The War Machines of Madness

A Transversal Inquiry into The Sectored Psychiatry in Denmark

Peter Engelschmidt

Ph.D.-dissertation
Institute of Organisation and Industrial Sociology
Copenhagen Business School, June 2001
2
 Table of contents

Acknowledgements _____________________________________________________ 6
Dansk resumé __________________________________________________________ 7
Introduction ___________________________________________________________ 9
Humanism as Embracing ‘The Other‘___________________________________ 12
Tendencies on The Cutting Edge of Organisation Science __________________ 15
Towards a New Critical Approach ______________________________________ 17
Section 1 - The World as Becoming _______________________________________ 20
The Event The Domain of Singularities__________________________________ 20
Becoming ‘Other’ ____________________________________________________ 22
The Real Time of Becoming ___________________________________________ 24
Humanism and Social-Psychiatry_______________________________________ 28
Summary ___________________________________________________________ 31
Section 2 - The Geologists and The Cartographer____________________________ 33
Enunciation and Visibility _____________________________________________ 35
The Diagrammatic ___________________________________________________ 36
From Subject to Subjectification ________________________________________ 40
Summary ___________________________________________________________ 42
Section 3 - The New Pragmatist and The Schizo ____________________________ 44
Stratification ________________________________________________________ 44
Double Articulation __________________________________________________ 50
Regimes of Signs ____________________________________________________ 55
Assemblages ________________________________________________________ 61
The Welfare State ____________________________________________________ 65
The Inverted ‘Functionality’ of The State - Involution in Exchange for Evolution67
Countersignifying ____________________________________________________ 72
Example one: Malcolm X - Becoming Afro-American ______________________ 73
Example Two: Counter-Signifying and Madness __________________________ 75
Example three: ‘The Real Homelessness’ ________________________________ 77
Summary ___________________________________________________________ 79
Section 4 - The Schizo-Nomad ___________________________________________ 81

3
 Tendencies and Assemblages __________________________________________ 82
The Contribution of Schizoanalysis _____________________________________ 84
Transversality - Towards a Geopsychiatry ________________________________ 85
The Four Rhizomatic Components _____________________________________ 89
The Generative Component ___________________________________________ 90
The Transformational Component ______________________________________ 92
The Diagrammatic Component_________________________________________ 94
Section 5 - The Void of The Post-human ___________________________________ 97
The War-Machines of Madness ________________________________________ 97
The Schizo and The Post-Human _____________________________________ 101
The Dionysian and The Apollonian - Ariadne ____________________________ 103
The Madman Versus Oedipus ________________________________________ 105
Section 6 - Intervention as Folding _______________________________________ 108
Pure Becomings ____________________________________________________ 108
Counter-Signifying as Intervention_____________________________________ 110
Section 7 - The Becoming Citizen of The Patient ___________________________ 114
The Birth of The Asylum Revisited _____________________________________ 115
Decentralisation – Integrating Body and Soul ____________________________ 118
Anti-Psychiatry and The Sectorisation of Psychiatry ________________________ 121
Out-Patient Treatment - Co-ordination of Systems _________________________ 124
The Italian Experiment ______________________________________________ 134
From Patient to Citizen ______________________________________________ 138
The Generative Component __________________________________________ 150
The Seventies and Early Eighties_______________________________________ 153
The Mid-Eighties to Start Nineties _____________________________________ 156
The Transformational Component _____________________________________ 160
The Diagrammatic Component _______________________________________ 170
Section 8 - The Becoming Mad of The Citizen _____________________________ 177
Social-Psychiatric Experiments________________________________________ 179
The Collaborating Psychiatry in The Nineties ___________________________ 200
An Experience from County X ________________________________________ 205
The Generative Component __________________________________________ 210
The Transformational Component _____________________________________ 219
The Diagrammatic Component _______________________________________ 224
Section 9 - The Stratification of ’Madness’ _________________________________ 228
’Society of control’ __________________________________________________ 230

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 New Assemblages of Mad-Reterritorialisation ___________________________ 233
For ’Organising and Its Double’ _______________________________________ 243
‘An Organising of Organising’_________________________________________ 246
Concluding Interventionist Remarks _____________________________________ 247
Bibliography: ________________________________________________________ 255
Reports & journals ____________________________________________________ 264

5
 Acknowledgements

The author would like to thank the following persons, who have been a great
support during the last four years that I have been working on the present text:

First of all my family: my father for his enthusiasm and care, Nicolas, Philip and
Tina for their inspiration and patience.

Then I would like to thank my supervisors:

Chris Steyaert for his friendship and professional support, which has been an
indispensable part of the whole work-process and Asmund Born for his curios-
ity, dedication and sharp comments, which I have benefited a lot from in the last
ten years.

Also I would like to thank my friend Oleg Kofoed, who has been a great partner
of dialogue and an invaluable inspirer.

Moreover I thank Thorbjörn Meyer and my former colleagues from the DIA-
LOGOS group with whom I was working on an action research project aimed at
improving the quality of cross-professional relations in the Danish sectored psy-
chiatry. I have gained a lot of insight from this project and had my initial expe-
rience with organisation intervention.

Last but not least I would like to thank The Copenhagen Business School and
Institute of Organisation Industrial Sociology especially Niels Thygesen, who
has been a very patient listener and commentator. Moreover Flemming
Agersnap, who during the years have showed great interest in the progress of
the project.

Copenhagen, June 1st 2001

6
 Dansk resumé
Den foreliggende afhandling søger at udfordre de etablerede grænser indenfor
samfundsforskningen herunder særligt organisationssociologien. Afhandlingen
søger teoretisk at indkredse en ramme indenfor, hvilken organiseringsbegrebet
kan udvikles ved at introducere bevægelse som det grundlæggende omdrejnings-
punkt. Afhandlingen i tilslutning hertil at nærme sig en undersøgelsesmetode. I
den forstand er afhandlingen et forsøg på at udfordre organiseringsbegrebet in-
defra på dets egne præmisser, dvs. ved at det erkendes at vores 'organiserede liv'
er et grundlæggende vilkår midt i det sociale.

Positionen er, at en radikalisering af organiseringsbegrebet kan, når det kobles

sammen med en tilhørende undersøgelsesmetodik være et vigtigt frigørende
element i forhold til at udfordre, opløse og transformere positioner, som har re-
levans for samfundet i bred forstand.

Organisering som bevægelse opløser den i begrebet indeholdte formålslogik og

fokuserer på, hvordan organisering bliver en anledning til at udpege et udsnit af
det sociale og det heri altid indeholdte transformationspotentiale.

Afhandlingen betjener sig af empirisk materiale primært fra det danske psykiatri-
felt. Ved at bringe det radikaliserede organiseringsbegreb gennem en undersøgel-
ses metodik søges det at generere transformations potentiale. Udviklingsretorik-
ken som har omgærdet psykiatrifeltet i en årrække kan ses som en ekstrem case i
midten af det sociale. Psykiatrien med dens traditioner og samfundsmæssige for-
ankring kan ses at afspejle vigtige transformations tendenser i samfundet. Feltet
bliver derfor en vigtig og interessant indikator på det, der ofte bliver kaldt trans-
formationen fra velfærdsstat til velfærdssamfund. I den forbindelse beskæftiger
afhandlingen sig med perioden fra midten af halvfjerdserne indtil starten af det
ny årtusind.

Det specifikke genstandsfelt er svært at afgrænse, fordi afhandlingen betjener sig

af forskellige tilgange fra moderne filosofi og jura til organisationsteori og kul-

7
turstudier samtidig med, at den indarbejder en bred empirisk tilgang til psykiatri-
feltet.

Afhandlingen intenderer således først og fremmest, at være en flade eller konsi-

stensplan, hvor grænser er emergente og kun optræder i det øjeblik der anlægges
en særlig iagttagelsesvinkel. På denne måde starter og slutter afhandlingen i mid-
ten. Den tegner først og fremmest spor og tendenser, som kan agere holdepunk-
ter for transformation for både videnskab og praksis. Man kan således spørge til
teksten: virker den? hvordan? - hvad er effekten og konsekvenserne?

8
 Introduction
“We are not good at thinking movement… The human world that we find so immediately nec-
essary and self-evident is thereby unreflectively constituted in static and dichotomous terms
through an organising logic based on the principles of division, location, isolation and the eleva-
tion of self-identity”.
(Chia & King: in: Organisation 5/4 1998)

Over the past few decades developments within organisation science show ef-
forts of challenging a history where organisation issues have been addressed
within some obscure frame of the organisation as an entity. This history includes
a heritage of rational company mission oriented approaches through a tendency
since March and Simon’s early works in the fifties to have a softening towards
more ’loosely coupled agendas’. A recent survey of organisation science litera-
ture1 shows that these developments reflect a curiosity toward creating a disci-
pline that addresses organisational issues within ‘a broader frame’ with inspira-
tion from a lot of academic traditions. At the same time the empirical nature of
organisation studies of relating to the everyday (work) life of people shows ten-
dencies of becoming more ‘global’ or political including the development of so-
cietal values. As such you can discern organisation studies disciplines, which are
translated differently according to the empirical/societal context that they are
situated in e.g. the difference of focus between Scandinavian, US action-research
and the PAR movement in developing countries.

The theorising of the organisation as an open system and of actors as behaving

under bounded rationality and operating under uncertainty where organisation
and environment come together in a mutual contingent interchange, has opened
toward a questioning of the organisation as an entity, stirring up a lot of issues
formerly taken for granted or just excluded as irrelevant for the localising and
optimising of organisational decision making. Different approaches have sought
1This literature include first of all what is often referred to as post-modern appeoaches to organisation development and
organisational behaviour. This would include relational, discoursive or narrative approaches (Dian-Marie Hosking et al. ed.
1995: Czarniawska-Joerges 1999, Potter & Whetherell, 1994) see also Burrell, 1997.

9
to address these issues treating organisations as populations within organisa-
tional fields framed by institutions, which account for the taxonomy of these or-
ganisational populations2. Other approaches have viewed the organisation as the
cognitive frame establishing the context for organisational decision-making and
thus development (Weick and different socio-psychological approaches). In this
field of more descriptive approaches to organisation science, you see also more
soft normative approaches, which seek to embed a concern for the dynamics
and multiplicity of organisational reality3. These approaches are concerned with
treating the organisation as living potential, which should be cultivated in a con-
tinuous process. The claim is that this could be done first and foremost through
a process-oriented and non-stereotyping approach, which embeds a certain mix
of values based on bottom-up ideals (work-place democracy, co-determination
and empowerment) and methods rather than grand theories and elaborate top-
down technologies.

The present text aims at addressing these tendencies of 1) opening up the or-
ganisation challenging assumptions about actors, sense-making and environ-
ments and 2) the tendencies on the pragmatic/normative level to translate these
into certain values concerning organisational design, intervention and develop-
ment or what I will also term critical interventionist projects.

The specific aim is here to critically examine the consequences of these two ten-
dencies by focusing on how the notion of movement can enter the agenda, radical-
ising our conception of organisation change/development in general and inter-
vention in particular. My basic argument is that the exclusion of this meta-issue
of movement contributes to installing a false consciousness of social co-
determination, ethics democracy, humanity, liberty, emancipation etc. in devel-
opment contexts. At the same time organisation science on the theoretical level
becomes framed by a history of managerialism, even if an explicit agenda of es-
caping it, is attempted. This framing I claim is due to the above mentioned lack
of radicalisation.

2 W.R Scott & John W. Meyer, 1994: Powell & Dimaggio, 1991 see further developments in Czarniawska & Sevon
ed.:”Translating Organizational Change”. De Gruyter, 1996.
3 E.g. learning approaches : Argyris, 1996: Argyris & Schön: and action research: Gustavsen, 1992.

10
When I seek to address a broad agenda like this, it could be argued, that I im-
pose an artificial limit by using organisation studies as a nexus, when a radicalisa-
tion points in directions, which in many ways do not appear to link themselves
to the representations of organisation science. My point is here that the tradition
of organisation studies generically is a function helping us to understand and
orient our actions, with, as mentioned, growing tendencies to embed the values
of broader society into its ‘toolbox’. The study of organising thus becomes the
study of the technologies that we use to make ourselves manageable lives. In line
with the globalising ‘visions’, the cutting edge of the scientific field should be
created through interpenetrations from a meta-point of view rather than work-
ing borders from inside established boundaries of organisation science disci-
plines. By saying ‘meta’ I do not mean to install a higher principle, but rather to
create a way of thinking that challenges the taken for granted nature of catego-
ries and practices.

Accordingly my approach will be one of addressing this very heterogeneous

scientific field by taking a pragmatic approach to the field of study addressed
from ‘an organising as movement’ perspective. That is a perspective where the
split between observer and the observed is challenged in its basic principle
installing the mutual constituency of observer-observed. Accordingly I will
attempt to take a non-disciplinary approach, where the meta-issue of movement
or change is the active core focus.

Both descriptive and normative agendas emphasise the temporary character of

organisational life, but seem not to ask themselves how they can think process
within a frame, which is basically structural (or based on referents to state of af-
fairs) in its theories and methods.

It can thus be argued that creation of new objects of study under varying labels
(work-place democracy, ethics, multiplicity, learning) have been the main feature
of the trends rather than they have engaged with radical new ways of conceiving
change. This lack, I claim, accounts for the blurred character of the field of or-

11
ganisation change and development, where to paraphrase Bergson you encoun-
ter too many false problems, that is non-existent problems (a confusion of the
more and the less) and badly stated questions (because their terms represent
badly analysed composites)4. An example is the tendency of developing concepts
and methods embedding a taken for granted conception of time and space,
blinding out movement in itself (see further below).

Projects of embracing ‘The Other’5 or making Otherness speak for itself, which
can be seen to be the ultimate aim in addressing organising issues as emerging
processes, will be futile without a radical new way of conceiving of change and
organisational issues if they cannot situate this project on the cutting edge of
these existing paradigms. Thus addressing how something new emerges is a
critical project extending itself into the core of broader societal values, thus
penetrating deeply into humans' everyday lives, which cannot be contained by
elaborate theories and methods.

The consequence is that we first of all should abandon grand theories in organi-
sation science. This is not a new claim, however instead of introducing a frag-
mentary 'bricolage' for the purpose at hand, we should rather focus on practices
or rather on how abstraction and practice communicate in a dynamic way – that
is the core of ‘organising as movement’.

Humanism as Embracing ‘The Other‘

The risk is present that ‘humanism’, which it can be said to relate to the preten-
sions of embracing ‘The Other’, becomes as much a stereotype as the one it
wants to challenge, when the object of the human is reduced to emerge within
the discursive frame of a taken for granted dominant reality. The failure thus to
connect the past with a future in the making, results from the trap of representa-

4 Deleuze, Gilles: Bergsonism. 1997, p. 17. Zone Books. New York

5This project, it will later be claimed, is bounded by an timely/spatial insensitivity or a ’logic of the one’ where an integra-
ted self is based on a straight forward relation with things positioned according to causal laws. In opposition, the logic of
’Otherness’ and the becoming belongs to the tension between possible worlds not realised and the actual-real. In this way
the one or the self (what Buber called ´the world as experience’ based on the basic phrase I-the one) belongs to a past
time. In this sense it is dependent on the discursive, the reference of propositions, which forms a relationship with a state
of affairs. In the same way D&G argued that philosophy is not discursive, but belongs to the event or the becoming,
where the idea of self as being in the world has to be abandoned benefiting our becoming with the world, a play with the
interstices between the possible-actual and the actual-real the relation with the impersonal. (see further in the following).

12
tion – the established categories of yesterday, which program both the scientific
agendas of theories and methods and those agendas that science wants to ad-
dress empirically. In line with this statement, it could very well be argued that
science cannot lend itself to a satisfaction with continuity, rather it must include
discontinuity as a basic premise to keep up its critical and provocative potential.
Maurice Blanchot posed this problem beautifully:

“How can one speak so that speech is essentially plural? How can the search for plural speech be affirmed, a
speech no longer founded on equality and inequality, no longer upon predominance and subordination, nor upon
reciprocal mutuality, but upon dissymmetry and irreversibility, so that between two instances of speech, a relation of
infinity would always be involved as the movement of signification itself? Or, again, how can one write in such a
way that the continuity of the movement of writing might let interruption as meaning, and rupture as form, inter-
vene fundamentally?”
(Maurice Blanchot: The Infinite Conversation, 1997 (1969) p. 8).

My argument is that studies within organisation change and development will

not be able to escape functionalism and representation in their strive to intro-
duce ‘a global’ (and political) agenda, if they cannot include a radical way of
thinking and performing movement. To paraphrase Blanchot, this would take a
radical road towards a research, which makes the murmur of a living potential,
not realised, be a plural speech, which can intervene in the research agenda in a
creative way. This writing or research thus should surface as a disjunctive syn-
thesis, a continuous movement in writing, avoiding codes of settled people.

The strife towards globalisation and to include the flows of societal discourses,
political and emancipatory projects, consequently should entail a meta-
theoretical and a meta-methodological examination. If we still want to argue that
organising situates itself in the middle of a human practice of orientation and di-
rection, with the over-coding of capitalism as the primary force, we must still
question how this force affects these choices of orientation and direction. This
should be done rather than just succumbing to the technologies issued by these
forces, which will be the case when the organisation as an entity is given up
without establishing conceptual and methodological devices, which manage to
embrace the radicalising pretensions included in these visions.

13
To put it very bluntly, organisation development science runs the risk of being
bare ad hoc tools rather than a critical science. As such it will not be able to have
a critical voice of its own, but only serve as a subtle helping device for the tools
of the protagonists of a dominant reality. It runs the risk of being trapped in the
imaginary, preventing it from creating a disruptive critical voice inside a domi-
nant reality. My argument is that organisation studies should seek inspiration in
other traditions e.g. philosophy, cultural studies, literary theory etc. However it
should not just escape it's focus all together, the challenge is still to maintain
enough of the tradition to be able to pull and stretch its thinking.

As I have already argued when I introduced this text, it seems important to ad-
dress the trustworthiness of practices and technologies, which surround us in-
stalling change in our everyday organisational lives. These technologies and prac-
tices are often applied to create the picture of fields of openness and possibili-
ties, where experiments and innovation thrive and identities have the possibili-
ties to create themselves in an environment of suspension. This, however,
should be where the most alertness should be exerted towards over-codings and
dominations.

When we use the globalised approach to organising, attempts to intervene and

change things in organisational settings become an issue of everyday life, and not
just an issue of a company mission. In this sense, change discourses affect the
reality from where we can extract the voice that we come to call our own - in
other words how we can work with creating our individual lives. It so to say
gives our everyday orders and directions as how to orient our selves. This obser-
vation suggests that we have an important project in mapping out how this
change discourse creates points of disappearance, that is points that hide issues
from being addressed by our everyday language, (which will include mainstream
organisational discourse).

These mappings or points of subjectification operating within these develop-

ment discourses, should be the first indication of how to go beyond and create a

14
new agenda of movement. As it will be shown, these points in this sense also
contain the possibility for transformation. Below I will present some of these in-
dications.

Tendencies on The Cutting Edge of Organisation Science

We clearly have a problem of tackling power and time when you open up the
organisation with global intentions6 and want to work with emerging flows of
meaning rather than with management tools and calculable futures.

