On Saturday November 18, Giorgio Antonucci died in Florence. He was a physician who became an international authority for the questioning of the basis of psychiatry. He was a psychiatrist who tried to dismantle the discipline from the inside once he understood its nature. He was the director of several wards of two psychiatric hospitals in Northern Italy who, through decades of field work side by side with the so-called ‘patients’, delving into their personal stories, listening with acute sensitivity, managed to liberate them from the clutches of psychiatry.
Giorgio was above all a humanist, a poet of freedom who dedicated his life to the liberation of the powerless. For me Giorgio was a special friend, who left in me an indelible mark.
Giorgio was a humanist who wisely combined science and poetry for the genuine progress of human kind. His deep humanity and delicate sensitivity towards the invisible, the forgotten, the powerless, together with his strength and courage to fight against violations of human rights demonstrated that it is possible to deal with suffering in a different, and non-coercive way.
His first contact with psychiatry was not theoretical, based on the study of so-called mental illnesses, but empirical, always through field work
Giorgio was against involuntary commitment, this form of legalised kidnapping practised everywhere in the world, every day. He was against the electroshock, now euphemistically called electroconvulsive therapy, following the linguistic cosmetics that has been deployed to improve psychiatry’s image, disguising it as medicine: he never approved, ordered or practised an electroshock. On the contrary, he entered into dispute with the University of Pisa, where they argue that the electroshock is a healing practice. He has always rejected any kind of coercion, whether mechanical, chemical or psychological.
Giorgio Antonucci was already actively defending the rights of the powerless, even before what is known as the era of ‘psychiatric reform’. This took place in Italy in the seventies and culminated in Law 180 which, officially, put an end to the asylum, but de facto had virtually no effect on the improvement of the lives of people, as it substituted for the asylum the psychiatric ward of ordinary hospitals, without tackling the issue at its very core, without questioning involuntary commitment, and leaving the power of psychiatry unaltered.
The victims of psychiatry, as has occurred since the birth of the asylum, are victims of an assertion of power. The key point, always, is power
His first contact with psychiatry was not theoretical, based on the study of so-called mental illnesses, but empirical, always through field work. In the late fifties he started to work at a centre whose aim was to help former prostitutes to reintegrate into social life. One day there was a discussion between a girl, a former prostitute, and somebody from management. As the discussion went on and became passionate, the management called an ambulance. When the ambulance arrived the medical staff took the girl to an asylum. At that time Giorgio, who wasn’t yet a medical doctor but still a student of medicine, didn’t have the power to prevent the commitment of the girl.
From that moment on, Giorgio Antonucci understood the true character of psychiatry: an exercise of power, a way to eliminate fragile people, in this case the girl who was a former prostitute (in Italy during the fifties prostitutes had a distinctive stamp on their identity card), without dealing with the real problem, the reason of the discussion. Its victims, as has occurred since the birth of the asylum, are victims of an assertion of power. The key point, always, is power. The hospitalised are always less powerful than the person or group who requests the hospitalisation.
Giorgio defended a “non-psychiatric thought, which considers psychiatry as an ideology without scientific content, a non-knowledge, whose aim is to annihilate people instead of trying to understand the difficulties of life, both individual and social, in order to defend people, change society and give life to an authentically new culture.” Giorgio maintained that the “essence of psychiatry lies in an ideology of discrimination.”
Edelweiss Cotti, a visionary psychiatrist who was the director of the psychiatric hospitals Osservanza and Luigi Lolli in the Northern Italian city of Imola, invited Giorgio to work with him.
Giorgio’s labour was based on honest listening, deep respect, acute sensitivity. A peer-to-peer relationship between two persons that subverted the traditional, unequal relation between psychiatrist and patient
At Osservanza he asked to work in the ward that was considered by the other psychiatrists of the asylum to be the most difficult: ward 14 for ‘donne agitate’ (‘agitated women’). He found 44 women, all of them diagnosed as schizophrenic, who had spent decades tied to a bed, sometimes to trees. Women who had been confined in the asylum for decades, subjected to humiliation, women whose lives had been taken from them.
