Jean Oury

The hospital is ill

RP 143 () / Interview

David Reggio Binswanger asserted that man was in the situation of psychiatry if psychiatry was within the situation of man. But it seems that this equation has become corrupted. In its current form, psychiatry has become a very complex and deterministic pursuit. At the same time, a moralism has proliferated that has eclipsed its ethic.

Jean Oury It is often said that psychiatry, like psychoanalysis, is unfinished. Lacan had this image, that such research took place within a vast developmental landscape where there was only a small conditioned surface to decipher. Lacan even said that here we would find the softened watches of Dalí. So, yes, psychiatry and psychoanalysis are indeed an unfinished project, because it is always in construction, a vast field. Yet we cannot exactly say that psychiatry is always to be invented: those who say this tend to say anything they like. It is often a form of what I call ʻtechnocratic simplismʼ – that culture of bureaucratic requirements and administrative measures developed under the mask of pseudo-scientific progress. I have constantly struggled against technocratic simplism, which, paradoxically, is often presented in very complicated formulae. Think, for instance, of recent neuroscientific research on schizophrenia. It is enormously complicated; nevertheless, it is still simplism.

I have always said that we should concern ourselves with ʻthe simpleʼ as opposed to ʻsimplismʼ. I often ask: what is more simple than standing up? Than walking? This is very simple, but if we study it neurophysiologically then such a study is unfinished. Standing, walking, has an extraordinary complexity, itʼs almost a permanent miracle. To reach the simple, the fact of being-here, the fact of saying ʻhelloʼ, of performing a very simple diagnostic, we need to traverse an enormous complexity. If not, we find ourselves within simplism, and simplism is a path leading to homogenization and ultimately dictatorship.

What I call the architectonic – the totality of relations, roles, functions and people that defines the site where something happens is based upon heterogeneity rather than homogeneity! This is the fundamental word, ʻheterogeneityʼ. It is a fundamental word for many, but especially for François Tosquelles. He often said that the milieu needed to be heterogeneous, even the educational milieu of children. He made clear that in order for things to be alive, for there to be exchanges, groups, inter-groups, initiatives, chance and encounters, there must be heterogeneity. Ferdinand Deligny also always spoke of heterogeneity. When Deligny left Armentières, for example, after his experience with dissident minorities and marginalized communities (les marginaux), he highlighted that in order to harness an approach enabling these people to remain even slightly interested in something, it was necessary to constitute an unexpected heterogeneous environment, for objects as much as spaces and different people. This was one of the essential conditions that guaranteed the effectiveness of the milieu. […]