In this way it could very well be argued, that what we need is a tougher game
and that this game should be revolving around two themes: a meta-
theoretical/ethical addressing change or the time/space problem and a meta-
methodological including strategies of analysis. The ethical theme is apparent
and already described as the one of freeing the individual, human subject from
managerial forces by opening up the organisation to become a nexus of societal
issues of identity creation rather than a functional unit to serve some purpose of
a managerial elite. This is the emphasis in what I will call post-modern ap-
proaches to organisation behaviour (OB).

The emphasis of the second theme is the one of dynamics and how this should
be accomplished by developing action methods for resisting managerial over-
coding. A lot of inspiration has been drawn from discourse analysis, where de-
construction of practices is assumed to contain the key to challenging these
over-coding power-games by way of reframing7. As such, deconstruction of dif-
ferent practices and technologies is argued to produce critical inquiries as the or-
ganisation is conceived as a flow or a nexus of sensemaking, which has to be
protected from illegitimate intervention. Other methods are established on more
strict pragmatic grounds like in different action-learning and action-research ap-
proaches.

6 Chia & King in: Organisation 5/4 1998.

7 Townley, Barbara : Reframing Human Resource Management : Power, Ethics and The Subject at Work. SAGE. London, 1994.

15
As later will be shown, these kinds of discourse analytic/de-constructively in-
formed approaches loose their chance of intervening and questioning essences.
As such, they have a message when it comes to commenting upon texts, but
they do not say how a textual corpus becomes prolonged as a living potential.
Rather, from an intervention point of view, they are stuck with a stereotyping
projection of the past into the future. At its best, this approach can only analyse
what we have been and not what we become.

In other, especially learning approaches, change or development becomes de-

fined by the mere ability to accomplish this protection or invigoration of organi-
sation potential without being aware of the functioning of (discursive) technolo-
gies. Hence what disappears, are the privileged positions at work, the invisible
games of persuasion, which endow people with a sense of identity.

The adoption of organisational ethics and other process oriented approaches

aims at de-essentialising identities. In this line of thought (e.g. Harlene Ander-
son8 and other relational approaches e.g. authors within social-constructionism9),
the movement aspect or the ongoing construction of identities seems to be the
primary concern. These approaches though do not seem radical enough and
seem to be stuck with a transference, which is not vehicular, that is, they cannot
be put to work in the everyday social contexts outside the therapy room. This
observation also applies to a lot of learning literature10.

The application of the concept of “change” seems in these cases to be stuck

within a closed approach, thus creating a state of entrenchment, trapping these
contributions to organising. To contrast this marginalisation of change and dif-
ference, I infer the notion of difference and time in-itself or what you can also
term the real time of becoming (‘la durée’) - where things penetrate each other.

8 Anderson, Harlene: Conversation, Language, and Possibilities. A Postmodern Approach to Therapy. BasicBooks. New
York, 1997.
9 Burr, Vivien: An introduction to Social Constructionism. Routledge, London og New York. 1995. See also Hosking,

Dian-Marie et alt. (ed.): Management and Organisation: Relational Alternatives to Individualism. Aldershot. Ashgate,
1995.
10 See e.g:. Argyris, Chris: On Organizational Learning. Blackwell, Cambridge 1992.

Argyris, C og Schön Donald: Organizational Learning II - Theory, Method, and Practice. 1996 and Schein, E.H: On Dia-
logue, Culture, and Organizational Learning. in: Organizational Dynamics. special issue on organizational learning. 1993.

16
A survey of the above contributions shows that they all have a concern for the
issues of development or change through group process in predefined spaces
and through comparisons of states of affairs over time. Change or difference
becomes of concern on more levels: a personal change level, a social group
change level and a community change level. However, there seems to be a ten-
dency to either over emphasise an evaluation aspect or just to veil the actual
privileged positions at work over time.

Towards a New Critical Approach

“Representation allows the world of difference to escape....”11.

The tendency of the above mentioned approaches not explicitly to address these
questions must be argued to stem from a certain human propensity tied to the
logic of the organon, which inhabits western logocentric metaphysics12.

During the last decade a tendency of showing interest in the isufficiency of cur-
rent approaches to 'the transitory world of organising'. Authors working from
within network theory e.g. Nohria & Eccles13 and organisation theory e.g.
Shafritz & Ott have all pointed towards the fact that organising is an activity im-
pregnated with unpredictability, contingency and complexity:
"Organisational processes are (like fires) elusive. They are hard to measure and even harder to
document in terms of their ultimate impact on the organisation"14.

A clear dilemma is seen between these conditions and the inherent logic of
measurement and rationality inherent in the term 'organising'.

11 See also Foucault, Michel: The Order of Things - An Archaeology of The Human Sciences. Vintage. New York, 1994

p.79. As Foucault also pointed at in the conclusion of “The order of things” man has only had the ability of existing in
the interstices of language, where a discursive unity has been in a state of break up, in the last hundred and fifty years
represented by the objectivating language of modernity. At the same time he points at the possibility of this language
closing on itself, making man disappear into oblivion.
12 As stated by Chia & I. W King (in: Organisation 5/4 1998):

“We are not good at thinking movement……….. The human world that we find so immediately necessary and self-evident is thereby unreflec-
tively constituted in static and dichotomous terms through an organizing logic based on the principles of division, location, isolation and the ele-
vation of self-identity”.
13 Nohria, Nitin & Robert Eccles (ed.): Networks and Organisations: structure Form and Action. Boston. Harv. Busines School

Press, 1992.
14 Shafritz in Shafritz & Ott: Classics of Organization Theory. Fort Worth. Harcount Brace College Publ. 1996

17
I earlier pointed at the problematic linked to the notion of la durée or the rela-
tion of our movement as beings, which must relate to the durée of things rather
than succumbing to what Whitehead and Chia15 term simple location16. To re-
place this ontology and the metaphysics of substance, Chia suggests a metaphys-
ics of process based primarily on the writings of Whitehead and Bergson. It is
one thing, however, to consider this ontological act and replace it with another
ontology, but it is another to maintain enough of the tradition of ‘simple loca-
tion’ to turn it against itself. I will refer to this as the challenge of creating a sub-
versive mode of reterritorialising organisation theory and practice. That is to in-
sist to do social-science in the empirical tradition, however with the application
of ‘methods’ that are based on a relation of co-existence rather than one of co-
incidence, and on a strategy which relates our existence in time (our durée) with
the one of things. I will also refer to this as the nomadic strategy of creation.

Our intelligence comes to take off from the immobility of things and thus seeks
to reconstruct movement by juxtaposing immobilities17. The argument is here
that texts concerned with change, continuity/discontinuity in organisation sci-
ence loose any legitimacy of interventional acts as long as they deal with dead
(non-folding) sediments rather than with the living potentials – continuous fold-
ing.

“.... Organizational outcome or ‘effect’ always already incorporates and hence implicates the
‘weight’ or ‘traces’ of its genealogical past which in turn, creates potentialities for the future as
well as constrains it”18.

Organising as movement takes an abstraction of humanly imposed forms to go

beyond this threshold of comparison of outcomes as ‘synchronic slices’ and rei-
fications of the past. It invites you to think of your claims or analyses not as

15 Robert Chia: In : Organization 5/3 1998: From complexity Science to Complex Thinking: Organization as Simple Location.
16 Simple location can be said to link to organisation:
“As an ontological act of: arresting, stabilising and simplifying what would otherwise be the irreducible dynamic and complex character of lived
experience. Organization is an inherently simplifying mechanism and the idea of complex organization(s) is in effect an oxymoron” (p.362).
17 “Intelligence therefore cuts out of the (virtual) whole – out of a becoming – a thing and makes of this thing a substitute for the whole”

(Ansell Pearson: Germinal Life, 1999).

18 Robert Chia & Ian W. King in Organization 5/4 1998 p. 470

18
grounded in a reification of historical practices, but as an ongoing creation of
multiplicities or what will later be referred to as continuous folding.

Existence as a work of art as Foucault would call it, stresses the temporary
character and the impersonal and subtle forces, which we face as we ‘act’19. We
never know what we do until we start to do, ‘knowing’ not in the sense of giving
meaning according to some established regime, but rather in the sense of crea-
tion as an embodied experience, which appears to us as we immerse ourselves in
the game of signs. This is not a game of interpreting and signifying, but of de-
territorialisation and reterritorialisation of the sign. Such displacements are the
signs or the sign-potential. Resistance appears from this immanent potential,
rather than from imagined (transcendent) positions outside the plane. Transcen-
dence and the possibility of shift of planes must appear from immanence, from
blocking of infinite speeds, from a becoming minor within the major, a stopping
of the world:

“........ [S]emiotise yourself instead of rooting around in your prefab childhood and Western
semiology”. Don Juan stated that in order to arrive at seeing one first had to stop the world -
the endless streams of signifying and interpreting"20.

The following section is an introduction to the general position of this body

of text. A more specific outline including the empirical focus of the text will
be presented at the end of section 1.

19 We have to create a sensitivity to the preliminarity of life: as Deleuze says:

”I’m not so concerned with being misinterpreted, I just go along with something else with people working in the same direction” (in: Negotia-
tions,1990).
20 Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone. London, 1988. p. 139.

19
 Section 1 - The World as Becoming
“We are not in the world, we become with the world”
(Deleuze & Guattari: in: What Is Philosophy? p. 169)

The following should be considered what you might call a rough guide to the
thought of the becoming and thus to the general line of thought running
through the present body of text. Hopefully it should create a frame for the later
development of a more specific framework as well as it should establish a first
connection to the transformation of Danish psychiatry, which is the empirical
focus of the present study.

The Event21 The Domain of Singularities

As already indicated the attempt to address the issue of organising as movement
dives into a whole body of history of philosophy concerned with the conception
of time and space from Heraclitus to Heidegger. However for the present pur-
pose I will present some of the most radical contributions brought about by
Gilles Deleuze, Felix Guattari, Deleuze & Guattari and Henri Bergson. The ba-
sic reason for this choice is that you here encounter a whole frame preoccupied
with thinking and performing movement.

I have mentioned the idea of the past being immanent in the present as a trace,
however not just traceable, but rather as a map. It is this argumentation of time
as geographical rather than historical, which I will pursue below. It will be a first
step on a ladder taking us beyond representation and the discursive, embedding
sensitivity towards a-signifying potentials.
Gilles Deleuze and Deleuze & Guattari are the primary inspiration for the pre-
sent project’s exploration of the becoming thought. The Rhizomic and the
Schizoanalytic, which are core concepts penetrating their projects, are like the

21”In every event there are many heterogeneous, always simultaneous components, since each of them is a meanwhile that makes them communi-
cate through zones of indiscernability: they are variations, modulations, intermezzi, singularities of a new infinite order. Each component of the
event is actualised or effectuated in an instant, and the event in the time that passes between these instants: but nothing happens within the vir-
tuality that has only mean-whiles as components and an event as composite becoming. Nothing happens there, but everything becomes , so that
the event has the privilege of beginning again when time is past” Deleuze, G & Felix Guattari: What Is Philosophy? p. 158, 1993.
Verso. London..

20
Nietzschean ‘Will To Power’, Bergsons ‘Elan Vital’ and Blanchot´s ‘neutral nar-
rative voice’, attempts to seek out life as an inorganic, non-individual force. This
force is referred to in some of the last Deleuze wrote as: A life22, a pure virtual-
ity, which is much different from its actualisation in individuals. This vitality or
life is one of the most essential things for Deleuze stressing the power of the
non-organic. The organic or the body as organism ties life to forms and subjects,
identities, which are actualised in individuals inscribed in historical milieus. This
limitation forms the imposed transcendent criteria, the representational frame of
the organic body, which directs how we can extract an identity as a subject. This
establishes the trap of continuity and history as dead sediment.

This isolation of life as a force stripped of forms, between life and death, is a
pure singularity freed from the subjectivity and objectivity of what happens. It is
not an individuation, but singularisation: a life of pure immanence, neutral be-
yond good and evil. A life thus goes beyond any lived experience, which belongs
to the reality of things and past times.

In ‘the critical an clinical project’ of Deleuze, this life is related to literature as a

passage of life that is traversing both the lived and the liveable23. Deleuze talks
about literature liberating the virtual, where new conditions of narration are re-
ferred to as (The Time Image: The Powers of The False) replacing a formal logic
of actual predicates with a ‘properly logic of pure singularities’. Under these
conditions, singularities can be connected to infinity, creating a multiplicity,
which is also referred to as ‘the rhizome’. This inexhaustible reserve makes it
possible for these singularities to enter into communication creating still new
multiplicities. This implies that the status of the individual goes from monad to
nomad. The individual becomes part of assemblages, which make every voice
that he extracts and calls his own, only a partial one, which is never exhausted.
The individual as such will remain a stranger to himself (a partial subject of
enunciation)24. In this sense we talk of collective assemblages, however not as
specified according to a group of individuals. Rather, the notion ‘collective’: “…
22 Deleuze, Gilles: Immanence: A life... in: Culture and Society vol. 14 no. 2, may 1997.
23 Deleuze, Gilles: Essays Critical and Clinical, cpt. 1. Verso. London, 1998.
24 “Instead of a certain number of predicates being excluded by a thing by virtue of the identity of its concept, each ‘thing’ is open to the infinity

of singularities through which it passes, and at the same time it looses its centre, that is to say, its identity as a concept and as a self”Ibid..

21
subsumes on one hand elements of human intersubjectivity on the other pre-personal, sensitive
and cognitive modules, micro-social processes and elements of the social imaginary”25.

What is in play is the conceptual quartet of the virtual, the actual, the possible
and the real, which is narrowly related to the philosophy of the event and which
serves as an important building block for understanding the world as becoming.
These concepts were first dealt with in Deleuze's two books ’The Logic of
Sense’ and ’The Fold: Leibniz and The Baroque’.

The real time of becoming is as indicated connected to the event or the virtual-
singularity event. The virtual is the domain of singularities, an inexhaustible re-
serve of infinities. It is also referred to as anteriority that is ‘before’ predicates.
These infinities can be realised in matter or in bodies in that sense they are ‘real’.
However we see an expressed in real language (given predicates) that belongs to
the possible, which is still actual, but not real (or as it is said not yet). As initially
formulated by Leibniz: the world has actuality only in monads, which conveys it
from its own points of view and on its own surface. We actualise ourselves in
the received forms of everyday language, it can be experienced directly, in that
sense we are real. There will always be infinity of possible worlds, actualised in
the monads conveying them. These possible worlds are termed compossible
worlds26.

Becoming ‘Other’
In this world of becoming we have to give up any stereotyped imaginations of
an acting subject given certain dispositions and identities in the world. On the
contrary, becoming is a becoming with the world. A subject will always be partial
in the sense that it supports a life as an infinite force. A subject will be partial as
it occupies positions, which are both actual and actual-real27.

25 See Felix Guattari: Chaosmosis – An Ethico-Aesthetic Paradigm. P. 70. Power Publications. Sydney. 1995 (1992).
26 Deleuze gives the example that the world actualised by Adam the sinner will have another possible world actualised by
Adam the non-sinner. As Deleuze mentions in: The Fold - Leibniz and The Baroque. Athlone. London, 1993.
Leibniz and The Baroque:
”Therefore there exist an actual that remains possible, and that is not forcibly real. The actual does not constitute the real: it must itself be rea-
lised, and the problem of the worlds realisation is added to that of its actualisation”. ”The world is a virtuality that is actualised monads or
souls, but also a possibility that must realised in matter or in bodies”. (in : Leibniz and The Baroque, p. 104).
27 ”The individuation of a life is not the same as the individuation of a subject

22
In Deleuzes critical and clinical project, this becoming is described as attached to
certain qualities associated with writing and literature. Writing is a way of creat-
ing multiplicities through certain qualities, which he terms affects and percepts.
These are not tied to perceptions or affections of a subject, but are the raw ma-
terial from where to create multiplicities. These are created from the synthesis of
singularities: of a life or a wind or a flower, they are all assemblages of non-
subjectified affects and percepts that enter into virtual conjunction. That is what
makes Deleuze and Guattari say:

”We are not in the world, we become with the world”28.

Above (see also footnote) the distinction was made between chronological time
(Chronos) and the real time of becoming (Aeon). The becoming embeds the
principle of a keeping in suspension of something between two terms. One term
doesn´t become the other, but the becoming is outside to them both. The be-
coming thus is a map or an assemblage e.g. the bee-flower assemblage, or the
example given by Deleuze & Guattari the becoming whale of Captain Ahab in
Moby Dick.

The becoming in this sense is also what Deleuze identifies with pure affect or
pure percept, which is irreducible to affections and perceptions of a subject as it
is pure singularities, which cannot be defined by predicates. They are thus for-
mulated linguistically: indeterminate, pure infinitives as they are not actualised in
determinate modes, tenses, persons, and voices29. The talk is thus of a virtual-
singularity-event, which is actualised in the predicates of expressive monads30.

that leads it or serves as its support. A ”life” is constructed on an immanent plane of consistency, that knows only relation between affects and
percepts, and whose composition, through the creation of block of sensation, takes place in the indefinite and virtual time of the pure event
(Aeon). A ”subject” is constructed on a transcendent plane of organisation that already involves the development of forms, organs, and func-
tions, and takes place in measured and actualised time (Chronos)”.
28 Deleuze, G & Felix Guattari: What Is Philosophy? p. 169. 1993. Verso. London.
29 Deleuze, Gilles: Essays Critical and Clinical, p. xxv. Verso. London, 1998.
30 “Let us proceed in a summary fashion : we will consider a field of experience taken as a real world no longer in relation to a self but to a

simple “there is”. There is, at some moment, a calm and restful world. Suddenly a frightened face looms up that looks at something out of the
field. The other person appears here as neither subject nor object but as something that is very different: a possible world, the possibility of a
frightening world. This possible world is not real, or not yet, but it exists nonetheless: it is an expressed that exist only in its expression-the
face, or an equivalent of the face. To begin with the other person is this existence of a possible world” Deleuze, G & Felix Guattari: What Is
Philosophy? P.17 1993. Verso. London.
“The other is a possible world as it exist in a face that expresses it and takes shape in a language that gives it reality. In this sense it is a
concept with three inseparable components: possible world, existing face and real language or speech”Ibid.

23
The Real Time of Becoming
Analytics in the nomadic sense must here be considered as a generative31 activity
in opposition to ex post reflection or as Bergson commented: analysis is a sym-
bolic and representative embedded activity32. Rather “difference in itself” cannot
be fixed, but only unchained and put into the free flow of a textual composi-
tion33, this composition should not be restrained by any form, rather it should be
acknowledged that it will feature as a demonstration, a vitalisation of forbidden
metaphors, a subversive current - pure tension. In this sense such a composition
is creation as a nomadic strategy of which it could be said:

It should step into the dead time of becoming: embrace language as the political and on the
threshold sense the rhythms, glimpse the strokes of light - ‘The Other’ or ‘difference-in-itself’,
which greet us through a ‘zone of indiscernability’, the zone where forms of expression and
forms of content spill into each other.

To stress the theme I introduce the basic distinctions made by Bergson about
difference namely difference in kind and difference in degree. Difference in de-
gree is spatial and represents the basic human mode of thinking and framing ac-
tion34.

According to Deleuze, difference in degree is a question of common sense,

whereas difference-in-itself (difference in kind) cannot be captured by good
sense as it belongs to the virtual (and not the actual)35.

31 D&G refer in this regard to the components as generative Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone. Lon-

don, 1988. p.146).

