Franco Basaglia
Encyclopedia
Franco Basaglia was an Italian
Italy
Italy , officially the Italian Republic languages]] under the European Charter for Regional or Minority Languages. In each of these, Italy's official name is as follows:;;;;;;;;), is a unitary parliamentary republic in South-Central Europe. To the north it borders France, Switzerland, Austria and...

 psychiatrist
Psychiatrist
A psychiatrist is a physician who specializes in the diagnosis and treatment of mental disorders. All psychiatrists are trained in diagnostic evaluation and in psychotherapy...

 and neurologist
Neurologist
A neurologist is a physician who specializes in neurology, and is trained to investigate, or diagnose and treat neurological disorders.Neurology is the medical specialty related to the human nervous system. The nervous system encompasses the brain, spinal cord, and peripheral nerves. A specialist...

, professor who proposed the dismantling of psychiatric hospitals, pioneer of the modern concept of mental health, Italian psychiatry reformer, charismatic leader in Italian psychiatry, figurehead and founder of Democratic Psychiatry
Democratic Psychiatry
Democratic Psychiatry is Italian society and movement for liberation of the ill from segregation in mental hospitals by pushing for the Italian psychiatric reform. The movement was political in nature but not antipsychiatric in the sense in which this term is used in the Anglo-Saxon world...

,
architect and principal proponent of Law 180 which abolished mental hospitals. He was the most influential Italian psychiatrist of the 20th century.

Biography

Franco Basaglia was born on 11 March 1924 in Venice
Venice
Venice is a city in northern Italy which is renowned for the beauty of its setting, its architecture and its artworks. It is the capital of the Veneto region...

. 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 Jaspers
Karl Theodor Jaspers was a German psychiatrist and philosopher who had a strong influence on modern theology, psychiatry and philosophy. After being trained in and practicing psychiatry, Jaspers turned to philosophical inquiry and attempted to discover an innovative philosophical system...

, Ludwig Binswanger
Ludwig Binswanger
Ludwig Binswanger was a Swiss psychiatrist and pioneer in the field of existential psychology...

 and Eugène Minkowski
Eugène Minkowski
Eugène Minkowski was a French psychiatrist, born in Saint Petersburg, Russia.Minkowski proposed that psychopathology should always be interpreted taking into account the personal experience of time. The main concepts created by Minkowski included the ideas of "vital contact with reality" and...

, developed an interest in the study of phenomenological philosophers, such as Edmund Husserl
Edmund Husserl
Edmund Gustav Albrecht Husserl was a philosopher and mathematician and the founder of the 20th century philosophical school of phenomenology. He broke with the positivist orientation of the science and philosophy of his day, yet he elaborated critiques of historicism and of psychologism in logic...

, Martin Heidegger
Martin Heidegger
Martin Heidegger was a German philosopher known for his existential and phenomenological explorations of the "question of Being."...

, Maurice Merleau-Ponty
Maurice Merleau-Ponty
Maurice Merleau-Ponty was a French phenomenological philosopher, strongly influenced by Karl Marx, Edmund Husserl and Martin Heidegger in addition to being closely associated with Jean-Paul Sartre and Simone de Beauvoir...

, and Jean-Paul Sartre
Jean-Paul Sartre
Jean-Paul Charles Aymard Sartre was a French existentialist philosopher, playwright, novelist, screenwriter, political activist, biographer, and literary critic. He was one of the leading figures in 20th century French philosophy, particularly Marxism, and was one of the key figures in literary...

, and then he analyzed the work of sociological and historical critics of psychiatric institutions, such as Erving Goffman
Erving Goffman
Erving Goffman was a Canadian-born sociologist and writer.The 73rd president of American Sociological Association, Goffman's greatest contribution to social theory is his study of symbolic interaction in the form of dramaturgical perspective that began with his 1959 book The Presentation of Self...

 and Michel Foucault
Michel Foucault
Michel Foucault , born Paul-Michel Foucault , was a French philosopher, social theorist and historian of ideas...

