Conclusion : l’Indonésie est aussi loin de l’Allemagne que le sort du patient moyen l’est de celui des maîtres du triage à l’entrée des chambres à gaz.
25.1.2024 by Isa Bellum - A great deal has been written about the Antipsychiatry movement. As one of their most radical proponents, founded in 1969 in the German city of Heidelberg, the SPK has had its great share of misrepresentation—especially within the German media landscape of the 1970s. Lots of it was factually wrong, however, spread by the boulevard press (mainly conservative and right-wing) politicians and literature, including Stephan Aust’s “Der Baader-Meinhof-Komplex,” contributing to the mythologization of the collective.
During the tumultuous upheaval surrounding the ’68 movements until the ‘German Autumn’ in 1977, the SPK gained notorious prominence, particularly for its emphasis on leveraging illness as a means for political agitation. In his preface for their theoretical work “Turning Illness into a Weapon” from 1972, Jean-Paul Sartre referred to the collective as the “sole potential radicalization of anti-psychiatry.”
With the concept of ‘lay therapists,’ the SPK pioneered group therapy in Germany and organized the very first patient assembly in the history of the Federal Republic of Germany in 1969. Moreover, their approach to mental illness from an emancipatory perspective not only rejects the notion that mental illness is solely an individual phenomenon, often associated with further “guilt-tripping”, but deeply challenges the stereotype of the ‘passive, helpless patient.’
The irrationality expressed in a chapter title of Aust’s book, ‘Irre ans Gewehr!’, which translates to ‘Mad Men to the Rifle!’, a quote mistakenly attributed to SPK founder Dr. Wolfgang Hubert, can be seen as symptomatic in the depiction of the collective: a bunch of absurd ideas made by ‘the insane.’
However, such framing undermines their productive, sharp theoretical foundations in terms of providing emancipatory (self-) help and conducting a profound analysis of the connections between capitalism and mental illness. Crucial for comprehending both the collective’s roots and development is to understand further the particular historical and societal circumstances that contributed to its foundation, success, and disappearance from the public eye.
First and foremost, we must acknowledge the (often ignored) fact that, despite transitioning into a federal democratic republic in 1949, Germany’s health system and political landscape continued to foster Third Reich ideologies.
Pretext: The Legacy of National Socialism and the Beginning of the Antipsychiatry Movement in Postwar Germany
The roots of modern psychiatry and the classification of “the sick” can be traced back to the 19th century, and Foucault’s insightful work, “Madness and Civilization,” highlights how psychiatry has consistently functioned as a tool for imposing social control, representing a power structure in its own right. The systematic effort to not only assimilate but eliminate what was deemed a “burden of the mentally ill” began during World War I under the term “Hunger Euthanasia” and reached its grim climax with the Nazi health policy in 1933, enacted through the “Law for the Prevention of Hereditarily Diseased Offspring.” Involving doctors, psychiatrists, and scientists, the law led to numerous forced sterilizations and the deliberate mass killing of both mentally and physically ill individuals. By the war’s end, approximately 200,000 people had fallen victim to euthanasia, a chilling euphemism for genocide.
Additionally, following Germany’s capitulation, around 20,000 hospitalized individuals had been abandoned by the Allies, leaving them to perish in the now-deserted clinics.
The post-war health institutions were in a dilapidated state. Despite the “economic boom” of the 1950s, patients remained neglected and largely forgotten. After the establishment of the Federal Republic of Germany in 1949, Nazism-related convictions decreased, and a “pardon fever” within the German justice system began. Between 1949 and 1993, only 31 (!) court proceedings related to euthanasia took place nationwide, without comprehensive historical or legal investigations. In other words, many Nazis — politicians, doctors, Psychiatrists and other “euthanasia experts” continued to hold public positions for the upcoming decades, both within the medical and political landscape of Germany.