32 See Bergson, Henri: An Introduction to Metaphysics. Hackett. Indianapolis, 1999.
33 This should however be done under the caution that:

“ You have to keep enough of the organism for it to reform each dawn: and you have to keep small supplies of significance and subjectification
if only to turn them against their own systems, when the circumstances demand it, when things, persons, even situations force you to: and you
have to keep small rations of subjectivity in sufficient quantity to enable you to respond to the dominant reality“Deleuze, G & Felix Guat-
tari: A Thousand Plateaus. Athlone. London, 1988. p. 160.
34 “ ...it is a multiplicity of exteriority, simultaneity, of juxtaposition, of order, of quantitative differentiation. It is a numerical multiplicity,

discontinuous and actual.

The other [difference in kind] appears in pure duration: It is an internal multiplicity of succession, of fusion, of organisa-
tion, of heterogeneity, of qualitative discrimination, or of difference in kind: it is a virtual and continuous multiplicity that
cannot be reduced to numbers” Deleuze, Gilles: Bergsonism. 1997. Zone Books. New York
35 Deleuze articulates relying on Bergson the distinction between the actual and the virtual as the distinction between

time and space:

“Everything is actual in a numerical multiplicity: everything is not realised, but everything there is actual..... On the other hand, a non numeri-
cal multiplicity by which duration or subjectivity is defined, plunges into another dimension, which is no longer spatial and is purely temporal, it
moves from the virtual to its actualisation, it actualises itself by creating lines differentiation that corresponds to its difference in kind”. (De-
leuze, Gilles: Bergsonism. 1997. Zone Books. New York

24
For Bergson, time has traditionally been conceived of in terms of space and not
as time in itself. Consequently time has been seen as spatially distributed arrays
of events. Deleuze's point was that the Bergsonian work could lead to an under-
standing of the reality of the virtual and thus the immanence of difference36.

Now where does this leave us in relation to the discursive practices of current
organisation science. As mentioned by Bergson, time has traditionally been con-
ceived in spatial terms, leaving little room for conceiving of time-in-itself. This
of course must be seen in conjunction with the roots, “the telos” of organising,
adjusted to capitalist needs of accountability. Constructs of time and space are
made according to immediate corporate needs of legitimacy. As such the com-
pany can emerge as an entity and all kinds of management tools can be fitted to
these basic constructs. If change is seen as a shift in compilation of basic ele-
ments, space indicates states of this compilation rather than the movement be-
tween states of different compilations. Space thus is that shape, which makes us

p.43).
36 May, Todd: Reconsidering Difference, p. 187, 1997. Columbia. New York.
For Bergson past and present is linked by memory in two ways 1) by psychological memory and 2) by ontological memo-
ry. The psychological memory is the conscious recollection of past events. When we remember this event we locate it in
a double context: first in the context in which it took place and second, the context of the entirety of our lived past,
which forms the framework of both the memory and the remembering. This larger past forms the context in which the
psychological memory takes place. This memory inscribes our constitution as temporal beings and as such it is ontologi-
cal rather than psychological.
Bergson see it as one past time where different participants participate from different perspectives. This pure recollection
exist in the mode of the virtual. It has no psychological existence and as such it is virtual, inactive, (unconscious).
To better grasp the implications of the actual/virtual distinction the Bergsonian view of the ontological past as contrac-
tion or relaxation should be payed attention to:
Bergson uses to illustrate his point the cone. The contracted extreme of the cone denoting the present and the other
parts denoting the past, the more relaxed, the more remote the past. In all parts or sections of the cone the past is pre-
sent in a more or less condensed form. In a cross-section of the cone what you find according to Deleuze is the exis-
tence of the past, in the shape of difference-in-itself or difference in kind (May, 1997 p. 189). The crucial point is here
that it cannot be identity that exists as past because that would imply inferring transcendence, that is some fixed principle
according to which you could claim this identity as a derivative.
Now going back to the distinction between the virtual and the actual, the actual as the present and the virtual as the past.
Both being real, but as actual and as virtual. The present then like each sections of the past containing all of the past just
in a more contracted state.
When the past is seen as always present in the present, what is then the distinction between past and present? According
to Deleuze the present is the actualisation of the virtual: it is bringing to the present what exists in time. In that way
bringing to the present is spatial, while time is linked to the past. In that sense we can experience directly what is actual-
ized, but not what is virtual.
Deleuze marks out the ontological difference between the virtual and the actual. He uses the term ‘existence’ for what is
actual and ‘insistence’ or ‘subsistence’ for what is virtual. If existence here is construed narrowly you can argue that what
Deleuze is saying is that the real comprises both existence, insistence and subsistence, that is both the actual and the vir-
tual. In this way the actual contains both identities and differences of degree, while the virtual contains the differences in
kind, that form the ground of those identities and differences of degree. “Being, then, is difference, difference-in-itself,
which exists virtually in time and actually in space” (May, 1997, p. 190).
Now what is forming identity or difference-in-itself is time, time becomes the unity working on what Deleuze refers to as
a plane of immanence. Time appears here in two ways. One where time is described as a whole, which constitutes a
plane on which difference is inscribed. A second where he conceives of each cross section of the cone of time as one
plane of immanence. Difference exists, insists, subsists on each of them, but each has its own unity.

25
see these compilations. What is in focus here, are the results of change rather
than the shift from one state to another.

In the same way time can be seen as the container where objects are situated
shifting location, if time is considered as the place where change takes place.
Time becomes the unchanging foundation and as such different from change,
and an exact parallel to space: a stable container of elements. As such no differ-
ence between time and space can be discerned.

This view makes change ungraspable, as the shift from one event to another
doesn’t concern this time. This view can from a pragmatic point of view seem
useful when you describe the result of change, when something occurred, how-
ever this marginal concern of time-in-itself traps us in a managerial deadlock.

D&G argued that philosophy is not discursive37, but belongs to the event or the
becoming. The idea of the self as being in the world has to be abandoned bene-
fiting our becoming with the world, a play of the impersonal in the interstices
between the possible-actual-virtual-real. In the same way, you could infer that
organising as a ‘globalised’ and critical project must be immanence abandoning
transcendent criteria installed by received forms, which can only accomplish a
pseudo-dynamics of propositions (creation of objects), words (signifieds) and
phrases (stereotyped subjects).

Organising as movement is immanent to itself38. Consequently everything has to

be read from this immanence, where a breach can occur when the infinite
speeds momentarily are stopped allowing transcendence to enter39. Rather than

37 Deleuze, G & Felix Guattari: What Is Philosophy? 17ff.1993. Verso. London.

38 “The plane of immanence is not a concept that is or can be thought, but rather the image of thought, the image thought gives itself of what it
means to think, to make use of thought, to find ones bearings in thought. It is not a method, since every method is concerned with concepts and
presupposes such an image. Neither is it a state of knowledge on the brain and its functioning, since thought here is not related to the slow
brain as to the scientifically determinable state of affairs in which, what ever its use and orientation, thought is only brought about. Nor is it
opinions held about thought, about its forms, ends, means at a particular moment. The image of thought implies a strict relation between fact
and right: what pertains to thought as such must be distinguished from contingent features of the brain or historical opinions. Quid Juris?- can,
for example losing ones memory or being mad belong to thought as such, or are they only contingent features of the brain, that should be consid-
ered as simple facts? Are contemplating, reflecting, or communicating anything more than opinions held about thought at a particular time and
in a particular civilisation? The image of thought retains only what thought can claim by right. Thought demands “only” movements that can
be carried to infinity. What thought claims by right, what it selects, is infinite movement or the movement of the infinite. It is this that consti-
tutes the image of thought” Deleuze, G & Felix Guattari: What Is Philosophy? P. 37 1993. Verso. London.

39 Deleuze, G & Felix Guattari: What Is Philosophy? (WP) 1993. Verso. London.( P. 47)“Infinite speed has no reference to the

26
installing a received reality and programming it into management and develop-
ment tools, this organising endorses the creative potential inherent in the non-
discursive and non-illusionary. The meeting with the forces of the impersonal,
the emerging Otherness is thus a challenge of concepts which are taken for uni-
versals (one of reflection, one of contemplation and one of communication)40.

The concept is not propositions, which are defined by their reference and their
relationship with state of affairs and their conditions. In this sense, propositions
are said to be pure extensional41. The creation of concepts is what escapes illu-
sions and installs immanence42, consequently philosophy must be the creation of
concepts escaping the three phantoms, which draw immanence towards the
transcendent and the discursive. In the same way organising as movement must
not satisfy itself with the received reality installed by the propositional character
of the discursive. Internal lack installs ultimate goals of organising (like), higher
transcendence installs the idea of a meta-level of abstraction from where a
deeper truth can be obtained, as an imaginary exteriority finally installs the (false)
picture of novelty (which contains an interiority linked to substance or a subject
like e.g. minorities at the workplace, empowerment thinking in OD).

The impersonal always side-steps the fixation of the present and erases the rec-
ognisable traits of the face. The face is expression and belongs to the possible,
whereas the impersonal belongs to the virtual. In fact, Deleuze mentions in cin-

movement of successive positions of objects according to objective reference points. Movement takes in everything, and there is no place for a sub-
ject or an object that can only be concepts. It is the horizon itself that is in movement: the relative horizon recedes when the subject advances, but
on the plane of immanence we are already on the absolute horizon. Infinite movement is defined by coming and going, because it does not ad-
vance toward a destination without already turning back on itself, the needle also being the pole. If turning toward is the movement of thought
toward truth, how could truth not also turn toward thought? And how could truth itself not turn away from thought when thought turns away
from it?” (WP, p.38)

40 “ A triple illusion one of contemplation, one of reflection and one of communication. Then there is the illusion of the eternal when it is forgot-

ten that concepts must be created, and then the illusion of discursiveness, when propositions are confused with concepts. It would be wrong to
think that these illusions logically entail each other like propositions, but they resonate or re-vertebrate and form a thick fog around the plane
[of immanence]”. WP, p. 49-50.
41 “They imply operations by which abscissas or successive linearisations are formed that force intensive ordinates into spatio-temporal and ener-

getic co-ordinates, by which the sets so determined are made to correspond to each other. These successions and correspondences define discursive-
ness in extensive systems. The independence of variables in propositions is opposed to the inseparability of variations in the concept” (WP,
p.22-23).
42 “The field of immanence is not internal to the self, but neither does it come from an external self or a non-self. Rather it is like the absolute

Outside that knows no selves, because interior and exterior are equally part of the immanence in which they have fused. Joy in courtly love, the
exchange of hearts, the test or “assay”: everything is allowed, as long as it is not external to desire or transcendent to its plane, or else internal
to persons. The slightest caress may be as strong as an orgasm : orgasm is a mere fact, a rather deplorable one, in relation to desire in pursuit of
its principle. Everything is allowed all that counts is for pleasure to be the flow of desire itself. Immanence instead of a measure that interrupts
it or delivers it to three phantoms, namely internal lack, higher transcendence, and apparent exteriority. If pleasure is not the norm of desire, it
is not by virtue of a lack that is impossible to fill, but on the contrary, by virtue of its positivity, in other words its plane of consistency it draws
in its course of its process”
(Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone. London, 1988, pp. 156-157).

27
ema I ‘The Movement Image’43, this de-personalising effect of close-up camera
shots, creating zones of in-discernabilty, sliding neighbouring zones where the
identity of the face with the self is fundamentally disturbed. Here the face merely
plays the role as a temporary wall (the possible), where everything is still in re-
serve (the virtuality of pure percepts and affects), in an awaiting of its actualisa-
tion44.

In opposition to Buber and the philosophy of dialogue, l´autrui (the fellow man
or ‘The Other’) in Deleuze always must be viewed as a perspective of the future,
an unknown sum of particles traits, creating a tension, which de-personalises45.
In this way, it could be said that man can be created in the interstices between
the virtual-real-actual-possible, which is contrary to Buber and the philosophy of
dialogue and other traditions like in Bakhtin´s ‘dialogism’, which never aban-
doned the recourse to the face (the subject) as the ultimate reference.

Humanism and Social-Psychiatry

It was Foucaults project46 to show how the broken dialogue madness/reason has
been maintained by elaborate technologies of control.

Jacques Derrida has later applied his method of deconstruction to this project of
Foucault47. His primary interest is to show how the establishment of discursive
technologies in texts can be shown to represent an undecided or existential am-
bivalence. His project thus becomes to show these ambivalences, the self-
contradictions and double-binds, that lie latent in any text. He sees a critical way

43 Deleuze, Gilles: Cinema 1 - The Movement-Image. Athlone. London, 1997.

44 Deleuze talks more in detail of the roles of the face: Ordinarily three roles of the face is recognisable: It is individuating
(it distinguishes or characterises each person: it is socialising (it manifests a social role): it is relational or communicating
(it not only communication between two people, but also, in a single person, the internal agreement between his charac-
ter and his role). Now the face, which effectively presents these aspects in the cinema as elsewhere looses all three in the
case of close-up. Bergman is undoubtedly, the dirctor who has been most insistent on the fundamental link which unites
the cinema, the face and the close-up: Our work begins with the human face......The possibility of drawing near to the
human face is the primary originality and the distinctive quality of the cinema’. A character has abandoned his profes-
sion, renounced his social role : he is no longer able to, or no longer wants to communicate, is struck by an almost abso-
lute muteness, he even looses his individuation to the point where he takes on a strange resemblance to the other, a re-
semblance by default or by absence. Indeed these functions of the face presuppose the reality of a state of things where
people act and perceive. The affection image make them dissolve, disappear. Deleuze in Cinema I - The Movement
Image 1997 (1983) p. 99,
45 In Buber’s installation of the two basic words (I-The One) and (I-You) he addresses the human as on the one side the

propensity to manage and orient actions in the world and on the other hand situates an ethics of life introducing ‘Other-
ness’ (I-You). When the now ‘ceases to burn’ man disappears and can only be retrieved or saved by the You (and the
possible).
46 See: Foucault, Michel: Madness and Civilization. A History of Insanity in The Age of Reason. Vintage books, 1973.
47 Derrida. J: Writing and Difference. Routledge. London, 1997.

28
out of a logocentric incorporation by writing out the undecided or transforming
structure into process by the double movement of overturning and metaphorisa-
tion48. Derrida stresses the double movement within any positively valued term
(e.g. civilisation), which is only given value in opposition to a negatively valued
term (e.g. barbarism), which continually threatens the other’s sovereignty. In this
way the two terms so to say inhabit each other where individual terms give way
to a process where opposites merge in a constant undecidable exchange of at-
tributes. The broken dialogue between madness-reason can be said to have a
point of disappearance or a point zero, one such point is the madness/reason
distinction in the Cartesian cogito49.

The zero points are seen in Derrida as the starting point for an inquiry into the
undecidables created by these binary oppositions. The Deleuzian approach is
different as the text is not seen as a closed system of representation. As Deleuze
once has mentioned, he has a lot of respect for Derrida and his method, but dif-
ferentiates his own method from this project as he specified:

“I don´t see myself as commentator upon texts. For me a text is merely a small cog in an ex-
tra-textual practice. It is not a question of commenting on the text by a method of de-
construction, or by a method of textual practice, or by other methods: it is a question of seeing,
what use it has in the extra-textual practice that prolongs the text”50.

This prolongation of the text is to consider the pre-suppositions inherent in a

statement as internal to the language system, which means again that it is the
ongoing modification and modulations of a textual corpus undermining the tex-
tual unity that is in focus.

A critical voice cannot be based on comments upon texts, which will remain
dead sediments if they cannot be linked to these ongoing practices of modifica-
48 Cooper, in: Organization Studies 10/4, 1989.
49 ”Whether I am mad or not, cogito, sum. Madness is therefore, in every sense of the word one, only one case of thought (within thought)” and
further about this zero point: ”Invulnerable to all determined opposition between reason and unreason, it is the point starting from which
the history of the determined forms of this opposition, this opened or broken dialogue, can appear as such and be stated”.
Derrida. J: Writing and Difference. P.56. Routledge. London, 1997.
50 Quoted from a speech in the Cerisy Colloquium on Nietzsche in 1972: as cited in the introduction to Deleuze, Gilles:

Essays Critical and Clinical. Verso. London, 1998.

29
tion. Attempts to be critical will be trapped in a language of yesterday without
any intervening potential, as it will only be able to address agendas already
passed. That is why a critical project should always have the perspective of the
future, negating the past in the present.

Derrida’s method seems to have the root tree logic as its reference as it starts
out from a zero point establishing a binarity, even if this binarity is dissolved
through ‘overturning’ and ‘metaphorisation’. However these operations remain
intra-textual and do not seek out how extra-textual practices disturb the textual
unity. This instability or pragmatics is what D&G tried to address in their
schizoanalytic framework and its four rhizomic components51. This framework
is later in section 4 used as inspiration for an analytic strategy.

In the cases, which have been applied for the present study, an attempt has been
made to demonstrate how multiplicities are sacrificed on the altar of normalisa-
tion through de-coupling of the possible - the living potential of the past - pro-
truding through the present into the future. It thus makes the extra-textual pro-
longation the primary focus rather than the normalising discursive apparatus.
This will actualise the emergence of mentally ill people from the other side of
the norm. ‘The becoming mad of the patient’ and ‘the becoming mad of the citi-
zen’ are here the war-machines52, the counter-signifying semiotics, represented
by the fear-some warlike, cattle-raising nomads53. I will later elaborate on these
concepts and how these war-machines can feature as intervention devices.

The overall confusion can be said to stem from the identification of minorities
(e.g. mad people) or otherness with subjects that are the product of forms estab-
lished by the norm. A becoming minor is different since it is always working as a
war-machine within the major (rather than from the major). It is an interior,
which is folded towards the exterior in a continued process (see further in sec-
tion 6). As such intervention into changing traditions according to the trends of
modern society comes to present itself as a manipulation of stereotypes - re-

51 Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone. London, 1988. p. 146 ff.
52 Ibid. p. 135.
53 Ibid. p. 118.

30
ceived realities, which cannot be questioned in their foundations. The result is
reproduction of ‘old’ strategic games, however covered with ‘new’ labels (rheto-
ric), rather than an invigoration of the creation potential of the reality in ques-
tion. Accordingly, developments of new paradigmatic work-zones within e.g. the
sectored psychiatry, which could be seen as ‘the managerial task’, are trapped in
narrow profession-thinking, where objects are situated according to fixed re-
ceived schemes. These schemes then become the docile bodies of government
and regulation and management tools.

This is in opposition to the becoming thought with its promotion of the event
as the coming together of future and past in the present, as an immanence medi-
ating all experience, which seeks out sensitivity towards the above mentioned
emerging flows of potential. That is to say that we have to give up time as a sta-
ble container of objects and shift location with a stereotyping effect of the life
that surrounds us. As such ‘organising as movement’ promotes a step out of the
tyranny of history, and defends an interventional project, that makes ‘The Other’
not a stereotyped subject, which on beforehand is endowed with certain qualities
as e.g. marginalised or underprivileged (succumbing to the despotic signifier),
but as a becoming “Other”. This whole project is an attempt to promote such
an interventional space as a timely sensitivity, thus radicalising the notion of in-
tervention in contexts of organising.