Giorgio eliminated electroshock, psychiatric drugs and any form of coercion. He listened to the personal stories, fears, fragilities of the women. He introduced medicine in the ward, real medicine, taking care of their health, as the patients had their muscles atrophied for having spent years in a bed, taking care of their nutrition.
After about a month, working day and night, Giorgio managed to free them, bringing them back to life. Giorgio then liberated other wards of the asylum. He organised events in the liberated wards, music, art, parties. The open wards directed by Giorgio were an oasis of freedom in a desert of coercion. The Italian writer Dacia Maraini described the atmosphere of the liberated wards in her interview with Giorgio Antonucci (1978) and in her novel La Grande Festa(2011).
He then continued the difficult task of helping the liberated women and men to return to life, a work that lasted many years. Later Giorgio went with the liberated people on several trips, they even went to the European Parliament to defend their rights. A debate among equals: the false separation between normal and non-normal disappeared, so-called specialists and so-called patients were talking together. It was the first time that something of this nature happened.
At the psychiatric hospital Luigi Lolli he was the director of a self-managed ward, Reparto Autogestito, where people had been given back their money, could wear their clothes and had the keys of the ward. The possession of the keys is the core of the matter. The key is the element that shows who has the power, and the key point to understanding psychiatry is power.
Giorgio’s labour was based on honest listening, deep respect, acute sensitivity. A peer-to-peer relationship between two persons that subverted the traditional, unequal relation between psychiatrist and patient, and generally between physician and patient. This substitution of authoritarianism with an honest communication, empathy and mutual trust was constantly obstructed by the establishment. Giorgio didn’t have an easy life, he had to fight against the institution, against the prejudice, against his own colleagues. He worked mostly alone to defend the powerless, with the support of a few friends.
As he wrote in his book Il pregiudizio psichiatrico, “behind the most absurd and groundless diagnosis there is always a history of marginalisation and of social and cultural exploitation, a history of family and affective crises.” The diagnosis itself is rejected on the same grounds of overweening power: “The power of the words of a psychiatrist is comparable only to the power of the words of a judge. Rather superior, because a judge is only one of the actors in a process with many participants. On the contrary the judgment of a psychiatrist can condemn a man directly to segregation without the necessity for a trial.”
Giorgio substituted the psychiatric diagnosis with the non-psychiatric approach to psychological suffering, based on the full respect of the person, tackling their problems in the specific personal and social situation.
In 1968 Giorgio Antonucci was invited by Edelweiss Cotti to work at the Centre for Human Relations (Centro di Relazioni Umane) in Cividale del Friuli, a city in Northern Italy, close to the border with the former Yugoslavia. The Centre for Human Relations was an alternative to coercive psychiatric wards, where patients were free to go out of the centre —to the cinema, to the hairdresser…— and have their own life.
At the beginning of September 1968 Antonucci and Cotti saw a column of trucks of police approaching the Centre. The deployment of a high number of security forces together with Cividale’s proximity to the border made them imagine an Italian government military action to liberate the recently occupied Czechoslovakia. But it transpired the police action had nothing to do with the Czechoslovakia, but with government annoyance at the too permissive approach of Edelweiss Cotti and Giorgio Antonucci.
After the work in Cividale, in 1969 he worked together with Franco Basaglia in Gorizia. While Basaglia was focused on the criticism of the asylum as institution Giorgio criticised the nature of psychiatry itself: “Psychiatry is a discipline which deals with dissent, a discipline which has no relations to medical science, a discipline which judges somebody’s thought.”
When Dacia Maraini asked Giorgio: “Regarding the so-called insane persons, what does this new method entail?” he replied: “For me it means that insane persons don’t exist and that psychiatry must be completely eliminated.” As he always said, “the asylum is not a building, it is a criterion for evaluation.”
Giorgio’s death leaves an incommensurable void. But after Giorgio’s work everything is different: he has demonstrated that it is possible to deal with suffering in a different way, tackling the personal and social problems, rejecting any kind of coercion. Now it’s our task to follow his steps fighting for the liberation of the powerless.
Giorgio has filled us with freedom. Thanks, Giorgio.
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