In the late 1950s, inspired by developments in Italy, GB and the US, reform-oriented groups emerged in West Germany, exploring new social psychiatric approaches. However, institutionalization admission remained the primary treatment for mental illnesses in the 1950s and 1960s due to a scarcity of psychotherapeutic assistance. The absence of ambulant services led to unnecessary hospitalizations, insufficient follow-up care, frequent relapses, and rehospitalization, creating a cycle known as “revolving door psychiatry.” About 75% of psychiatric patients were involuntarily admitted, with ambiguous legal incapacitation, often based on attributing “dangerousness” to those refusing admission. For the persons in question, this often led to prolonged deprivation of liberty without legal assistance — often locked inside hospitals for years.
David Cooper coined the term Antipsychiatry in 1966 to critique psychiatry within a broader societal context. In contrast to reformists, the focus was on analysing the structure of psychiatry and challenging traditional understandings of mental illnesses, including criticism of the biological concept of illness and hierarchical role assignments within psychiatry.
The theoretical foundations of the SPK
As a young, ambitious physician, Dr. Huber began his work at the University Polyclinic in Heidelberg in 1966. Shocked by the lack of assistance, especially for young individuals, he opened a psychological counselling centre that quickly gained popularity. From the outset, young people from working-class backgrounds became regular clients in addition to students. Due to its increasing politicization (Huber was involved in political activity such as university occupations), he was dismissed in 1970 and opened his therapy centre near the University of Heidelberg.
Unlike classical Antipsychiatry, the criticism of the SPK was less directed towards institutional psychiatry “in itself” but rather focused on society and its “extraterritorialization of forms of misery, characteristic of capitalism”. Their theoretical frame was based on “the categorical system of radical dialectics and Marx’s political economy, combined with the progressive elements of psychoanalysis”. The term dialectics originates from Hegel: dialectical development generally arises from contradictions — the antithesis follows the thesis until the synthesis resolves the contradiction (broadly speaking). The dialectic is applied within Marxism to the modern class struggle between the proletariat and the bourgeoisie. Due to the division of labour, the intersubjectively shared state of alienation arises from the contradiction between “human nature” and the (dehumanized) living conditions of the working class. For the worker, this state can only be resolved by gaining the means of production and the subsequent classless society that will follow as soon as all production is controlled by public means in the hands of the proletariat. Here, the proletariat represents the revolutionary subject, with communism as its real movement, able to abolish the status quo.
SPK’s theory is fundamentally rooted in the Marxist dialectic, tailored to the specificities of modern capitalist society in the 20th century. Broadly speaking, life was marked by increased material prosperity in Western societies, while mental illness continued to rise steadily:
“When Marx wrote The Capital, the most apparent form of exploitation was the material poverty of the workers. Today, this material destitution is less overt. The most conspicuous form of exploitation in contemporary times is illness. Hence, the term ‘proletariat’ must now encompass most of the exploited, equating to the sick.”
According to the SPK, the capitalist production process leads to isolation, expressed as the symptom of “illness” in the individual. This illness arises as a contradiction between the yearning for life, drawing on Freud with the substitution of “libido” for “life drive,” and the limitation of life imposed by the individual’s specific conditions in capitalism. The healthcare system, however, perceives “illness” merely as an isolated “individual fate,” causing patients to view their ailment as a self-inflicted failure, detached from a broader societal context.
When the patient recognizes the connection, the illness’s productive aspect becomes apparent. Since everyone in capitalist society is fundamentally considered sick, “illness” serves as both a starting condition and a symptom of a wider societal issue. Consequently, the SPK distinguishes between conscious and unconscious patients. While the unconscious patient is deemed socially “healthy” solely due to their ability to work, the conscious patient is already in a state of protest — with his or her suffering as a necessary symptom. Hence, “protest” is defined as the progressive, and “inhibition” is the reactionary element of illness. This distinction leads to the understanding that, as illness also has societal (supra-individual) causes, it can only be overcome collectively. Only then does the suffering transform into political protest, turning the patient into a “revolutionary subject.” By acknowledging the link between personal suffering and society, the patient undergoes a process akin to Marx’s concept of class consciousness.
In short, “therapy” and “political practice” converge, and its central subject, the “patient,” delineates not a societal role but a specific state of consciousness. Consequently, the SPK’s theory of illness simultaneously serves as a societal analysis, expressing “illness” in all societal domains, with the healthcare system being just one aspect of this “manifestation of authority.” This stance is integral to their analysis of the connection between “illness in capitalism,” where individual suffering is identified as synonymous with societal contradictions.