.

Views

According to Renato Piccione, intellectual legacy of Franco Basaglia can be divided into three periods:
  1. university period which initiated the process of criticizing psychiatry as "science" that must cure and liberate a person but in fact oppresses him;
  2. institutional negation which coincides with experience in Gorizia
    Gorizia
    Gorizia is a town and comune 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, and it is a local center of tourism, industry, and commerce. Since 1947, a twin...

     (1962—1968);
  3. deinstitutionalization which coincides with direction of experience in Trieste
    Trieste
    Trieste is a city and seaport in northeastern Italy. It is situated towards the end of a narrow strip of land lying between the Adriatic Sea and Italy's border with Slovenia, which lies almost immediately south and east of the city...

     (1971—1979).


When Basaglia arrived at Gorizia, he was revolted by what he observed as the conventional regime of institutional ‘care’: looked doors and keys only partly successful in muffling the weeping and screams of the patients, many of them lying nude and powerless in their excrements. And Basaglia observed the institutional response to human suffering: physical abuse, strait jackets, 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 binding patients at their beds in the Lunatic Asylum of Gorizia. He also abolished any isolation method. From this initiative commenced a wide theoretical and practical debate all over Italy. Such a huge debate resulted in the endorsement of a national Reform bill in 1978. The bill 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 bad been requited to contain. He considered psychiatric hospital as an oppressive, locked and total institution
Total institution
A total institution is place of work and residence where a great number of similarly situated people, cut off from the wider community for a considerable time, together lead an enclosed, formally administered round of life...

 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 word salad, the vacant stares, the perseverative gestures and movements, appeared to dissolve as they left the confines of the asylum. From these observations, Basaglia concluded that we would not know what mental illnesses were, or what limitations they would inherently put on persons suffering from 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.

Basagla considered mental illness as the consequence of the exclusion processes acting in the 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 the 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.’

Basaglia and his followers deemed that psychiatry was used as the provider of scientific support for social control to the existing establishment. 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 behaviors and social problems.

Works

A first considerable report by Franco Basaglia was titled The destruction of the Mental Hospital as a place of institutionalisation and presented by him on 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:
  1. Pression on the administration, on which the hospital depends, by the involved action of joint responsibility for the situation previously maintained.
  2. The awakening of conscience and of joint responsibility on the part of the doctors who have accepted and preserved this situation.
  3. The introduction of drugs by means of which, notwithstanding the institutionalised climate, the breaking of the "bond" of the patients was made possible.
  4. The attempt at re-education—theoretical and humane—of the nurses (this however is still far from having been reached).
  5. The keeping alive—as far as possible—of the ties of the patient with the world outside (family, friends, interests).
  6. The opening of the doors, and the beginning of life according to the open door system.
  7. 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, came out of press. 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.

Estimations

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
Philippe Pinel
Philippe Pinel was a French physician who was instrumental in the development of a more humane psychological approach to the custody and care of psychiatric patients, referred to today as moral therapy...

 in France
France
The French Republic , The French Republic , The French Republic , (commonly known as France , is a unitary semi-presidential republic in Western Europe with several overseas territories and islands located on other continents and in the Indian, Pacific, and Atlantic oceans. Metropolitan France...

 in the 19th century and Franco Basaglia in Italy
Italy
Italy , officially the Italian Republic languages]] under the European Charter for Regional or Minority Languages. In each of these, Italy's official name is as follows:;;;;;;;;), is a unitary parliamentary republic in South-Central Europe. To the north it borders France, Switzerland, Austria and...

 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 heath. Thirty years later, it has become more obvious that this reform reflects a concept of modern heath 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 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
Nobel Prize in Physiology or Medicine
The Nobel Prize in Physiology or Medicine administered by the Nobel Foundation, is awarded once a year for outstanding discoveries in the field of life science and medicine. It is one of five Nobel Prizes established in 1895 by Swedish chemist Alfred Nobel, the inventor of dynamite, in his will...