Summary
In this section the tradition of the empirical social sciences has been questioned.
What has been in focus is the tendency to create a hierarchy of observation
through the elaboration of theory and methods to accomplish an ordering of an
empirical landscape. As a counter-position the real-time-of-becoming stages or-
ganising as immanence, as a creation of singularities through a mutual constitu-
ency of concepts and the empirical. Organising as movement in this way is char-
acterised by its event-likeness, that is its side-stepping of the present: as such it
does not privilege any positions. No hierarchy exists, as the creation of concepts
is no less ‘empirical’ than ‘the empirical’ is the creator of concepts. Only one

31
plane exists: a plane of pure intensities, pure percepts and affects, the raw mate-
rial, which is condensed through stratification, the first move of creation.

The case of the sectored psychiatry is introduced to show how organisation sci-
ence can have a mission in creating a space for critical inquiries, research prac-
tices that abandon grand theory and representation and procedural demands of
methodology. The application of the case is aimed at showing how the lack of
concern for the meta-issues of movement (and thus power) has radical conse-
quences for thinking the political and inclusion of singular beings.
The main enemy is here the ‘knowings’ of the pre-established academic norm.
Bergson challenged this tendency of science to be tied up in representation
stressing that:

”Analysis is the operation that reduces objects to elements already known, that is to elements
common to both it and other objects”54.

In opposition, Bergson suggested intuition as method and Deleuze & Guattari

developed the notion of ‘transcendental empiricism’55. These approaches will be
further touched upon as the following five sections will treat more in detail how
this general position outlined above can be elaborated and connected to a strat-
egy of analysis.

This strategy of analysis will be applied to the Danish field of psychiatry focus-
sing on the singularisation of madness in the transformation of institutional psy-
chiatry into sectored psychiatry in the period 1976 until year 2000. The empirical
material will feature primarily in sections 7, 8 and 9.

54 Bergson, Henri: An Introduction to Metaphysics, p.24. Hackett. Indianapolis, 1999.

55 Empiricism to Deleuze can be described as discovering the conditions under which something new might be produ-
ced. The ‘transcendental empiricist’ assumes that things exist only as multiplicities (see below about singularities). Infer-
ring the notion of the ‘transcendental’ the subject-object systems are rejected in favour of a sort of ‘absolute conscious-
ness’. What is in focus is the ongoing self-construction of the mind by the relaying of abstraction and practice, as oppo-
sed to a split between pure experience and mind. This relaying is contained in the event, as such there are no beginnings
nor ends only in-betweens - multiplicitites.

32
 Section 2 - The Geologists and The Cartog-
rapher
“[The machine] makes history by unmaking preceding realities and significations, constituting
hundreds of points of emergence or creativity, unexpected conjunctions or improbable continu-
ums. It doubles history with a sense of continual evolution”.
(Deleuze in: Foucault, 1986, p. 35)

The event-like character of organising as movement should make us treat the

past as protruding into the future. Organising in this sense is a continuous crea-
tion of singularities, which enter into conjunction. The research into organising
becomes a mapping of assemblages, rather than a tracing of causal relations or
symbolically determined relations of social construction.
As stated by Chia & King:

“What is needed is a more ‘global’ perspective of the phenomenon of organization, which recog-
nises the latter as a generic process of world making rather than a bounded social entity” 56.

The world making of a ‘globalised organisation’ would take a radicalising step

toward conceiving of organising as a process to be evaluated according to crite-
ria, which are immanent to this process.

This calls for a research methodology creating sensitivity towards the dynamics,
the temporary character of a social field. This calls forth the Deleuzian condition
of ’our becoming with the world’, which is a fundamental break away from the
logic of discovering and interpreting the world through an optics of theories as
one can find this in the mainstream empirical tradition of the social-sciences.

Deleuze & Guattari57 worked with the idea of the face of the earth being the vast
openness of particles signs, which is stratified and de-stratified. In this sense,

56Chia, Robert & Ian W. King: The Organisational Structuring of Novelty. In: Organization vol. 5 no. 4 1998.
p. 473.

57 See: Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone. London, 1988.

33
their philosophy is a geo-philosophy: the sediments (sedimentary rock) are cre-
ated by stratification that is by stratifying and de-stratifying movements on the
earth, rather than by intervention from the outside according to a transcendent
principle. Accordingly, they state we are not signifier and signified, but that we
are stratified. That is, we as human beings are captured or bounded by certain
strata. This accounts for the first extraction out of these particles signs, thus cre-
ating the foundation for action and meaning. The movements on the surface of
the earth represent an auto-force, whereas a signifier-signifier relation presupposes
a giant signifier that other signifiers can refer to in an endless circle of signifying
and interpreting. The stratum of signification and interpretation is only one
among other strata. This allows us to conceive of how social worlds are con-
stantly challenged from within by the inherent creation potential, which is con-
veyed by the auto-force of matter.

D&G’s mission thus, is to create a theory of signs based on the idea of stratifica-
tion rather than signifiance. Signs in D&G are not signifiers, but de-
territorialisations and reterritorialisations - mixed semiotics. Accordingly, territo-
ries never become lands - they are suspense, temporary.

Foucault chose cartography as his strategy, which consists of mappings of the

different lines within a social apparatus (‘dispositifs’). They can be seen as lines
of sedimentation, lines of breakage and fracture, which do not just make up a
social-apparatus, but run through it and pull at it. This survey activity on un-
known landscapes is by Deleuze referred to as ‘working on the ground’: "Great
thinkers are always somewhat seismic: they do not evolve but proceed by means of crisis, in fits
and starts. This picture of the analytical process exposes the affiliation between geology and car-
tography – the interest in writing up the undecided and preliminary character of a social field"58.

A combination of these two approaches should produce a first move towards an

analytical sensitivity for the purposes of the present text. I will proceed with a
reading of Foucault under the guidance of Deleuze with the aim of conceiving

Deleuze, G & Felix Guattari: What Is Philosophy? 1993. Verso. London.

58 Gilles Deleuze: What is a Dispositif?, p. 159, in: Michel Foucault: Philosopher. Harvester Wheatsheaf, 1992.

34
the creation of multiplicities or the production of subjectivity. This guided read-
ing of Foucault should be a first preparation before a deeper penetration into
the conceptual landscape, which will feature in the following sections.

Enunciation and Visibility

Foucault brings to our attention first of all curves of visibility and curves of
enunciation. Lines of light are structured according to an apparatus in question
and not according to a general source of light, which falls upon pre-existing ob-
jects. Rather an apparatus accomplishes the birth of objects as it structures the
way light falls, by blurring, dispersing and distributing59. Second, he mentions
statements (enoncés) or affirmations, which can be traced back to lines of enun-
ciation: curves that distribute variables.

In Foucault’s analysis of the statement in ‘The Archaeology of Knowledge’

(AK), statements (order-words) are seen as dispersed in a space tied together in
families, however always covered with words, phrases and propositions.

What appears on the surface, indicating new directions, becomes assimilated ac-
cording to some family of statements within the discursive formation. State-
ments thus appear in opposition to words, phrases and propositions in so far as
they are:

“Formations thrown up by the corpus in question only when the subjects of the phrase, the ob-
jects of the propositions and the signified of words change in nature: they then occupy the place of
the ‘One speaks’ and become distributed throughout the opacity of language”60.

This surface must be the methodological starting-point based on the observa-

tion, that these fundamental words, phrases and propositions carry out a simple
function in general situations, as such they are not selected according to some
structure or from the author-subject from whom they emanate. Rather the crite-
ria for the selection must be there: ”[E]volving around focal points of power (and resis-

59 Gilles Deleuze: What is a Dispositif?, p. 159, in: Michel Foucault: Philosopher. Harvester Wheatsheaf, 1992.
60 Gilles Deleuze: Foucault., p. 14. Athlone. London, 1986.

35
tance) set in play by a particular problem”61. This is the criterion that Foucault gives in
his books published after ‘The Archaeology of Knowledge’, however it can al-
ready be seen at work in AK. In ‘The History of Sexuality’62, this revolving was a
study of sexuality connected to institutions as birth, marriage, etc.

The point is that what counts is the newness of the regime itself in which the
enunciation is made, given that such a regime is capable of containing contradic-
tory enoncés. You can ask what enoncés were given rise to within a given social
apparatus (dispositif) e.g of ‘the sectored psychiatry’. It is the newness of the re-
gime and not of the enoncés.

The analysis of conditions of possibilities tied to statements is neither axiological

nor typological, but topological. These cannot be represented only mapped out,
as such statements are echoing Blanchot as he denounces all linguistic personol-
ogy: the deep anonymous murmur from where the speaking subject can extract
his voice63 (What D&G and Deleuze later connect to their notion of free indi-
rect discourse and enunciative assemblage). If we thus think of history or epochs
as multiplicities we have to give up the idea of the subject unifying matter64. An
analysis of the diagonal lines of statements, the historical archive of the recent
past, should be the first step towards a diagnostics of the becoming.

The Diagrammatic
The nature of the statement is to span across language systems rather than stay-
ing within one system, which is the case with words and propositions, as such
statements operates neither vertically nor horizontally, but transversally. Deleuze
refers to this methodology running through all of Foucault’s work as paradoxi-
cal, that language so to say:

61 Gilles Deleuze: Foucault., p. 17. Athlone. London, 1986.

62Foucault, Michel: The History of Sexuality. New York, Pantheon, 1986.
63 See Gilles Deleuze: Foucault p. 7. Athlone. London, 1986.
64 Rather multiplicities escape:

”The reign of the subject and the empire of structure. Structure is propositional and has an axiomatic nature that can be tied to a specific level
and forms a homogenneous system, while a statement is a multiplicity that passes through all levels and cuts across a domain of structures and
possible unities, and which reveals them, with concrete contents in time and space” (Deleuze in: Foucault. Athlone London, 1986. pp.
14-15).

36
“Coagulates around a certain point only in order to facilitate the distribution or dispersion of
statements and to stand as the rule for a ‘family’ or (threshold) that is naturally dispersed”65.

The same holds for visibilities as for statements, they are not concealed as well
as they are not immediately visible. The visible or what was phrased as the non-
discursive in AK was given a form in Discipline and Punish66 where the inter-
lockings between the forms of the visible and of whatever can be expressed is
shown67.

The expression is as mentioned said to exist in the form of sound, while content
is said to exist in the form of light, these two forms in this way are always exte-
rior to each other68. This basic duality is the precondition for dealing with the
pragmatics of language.

This instability of forms is linked to the ’power/knowledge’ of Foucault. In this

regard Deleuze stresses how knowledge passes through forms while power
passes through forces:

“Knowledge concerns formed matters (substances) and formalised functions, divided up segment
by segment according to the two great formal conditions seeing and speaking, light and lan-
guage: it is therefore stratified, archivised, and endowed with a relatively rigid segmentarity.
Power on the other hand, is diagrammatic: it mobilises non-stratified matters and functions,
and unfolds with a very flexible segmentarity. In fact, it passes not so much through forms as
through points which on each occasion mark the application of a force, the action or reaction of

65 Ibid.
66 Foucault, Michel: Discipline and Punish: The Birth of The Prison. Penguin, London. 1977.
67 Language with its conditions form a spontaneity - visibilities with its conditions form a receptivity (Deleuze: in: Fou-

cault.p.60).
68 In this regard Deleuze mentions that one of Foucault´s central theses was:

”There is a difference in nature between the form of content and the form of expression, between the visible and the articulable (although they
continually overlap and spill into one another in order to compose each stratum or form of knowledge)” (in: Foucault p.61).
Archeology in Foucault can be said to be concerned with: “the production of statements and visibilities and their relative distribution
in time and space”.
“Visibilities are not defined by sight, but are complexes of actions and passions, actions and reactions, multisensoral complexes, which emerge
into light of day” (in: Foucault, p.59).
“There is ‘a light being’ as there is ‘a language being’ everyone is seen as absolute and yet historical since each is inseparable from the way in
which it falls into a historical corpus. The one makes visibilities visible or perceptible, just as the other made statements articulable, sayable and
readable” (in: Foucault, p.58).

37
a force in relation to others, that is to say an affect like ‘a state of power that is always local
and unstable’ “69.

The notion of power being diagrammatic is an important observation and

closely connected to the D&G notion of the abstract machine, which will be in-
troduced below. About the diagrammatic is also said that: it is a transmission
and distribution of particular features. In relation to the dispositif it is said to
represent a line of force, which acts as a go-between between seeing and saying,
acting as arrows continually crossing between words and things. In this sense it
is closely knitted with the other lines from which it is still separable, though in-
visible and unsayable70.
It is said to be as in the Panopticon:

”A pure disciplinary function, which is detached from any specific use, as from any specified
substance”. Other ‘interlocking’ definitions are: “ it is the presentation of the relations
between forces unique to a particular formation: it is the distribution of power to affect and the
power to be affected: it is the mixing of non-formalised pure functions and unformed pure mat-
ter”71.

This variability of course actualises the question of “[A] common immanent cause”
existing within the social field outside forms. The primacy of the statement,
which was given in ‘Archaeoology of Knowledge’, thus did not produce a con-
ceptualisation of how the two forms mix in variable ways in particular cases.
That is, how forces accomplish the interspilling of forms and how the dynamics
of stratified matters can be seen as interplay between the subject of enunciation
and the subject of the statement72.

Accordingly, a crucial step for organising as movement thinking and ‘creating

something new’ is to conceive of pure matter and pure functions abstracting the
forms embodying them. Deleuze gives here the example of formalised functions

69 Gilles Deleuze: Foucault., p. 73. Athlone. London, 1986.

70 Gilles Deleuze: What is a Dispositif?, p. 160, in: Michel Foucault: Philosopher. Harvester Wheatsheaf, 1992.
71 Gilles Deleuze: Foucault., p. 72-73. Athlone. London, 1986.
72 That is the relation between the stratum of signification and interpretative function and the stratum of subjectification

(see the elaborations in the following section).

38
as care, punishment, education etc. and matter formed as e.g hospital, school,
workshop etc. This step was in fact taken to show that the panopticism is affect-
ing visible matter, but also articulable functions. This would make possible the
abstract formula of ‘imposing a particular conduct on a particular human multi-
plicity’ (The Panoptical-machine) instead of the one of ‘seeing without being
seen’73. The diagram is the interplay between matter and function. Deleuze
comes up with the following statement, which can be seen as an important con-
necting point with Foucauldian thought and his own work with Guattari:

“What can we call such a new informal dimension [the matter-function]? On one occasion
Foucault gives it its most precise name: it is a ‘diagram’, that is to say a ‘functioning, ab-
stracted from any obstacle [....] or friction [and which] must be detached from any specific use’.
The diagram is no longer an auditory or visual archive but a map, a cartography, which is co-
extensive, with the whole social field. It is an abstract machine. It is defined by its informal
functions and matter and in terms of form makes no distinction between content and expres-
sion, a discursive formation and a non-discursive formation. It is a machine that is almost
blind and mute, even though it makes others see and speak”.

“[The machine] makes history by unmaking preceding realities and significations, constituting
hundreds of points of emergence or creativity, unexpected conjunctions or improbable continu-
ums. It doubles history with a sense of continual evolution” 74.

The relation between content and expression has earlier been phrased by D&G
in geo-philosophical terms as: the expression doesn’t merely represent the con-
tent:

“Rather forms of expression and forms of content communicate, through a conjunction of their
quanta of relative de-territorialization, each intervening, operating on the other”75.

This instability or prolongation of a signifying unity was illustrated several times

in Foucault’s work, how the prison did not have a one to one correspondence

73 Gilles Deleuze: Foucault., p. 72-73. Athlone. London, 1986.

74 Gilles Deleuze: Foucault., p.34. Athlone. London, 1986.
75 Deleuze & Guattari,: A Thousand Plateaus, p. 88. Athlone. London, 1988.

39
with delinquency: delinquency as a form of expression has a distinct form of
contents represented by different ways of committing crimes. These still new in-
terspillings of expression and content are accomplished by a shared state of the
abstract machine. What is needed is a double pincered, or double-headed con-
crete assemblage to take its real distinction into account.

You can consider the relation as a state of unstable equilibrium. The one doesn´t
dominate the other, but each has their distinct micro-history, where the one is
present in the other. This double-headedness is one of the primary features of
D&G’s micro-political analysis, which will be presented more in detail in the fol-
lowing section.

From Subject to Subjectification

Foucault took a new turn late in his career as he attempted to develop a way out
of what seemed to be a definitive dead end with power constituting unbreakable
lines of force. He broke the line by viewing it as turning on itself, rather than re-
lating to other forces. It was here he saw the production of subjectivity as a line
of subjectification (a-signifying regime). As Deleuze mentions: in this sense it
was a line of escape:
“The self is neither knowledge nor power. It is a process of individuation, which bears on
groups and on people, and is subtracted from the power relations which are established as con-
stituting forms of knowledge: a sort of surplus-value”76.

Deleuze sees the possibility that these lines of subjectification constitute the
borders of a social apparatus (dispositif) in that sense preparing for lines of frac-
ture. Deleuze mentions an example of how subjectification comes about
through the marginalised existence of an outsider. The example was given by the
Sinologist Tokeï and seems to be an exact parallel to the de-institutionalisation
of psychiatry/madness: “…[T]he liberated slave somehow lost his social status and found
himself thrown back on an isolated, lamenting, elegiac existence, out of which he was to shape
new forms of power and knowledge”. And he adds: “The study of the variations in the proc-

76 Gilles Deleuze: What is a Dispositif?, p. 161, in: Michel Foucault: Philosopher. Harvester Wheatsheaf, 1992.

40
ess of subjectification seems to be one of the fundamental tasks, which Foucault left to those who
would follow him”77.

Lines of subjectification in this way account for how the production of subjec-
tivity escapes one social apparatus to enter another, either through what D&G
later would refer to as a shift of plane or annihilation in a black hole.

The problem of how to judge a social apparatus without falling back on univer-
sals and transcendent criteria Deleuze refers78 again to thinkers like Spinoza and
Nietzsche, who first of all would escape nihilism of equal values by referring to
an assessment according to immanent criteria. It has to be considered what crea-
tive potential a given content of an apparatus consists of.

Now when we cannot turn to universals we also have to abandon the eternal in
favour of the new as the variable creativity, which emerges out of a social appa-
ratus. In this regard it is mentioned how especially lines of subjectification (a-
signifying semiotics): “[S]eem particularly capable of tracing paths of creation, which are
continually aborting, but then restarting, in a modified way, until the former apparatus is bro-
ken”.

It is here important to treat social apparatuses as part of our becoming other.

“As such it must be determined what we are (that is what we are no longer), and what we are
in the process of becoming: the historical part of the current part”.

The real creation of singularity events thus has to be concerned with the frac-
tional potentials inherent in an apparatus, where the consideration of lines of
subjectification is the last step. Deleuze79 also refers to how this last step actual-
ises the concept of the fold as it was also developed in: ‘Leibniz and The Ba-
roque’. Marks80 mentions how Leibniz in this way forms a point of convergence
between Deleuze and Foucault. The fold makes it possible to replace the experi-

77 Ibid. 161-62.
78 Ibid. 163-64.
79 Deleuze Gilles: Foucault. 1986. Athlone. London.
80 Marks, John: Gilles Deleuze. Vitalism and Multiplicity., p.76-77. Pluto Press. London, 1998.

41
encing subject and thus to create a new perspectivism, staging a point of view,
which is in constant variation - a point of view of the world as an act.

So Foucault’s project becomes one of finding folds in power or rather what I

later in section 4 will phrase as generating a counter-signifying potential by con-
jugating fractures and transformations of the diagrammatic. It becomes a project
of bending force making it impinge on itself. This perspective of Foucault is ac-
cording to Deleuze an optimistic dimension of vitality stipulating a fundamental
pluralist conception of the individual81.