Political opposition and further radicalization
At the same time as the high phase of the SPK, several legislative decrees to oppose left-wing activity were issued by the state of Baden-Württemberg. Not only did the state possess a conservative majority with the CDU (Christian Democratic Union) as the strongest party, but it also employed Hans Filbinger, a former NS naval judge, as the Minister-President. On June 19, 1970, during the Conference on Development Aid, where US Senator McNamara was also present, violent street battles erupted between police and demonstrators. Under the leadership of Prof. Wilhelm Hahn, the Ministry of Culture of Baden-Württemberg immediately prohibited all remaining left-wing student groups, including the Socialist German Student Union SDS, which has existed since 1946. The wave of anti-leftist reprisals culminated in the Anti-Radical Decree of 1972, which affected the SPK’s work and led to plenty of professional bans, particularly within the public sector.
As a consequence, the mood within the group intensified. The language of the pamphlets became progressively radicalized, and direct action now targeted both the mental health sector and politicians while also claiming solidarity with the Red Army Fraction. During a house search of Huber in July 1971, materials for the production of explosives were seized, which coincided with components of a failed attack on a tax office in Heidelberg. However, Huber could not be directly attributed to the act. In addition to weapons and ammunition, forged identification papers were seized, along with various literature on the topic of “Armed Resistance.” The populistic Boulevard paper BILD called it an “attempted coup”; however, due to lack of evidence, most arrested members were released afterwards. However, Huber, his Wife and four other members went to jail for 4 years.
The collective disappeared from the public eye before re-emerging in 1976, now under the new name Patientenfront. According to their statements, they are still active globally but have significantly restricted their public presence and largely declined interviews.
Looking back at the SPK’s short but intensive work, it’s important not to join (both negative and positive) mythologizations. However, one shouldn’t solely reduce the collective to its later, more radicalized actions. The Antipsychiatry movement remained one of the groups that revolutionized the mental health sector and addressed the structural problem of the ongoing presence of former Nazis still active within the German sociopolitical landscape — including their despicable mindset towards how to deal with “the mentally ill”. Especially within the health sector and its self-prescribed oath of apolitical, scientific objectivity, the dogma of ‘keeping apolitical’ not only doesn’t correspond with reality but has served to favour the silencing of a particularly disgusting chapter of German history.
It is also true that the extension of what was known as the proletariat back when Marx wrote Das Kapital has changed dramatically in the last decades. More and more jobs now belong to the working class, including many that require academic education. A prominent example can be seen in the emerging phenomena of Digital Labour, a term comprising various jobs with various educational backgrounds. What they have in common, however, is an emphasis on “high flexibility”, short-term employment contracts, freelance contract models and performance-based compensation. Many have never met their superiors or colleagues (which further adds to platform workers’ difficulties in unionising to improve their working conditions!) It is also true that mental illness is at a global all-time high — and keeps continuing to rise. The close correlation between capitalism and mental illness, therefore, has been the subject of many contemporary studies, coming to a similar conclusion as the SPK more than half a century ago.
Source:
Aust, Stefan: Der Baader-Meinhof-Komplex, 2017
Bopp, Antipsychiatrie. Theorien, Theraphie, Politik, 1980.
Foucault: Wahnsinn und Gesellschaft,
Marx, Karl/Engels, Friedrich: Werke. Hg. vom Institut für Marxismus-Leninismus beim ZK des SED. 42 Bände. Berlin 1962–1983
Pross: Wir wollten ins Verderben rennen, 2017
Sozialistisches Patientenkollektiv: SPK-Aus der Krankheit eine Waffe machen. Eine Agitationsschrift des Sozialistischen Patientenkollektivs an der Universität Heidelberg. Mit einem Vorwort von Jean-Paul Sartre. Hg. vom IZRU (Informationszentrum Rote Volksuniversität). München, 1972.
Keywords
#Left_Wing
#History
#Germany
#Mental _ealth
#Capitalism
Written by Isa Bellum
Historian based in Indonesia/Music Lover/Dog Worshipper