 Rita Levi-Montalcini
Rita Levi-Montalcini
Rita Levi-Montalcini , Knight Grand Cross is an Italian neurologist who, together with colleague Stanley Cohen, received the 1986 Nobel Prize in Physiology or Medicine for their discovery of nerve growth factor...

 expressed her admiration for Franco Basaglia by calling him the founder of the new conception of mental illness, magnificent scientist and fine human being who really lived the tragic problem of mental illness.

British clinical psychologist Richard Bentall
Richard Bentall
Richard Bentall is currently appointed as a Chair of Clinical Psychology at the University of Bangor in Wales, UK and is a Chartered Clinical Psychologist. Born in Sheffield, he attended the University College of North Wales, Bangor as an undergraduate before registering for a Ph.D. in...

 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". 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
World Phenomenology Institute
World Phenomenology Institute is an academic organization founded in 1976 to promote scholarship in the area of phenomenology. The organization was founded by Anna-Teresa Tymieniecka.- See also :* Emmanuel Levinas* Paul Ricoeur* Hans-Georg Gadamer* Stephan Strasser...

 Anna-Teresa Tymieniecka
Anna-Teresa Tymieniecka
Anna-Teresa Tymieniecka is a Polish-born American philosopher, one of the most important and continuously active contemporary phenomenologists, founder and president of The World Phenomenology Institute, and editor of the book series Analecta Husserliana, presently published by...

 states that Basaglia managed to pool 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 make salutary shock in Italian psychiatry which had lain in a torpid slumber before.

American psychiatrist Loren Mosher
Loren Mosher
Loren Richard Mosher was an American psychiatrist, clinical professor of psychiatry, expert on schizophrenia and the chief of the Center for Studies of Schizophrenia in the National Institute of Mental Health...

 called Basaglia the most innovative and influential European psychiatrist since Freud
Sigmund Freud
Sigmund Freud , born Sigismund Schlomo Freud , was an Austrian neurologist who founded the discipline of psychoanalysis...

.

Francine Saillant and Serge Genest assert that Basaglia’s reform of psychiatry in Italy, renewed vision on Italian society, and radical critique of public institutions made Franco Basaglia one of Italy’s greatest, most progressive intellectuals and a leading figure of the second half of the 20th century.

See also

  • Basaglia Law
    Basaglia Law
    Basaglia Law is the Italian Mental Health Act of 1978 which signified a large reform of the psychiatric system in Italy, contained directives for the closing down of all psychiatric hospitals and led to their gradual replacement with a whole range of community-based services, including settings...

  • Democratic Psychiatry
    Democratic Psychiatry
    Democratic Psychiatry is Italian society and movement for liberation of the ill from segregation in mental hospitals by pushing for the Italian psychiatric reform. The movement was political in nature but not antipsychiatric in the sense in which this term is used in the Anglo-Saxon world...

  • Psychiatric reform in Italy
  • Deinstitutionalisation
    Deinstitutionalisation
    Deinstitutionalization or deinstitutionalization is the process of replacing long-stay psychiatric hospitals with less isolated community mental health service for those diagnosed with a mental disorder or developmental disability. Deinstitutionalization can have multiple definitions; the first...

  • Anti-psychiatry
    Anti-psychiatry
    Anti-psychiatry is a configuration of groups and theoretical constructs that emerged in the 1960s, and questioned the fundamental assumptions and practices of psychiatry, such as its claim that it achieves universal, scientific objectivity. Its igniting influences were Michel Foucault, R.D. Laing,...


Books and reports

Che cos'è la psichiatria?, 1967, Einaudi (some passages) L'istituzione negata, Turin
Turin
Turin is a city and major business and cultural centre in northern Italy, capital of the Piedmont region, located mainly on the left bank of the Po River and surrounded by the Alpine arch. The population of the city proper is 909,193 while the population of the urban area is estimated by Eurostat...

