A clinic of lack : Franco Basaglia, biopolitics and the Italian psychiatric reform

In this thesis, I propose a new reading of the work of Franco Basaglia, the psychiatrist responsible for Law 18011978, which, to date, makes Italy the only country in the world where psychiatry does not rely on asylums. Basaglia's oeuvre has often been divided into two periods: his early philosophical self-education, revolving around the rethinking of the psychiatrist-patient relationship in terms of intersubjectivity, and his subsequent 'political activism', centred on his struggle against institutional psychiatry and his reformation of the latter, which culminates in Law 180. Critics have overlooked the structural continuity between these two phases. Such an interpretative division has produced a fragmented reading of Basaglia's work, which I endeavour to overcome in my thesis. I aim at establishing a solid connection between Basaglia's 'theory of the subject', which I compare to Lacan's, and Basaglia's activity of de-institutionalisation, which is indebted to Foucault's reflection on disciplinary power and psychiatry. The notion of the 'subject', according to both Basag1ia and Lacan, revolves around a constitutional lack: as human beings we lack the very possibility of being without the other. While for Foucault this notion is nothing other than an effect of power-knowledge relations, for Basaglia and Lacan subjectivity as lack entails a constitutional participation in otherness. My claim is that this stance anticipates Roberto Esposito's biopolitical notion of communitas, as the 'place' where subjects lose their illusory individual subjectivity to actively embrace intersubjectivity. The formation of a communitas prevents an excess of immunisation. On the contrary, the extreme consequence of withdrawing from otherness by objectifying the patient is the creation of an organicist thanatopolitical psychiatry. This is why I propose to call Basaglia's practical and theoretical work a 'clinic of lack', an affirmative biopolitical psychiatry centred on the idea that subjects are constitutionally lacking.