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Franco Basaglia (; 11 March 1924 29 August 1980) was an Italian
psychiatrist A psychiatrist is a physician who specializes in psychiatry. Psychiatrists are physicians who evaluate patients to determine whether their symptoms are the result of a physical illness, a combination of physical and mental ailments or strictly ...
,
neurologist Neurology (from , "string, nerve" and the suffix -logia, "study of") is the branch of medicine dealing with the diagnosis and treatment of all categories of conditions and disease involving the nervous system, which comprises the brain, the ...
, professor, and disability advocate who proposed the dismantling of psychiatric hospitals, pioneer of the modern concept of mental health, Italian psychiatry reformer, figurehead and founder of '' Democratic Psychiatry'', architect, and principal proponent of Law 180, which abolished mental hospitals in Italy. He is considered to be the most influential Italian psychiatrist of the 20th century.


Biography

Franco Basaglia was born on 11 March 1924 in
Venice Venice ( ; ; , formerly ) is a city in northeastern Italy and the capital of the Veneto Regions of Italy, region. It is built on a group of 118 islands that are separated by expanses of open water and by canals; portions of the city are li ...
. After obtaining his medical degree from University of Padova in 1949, he trained in the local school of psychiatry, where he acquainted himself with the philosophical ideas of
Karl Jaspers Karl Theodor Jaspers (; ; 23 February 1883 – 26 February 1969) was a German-Swiss psychiatrist and philosopher who had a strong influence on modern theology, psychiatry, and philosophy. His 1913 work ''General Psychopathology'' influenced many ...
,
Ludwig Binswanger Ludwig Binswanger (; ; 13 April 1881 – 5 February 1966) was a Swiss people, Swiss psychiatrist and pioneer in the field of existential psychology. His parents were Robert Johann Binswanger (1850–1910) and Bertha Hasenclever (1847–1896). ...
and Eugène Minkowski, developed an interest in the study of phenomenological philosophers such as
Edmund Husserl Edmund Gustav Albrecht Husserl (; 8 April 1859 – 27 April 1938) was an Austrian-German philosopher and mathematician who established the school of Phenomenology (philosophy), phenomenology. In his early work, he elaborated critiques of histori ...
,
Martin Heidegger Martin Heidegger (; 26 September 1889 – 26 May 1976) was a German philosopher known for contributions to Phenomenology (philosophy), phenomenology, hermeneutics, and existentialism. His work covers a range of topics including metaphysics, art ...
,
Maurice Merleau-Ponty Maurice Jean Jacques Merleau-Ponty. ( ; ; 14 March 1908 – 3 May 1961) was a French phenomenological philosopher, strongly influenced by Edmund Husserl and Martin Heidegger. The constitution of meaning in human experience was his main interes ...
, and
Jean-Paul Sartre Jean-Paul Charles Aymard Sartre (, ; ; 21 June 1905 – 15 April 1980) was a French philosopher, playwright, novelist, screenwriter, political activist, biographer, and literary criticism, literary critic, considered a leading figure in 20th ...
, and analyzed the work of sociological and historical critics of psychiatric institutions such as
Erving Goffman Erving Goffman (11 June 1922 – 19 November 1982) was a Canadian-born American sociologist, social psychologist, and writer, considered by some "the most influential American sociologist of the twentieth century". In 2007, '' The Time ...
and
Michel Foucault Paul-Michel Foucault ( , ; ; 15 October 192625 June 1984) was a French History of ideas, historian of ideas and Philosophy, philosopher who was also an author, Literary criticism, literary critic, Activism, political activist, and teacher. Fo ...
. He died in Venice.