The challenge thus is to entangle the lines of the recent past and those of the
near future, of the past and of the becoming: The lines belonging to the analytic and
those belonging to the diagnostic. This is just one of the places in Foucault’s work
where the Nietzschean heritage82 surfaces: using history for something beyond it,
acting against time, and thus on time, for the sake of a time one hopes will
come83.

Summary
In this section it has been shown how the creation of multiplicities (the creation
of something new) can be conceived as dependent on a dynamic of lines making
up a social apparatus or ‘dispositif’, thus lines of: visibility, enunciation, force
and subjectification.

Through a Deleuzian reading of Foucault, it has been attempted to stage how

the concept of ‘dispositifs’ of power applied by Foucault can point us towards a
strategy of analysis aimed at studying the conditions of possibility for the crea-
tion of something new or the creation of multiplicity.

Lines of enunciation and lines of visibility are the basic ingredients in Foucault’s
analysis of the statement in ‘Archaeology of Knowledge’. Here we find the his-
torical nature of social apparatuses – the archive. A given social arrangement or

81 Deleuze Gilles: Negotiations, p. 98. Columbia Univ. Press. 1990.

82 Nietzsche Friedrich: Historiens Nytte. Gyldendal. København, 1962.
83 Gilles Deleuze: What is a Dispositif?, p. 164, in: Michel Foucault: Philosopher. Harvester Wheatsheaf, 1992.

42
problem e.g the de-institutionalisation of psychiatry is defined by the regimes of
enunciation to which it gives rise. A social field thus and its specific history must
be determined from an analysis of the drifting, the transformation and the muta-
tions, which emerge from the point of visible and from the point of view of
what can be enunciated.

Lines of force were actualised with Foucault’s work after archaeology. The dia-
grammatic and the abstract machine of Deleuze & Guattari account for the di-
sruption of forms by abstract forces. It goes between seeing and saying and is
said to be immanent to knowledge and yet separable.

The notion of lines of subjectivation touched upon the creation potential imma-
nent to social-apparatuses. Lines of forces can be considered as impending on
themselves thus creating transformational potential, rather than deadlocks of
unbreakable relations of power. This stages the possibility of creating something
new as a matter of the past always protrudes into the future and how the present
is always side-stepped in this process.

The next sections will be a more focused endeavour of developing an analyti-

cal frame along the lines sketched in the present section.

43
 Section 3 - The New Pragmatist and The
Schizo

"Everything I have written was vitalist, at least I hope so,

and constitutes a theory of signs and of the event."
(Deleuze in Negotiations: ’On philosophy’, p. 196)

Stratification
The focus of the present section is a development of a theoretical base for the
analysis of language as a political marker. The road Foucault took when moving
from archaeology to genealogy was as mentioned to point at the disruption of
knowledge and forms through forces and the diagrammatic. Accordingly his in-
terest was rather sub-representation, that is dissolving the binarities of the dis-
cursive and stressing the diagrammatic character of power.

The fracture and transformation inherent in lines of subjectification will further

be elaborated in the present section.

I will try to elaborate on how the observations of the preceding section can take
us further towards a pragmatic strategy of analysis, through the doublings and
elaborations of Deleuze, Guattari and Deleuze & Guattari.

The main observations to hold on to are first of all the machinic character and
the instability of forms of expression and forms of contents, and the creational
lines of subjectification, which all points us towards the creation of something
new. First of all, this will link up with what Deleuze saw in the dispositifs of
power of Foucault namely on the one hand lines of stratifications or sedimenta-
tions (analyses) and on the other lines leading to the present day of creativity (di-
agnostics)84. This section will accordingly be combining an analytical with a di-
agnostic attitude.

84 Gilles Deleuze: What is a Dispositif?, p. 165-166, in: Michel Foucault: Philosopher. Harvester Wheatsheaf, 1992.

44
D&G adopt the notion of the stratification of language from Hjelmslev in ‘A
Thousand Plateaus’ (ATP) and develop a whole theory of signs on this basis.
This development will be described below with the aim of approaching an ana-
lytic strategy, which will be presented in section 4.

The development of a semiotic theory inspired by Hjelmslev was, it seems,

originally pursued by Guattari in his collection of writings from 1977: ‘La Revo-
lution Moléculaire’ (RM). The primary interest was a challenge of structuralism
and structural linguistics (Levi-Strauss, de Saussure, Jakobson, Lacan etc.) and in
particular the grand narratives of psychoanalysis and Marxism. Guattari founded
what he called a micro-politics of desire, where the title of the book ‘The Mo-
lecular Revolution’ came to stand for a challenge of a politics of interpretation
founded on idealism and the imaginary. The basic critique against structuralism
was stated in the introduction to the section of the micro-politics of desire85.
This included first of all a critique of the masking of the fundamental duality be-
tween expression and content, which in this way only focuses on expression and
blinds out contents. In this sense, structuralists consider it legitimate to split up
the work to be done on expression from the one to be done on contents.

In opposition, Guattari suggested a politics of experimentation, which chal-

lenges representation by stressing the machinic character of power, or as
phrased by Guattari a politics of desire, which appropriates the actual intensities
of desire. In this connection, it is stressed that interpretation is undertaken in the
spoken language, whereas experimentation belongs to signs, machinic functions
and assemblages of things and persons86.

The aim should be to counter semiotic enslavement accomplished by the union

of structuralism, binarism and the discursive. Within this frame, the processes of
power and machinic mutations that have fixed or stabilised a form become inde-
structible. Consequently, within this frame, the different performances of society
(for instance, the monetary) are considered as: “ [H]aving always and already been

85 Guattari, Felix: La Revolution Moléculaire. ENCRES. Fontenay-sous-Bois, 1977. p. 241.

86 Guattari, Felix: La Revolution Moléculaire. ENCRES. Fontenay-sous-Bois, 1977. p. 248.

45
there in full force ….87”. This observation is in accordance with another remark
made by Guattari in the same text, where he attempts to address the doubleness
of machinism:
“Machinism is at once threatening and potentially liberatory: the former due to the microscopic
means of disciplinarisation of thought and affect and the militarisation of human relations: the
latter to the extent that it remains open to ‘singularisation and creative initiatives”88.

Guattari further justifies this approach by pointing towards the fact that:
The systematic ignorance of society and politics characteristic of current linguistics and semiotics
can only be smashed by calling into question or dismembering their basic categories 89 .

On this matter Guattari turns to Hjelmslev, a Danish linguist, who though wor-
king from a structural linguistic tradition was seen as possibility for dissolving
the reliance on the signifier-signified scheme. The famous net of Hjelmslev was
applied by Guattari and later D&G (ATP) as a basic building block in their schi-
zoanalytic project90 and the theory of signs accompanying this project.

The overall project of Guattari in relation to the heritage of Hjelmslev and the
later contributions by Eco can be said to produce a political understanding of
signification through the development of a typology of polysemiotic interac-
tions.

The important quote of Hjelmslev adopted by Guattari91 goes like this: “Form is
projected on to the purport (matter), just as an open net casts its shadow on an undivided sur-
face”. The shadow of the net indicates the non-concrete character of form, which
is cast over matter (purport).

Matter was the term, which was later doubled by D&G as:

87 Felix Guattari: Semiological Subjection, Semiotic Enslavement from L’Inconscient Machinique p. 34-42, 1979. printed

in Genosko, Gary: The Guattari Reader p. 142. Blackwell. Oxford, 1996.

88 In: L’Inconscient machinique, p.200. As quoted in Genosko, Gary: Undisciplined Theory. SAGE. Guildford, 1998.
89 Ibid. p. 145.
90 See further below in the following section.
91 Guattari, Felix: La Revolution Moléculaire. ENCRES. Fontenay-sous-Bois, 1977. p.278

46
”.. [T]he plane of consistency or the Body without Organs, in other words the unformed unor-
ganised, non-stratified, or de-stratified body and all its flows: subatomic and sub-molecular par-
ticles, pure intensities, pre-vital and pre-physical free singularities” 92.

Matter thus is to equal with the primordial soup of which stratification is a first
extraction. Guattari describes these strata (or criteria) in his major work Revolu-
tion Moléculaire and develops them or this concept further in 1992 (Chaosmo-
sis)93. Also the description of the Schizoanalytic method in ATP is based on
these developments.

D&G developed the theme by stating that Hjelmslev wove a net out of matter,
content and expression94 form and substance. Form cast over matter creates
substance on the two planes of content and expression. These can be said to be
the five criteria or strata95, which were the base for the development of a typol-
ogy. The overall challenge was seen as: 1) Escaping the tyranny of the signifier-
signified binarism: 2) Eluding the abstraction of the signified: 3) Breaking the
negative, differential of the sign defined against other signs ad infinitum: 4)
Challenging signifier despotism and fetishism96.

What is crucial for Guattari is that form is not autonomous, as it does not exist
unless it is put in action. Consequently Guattari conceives it in terms of an ab-
stract machine, which brings about meaning and meaning-making formations
with matter: form semiotizes matter. For Guattari matter is considered inde-
pendently from its formation as a substance, it is seen as unformed and unor-
ganised material intensity.

92 Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone. London, 1988. p. 43.

”Desiring machines make us an organism: but at the very heart of this production, within the very production of this
production, the body without organs suffers from being organised this way, from not having some other sort of organi-
sation, or no organisation at all. “An incomprehensible absolutely rigid stasis in the very midst of process, as a third
stage: No mouth. No tongue. The automata stop dead and set free the unorganised they once served to articulate. The
full body without organs is the unproductive sterile, unengendered, unconsumable. Antonin Artaud discovered this one
day, finding himself with no shape or form what so ever, right there where he was at that moment”. (D&G in Anti
Oedipus: 1972 p. 8).
93 Guattari Felix: Chaosmosis-An Ethico-Aesthetic Paradigm. Power Publications. Sydney, 1995 (1992).
94 See the discussion of these distinctions in the preceding sections: 'The World as Becoming' and 'The Geologist and The Cartog-

rapher'.
95 Deleuze, G & Felix Guattari: A Thousand Plateaus. P.43. Athlone. London, 1988.
96 Guattari, Felix: La Revolution Moléculaire. ENCRES. Fontenay-sous-Bois, 1977. p.279.

47
In order to accomplish this overall challenge described above, Guattari sketches
out a tripartite typology of modes of semiotisation through an analysis of the in-
tersecting five criteria (strata) of the net.
The first mode refers to a-semiotic encodings or natural encodings, which func-
tion outside any semiotic substance. It forms fields of material intensity without
falling back on an autonomous and translatable écriture97.

The second involves signifying semiologies, that is sign-systems with semioti-

cally formed substances on the planes of expression and content. These again
are split into symbolic semiologies and semiologies of signification. Symbolic
semiologies have numerous strata none of which can overcode the other. Semi-
ologies of signification are determined by one single substance, often the linguis-
tic and the giant signifier. The linguistic sign, it is said, is cut of from the real as
it must pass through the mental world of representation. It is cut of from the
material intensity to be trapped in a signifying ghetto of representation through a
process of repetition. As such, the production of subjectivity is a shut-in. Enun-
ciative polyvocity is crushed as it is split between the subject of the statement
and the subject of enunciation. In between this split, individuation, personalisa-
tion and gender are effectuated. As such, polyvocity becomes bi-univocity (je-tu,
il/elle).

Inside all this, the goal for Guattari is to discover the residual traces, the trans-
versal flights of a collective assemblage of enunciation: “……[T]he real productive
insistence of all semiotic machinism”98. This interest which embeds the real goal of
schizoanalysis (see below) leads him towards the third mode of semiotisation –
a-signifying semiotics.

A-signifying semiologies so to say skirt around signifying semiologies, but with-

out leaving, unlike a-signifying encodings, the expression and content planes.
Consequently, what characterises a-signifying semiologies is that they are inde-
pendent of, and in a non-hierarchical relation with signifying semiologies and

97 Guattari, Felix: La Revolution Moléculaire. ENCRES. Fontenay-sous-Bois, 1977. P. 279.

98 Guattari, Felix: La Revolution Moléculaire. ENCRES. Fontenay-sous-Bois, 1977. P. 256-257.

48
language. This shift from signifying semiologies to a-signifying semiologies is de-
scribed as de-localisation, de-privatisation, an-oedipalisation of the individuated
subject to a collective assemblage of enunciation. The individual is equated with
signification and the collective with machinic assemblages. The signifier thus is
associated with subjugated groups, whereas collective assemblages of enuncia-
tion consist of conjunctions of abstract machines (machinic nodes) and material
fluxes belong to the phantasms of subject groups.

Signification implies self-reference and thus the rupture of machinic conjunc-

tions, whereas collective assemblages give up comprehension, being in some in-
stance without signification for anyone, for the sake of creating meaning directly
from the fluxes. Signification thus has no machinic meaning because of the ab-
sence of conjunctions with the real fluxes.

As it is, collective assemblages cannot be individuated and thus are not to be

confused with groups of individuals. Rather a-signifying semiotic machines free
desiring production or the singularities of desire from the different signifiers of
transcendent values, as it is stated that desiring production might be set free
from all territorialising alienations and preset coordinates99. This position is fur-
ther elaborated in Chaosmosis100:
“The term ‘collective’ should be understood in the sense of a multiplicity that deploys itself as
much beyond the individual, on the side of the socius, as before the person, on the side of prever-
bal intensities, indicating a logic of affects rather than a logic of delimited sets” .

Even the myth of a return to a natural state of a-semiotic or pre-signifying world

should be deterritorialised. The schizoanalytic project aims at extracting sign-
potential from inside the very core of signification. In this way: “Its objective is not
at all to recuperate facts and acts that are outside the norm: on the contrary, it is to make a
place for the singularity traits of subjects who, for one reason or another, escape the common
law”101.

99 Guattari, Felix: La Revolution Moléculaire. ENCRES. Fontenay-sous-Bois, 1977. p. 263.

100 Guattari Felix: Chaosmosis-An Ethico-Aesthetic Paradigm. Power Publications. Sydney, 1995 (1992). p.8.
101 Guattari, Felix: La Revolution Moléculaire. ENCRES. Fontenay-sous-Bois, 1977. P. 284.

49
Guattari addresses the question of singularity and to what extent it is tolerable as
the real task of an analytic practice. The practice must consider the subject in
contact with desiring machines in a-signifying semiotics, which oscillates be-
tween reterritorialisations on signification and de-territorialisations into new ma-
chinic conjunctions. It is obvious that signification always has a role to play: in
this sense Guattari’s semiotics are mixed.

A-signifying semiotics is a question of post-signifying semiotics, where as it has

later been stated by D&G102 the subject of the statement and the subject of
enunciation recoil into each other. The signifying/post-signifying is the white
wall/black hole scheme. Thus in the a-signifying semiotics the position of the
subject changes radically as the world of mental representation, that is, reference
(symbol and referent together) is replaced by ‘signs’ and how they work things
prior to representation103.

Double Articulation
Accordingly, these main modes of semiotisation can be related to the main types
of strata binding human beings: the organism, interpretation and signifiance and
subjectification and subjection104. In this way you could say that strata function
mainly as basic pragmatics of human existence, not merely a linguistic structure
of signifiers and signifieds, which programs and projects. Rather the constant
movement in and between strata furnishes creational potential105.

The important thing is to see the stratification of language as accomplished by

double articulation, inside enunciative assemblages, which function as an inva-
riance, a building block or a preparation for regimes of signs, which are built on
the surface of strata. This is what make D&G say that we are not signifier and
signifieds, we are stratified106.

102 Deleuze, G & Felix Guattari: A Thousand Plateaus.p. 137. Athlone. London, 1988.
103Guattari, Felix: La Revolution Moléculaire. ENCRES. Fontenay-sous-Bois, 1977. P. 281-282.
104 Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone. London, 1988. p. 134.
105 About this relation it is further said:

”The materials furnished by a sub-stratum organisation in the substratum are no doubt simpler than the compounds of a stratum, but their
level of organization in the substratum is no lower than that of the stratum itself” Deleuze, G & Felix Guattari: A Thousand Plateaus.
Athlone. London, 1988. p. 49.
106 Deleuze, G & Felix Guattari: A Thousand Plateaus. P. 67. Athlone. London, 1988.

50
As in the example given above in section 2 from the Panopticon of Foucault
there is a firstness linked to content and a secondness related to expression. This
is the relation or duality, which is masked by structural analysis, as mentioned by
Guattari in the introduction to his semiotics107.

The breaking point is here to deal with the duality of form of expression and
content since as it is said there is a form of expression as there is one of content.
Substance is simply, as mentioned, formed matter as pure matter only exists on
the plane of consistency. Like expression and content have a form of their own
they also have a substance of their own. Thus not surprisingly the link between
pure unformed matter and content and expression is the thickening of the plane
of consistency at the one end by stratification.

To sum up you could say that stratification in this way is the preliminary struc-
ture, which precedes the regime of signs. Strata are like the first creational mo-
ves, which extract the world out of chaos. In this way it is said that strata consti-
tute the judgement of God. Like classical artists make the world: “ [B]y organising
forms and substances, codes, milieus, and rhythms”108.

An example is the stratum of the state featured by both content and expression,
where both expression and content have their own respective substance and
form, which come together in double articulation or stratification:

”Where the first articulation concerns content and the second expression.[…] The distinction
between content and expression is always real, in various ways, but it cannot be said that the
terms pre-exist their double articulation. It is the double articulation that distributes them ac-
cording to the line it draws in each stratum: it is what constitutes their real distinction”109.

107 Guattari, Felix: La Revolution Moléculaire. ENCRES. Fontenay-sous-Bois, 1977. pp. 241-42.
108 Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone. London, 1988. p. 502.
109 Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone. London, 1988. p. 44.

51
The first articulation in this way is said to be the sedimentation, the other
articulation is the folding that sets up a stable functional structure that
effectuates the passage from sediment to sedimentary rock110.

The point is that both articulations are double, it is a double pincer, or as it is

stated god is a lobster, and that is why to express is to sing the glory of god:

“([B]ut the earth, or the body without organs, constantly eludes that judgement, flees and be-
comes de-stratified, decoded, de-territorialised”111.

Stratification thus consists of coded milieus and formed substances. Where

forms and substances, codes and milieus are not really distinct, but: ”[A]bstract
components of every articulation”112. However we should still elaborate on how strati-
fication precedes assemblages and regimes of signs113.

Assemblages are said to be produced in strata: ” [B]ut operate in zones where milieus
become decoded as such assemblages extract a territory from milieus”. As it is stated:

“Territory is more than organism and milieu and the relation between the two: and that is why
assemblages go behind mere “behaviour” (hence the importance of the relative distinction be-
tween territorial animals and milieu animals)” 114.

Expression is the preliminary function and content is the preliminary material

relating to this function. The force, which sweeps away these forms and sub-
stances, is the relative and absolute de-territorialisations, accomplished by the
abstractions on the plane of consistency - particles signs, pure matter-functions.