, 1968, Einaudi (last edition: ) Morire di classe (photo book). Il malato artificiale, Turin
Turin
Turin is a city and major business and cultural centre in northern Italy, capital of the Piedmont region, located mainly on the left bank of the Po River and surrounded by the Alpine arch. The population of the city proper is 909,193 while the population of the urban area is estimated by Eurostat...

, 1969, Einaudi La maggioranza deviante (with Franca Ongaro), Turin
Turin
Turin is a city and major business and cultural centre in northern Italy, capital of the Piedmont region, located mainly on the left bank of the Po River and surrounded by the Alpine arch. The population of the city proper is 909,193 while the population of the urban area is estimated by Eurostat...

, 1971, Einaudi Crimini di pace, (with Foucault
Michel Foucault
Michel Foucault , born Paul-Michel Foucault , was a French philosopher, social theorist and historian of ideas...

, Goffman
Erving Goffman
Erving Goffman was a Canadian-born sociologist and writer.The 73rd president of American Sociological Association, Goffman's greatest contribution to social theory is his study of symbolic interaction in the form of dramaturgical perspective that began with his 1959 book The Presentation of Self...

, Laing
Ronald David Laing
Ronald David Laing was a Scottish psychiatrist who wrote extensively on mental illnessin particular, the experience of psychosis...

, Chomsky
Noam Chomsky
Avram Noam Chomsky is an American linguist, philosopher, cognitive scientist, and activist. He is an Institute Professor and Professor in the Department of Linguistics & Philosophy at MIT, where he has worked for over 50 years. Chomsky has been described as the "father of modern linguistics" and...

). Morire di classe, Edizioni Gruppo Abele Conferenze brasiliane, Raffaello Cortina Corso di aggiornamento per operatori psichiatrici, 1979 La chiusura dell'ospedale psichiatrico, 1976 Le contraddizioni della comunità terapeutica, 1970 La distruzione dell'ospedale psichiatrico come luogo di istituzionalizzazione, 1964 Scritti, vol. 1: 1953-1968: Dalla psichiatria fenomenologica all'esperienza di Gorizia, Einaudi, Turin
Turin
Turin is a city and major business and cultural centre in northern Italy, capital of the Piedmont region, located mainly on the left bank of the Po River and surrounded by the Alpine arch. The population of the city proper is 909,193 while the population of the urban area is estimated by Eurostat...

, 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
Turin is a city and major business and cultural centre in northern Italy, capital of the Piedmont region, located mainly on the left bank of the Po River and surrounded by the Alpine arch. The population of the city proper is 909,193 while the population of the urban area is estimated by Eurostat...

, Einaudi.

Films on Franco Basaglia

  • C'era una volta la città dei matti...
    C'era una volta la città dei matti...
    C'era una volta la città dei matti... is Italian television film of two episodes.The film was shot in 2009. Its screenplay was written by Marco Turco, who also directed it. Rai Fiction and Ciao Ragazzi! produced the film under the direction of Claudia Mori...

    (There was once the city of the mad...) directed by Silvano Agosti, 2000, Istituto Luce.
  • La seconda ombra
    La seconda ombra
    La seconda ombra is Italian film directed by Silvano Agosti in 2000.The major part of cast was composed of people who had actually worked or lived in psychiatric hospitals of Gorizia and Trieste.-Plot:...

    (The second shadow) directed by Marco Turco
    Marco Turco
    -Life and career:Turco holds degrees in History and Philosophy. He studied under Ugo Pirro, Leonardo Benvenuti and Robert McKee at Aldo Giuffrè's drama school. Turco also wrote for L'Unità and Movie magazine....

    , producer Rai Fiction
    Rai Fiction
    Rai Fiction is an Italian production company.The company was founded in 1997.Rai Fiction is owned and opoperated by RAI,the public broadcaster of Italy ....

     and Ciao Ragazzi!, 2010
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