Views

According to Renato Piccione, the intellectual legacy of Franco Basaglia can be divided into three periods: # ''university period'' which initiated the process of criticizing psychiatry as "science" that ought to cure and liberate a person but, in fact, oppresses them; # ''institutional negation'' which coincides with experience in
Gorizia Gorizia (; ; , ; ; ) is a town and (municipality) in northeastern Italy, in the autonomous region of Friuli-Venezia Giulia. It is located at the foot of the Julian Alps, bordering Slovenia. It is the capital of the Province of Gorizia, Region ...
(1962–1968); # ''
deinstitutionalization Deinstitutionalisation (or deinstitutionalization) is the process of replacing long-stay psychiatric hospitals with less isolated community mental health services for those diagnosed with a mental disorder or developmental disability. In the 195 ...
'' which coincides with direction of experience in
Trieste Trieste ( , ; ) is a city and seaport in northeastern Italy. It is the capital and largest city of the Regions of Italy#Autonomous regions with special statute, autonomous region of Friuli-Venezia Giulia, as well as of the Province of Trieste, ...
(1971–1979). When Basaglia arrived at Gorizia, he was revolted by what he observed as the conventional regime of institutional 'care': locked doors only partly successful in muffling the weeping and screams of the patients, many of them lying nude and powerless in their excrement. And Basaglia observed the institutional response to human suffering: physical abuse, straitjackets, ice packs, bed ties, ECT and insulin-coma shock therapies to 'quiet' the melancholy and the terrified, and to strike terror in the agitated and the difficult. In 1961, Franco Basaglia started refusing to bind patients to their beds in the Lunatic Asylum of Gorizia. He also abolished any isolation method. From this initiative started a wide theoretical and practical debate all over Italy. Such a huge debate resulted in the endorsement in 1978 of a national reform bill in 1978 that provided the gradual but radical closure and dismantling of the mental hospitals in the whole country. Basaglia insisted that much in the inveterate stereotypes of madness was actually the consequence of institutional conditions, but not a real danger which the walls of a mental hospital had been required to contain. He considered psychiatric hospital as an oppressive, locked and total institution in which prison-like, punitive rules are applied, in order to gradually eliminate its own contents; and patients, doctors and nurses are all subjected (at different levels) to the same process of institutionalism. Basaglia recognized that many of the characteristics of his patients which were believed to be inherent in their mental illness, such as the vacant stares and the repetitive gestures and movements, appeared to dissolve as the patients left the confines of the asylum. Basaglia concluded from this that society would not know what mental illnesses were, or what limitations they would inherently put on persons with them until both staff and patients were freed from the beliefs, attitudes and culture of the asylum. Basaglia was concerned that, without the complete closing of asylums, mental health professionals would unknowingly reconstitute the asylum culture in community facilities. As long as confinement remained possible, professionals would continue to regard themselves as the ultimately responsible parties, and patients would continue to regard their agency and freedom as dependent on the doctor's will. Basaglia considered mental illness as the consequence of the exclusion processes acting in social institutions. He stated: "The mental illness is not reason and origin but the necessary and natural consequence of the power dynamics–related exclusion processes potentially and concretely acting in all social institutions. It is not sufficient to liberate the ill to restore life, history to the persons who were deprived of their life, their history.""La malattia mentale non è ragione e origine, ma conseguenza necessaria e naturale dei processi di esclusione legati alla dinamica del potere, potenzialmente e concretamente attivi in tutte le istituzioni sociali. Non basta liberare i malati per ridare una vita, una storia, a persone che sono state ptivate della loro vita, della loro storia." ''See:'' Basaglia and his followers believed that psychiatry was used as the provider to the establishment of scientific support for social control. The ensuing standards of deviance and normality brought about repressive views of discrete social groups. This approach was nonmedical and pointed out the role of mental hospitals in the control and medicalization of deviant behaviours and social problems.


Works

The first substantial report by Franco Basaglia was titled ''The destruction of the Mental Hospital as a place of institutionalisation'' and presented by him at the First International Congress of Social Psychiatry held in London in 1964. In this report Basaglia stated that "the psychiatrist of today seems to have discovered, suddenly, that the first step towards the cure of the patient is his return to liberty of which, until now, the psychiatrist himself had deprived him" and that "it is true that the discovery of liberty is the most obvious that Psychiatry could reach." In conclusion, Basaglia tried to fix some points in an attempt to form a lever for discovering liberty: # Pressure on the administration on which the hospital depends, by the involved action of joint responsibility for the situation previously maintained. # The awakening of conscience and of joint responsibility on the part of the doctors who have accepted and preserved this situation. # The introduction of drugs by means of which, notwithstanding the institutionalised climate, the breaking of the "bond" of the patients was made possible. # The attempt at re-education—theoretical and humane—of the nurses. (This, however, is still far from having been reached.) # The keeping alive—as far as possible—of the ties of the patient with the world outside (family, friends, interests). # The opening of the doors, and the beginning of life according to the open door system. # The creation of presuppositions of the Day Hospital, soon to be opened, as a part-time service. In 1968, ''L'istituzione negata'' ('The Institution Denied'), edited by Franco Basaglia, was published. Widely read all over Italy, this book not only documented and analyzed the changes at Gorizia but also carried anti-institutional debate into other areas: factories, universities and schools.