110 Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone. London, 1988. p. 41.
111 Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone. London, 1988. p.40.
112 Ibid.
113 “Strata come at least in pairs where the one serves as substratum for the other. The surface of stratification is a machinic assemblage dis-

tinct from the strata. The assemblage is between two layers, between two strata: on one side it faces the strata (in this direction, the assemblage
is an interstratum), but the other side faces something else, the body without organs or plane of consistency. The plane of consistency thickens
and become compact at the level of strata” Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone. London, 1988. p. 40.
Further D&G talks about this relation:
”He [Hjelmslev] used the term expression for functional structures, which would also have to be considered from two points of view: the organi-
sation of their own specific form, and substances insofar as they form compounds (form and contents of expression). A stratum always has a
dimension of the expresssible or of expression serving as the basis for a relative invariance: for example, nucleic sequences are inseparable from
a relatively invariant expression by means of which they determine the compounds, organs and functions of the organism” Deleuze, G &
Felix Guattari: A Thousand Plateaus. Athlone. London, 1988. p. 43.
114 Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone. London, 1988. p.504.

52
The fundamentally unstable relationship between content and expression can of
course not be equalled with the relation signifier-signified. This instability is cre-
ated by the duality of expression and content having their respective forms and
substances so the one will never dominate the other. Rather the one is always
present in the other. What is left, are inter-spillings accomplished by the lines of
double articulations. There is a movement from a concrete (collective) assem-
blage on stratified matters to relative de-territorialisation and absolute de-
territorialisation: that is the singular abstract machine and the diagrammatic
transformation - an oscillation between deterritorialisation and reterritorialisa-
tion.

The plane of consistency features the pure matter-function of the abstract ma-
chine and its two vectors: one pointing towards strata and content-expression
and one pointing towards the plane of consistency. The abstract machine is
marking without fixing: it is singular. D&G refer to the three strata: the organ-
ism, signifiance and interpretation and subjectification and subjection, as making
an absolute border toward the plane of consistency115. Abstract machines, are
the ones, which accomplish stratifying and de-stratifying movements. The lines
drawn by double articulation run through the only assemblages there are: collec-
tive assemblages of enunciation and machinic assemblages of desire.

The abstract machine having the diagrammatic as its sign of recognition is de-
scribed as being present in every concrete assemblage, while at the same time it
has absolute de-territorialisation as an option. It is the abstract machine with its
one vector pointing towards expression and contents and the other toward the
plane of consistency (particle signs).

The element by which the assemblage extracts itself from the strata (to which
they still belong, but are not confined) is where expression becomes a semiotic

115 “These strata together are what separates us from the plane of consistency and the abstract machine where there is no longer any regime of

signs, where the line of flight effectuates its own potential positivity and de-territorialisation its own absolute power. The problem from this
standpoint, is to tip the most favourable assemblage from its side facing the plane of consistency or the body without organs”.
Subjectification carries desire to such a point of excess and unloosening that it must either annihilate itself in a black hole or change planes.
Destratify open up to a new function a diagrammatic function” Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone. Lon-
don, 1988. p. 134.

53
system, a regime of signs, and content becomes a pragmatic system, actions and
passions, what has been referred to as visibilities in section 2.

As mentioned in the example above from the Panopticon of Foucault there is a

firstness linked to content and a secondness related to expression (commitment
of crime and delinquency). The statement (enoncé) builds a preliminary functio-
nal structure or a folding of material. As mentioned there is no regime of signs
on the level of stratification (and still regimes of signs permeate all of the strata).
In this way, the enoncé can only emerge on the level of assemblage. The redun-
dancy of the order-word within the word is referred to as an enunciative assem-
blage. The expressed of a statement becomes an indirect discourse. This collec-
tive enunciative assemblage is then what must account for the social character:
which leads to the final nominal definition of the enunciative assemblage: As the
redundant character of the act and the statement, that necessarily accomplishes it 116.

However, this redundancy or prolongation of the statement must be related to

the acts or incorporeal transformation of bodies (in the broadest sense). Pure ac-
tions-passions that affect bodies are e.g. the actions of a madman, which are
considered abnormal and later on classified as dangerous actions, which should
entail a forced incarceration in a mental hospital. These actions-passions are the
ones affecting bodies, the body of the patient, of the relative, of the hospital, the
local community etc.

In opposition to these pure incorporeal transformations, the expression of a

statement like the diagnosis, which transforms the madman into patient and
makes this his forced incarceration, is the expressed of the doctors diagnosis, a
non-corporeal attribute accomplished through the evaluation of actions accord-
ing to given classifications. This complex of the diagnostic function are the
statements, the order-words within the word – the enunciative assemblage. It is
from these complexes of order-words, that the patient as citizen can extract his
voice. It becomes as much dependent on the order-words of medicine as the
one of social-psychiatry, out-patient psychiatry, anti-psychiatry etc. The assem-

116 Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone. London, 1988. p. 80.

54
bling or articulation of these assemblages and their machinic components is
what accounts for the social character as referred to above with regard to the
becoming citizen of the patient117.

The contents are the actions of the madman (incorporeal transformations) and
the expressed the incarceration in the hospital (non-corporeal attributes).

" The order-words or assemblages of enunciation in a given society (in short the illocutionary)
designate this instantaneous relation between statements and the incorporeal transformation or
non-corporeal attributes they express"118.

Order-words, statements or enunciative assemblages designate the indeterminate

relation of semiotic reserves, which are effectuated by the tension between in-
corporeal affections on the bodies of society and the functions or expressions of
statements, which attribute certain qualities to these affections.

In relation to the question madness-normality, it is apparent that this relation

can only be made visible by extracting a voice from a concrete enunciative as-
semblage. These assemblages however are swept away by order-word machines,
making the concrete disappear into the particle mist. However, counter-
signifying119 creates a slowing down of these de-stratifying sweeps, to make the
concrete emerge as a momentarily apprehension of a multiplicity. Enunciation is
an indirect discourse, secured by the redundancy of the order-word, the pres-
ence of the order word within the word. In this way, all language is indirect dis-
course (the impersonal – the anonymous murmur)120.

Regimes of Signs
The redundancy of the signifier can be formulated as the sign does not signify

117 I will refer to this notion troughout the text as the as the double condition of the patient becoming a client of the sectored psy-

chiatry. This condition as will be elaborated in the three last sections is defined by both liberating mechanisms, aswell as threaten-
ing mechanisms.
118 Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone. London, 1988. p. 81.
119 See further in the following paragraphs.
120 D&G talks about:..” that the collective assemblage is always like the murmur from which I can take my proper name

the constellation of voices concordant or not from where I draw my voice” Deleuze, G & Felix Guattari: A Thousand
Plateaus. Athlone. London, 1988. p.84. See as a parallel Bakhtin’s notion ventriloquism. Bakhtin, M: The Dialogic Imagi-
nation. Univ. of Texas Press, 1981: And for secondary literature: Holquist, Michael: Dialogism. Bakhtin and His World.
Routledge. London, 1990.

55
anything in itself all it does is relating to other signs: it forms a signifying chain
or an amorphous atmospheric continuum121. Having seen this relationship it be-
comes the more important to investigate how the inter-spillings of forms of
contents and forms of expression can be analysed as mixed semiotics (regimes
of signs) creating the conditions of possibilities for the emergence of forms of
contents.

In ATP, D&G refer to a mundanisation or atmospherisation acknowledging that

what we experience in a signifying is only signifieds. In this way not acknowledg-
ing that contents has its own specific forms, which can never be the one of sig-
nifieds. Contents however cast a shadow, which penetrates into the signifying
chain. This casting is ungraspable if not seen from an angle of mixed semiotics
as opposed to a signifying semiotics: the world is signifying before anyone can
think of what it signifies. The signifying chain becomes the whisperings behind
your back that detach you and disconnect you from experience. If we were not
able to rely on the discretion of the forms of contents (and mixed semiotics), we
would enter a paranoiac nightmare, ruled by the despotic signifier.

To further approach the idea of mixed semiotics and how they are based on
several regimes of signs, I will now more in detail turn to the issue of regimes of
signs as it is described in ATP.

The D&G theory of signs distinguishes itself in important ways, as already indi-
cated, from more structural and deconstructive traditions of analysis. By privi-
leging process upon structure the latter approaches always have the signifier-
signified relation as the analytical focus, whereas the intensities of matter-
function are outside reach. Signifying semiotics are thus given a primate (the
white wall), as the black hole of disappearance can only be described from the
discursive, blinding out the creation potential of material intensities122. The big-
gest difference between the two approaches on an overall scale can be said to be

121 “That for the moment plays the role of the signified, but it continually glides beneath the signifier, for which it serves only as the medium or

wall: the specific forms of all contents dissolve in it. The atmospherisation or mundanisation of contents. Contents are abstracted” Deleuze, G
& Felix Guattari: A Thousand Plateaus. Athlone. London, 1988. p. 112.
122 See intro to ’year zero plateau’ in: Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone. London, 1988. p.

167ff.

56
the balancing by D&G in favour of the material extra-textual prolongations. The
signifier of structural linguistics has been referred to as the murderer of ‘things’
and as context-petrifying chaosmic abolition. By making it loose its immanence,
it transforms into deathly negativity, into a cadaverous object123. The real contri-
bution of schizoanalysis is here to embed a theory of signs, which stages the in-
stability of forms and substances working on the border of representation and
pure desire.

Rather than having the text and how it organises representation as the first and
last reference, the primary creation potential in Schizoanalysis is the auto-force
of matter, which resists representation and organisation. This is the very core of
the reterritorialisation of language where pragmatics is considered rather as in-
ternal to language than as traditionally external to language.

The schizoanalytic ’strategy of analysis’ rests on four analytical components,

which will be presented in the following section to produce a strategy of analy-
sis. It should be an analysis, which favours potentialities, interstices, dissolu-
tions/transformations, brought together in compositions rather than treated
through theories, techniques, descriptions and narratives, chained together by a
logic of accumulation and correspondence. Such an analysis is about local strate-
gies emerging.

In the following I will specify the general “attitude” and how this finds its ex-
pression in a rhizomatic frame, which is the characteristic of schizoanalysis124 as
a strategy of analysis. It should produce a picture of the schizo as a meta-model
embedding the nomadic principle, which will be specified further below in sec-
tion 4.

123 Guattari Felix: Chaosmosis-An Ethico-Aesthetic Paradigm. Power Publications. Sydney, 1995 (1992). p. 76.
124“The tree articulates and hierarchises tracings: tracings are like the leaves of a tree.
The rhizome is altogether different, a map and not a tracing. Make a map not a tracing. The orchid does not reproduce the tracing of the wasp,
it forms a map with the wasp, in a rhizome”. Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone. London, 1988. p.
12.
In “A Thousand Plateaus”, the idea of the rhizome is written out as an assemblage of plateaus making up a totality,
which is not totalizing in the sense that it demands certain fixed couplings. Rather it tends to open up and provoke dif-
ferent combinations of concepts and abstractions as you shift from one plateau to the other. In this way it embodies the
idea of the rhizome, which is a mode of analysis inscribing movement and creation as its characteristics.

57
As indicated schizoanalysis or pragmatics challenges traditions of formal linguis-
tics125 concerned with ‘language in its own right’ structured by rules (syntactics,
phonematics etc.). Acknowledgeding the relational nature of the sign and the
signifier as basically empty (or formally redundant) as it refers ‘only’ to an end-
less relation between signifiers and signifieds, language becomes of less interest
to the social scientist as a scientific zone of inquiry outside language in use. In-
stead focus should be on how signifiance can be seen as divided into several re-
gimes of signs having their own functionings of signifiance. The studies of lan-
guage and life become the study of the interrelations of signifying regimes or
mixings of semiotics, their transformational potential and the diagrammatic
function (the abstract component). The relation of ‘signs’ to things and persons
becomes machinic and creative and in this sense prior to representation.

The regimes of signs have each their function or varieties of assemblages, which
are performed as internal to enunciation, but external to constants of language
and irreducible to linguistic categories. The following is a short presentation of
the regimes of signs and their functions as mentioned by Deleuze & Guattari.
The primary goal is here to point at how regimes of signs can be thought of as
mixed semiotics, which comes together with the presence of different regimes in
different degrees according to what is the focus of a specific social analysis. It
will be elaborated below in the three last sections how mixed semiotics can be
studied in concrete contexts of Danish Social-Psychiatry. The list of regimes of
signs must be considered, as mentioned by D&G, an arbitrary list as many more
regimes of signs can be discovered:

The pre-signifyng regime (a-semiotic encodings) function by segmentarisation, which is

close to natural codings operating without signs. There is no reduction to facial-
ity (the body of the sign) as the sole substance of expression (the confusion of

125 The relation of schizoanalysis or pragmatics within the frame of D&G to structural linguistics that is de Saussure is

disputed. Functionalists like Jakobson and the semiotics of Peirce are explicitly referred to, which is natural because of
their growing emphasis on the sign as an independent variable and the growing interest of these linguists for the parole
rather than the langue. However it is argued by some linguists (Wouter Kusters on the D&G list) that Hjelmslev has been
given too much honour by D&G of escaping structuralism as many of his elements have already been present in de
Saussure. Hjelmslevs biggest achievement in this regard seems to have been the development of the net as presented
above. The inspiration from Peirce seems also obvious, where especially the firstness, secondness and thirdness seem to
link itself to the net: interspillings of forms of content and forms of expression. (see for further discussion the Deleuze
and Guattari list archives http://lists.village.virginia.edu/~spoons/d-g_html/, The Essential Peirce. Selected Philosophi-
cal Writings p. 160. Vol. 2. 1998. Kristeva : Language The Unknown. 1989.

58
the signifier with expression). There is no elimination of forms of content
through abstraction of the signified126.

The signifying regime functions by signifiance and interpretation. The regime is defined
by eight principles127. These principles sustain how the signifier has irreplaceable
body or face to, which all other signs in the signifying chain relate.

The countersignifying regime functions by numeration. The regime and its function
have to be considered in opposition to the role numbers play in the pre-
signifying and the signifying regime. Here numbers are signifying something
rather producing something in itself. In the countersignifying regime numeration
is characterised by distribution rather than collection, arrangements rather than
totals operating more by breaks, transitions, migrations and accumulation than
by combining units. We talk of countersignifying as an instantaneous apprehen-
sion of multiplicity as disjunctive synthesis. It is a momentary block of deterrito-
rialising and reterritorialising of the sign, a conjugation of cutting edges of deter-
ritorialisation. The war-machine issued from this counter-signifying step inserts
itself in the very flight of society. The definition of a specific patient as a citizen
voice can only be carried out from the position of the countersignifier. The
countersignifier blocks the recoiling of the voice of the patient/citizen into these
statements. The specific voice is the extraction of sign-potential from these
enunciative assemblages, or you could say a statement is never singular it is al-
ways collective. A proper name does not designate an individual, but is “[A]n in-
stantaneous apprehension of a multiplicity”128.

126 “Thus forms of corporeality, gesturality, rhythm, dance, and rite coexist heterogeneously with the vocal form. A variety of forms and sub-
stances of expression intersect and form relays. It is a segmentary but plurilinear, multidimensional semiotic that wards of any kind of signify-
ing circularity. Segmentarity is the law of the lineages. Here the sign owes its degree of relative de-territorialisation not to a perpetual referral to
other signs, but rather to a confrontation between the territorialities and compared segments from which each sign is extracted (the camp, the
bush, the moving of the camp). Not only is the polyvocality of statements preserved, but it is possible to finish with a statement: A name that is
used up is abolished, a situation quite unlike the placing in reserve or transformation occurring in the signifying semiotic”. Deleuze, G &
Felix Guattari: A Thousand Plateaus. Athlone. London, 1988. p. 117-118).
127 “1) the sign refers to another sign infinitum: 2) the sign is brought back by other signs and never ceases to return (circularity of the deterri-

torialised sign): 3) the sign jumps from circle to circle and constantly displaces the centre at the same time as it ties into it (the metaphor or hys-
teria of signs): 4) the expansions of the circles are assured interpretations that impart signified and reimport signifier (the interpretosis of the
priest): 5) the infinite set of signs refers to a supreme signifier presenting itself as both lack and excess (the despotic signifier, the limit of the sys-
tem´s de-territorialisation): 6) the form of the signifier has a substance, or the signifier has a body, namely the Face The principle of faciality
traits, which constitute a reterritorialisation: 7) the systems line of flight is assigned a negative value, condemned as that which exceeds the signi-
fying regimes power of de-territorialisation (the principle of the scapegoat): 8) the regime is one of universal deceptio, in its jumps, in the regula-
ted circles, in the seer´s regulation of interpretations, in the publicness of the facialised centre, and in the treatment of the line of flight”
Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone. London, 1988. P. 117.
128 Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone. London, 1988. P. 37.

59
The postsignifying regime (a-signifying semiotics) functions by subjectification. The pas-
sional, postsignifying regime can be summed up in opposition to the signifying
regime in the following way:

“There is no longer a centre of signifiance connected to expanding circles or an expanding spi-

ral, but a point of subjectification constituting the point of departure of the line. There is no
longer a signifier-signified relation, but a subject of enunciation issuing from the point of subjec-
tification and a subject of the statement in a determinable relation to the first subject. There is
no longer a sign-to-sign circularity, but a linear proceeding into which the sign is swept via sub-
jects”129.

The point of subjectification is said to be the origin of the passional line of the
post-signifying regime130. The shift between points of subjectification is the ac-
complishment of different codings (e.g normalisation from a certain perspective
of mixed semiotics e.g. associated with Social-Psychiatry and de-centralisation)
creating in a progressive way shifting points, which work as effective measures
of suppressing ‘madness’ or the multiple (synthesis of singularities). Between
these leaps, ‘madness’ shows itself only as breakdown covered by the normalis-
ing technologies, which are in current society represented by the medical func-
tion, the economic function, the anti-psychiatric function and the humanistic
function etc131. This is mainly the case since a romantic gloss of ‘the normal’ is

129 Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone. London, 1988. P. 127
130 “The point of subjectification can be anything. It must only display the following characteristic traits of the subjective semiotic: the double
turning away, betrayal, and existence under reprieve” (.....) ” A dress, an article of underwear, a shoe are points of subjectification of a fetish-
ist” (....) ”Whenever the beauty of the female becomes irresistible, it is traceable to a single quality: a point of subjectification in the departure of
a passional line”.
What is important is, what makes the post-signifying passional line a line of subjectification or subjection, is the constitution, the doubling of
the two subjects, and the recoiling of the one into the other, of the subject of enunciation into the subject of the statement (the linguists acknowl-
edge this when they speak of “the imprint of the process of enunciation in the statement”) Deleuze, G & Felix Guattari: A Thousand
Plateaus. Athlone. London, 1988. P. 129)
131 “Only one side of the assemblage have to do with enunciation or formalises expression: on its other side inseparable from the first, it formal-

ises contents, it is a machinic assemblage or an assemblage of bodies.

Now contents are not signifieds dependent upon a signifier in any way nor are they objects in any kind of relation of causality with the subject.
They have their own formalisation and have no relation of symbolic correspondence or linear causality with the form of expression: the two
forms are in reciprocal presupposition, and they can be abstracted from each other only in a very relative way because they are two sides of a sin-
gle assemblage. We must therefore arrive at something in the assemblage itself that is still more profound than these sides and can account for
both of the forms in presupposition, forms of expression or regimes of signs (semiotic systems) and forms of content or regimes of bodies (physical
systems). This is what we call the abstract machine, which constitutes and conjugates all of the assemblage´s cutting edges of de-
territorialisation. We must say that the abstract machine necessarily “much more” than language. When linguists (following Chomsky) rise to
the idea of a purely language based abstract machine, our immediate objection, that their machine, far from being too abstract, is not abstract
enough because it is limited to the form of expression and to alleged universals that presuppose language” Deleuze, G & Felix Guattari: A
Thousand Plateaus. Athlone. London, 1988. p. 140-41)
“A true abstract machine has no way of making distinction within itself between a plane of expression and a plane of content because it draws
a single plane of consistency, which in turn formalises contents and expressions according to strata and reterritorialisations. The abstract ma-
chine in itself is destratified, deterritorialised: it has no form of its own (much less substance) and makes no distinction within itself between
content and expression, even though outside itself it presides over that distinction and distributes it in strata, domains and territories. An ab-

60
accomplished by a trustworthiness ascribed to the signifier. There is no more
room for interpretation as de-territorialisation is followed by re-territorialisation
in constant sweeps accomplished by a network of abstract machines.

