, who were no longer tied up, beaten or tortured but were encouraged to contemplate their return to “liberty”.

As John Foot makes clear in his fascinating account of the life and times of Basaglia, Italy’s “anti-institutional” movement did not deny the existence of mental illness. Instead, it aimed to make the asylum a place fit for human habitation. Prior to Basaglia’s interventions, asylums in Italy had imposed a system of punishment and control, in which the watchword was “custody” rather than “cure”. In such places, mental illness was worse than draining for the patients; it was killing.

For all his originality, Basaglia borrowed from R D Laing, Michel Foucault and other left-leaning thinkers and therapists at work in the idealistic 1960s. His Gorizian project aimed to replace the arrogant and condescending attitude (as it was often rightly perceived to be) of the old-school psychiatrist with an ever-attentive therapeutic concern. Teamwork was of the essence. The patient’s freedom was not allowed to be dependent on the doctor’s will alone.

Born in 1924 in Venice to wealthy parents, Basaglia was typical of the Italian insurrection of 1968, which was largely fought by children of the bourgeoisie. Having been jailed in Venice in 1944 for anti-fascist activity, he had a strong civic conscience and respected the right to disagree. Across Vietnam-war-era Italy, students were organising faculty sit-ins protesting against napalm attacks. At the Sorbonne in Paris, they did the same but the idea of revolution in Italy was intensified because of the nature of the ruling Christian Democrat power: corrupt, hidebound and, in Basaglia’s view, repressive.

From the start, the Basaglian revolution was as much political as medical, Foot argues. Rashly, Basaglia was moved to equate the “asylum system” to Nazi concentration camps. Primo Levi’s Auschwitz memoir If This Is a Man, with its images of Dante-like horror and human abasement, was a major influence on the Basaglian experiment. But Levi was aggrieved by attempts to co-opt his book for the “anti-psychiatric” cause. (“You can be very badly off in the psychiatric hospital,” he said, “but there’s no oven, there’s an exit and your family can come to visit.”) Ultimately, the gauchiste image of the asylum as a punitive and alienating Nazi camp was effective only in terms of its “propagandist power” for Basaglia’s cause.

The times were changing and ­Basaglia caught the spirit of excitement in the air in 1968: the Black Panthers; the Beatles’ “White Album” and Stockhausen’s Hymnen in the record shops. That year, L’istituzione negata (“The Institution Denied”), a now classic collection of writings on “democratic psychiatry” that Basaglia edited, became a bestseller and a staple of every cultivated Italian home. A decade later, in 1978, a national reform bill known as the “Basaglia law” allowed for the gra­dual closure and dismantling of every asylum in Italy.

Over time, a network of community health clinics replaced the discredited mental health system and it became no longer acceptable to electrocute people, or to tie them to beds. While John Foot’s book is not without clichés (“seeds of change”, “drop in the ocean”, and so on), it is a superb primer on the history of democratic psychiatry in Italy and its triumph over the straitjacket of Bedlam. 

The Man Who Closed the Asylums: Franco Basaglia and the Revolution in Mental Health Care by John Foot is published by Verso (404pp, £20)

This article first appeared in the 24 September 2015 issue of the New Statesman, Revenge of the Left

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Casting the Brexit movie that is definitely real and will totally happen

Details are yet unclear as to whether The Bad Boys of Brexit will be gracing our screens, or just Farage's vivid imagination.

Hollywood is planning to take on the farcical antics of Nigel Farage et al during the UK referendum, according to rumours (some suspect planted by a starstruck Brexiteer). 

Details are yet unclear as to whether The Bad Boys of Brexit will be gracing our big or small screens, a DVD, or just Farage's vivid imagination, but either way here are our picks for casting the Hollywood adaptation.

Nigel Farage: Jim Carrey

The 2018 return of Alan Partridge as "the voice of hard Brexit" makes Steve Coogan the obvious choice. Yet Carrey's portrayal of the laughable yet pure evil Count Olaf in A Series of Unfortunate Events makes him a serious contender for this role. 

Boris Johnson: Gerard Depardieu

Stick a blonde wig on him and the French acting royalty is almost the spitting image of our own European aristocrat. He has also evidently already mastered the look of pure shock necessary for the final scene of the movie - in which the Leave campaign is victorious.

Arron Banks: Ricky Gervais

Ricky Gervais not only resembles Ukip donor Arron Banks, but has a signature shifty face perfect for the scene where the other Brexiteers ask him what is the actual plan. 

Gerry Gunster: Anthony Lapaglia

The Bad Boys of Brexit will reportedly be told from the perspective of the US strategist turned Brexit referendum expert Gerry Gunster. Thanks to recurring roles in both the comedy stalwart Frasier, and the US crime drama Without a Trace, Anthony Lapaglia is versatile enough to do funny as well as serious, a perfect mix for a story that lurches from tragedy to farce. Also, they have the same cunning eyes.

Douglas Carswell: Mark Gatiss

The resemblance is uncanny.

David Cameron: Andrew Scott

Andrew Scott is widely known for his portrayal of Moriarty in Sherlock, where he indulges in elaborate, but nationally destructive strategy games. The actor also excels in a look of misplaced confidence that David Cameron wore all the way up to the referendum. Not to mention, his forehead is just as shiny. He'll have to drink a lot of Bollinger to gain that Cameron-esque puppy fat though. 

Kate Hoey: Judi Dench

Although this casting would ruin the image of the much beloved national treasure that is Judi Dench, if anyone can pull off being the face of Labour Leave, the incredible actress can.