Legacy

While discussing the process of transformation of mental health care across the European Region, Matt Muijen argues that the influence of professionals has obviously been decisive, mostly psychiatrists who acted as advocates of change, such as Philippe Pinel in
France France, officially the French Republic, is a country located primarily in Western Europe. Overseas France, Its overseas regions and territories include French Guiana in South America, Saint Pierre and Miquelon in the Atlantic Ocean#North Atlan ...
in the 19th century and Franco Basaglia in Italy in the 20th. They offered conceptions of new models of effective and humane care, revolutionary for their times, replacing abusive and inadequate traditional services. Their real accomplishment was the ability to inspire politicians to advocate these conceptions and persuade colleagues to implement them, thereby enabling sustainable and real change. Giovanna Russo and Francesco Carelli state that back in 1978 the Basaglia reform perhaps could not be fully implemented because society was unprepared for such an avant-garde and innovative concept of mental health. Thirty years later, it has become more obvious that this reform reflects a concept of modern health and social care for mental patients. The Italian example originated samples of effective and innovative service models and paved the way for deinstitutionalisation of mental patients. Giovanni de Girolamo with coauthors argues that Basaglia's contribution was crucial to move psychiatric practice into the realm of health care and give visibility to psychiatry. P. Fusar-Poli with coauthors argues that thanks to the Basaglia law, psychiatry in Italy began to be integrated into the general health services and was no longer sidelined to a peripheral area of medicine. In the 2001 National Mental Health Conference, Italian neurologist and laureate of the 1986
Nobel Prize in Physiology or Medicine The Nobel Prize in Physiology or Medicine () is awarded yearly by the Nobel Assembly at the Karolinska Institute for outstanding discoveries in physiology or medicine. The Nobel Prize is not a single prize, but five separate prizes that, acco ...
Rita Levi-Montalcini expressed her admiration for Franco Basaglia by calling him the founder of the new conception of mental illness, a magnificent scientist and fine human being who really lived the tragic problem of mental illness.See 7:45 from the start of the film fragment: British clinical psychologist Richard Bentall argues that after Franco Basaglia had persuaded the Italian government to pass Law 180, which made new hospitalizations to large mental hospitals illegal, the results were controversial. In the following decade many Italian doctors complained that the prisons had become depositories for the seriously mentally ill, and that they found themselves "in a state psychiatric-therapeutic impotence when faced with the uncontrollable paranoid schizophrenic, the agitated-meddlesome maniac, or the catatonic".Bentall cites Palermo's article: These complaints were seized upon psychiatrists elsewhere, eager to exhibit the foolishness of abandoning conventional ways. However, an efficient network of smaller community mental health clinics gradually developed to replace the old system. The president of the World Phenomenology Institute Anna-Teresa Tymieniecka states that Basaglia managed to pull together substantial revolutionary and reformatory energies around his anti-institutional project and created the conditions which within a few years brought to the reform of mental health legislation in 1978. This reform was introduced amongst great enthusiasm and bitter criticism, hostility and perplexity, critical and sometimes unconditional support. Basaglia thereby managed to inflict a salutary shock on Italian psychiatry, which had previously been torpid. American psychiatrist Loren Mosher called Basaglia the most innovative and influential European psychiatrist since Freud. Francine Saillant and Serge Genest assert that Basaglia's reform of psychiatry in Italy, a renewed vision of Italian society, and radical critique of public institutions made him one of Italy's greatest, most progressive intellectuals and a leading figure of the second half of the 20th century.
Thomas Szasz Thomas Stephen Szasz ( ; ; 15 April 1920 – 8 September 2012) was a Hungarian-American academic and psychiatrist. He served for most of his career as professor of psychiatry at the State University of New York Upstate Medical University. A dis ...
had a radically critical opinion about the work of Basaglia. In 1986, in the preface to the book by Giorgio Antonucci ' I pregiudizi e la conoscenza critica alla psichiatria', Szasz writes the following words about the misunderstanding of the ideas of Basaglia:


See also

* Basaglia Law * Giorgio Coda * Giorgio Antonucci * '' Democratic Psychiatry'' * Psychiatric reform in Italy *
Deinstitutionalisation Deinstitutionalisation (or deinstitutionalization) is the process of replacing long-stay psychiatric hospitals with less isolated community mental health services for those diagnosed with a mental disorder or developmental disability. In the 1950 ...
* Anti-psychiatry