The overall strategy of countersignifying within Social-Psychiatry is to study how

professions, relatives and patients are subjugated to technologies and to extract
from these potential blockings and retentions by inferring potential machines,
which can join the network of efficient emergent machines.

A ‘budding’ machine could be ‘the experimental machine’ working inside de-

centralisation, experimenting with multi-paradigmatics and housing facilities
based on the idea of communes. Another potential machine could be the one of
re-centralisation of thinking the idea of the asylum as a protection facility to-
wards the over-coding of normalisation. Consequently, what is at stake is the
creation of new articulations within enunciative assemblages, complexes of sub-
jectification. As mentioned by Guattari132 when talking about patients creating
new ways of expressing themselves in the clinic: “The important thing here is not only
the confrontation with a new material of expression (horseriding, gardening etc.), but the consti-
tution of complexes of subjectification. The constitution of complexes of subjectification: multiple
exchanges between individual-group-machine. These complexes actually offer people diverse pos-
sibilities for recomposing their existential corporeality, to get out of their repetitive impasses and,
in a certain way, to resingularise themselves”.

We now turn to the concept of the assemblage to further approach how these
multiple exchanges sustaining complexes of subjectification are generated.

Assemblages
What is characterising the two generic assemblages as indicated above is that the
abstract machine is always singular (diagrammatic), while the enunciative assem-
blage is always collective and concrete (programmatic).

stract machine in itself is not corporal or physical, any more than it is semiotic: it is diagrammatic (it knows nothing of the distinction between
the artificial and the natural either). It operates by matter, not by substance by function, not by form” Deleuze, G & Felix Guattari: A
Thousand Plateaus. Athlone. London, 1988. p.141).
132 Guattari Felix: Chaosmosis-An Ethico-Aesthetic Paradigm. Power Publications. Sydney, 1995 (1992). p. 7.

61
“The diagrammatic or abstract machine does not function to represent, even something real, but
rather constructs a real, that is yet to come, a new type of reality. Thus when it constitutes
points of creation and potentiality it does not stand outside history, but is instead always prior
to history”133.

Abstract machines have names that of course do not designate persons or sub-
jects, but matters and functions:

”.. [A]s such there is always a diagram, whenever a singular abstract machine functions di-
rectly in a matter” 134.

It is said that all semiotics are mixed e.g presignifying elements are always active
in signifying regimes: counter-signifying elements are always present and at work
within it, and post-signifying elements are already there. That is why the beco-
ming minor within the major never can depart from a pure signifying or coding
function, it is a working of the signifying potential already there juggling for the
more favourable position.

These mixings of semiotics are conceived as assemblages, enunciative assembla-

ges, which however presuppose other assemblages: machinic assemblages, this is
what makes them more than language and more than expression, it is what ma-
kes them more than semiotic systems and signifying regimes.
What is at play is how new things are formed or what Foucault referred to as ac-
tuality or emergence135.

133 Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone. London, 1988. p. 142.
134 This leads for now to the following conclusion, when it comes to the interconnection of language, the diagrammatic,
the abstract machine and regimes of signs: “There are no regimes of signs on the diagrammatic level, or on the plane of
consistency [immanence], because form of expression is no longer really distinct from form of content”. “ All of this
culminates in a language stratum that installs an abstract machine on the level of expression and takes the abstraction of
content even further, tending to strip it of any form of its own (the imperialism of language, the pretensions to a general
semiology). In short the strata, substantialize diagrammatic matters and separate a formed plane of content from a
formed plane of expression” Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone. London, 1988. p. 142.
“However it is maintained, that: “We cannot, however content ourselves with a dualism between the plane of consis-
tency and its diagrams and abstract machines on the one hand, and the strata and their programs and concrete assem-
blages on the other” Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone. London, 1988. p.144).
This is an important distinction as the machine or the different modes of the machine has two vectors, one that work on
the different strata, where it distributes territorialities, relative deterritorializations, and reterritorializations: and the other
vector that is oriented towards the plane of consistency or destratification, upon which it conjugates processes of deterri-
torializations, carrying them to the absolute of the earth”.
135 Deleuze talks about his project and its correspondence with Foucault:

“We set out to follow and disentangle lines rather than work back to points: a cartography, involving microanalysis (what Foucault called the
microphysics of power: and Guattari the micropolitics of desire). We looked for foci of unification, nodes of totalization, and processes of subjec-
tification in arrangements, and they were always relative, they could always be dismantled in order to follow some restless line still further. We

62
You can from the side of discourse reach a point where regimes of signs are
transformed (a product of the three other transformation modi: analogue-
transformation, symbolic transformation, polemic transformation or strategic
transformation) into subjectification from where the diagrammatic function
takes over. The point of subjectification is, as mentioned above, the point where
the subject of the statement and the subject of enunciation recoil into each
other. It is the point where the rules and the player of the game are indistin-
guishable.

As an example you could mention the management thinking within the de-
institutionalisation of psychiatry and the rhetoric of humanism, which dominates
the field of psychiatry from the nineties and onwards. The abstractions accom-
plished by the order-word of management thinking (the statement) make hu-
manism (expression) apply to the rules so defined. Or you can see humanism as
the expressed of the statement containing segmentation according to the logic of
de-centralisation, whereas content is characterised by different actions of pa-
tients-becoming citizens, actions of professionals, actions of associations, visions
of the central administration etc.

Humanism thus comes to function as another persuasion inside the regime of

management thinking. The humanism of the state becomes de-territorialised by
a managerialistic over-coding (order-word-machine). This is the machinic net-
work of management and humanism, which accomplishes deterritorialising
sweeps by creating points of disappearance. They show themselves, when the
patient has his bow and arrows taking away, when he can no longer anchor his
voice anywhere136.

were not looking for origins even lost or deleted ones, but setting out to catch things where they were at work, in the middle: breaking things
open, breaking words open” Deleuze Gilles: Negotiations. Columbia Univ. Press. 1990. p. 86.
136 ”Signifiance is never without a white wall upon which it inscribes its signs and redundancies. Subjectification is never without a black hole

in which it lodges its consciousness, passion and redundancies. Since all semiotics are mixed and strata come at least in twos, it should come as
no surprise that a very special mechanism is situated at their intersection. Oddly enough it is a face: the white wall/black hole system”.
Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone. London, 1988. p. 167.

63
As it appears these points cannot be represented, but only pointed at from a
counter-signifying position. That is why you can talk of countersignifying as a
creation of something new. A countersignifying potential effects new articula-
tions of assemblages consisting of still new interspillings of expression and con-
tent – effecting new complexes of subjectification.

This movement from the organising functioning of signifying regimes to pure

embodiment (the abandon of the distinction sign-and use or signifier-signified)
is always in any case non-conclusive. It is a game of signs, which is at the same
time: unfinished, neutral, deep and impersonal. Expression is always the expres-
sion of a statement or order-word. As such the only stability left for the signifier
is simply to function as a temporary white wall, from where the game can go
anywhere.

The diagrammatic function creates still new variations/interspillings of content

and expression. In other words power must be considered in conjunction with
the forces passing through the particles of flickering matter and vibrating func-
tions. Analytically, concrete assemblages can be studied as order-words and ex-
pressions and incorporeal transformations and non-corporeal attributes. Signify-
ing regimes and their transformations thus are studied as a de-stratification. On
the level of the machine we can formulate the problem as we can discover the
machine as it marks of a given stratum with one vector and with the other point-
ing towards the plane of consistency137. We can see them as effective emergences in
this sense they are actual-real. We can like in the archaeology of Foucault, as a
first analytical activity, focus on the expression of the statement as though it had
autonomy. However the redundancy of the statement can only be touched by
also considering ever new interspillings of content-expression. This implies that
we also have to look for the potentialities of machines belonging to the possible-
virtual. The dynamics are accomplished by points of subjectification: where the
subject of the statement recoils into the subject of enunciation, where the de-
stratifying forces of the abstract vector of the abstract machine draw in all com-
possible worlds.

137 See also above on page 40.

64
Thus we have to describe the machinic assemblage and its potentiality for trans-
formation (tendency rather than identity). This is the case as any de-
territorialisation of the sign necessarily is followed by a re-territorialisation - a
new assemblage.

As a diagrammatic transformation means disappearance, it brings the whole dis-

cussion of the conception of ‘la durée réelle’ back in position. As schizoanalysis
takes both revolutionary, analytical and artistic cogs to work together, it becomes
the more important to consider signifiance and de-territorialisation and to ad-
dress how the order-word/statement accomplishes re-territorialisation

In order to bring these observations into play I will apply it to a few examples,
addressing how the speed and flight of society create the conditions for counter-
signifying. I will continue by introducing the generalised example of The Wel-
fare-State.

The Welfare State

Consider The Welfare State, which is defined by the task to care and distribute
welfare according to fair, humanitarian and democratic principles. However
these principles are built on the logic of abstraction, which embeds very subtle
control mechanisms. Abstraction or sudden de-stratifications become the work
mode of the Welfare State, more accurately this is not due to something within
the state itself, but rather due to something positioned alongside The Welfare
State, which it cannot contain. This abstraction is sustained by the rhetoric of
equality and tolerance. The Welfare State and its ‘humanism’ comes to serve
these abstractions, as it blocks the counter-signifying forces, which seek to retain
potential by expressing (slowing down de-stratification) and by making borders
appear. Abstraction creates a tolerance of an imaginary ‘Other’, the real face of
who is recognised by The Welfare State. These ‘Others’ can be practically any
member of society, but seem to be what is referred to as the marginalised peo-
ple, referring to their visible characteristics like ethnicity, illness, social-status in
general etc.

65
The abstract machine or order-word machine of management and control ac-
counts for these destratifications. It is more correct to say that there is not only
one abstract machine, rather it is a network of machines defined by different ab-
stract tendencies or desires.

It could be stated that a society built on abstraction creates a general state of

alienation and indifference. This fact becomes the more profound and deep as it
installs a false consciousness of the concrete. Rather the concrete is constantly
swept away and only installed as imagination, when The Welfare State sustains
rhetoric on quality, co-determination and de-regulation. The systems of the state
do not belong to the state more than they belong to the de-stratifying forces of
abstract machines. The state thus can be said to have existence as double
headed138, as the jurist priest and as the magician king, which is the double ar-
ticulation turning the state into a stratum. One could confuse the war-machine
with one or the other head, however the binding effect of the creation of imagi-
nary unities is no more war-like than the organising of systemic entities.

The Welfare State is penetrated by mechanisms, which create abstractions and

thus de-stratifications, which are too sudden. This creates stasis and rigidified
strata. The Welfare State gives the image of creating equality and caring for the
concrete existence of every citizen. Abstraction makes values as co-
determination, democracy and equal rights disappear into a particles-mist in de-
stratifying sweeps. In relation to the concrete ‘Other’ citizen, it creates a state of
betrayal, entrenchment, exclusion, indifference and annihilation. This becomes a
state of rigidity and solidification as this de-stratification can happen more sud-
den because of the legitimising gloss given by the specific humanistic rhetoric or
a humanistic machine. In short, counter-signifying is blocked as long as the liai-
son ‘humanism’-‘management’ is in effect as order-word machines.

This order-word machine joins a network of the other machines. It over-codes

language by inventing new words and concepts, which function to de-

138 ” Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone. London, 1988. pp. 352-354.

66
territorialise and re-territorialise, creating a state of relative autonomy as it helps
to block out counter-signifying.

The Inverted ‘Functionality’ of The State - Involution in Exchange for

Evolution
The network of machines and enunciative assemblages create a coding of terri-
tories, which blocks co-existence with the state, because The Welfare State is in-
stalled and sustained on an old principle of state evolution. However as shown
above this cannot be challenged, within the existing frame because re-
territorialisation immediately follows de-territorialisation. That is why a new
principle must be installed the one of co-existence and inverted functionality.

Consider the neolithic revolution139: Who does the earth think it is? Was it the
first statement of the neolithic farmer who wanted to tame the earth and culti-
vate land? Is it the question that installs the overarching concept of land rather
than territory? Talking about man as a geological being you need to install an-
other principle. One needs stratifications, which are not a judgement of man as
citizen. In this context, man can only work with land and signifiers and signi-
fieds. He can only be a pseudo-strategiser contained by the state. Man as a his-
torical-archaeological being is submitted to the terror of representation, meas-
urement and the programming forces of functionalism. He is working the land
to accomplish the needs and development of the state. He is always determined
from the state, he is signifier and signified. The neolithic revolution is the imagi-
nary installed by this functionalist over-coding. The hunter-nomad in this per-
spective is assimilated by the state. In archaeology140, he disappears under the

139 ”It is no longer the State that presupposes advanced agricultural communities and developed forces of production. On the contrary , the State

is established directly in a milieu of hunter-gatherers having no prior agriculture or metallurgy, and it is the State that creates agriculture, ani-
mal raiusing and metallurgy: it does so first on its own soil, then imposes them upon the surrounding world. It is not the country, that progres-
sively creates the town but the town that creates the country. It is not the State that presupposes a mode of production: quite the opposite, it is
the State that makes production a “mode”. The last reasons for presuming a progressive are invalidated. Like seeds in a sack: It all begins
with a chance intermixing. The “state and urban revolution may be Palaeolithic, not neo-litihic as childe believed. Deleuze, G & Felix
Guattari: A Thousand Plateaus. Athlone. London, 1988. p. 429.

140 ”More generally, one marvels at the bizarre indifference that ethnology manifests for archaeology. It seems as though ethnologists, fenced of in

their respective territories, are willing to compare their territories in an abstract or structural way, if it comes to that, but refuse to set them
against archaeological territories, that would compromise their autarky. They take snapshots of their primitives but rule out in advance the co-
existence and superposition of the two maps, ethnographical and the archaeological. Catal Hüyük, however would have had a zone of influence
extending two thousand miles: how can the ever recurring problem of the relation of coexistence between primitive societies and empires even
those of Palaeolithic times, be left unattended to?
As long as archaeology is passed over the question of the relation between and history is reduced to an idealist confrontation, and fails to wrest
itself from the absurd theme of society without history or society against history. Everything is not of the State precisely because there have been

67
pressure of settled people and their categories of normalisation. Monuments in
archaeology always have reference to states and empires and their tools of binary
logics, accumulations, classifications and measurement. Even history and her-
meneutics as Foucault stated should aspire to becoming archaeology. However,
discursive monuments and their discontinuous status could only be determined
through generalised categories such as Madness and Civilisation. In geology you
only find stratifications and assemblages. Stratifications and assemblages are not
prior to the state rather they are exterior, co-extensive with the state141.

From the perspective of the geologist, the hunter-gatherer nomad and the cattle
raising semi-sedentary nomad, will be the creators of new articulations. Their
new complex refrains open up new fields of virtuality142, as a counter-signifier
within evolutionism and the unitary state-programming. Geology and the no-
madic are linked as exteriorities to the state and the despotic signifier. It is both
exterior and anterior and as such not an original or formal essence. As such it
communicates with the state, not from the state and thus against the state. We are
not talking about some fluffy rebelliousness, but about a determined provoca-
tion from within ‘the known’. The desert is here in the middle of pure abstrac-
tion and condensations. Coming out of the desert the war-machines accom-
plishes momentarily (vertical) blockages, stopping the infinite speeds.

Abstract machines undermine the concrete and sweep it into particles. Any con-
crete enunciative assemblage has the traces of the past. The de-territorialisation
of the counter-signifier accomplishes suspense and creates retention of these
traces. Even re-territorialisation is never an expected, but only an extraction of
potential for the next move. Keeping up suspense and extracting potential from
each side by blocking it, is a hypostatical activity. It is to retain enough signifying

States always and everywhere. Not only does writing presuppose the State, but so do speech and language. The self-sufficiency, autarky, inde-
pendence, pre-existence of primitive communities, is an ethnological dream: not thet these communities necessarily depend on states, but they co-
exist with them in a complex network”.
Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone. London, 1988. p.429-30 reflecting on the development the-
ses of Pierre Clastres.
141 ”It is in terms not of independence, but of co-existence and competition in a perpetual field of interaction, that we

must conceive of exteriority and interiority, war-machines of meta-morphosis and State apparatuses of identity, bands
and kingdoms, megamachines and empires” Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone. London, 1988.
p. 360-361.

142 Guattari Felix: Chaosmosis-An Ethico-Aesthetic Paradigm. Power Publications. Sydney, 1995 (1992). p. 18.

68
potential to turn it against a dominant reality. It is to set out from the function
of expression to accomplish a momentarily blocking of de-territorialisation and
re-territorialisation making borders appear as anomalia. This keeping in suspense
in the middle of the signifying game can only be accomplished, because of the
exteriority of the counter-signifier. The counter-signifier is a trickster, which
cannot be appropriated by the state. Like the wolf, which is at the same time col-
lective and singular. It evades judgement in the sense that it has the characteris-
tics of the singular pack avoiding any codings or rules of a state. At the same
time however the pack forms its own collective, the wolf is never alone as a be-
ing: he is a part of a collective becoming pack. It creates suspense, a provocation
of the codes of settled people. This is the other silence143 within that silence of
the silenced, it is the true singularity in between the double negativity of being
and nothingness, in between acting subject and death.

Another example of a trickster or a war-machine could be the function of sex in

western societies as an ultimate programmer of roles and participation in society,
which can be highlighted by a counter example from a ‘sociocentric’ culture.
Consider the Faafafinas of Samoa. A group of people, who disregarding its male
genetics insists on adopting roles of what normally would be ascribed to genetic
females. What is notable among these people is that some have decided to
change their sex surgically whereas some other have not. They cannot be catego-
rised according to what the western mind finds to be appropriate categories. The
Faafafinas choose too consider themselves among themselves as sisters and not
as potential partners, as such they are not ‘gay’. On the other hand, they are not
‘transsexuals’, as they do not necessarily have an urge to change their biological
sex and not all of them dress up like women. They are nothing in themselves as
classified subjects rather they are their roles (which however it seems are an
adoption of traditional genetic female roles). These people seem to have the
possibility to 'shop' around for roles in a fashion incomprehensible to the mind
of the egocentric or subject oriented western mind. Genetic sex does not pro-
gram an individual, rather society produces roles that people can shop for ‘by

143 What was referred to as ’l´autre nuit’ in: Blanchot, Maurice: The Infinite Conversation. Univ. Minnesota Press. Minneapolis,

1997. Blanchot)

69
choosing their own sex’ disregarding their biological sex. This principle of socio-
centrism and its concrete manifestations could be seen as a trickster or a
counter-signifier in relation to western society. As long as sex can be used as a
coder in accordance with the western state and its institutions it can program the
roles that people choose. Sex as such becomes a measure of control, which is ra-
tionalised according to a whole tradition of western moralisation not in the least
conferred by the church. The instance of socio-centrism is likely to produce a
smooth space, where differentiated roles pick people and vice versa. These roles
can be evenly stereotyped and coded, but it seems that socio-centrism features a
supple segmentarity144 – a flexibility and a non-control society.