References


Selected bibliography


Research papers

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *


Books and reports

* ''Che cos'è la psichiatria?'', 1967, Einaudi
some passages
) * ''L'istituzione negata'',
Turin Turin ( , ; ; , then ) is a city and an important business and cultural centre in northern Italy. It is the capital city of Piedmont and of the Metropolitan City of Turin, and was the first Italian capital from 1861 to 1865. The city is main ...
, 1968, Einaudi (last edition: ) * '' Morire di classe'',
Turin Turin ( , ; ; , then ) is a city and an important business and cultural centre in northern Italy. It is the capital city of Piedmont and of the Metropolitan City of Turin, and was the first Italian capital from 1861 to 1865. The city is main ...
, 1969, Einaudi (book of photographs by Carla Cerati and Gianni Berengo Gardin). * ''Il malato artificiale'', Turin, 1969, Einaudi * ''La maggioranza deviante'' (with Franca Ongaro),
Turin Turin ( , ; ; , then ) is a city and an important business and cultural centre in northern Italy. It is the capital city of Piedmont and of the Metropolitan City of Turin, and was the first Italian capital from 1861 to 1865. The city is main ...
, 1971, Einaudi * * ''Crimini di pace'', (with
Foucault Paul-Michel Foucault ( , ; ; 15 October 192625 June 1984) was a French historian of ideas and philosopher who was also an author, literary critic, political activist, and teacher. Foucault's theories primarily addressed the relationships be ...
, Goffman, Laing,
Chomsky Avram Noam Chomsky (born December 7, 1928) is an American professor and public intellectual known for his work in linguistics, political activism, and social criticism. Sometimes called "the father of modern linguistics", Chomsky is also a ...
). * ''Conferenze brasiliane'', Raffaello Cortina
''Corso di aggiornamento per operatori psichiatrici'', 1979






* ''Scritti, vol. 1: 1953-1968: Dalla psichiatria fenomenologica all'esperienza di Gorizia'', Einaudi,
Turin Turin ( , ; ; , then ) is a city and an important business and cultural centre in northern Italy. It is the capital city of Piedmont and of the Metropolitan City of Turin, and was the first Italian capital from 1861 to 1865. The city is main ...
, 1981 * ''Scritti vol. 2: 1968-1980. Dall'apertura del manicomio alla nuova legge sull'Assistenza psichiatrica'', Einaudi, Torino * ''La violenza'' (scritto con Franco Fornari), Vallecchi, Flowrence, 1978 * ''L'utopia della realtà''
Turin Turin ( , ; ; , then ) is a city and an important business and cultural centre in northern Italy. It is the capital city of Piedmont and of the Metropolitan City of Turin, and was the first Italian capital from 1861 to 1865. The city is main ...
, Einaudi.


Further reading

* * * * * * * * * * * * * * * Francesco Codato. Follia, potere e istituzione: genesi del pensiero di Franco Basaglia, UNI Service, Trento, 2010 * Jürgen Härle. Die demokratische Psychiatrie in Italien. Modell oder Utopie, Munich 1988. * Malte König. Franco Basaglia und das Gesetz 180. Die Auflösung der psychiatrischen Anstalten in Italien 1978, in: Petra Terhoeven (ed.). Italien, Blicke. Neue Perspektiven der italienischen Geschichte des 19. und 20. Jahrhunderts, Göttingen 2010, S. 209–233. * Giuliano Scabia. Marco Cavallo. Da un ospedale psichiatrico la vera storia che ha cambiato il modo di essere del teatro e della cura, Alphabeta Verlag, Merano, 2011, . * Horacio Riquelme (ed.). Die neue italienische Psychiatrie. Wandel in der klinischen Praxis und im psychosozialen Territorium, Frankfurt a.M. 1988. * * * * * * *


Films on Franco Basaglia

*
I giardini di Abele
'' by Sergio Zavoli, 1968, on RaiPlay. * '' C'era una volta la città dei matti...'' () directed by Silvano Agosti, 2000, Istituto Luce. * '' La seconda ombra'' () directed by Marco Turco, producer Rai Fiction and Ciao Ragazzi!, 2010 * * * * {{DEFAULTSORT:Basaglia, Franco 1924 births 1980 deaths Theorists in psychiatry Italian psychiatrists Italian political philosophers Psychiatry academics Medical anthropologists Phenomenologists Existential therapists Physicians from Venice University of Padua alumni Academic staff of the University of Parma Anti-psychiatry activists Deaths from brain cancer in Italy Deinstitutionalisation in Italy Burials at Isola di San Michele 20th-century Italian physicians