Madness in Foucault's ‘Madness and Civilisation’ could only emerge from the
rigid segmentarity, the normalising functions of the western state. Likewise, the
becoming citizen of the mad person today is a project of the normalising
technologies of the state. The functional structure (expression and the jurist
priest) is here the de-institutionalisation of the patient, where content (magician
king) goes from patient defined by his institutional history to an object of more
vague normalising technologies. This transposition can be voiced from the state
by choosing synchronic revolving-points, where de-institutionalisation creates
different conditions of possibilities of becoming citizen of the patient. This
rhetoric of the state however is a territorial one, whereas the more subtle
capitalist codings operate in de-territorialising sweeps145.

These sweeps seem at certain points to amount to de-stratifications, which result

in a state of chaos. The state installs an imaginary idealism of psychiatric unity
based on humanism and individual co-determination, which can be considered
its primary content (the magician king). This is distributed through different

144Deleuze, Gilles & Felix Guattari: Mille Plateaux. Les Éditions de Minuit. Paris, 1980. p. 213.
145 “…. [C]apitalism has from the beginning mobilised a force of deterritorialisation infinitely surpassing the de-territorialisation proper to the
State. For since Paleolithic and Neolithic times, the State has been deterritorilising to the extent that it makes the earth an object of its higher
unity, a forced aggregate of coexistence, instead of the free play of territories among themselves and with the lineages. But ithis is precisely the
sense in which the state is termed territorial. Capitalism on the other hand, is not at all territorial, even in its beginnings: its power of deterrito-
rialisation consists as making as its object, not the earth, but ‘materialised labour’, the commodity. That is why capitalism marks a mutation
in wotldwide ecumenical organzations, which now take on a consistency of their own: the worldwide axiomatic, instead of resulting form hetero-
geneous social formations and their relations, for the most part distributes these formations, determines their relations, while organising an in-
ternational division of labour. Form all these standpoints, it could be said that capitalism develops an economic order that could do without the
State. And in fact capitalism is not short on war cries against the state, not only in the name of the market, but by virtue of its superior deter-
ritorialisation” Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone. London, 1988. pp. 453-54.

70
management technologies (the jurist priest). However, the managerialism at-
tached to the becoming citizen seems to be exposed to sudden de-stratifications,
leaving little room for the territorial working of the state and its institutions. As
such a state of stasis comes to dominate the field of psychiatry through a stratifi-
cation or (de-stratification) consisting of values of imaginary unity, cross-
professionalism etc. and organisational reforms.

The destratification of the old institutional psychiatry can be observed to create

a state of crises where the past seems disconnected from the future. Decentrali-
sation seems to lock the creation of a new psychiatry as it does not allow the
traces of the past to slide into the future. Rather decentralisation and the abstract
normalisation/humanitarian trend, block sign-potential resulting in regression:

“Every undertaking of de-stratification (for example, going beyond the

organism, plunging into a becoming) must therefore observe concrete
rules of extreme caution: a too sudden destratification may be suicidal or
turn cancerous. In other words it will sometimes end in chaos, the void
and destruction, and sometimes lock us back into the strata, which be-
come more rigid still, losing their degrees of diversity, differentiation and
mobility”146.

When analysing a social field and its sign-potential, archaeology is only a pre-
liminary operation, as signifiance always has counter-signifying potential.
In order to go beyond synchronicity, we have to consider the shadows of geol-
ogy as mixed semiotics and to stress how we as stratified beings have a reserve
of sign-potential. The singularity of madness has a potential role as a trickster, a
true creator inside normalising over-coding.

Archaeology is merely a pragmatic methodological starting-point where the ex-

pression side is in focus. It is the expression and the territory of the state, that is
the expression of psychiatric unity manifested through management reforms.
However, ‘archaeology’ is merely like the archological survey. It focuses on as-

146 Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone. London, 1988. P. 503.

71
semblages of artifacts to be judged and valued as scientific potential according to
classifications and known categories (order-words). It is mere interpretation of
ideologies, sciences – writings. However the primary tension is exterior to the
state, war-cries belonging to the de-territorialisations of the war-like cattle raising
nomads or of capitalistic mutations.

Countersignifying
‘Breaking words open’, ‘to catch things where they are at work’ is a way of stressing the relativity of any ‘structure’
and the possibilities of life as a continuous creation of ways of existing147.

In the following I will proceed by giving examples of how to apply the general
perspective of experimenting with signs and assemblages of things and persons
to create something new. The aim of the following three examples is to show
how resistance, becoming or a resingularisation of individuals should be thought
of as repetition with a difference, or rather as an extraction of sign-potential
from within the very core of signifiance.

The undecidedness and unfinalised character of the analysis of stratifications and

the creational diagnostic lines of becoming poses a certain challenge to subver-
sive modes of reterritorialisation. It stresses how148 there is a tendency of confus-
ing the concept of difference with merely conceptual difference. If you decide to
remain content to inscribe difference in the concept in general, you loose the de-
territorialising power of becoming. When difference becomes a theme to be
found and pointed out, located, it looses its critical force to change or disrupt, to
become other.

Conceptualisation of difference such as applied by the welfare-state serves to le-

gitimate itself as humanitarian. It equals the technologies of 'white society' to
model and stereotype black resistance, or the modelling mad-people to confirm
'the normal'. The consequence of the application of these repressive technolo-
gies is the limiting of the intensities of black-becoming or mad becoming.

147 This notion of life as a work of art was what Nietzshe termed the highest dimension of the will to power, artistic will.
148 Deleuze, G: Difference & Repetition, p. 27. 1994. Columbia. New York.

72
Repetition with a difference is a politics of resistance, an alterity politics of per-
formative subjectivity149. Resistance becomes the issue of a war-machine inserted
on the outside of representation, thus pulling and twisting a given social regime.
The notion of the war-machine seems to be traced as far back as ‘Difference and
Repetition’150 by Deleuze, but it later became a major theme in ATP, as will be
discussed further in section 4.

Example one: Malcolm X - Becoming Afro-American

The following is an example of how de-territorialisation and re-territorialisation
of the sign can be seen as a political struggle of resistance. In this regard, I will
make a few illustrations from the movie of the life of Malcolm X. The movie is
an interesting example of how strategies of resistance rely on signs and how
these signs make up the flows and interpenetrations of our seeing and speaking.

Malcolm X goes from being the victim of memory and points, to forming a
blockage – a counter-signifier as he finally sees that the space reserved for ‘the
negro’ could only be maintained by retaining the black-white segregation (which
he himself reproduced for a long time before his epiphany in Mekka, as he real-
ised that the militant course of the black muslims would fail as strategy of eman-
cipation as it would only create further segregation.

The step towards ‘becoming Afro-American’ and thus creating something new,
took first a challenge of the colonial memory. The name given by the slave own-
ers was from the beginning thrown away, but it became not replaced by another
stamp of authentication, such as an African-native icon. The X was a segmenta-
tion of blackness, which was first translated into an imaginary memorised origin,
projected in a vision of black identity/nationalisation151. This was later erased
and translated into another signifying regime than the one of black and white

149 See Jeffrey T. Nealon: Alterity Politics. Ethics and Performative Subjectivity, pp. 118-37. Duke Univ. Press. Durham

& London, 1998.

150 Deleuze, G: Difference & Repetition. 1994. Columbia. New York.

151 “Jews, Gypsies etc. might constitute minorities under certain conditions, but that in itself does not make them becomings. One reterritorial-

ises, or allows one self to be reterritorialised, on a minority as a state: but in a becoming one is de-territorialised. Even blacks, as the Black
Panthers said, must become black. Even women must become women. Even jews must become jewish (it certainly takes more than a state).
But if this the case, then becoming jewish necessarily affects the non-jew as much as the jew” Deleuze, G & Felix Guattari: A Thousand
Plateaus. Athlone. London, 1988. p.291).

73
segregationism. We could state that there was both a world of Malcolm the seg-
regationist and Malcolm the non-segregationist. Malcolm accomplished a block-
age escaping a fundamentalism inherent in his original ideology, which contains
the danger of annihilating itself in a black hole of subjectification. However, the
change of plane accomplished by the line of becoming Afro-American opened
up new opportunities creating new technologies of becoming ‘white’ without
whiteness being supremacy, but rather a border to play with. You can see this
working with ‘becoming Afro-American’, which Malcolm did by rejecting his
former ideas of black and white segregation, as a becoming minor within the
major, rather than as a pseudo-resistance reproducing historical fights, framed
by the endless interpreting and signifying.

In the beginning of the movie, young Malcolm is concerned with having the ap-
pearance of a white person, getting his hair done in the barber-shop. He exclai-
med: “It looks white doesn´t it”? Whiteness at this stage comes to signify acceptance
as a person in a racist state, which feature an over-coding by the despotic signi-
fier of whiteness/blackness. However you could use the phrasing ‘becoming
white’ (after the revelation in Mekka) differently. By retaining the signifier ‘white’
of a black person, you indicate a counter-signifier that is a de-territorialisation of
the sign and a suspension of reterritorialisation. The signifier ‘white’ now
doesn´t merely signify a white person and white ideals, but the becoming of a
black person embracing whiteness as blackness, rather than a passive submission
to memory and habit (white ideals). The praxis of turning and twisting signifiers
is an efficient resistance, which works a dominant reality from within, bouncing
against the white wall of the signifier working with signs rather than succumbing
to signifiers, which can only sustain interpretation and thus reproduction.

It becomes an adoption of a signifier by a group of people transforming it into

an active mode of resistance within the major.

Like mentioned by Jeffrey Nealon referring152 to the works of Baraka and Reed,

152 Nealon, Jeffrey, T.: Alterity Politics. Ethics and Performative Subjectivity. Duke Univ. Press. London & Durham,

1998.pp. 118-138.

74
black resistance has a long tradition of these subversive modes, as they have
been reterritorialising, white culture with genres from Charlie Parker to com-
temporary rap music. These reterritorialisations have all featured as repetitions
with a difference.
When black people adopt the old predicate: ‘Nigger’ an anachronistic expression
used by white people to show their disrespect, it is a counter signifying, a war-
machine, which slows down de-stratifications. It slows down the momentum of
the interpreting and signifying of the ‘whites nigger’, by rediculing and twisting,
rather than being subjected to the memory of a history of exclusion. It thus be-
comes a black-nigger, a trickster153 created to suspend re-territorialisation and a
potential over-coding. The de-territorialising sweeps of the machinery of
black/and whiteness, which can not appropriate this trickster. The reason is that
it cannot be subordinated to the machinic desire to create segregation according
to colour (depending on a signifying chain). That is why it could serve as a coun-
ter-signifier or nomad war-machine.

The signifier is a temporary wall, which is why to repeat pragmatics and the dy-
namics of signs are mixed semiotics rather than signifiers. The signifier never
has a straightforward relation with the signified - it is always in a state of compo-
sition. The pure signifier only exists in memory and representation, not in be-
coming. That is why 'becoming thought' must embed a theory of sign at its ba-
sis.

Example Two: Counter-Signifying and Madness

‘Mad people’ or rather people with a psychiatric history in the new Welfare State
are faced with forces as they are exposed to normalisation outside the hospital.
Having had their strategies of becoming a patient inside the hospital, they are

153 The trickster is a mythological figure, which you find in native cultures all over the world. "Trickster" is an important

(often sacred) figure in the folklore of numerous cultures all around the world: a paradoxical creature who is both very
clever and very foolish, a culture hero and destructive influence -- often at one and the same time. In the legends of
many societies, it's Trickster who is responsible for giving humans fire, language, hunting skills or even life itself. . .but
he's also the one who brought us death, hunger, difficult childbirth, illness and other woes. Alan Garner (the great British
fantasy writer and folklorist) calls Trickster: "the advocate of uncertainty. . . . He draws a boundary for chaos, so that we
can make sense of the rest. He is the shadow that shapes the light." Terri Windling : Http://www.Endicott-
studio.com/fortrck.html. The semiotic production of ‘a black nigger’ becomes a culture specific expression (a folding) or
a territorial mark, a countersignifier, which cannot be apprehended or sub-ordinated by order-words. In this way it ab-
sorbs or territorialises uncertainty making a space for a singular blackness on the inside. A trickster within this frame is
not merely a phantasy with a stereotyped function (which is the interpretation given by structural anthropologists), but
part of semiotic production – a countersignifying potential.

75
now exposed to a vast body of normalising technologies. As such the mad per-
son faces either annihilation in a black hole or a re-territorialisation. The ques-
tion is: how is a mad-person able to work with his becoming inside this normal-
ising over-coding of?

An illustration of how madness as a singularity plays with this border of nor-

malisation, can be retrieved from the brilliant Cassavetes movie: “A Woman
Under The Influence”154:

The main character Mabel has just been discharged from mental health care and
is finding her way back to the fine balance between keeping up her distinctive
character as a mad-person and being in some kind of communication with nor-
mality. This fine and delicate communication is held up through the close inter-
action with her husband Nick and her three kids. Her liaison with the husband
and kids comes to function as a counter-signifyier inside the over-coding forces
of normalisation, which take over and show themselves, when Mabel’s sensitiv-
ity is misconstrued in different situations. The result is eventually Mabel’s break-
down, when counter-signifying is weakened (Nick starts to misconstrue her as
well). From there Mabel is excluded finding herself in total isolation feeling be-
trayed by everybody. She is forced to medicalisation, taken away and hospital-
ised. What follows is either annihilation in a black hole of subjectification (Mabel
is silenced and locked away without any chance of participation in the game of
signs) or a shift of planes where the communication between madness and nor-
malisation can be retrieved, through a new counter-signifying155. This last thing
happens in the end of the movie, where Mabel retrieves the link, through the
decisive loving and caring intervention of Nick and the three kids. However, if
the change of planes is on a higher level or lower, one is not able to say: it re-
mains a neutral, which makes the story nor conclusive nor moralistic.

John Cassavetes director, 1974. Starring Gena Rowlands and Peter Falk.
154

Subjectification carries desire to such a point of excess and unloosening that it must either annihilate itself in a black hole or change planes.
155

Destratify open up to a new function a diagrammatic function” Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone. Lon-
don, 1988. p. 134.

76
The most fascinating is how the form of cinema creates this neutrality around
Mabel´s breakdown. A long shot and close ups156 on the stern faces of the
mother in law and the doctor make normalisation speak, whereas madness pre-
sents itself with the face of Mabel total in despair. The quick hand-held camera
panoramic shots between these two faces make the signifying game present itself
as the real drama that it is. The framing of the faces and their traits are dissolved
and the personal identities are swept into the neutrality of pure faciality traits.

When Mabel finds herself back in her home, nothing indicates a change of
plane. The camera is a standstill shot in a frog’s perspective of the closest family,
mother in law, uncles etc. as they stand around Mabel sitting in a living-room
arm-chair. This shot indicates annihilation rather than shift of plane. The shift of
plane does not occur until the family is sent home, and Mabel has a new break-
down of frustration, from where Nick and the kids retrieve her restoring a new
order. This is indicated by the half distance camera shot of Mabel and Nick in an
everyday conversation in the kitchen, which is the end of the movie.

What is important to note, which is also mentioned by Guattari, is that the cin-
ema is not a passive representative image, but a vector of subjectification. “We
are actually confronted by a non-discursive, pathic knowledge, which presents itself as a subjec-
tivity that one actively meets, an absorbant subjectivity given immediately in all its complex-
ity”157. This intuition is what Bergson referred to as non-discursive experience of
duration.

Example three: ‘The Real Homelessness’

A counter-signifier creates movement as it retrieves a provocation, a tension or a
continuous folding of material.

Like the Danish movie director Lars von Trier states: “I want to be like a stone in
the shoe”. He does not want to be in opposition or revolt or something else
’fluffy’. He wants to be a thing in a known place producing a pain, which is felt

156 Notice that the close up dissolves 'the face' and transforms it into pure facility traits. Like in the close-up masterpiece
of Carl Th. Dreyer from 1928: "The Passion of Joan of Arc".
157 Guattari Felix: Chaosmosis-An Ethico-Aesthetic Paradigm, p. 25. Power Publications. Sydney, 1995 (1992).

77
with certain firmness. "In this way he becomes the expression of the strange connection be-
tween form and passion" 158.

Such possibilities for creating something new are found in many places where
people surf and ride the breaking waves of discourse.

Like the homeless people working with becoming inside the systems of The
Welfare State. The development of Social-Psychiatry thus became one such fond
of signifying potential as it is concerned with the inclusion of people who are
marginalised due to their special relation with the state. The lack of home or
personal or private space is the way these people are segmented. In the state, the
home relates to a whole signifying chain defining the legal and actual existence
as a citizen. Homeless-people could be defined as the people living in prelimi-
nary shelters in the street by their own choice or people who use institutions de-
signed for people with no permanent accommodation. However this is the way
The Welfare-State categorise (subject) and create clients or users. Real homeless
people, as one homeless man once said:” Are the people, who want to be left alone”.
They are those who are not migrants who go from one permanent shelter to the
other, but who wander around defying psychiatrification, normalisation and
other over-codings. To be left alone however is not to state an imaginary inde-
pendence, but the need to work on the edge, to twist and fold the material is-
sued from The Welfare State.

However the overall situation is that the Welfare State views homelessness as a
problem merely because it does not suit the picture of a good normal life. These
people then are either treated as patients or clients, who need special treatment
rather than as people who basically want to be ‘left alone’.

In this sense you can see ‘The Real Homeless’ as the nomads or counter-
signifiers of The Welfare-State. Those who overcome the temptations to pick
what they are given by the state, but who insist that the system must respect

158 Politiken May 23. 00. From an interview with Mogens Rukov, Lars von Triers teacher from the film academy, after

‘Dancer in The Dark’ winning The Palme d'Or in Cannes.

78
their singular existence. One initiative, which could be seen as accomplished by
such counter-signifying, is ‘alternative’ housing facilities.

We are talking here of ‘the real homeless’, who have organised their existence
around this possibility of not choosing a permanent dwelling. We should not
confuse this real homelessness with people who by misfortune loose their per-
manent dwelling and who identify themselves with the family and other institu-
tions. These people should still be seen as contained within the systems of The
Welfare State.

These three general examples should only serve as an illustration of the potential
of the perspective of mixed semiotics. The following section is a more detailed
analytical and methodological statement based on the principles of the Schizo-
analysis of Deleuze & Guattari – what you could term a rhizomatic strategy of
analysis. This strategy will then be applied in detail to the field of Danish-
sectored psychiatry in sections 7, 8 and 9.

Summary
In this section it has been attempted to relate a general ‘discursive’ conception of
the social to a semiotic/pragmatic analytical attitude, which touches the social
from the other side of signifiance and interpretation. Desire or emancipation
from within thus is not conferred to mere fantasy or framed within even a frag-
mented unity. Rather desire is activated or invested directly in the social. The
abstract machine is breaks and jumps - it is particles signs. A theory of signs in-
cludes regimes, which is not the workings of systems, but is the investment of
the social in the abstract. Thus there is no determining link of the abstract upon
the social. There is only disruption within the regimes of signs, de-
territorialisation and re-territorialisations in the middle of the social. This break-
through is from within the signifier, not from an imaginary position outside the
known. To discover abstract machines, it takes the discovery of their thresholds
of dispersion, where neither their imaginary or structural unity are permitted to
subsist.

79
In this way it is stressed how language has immanent non-discursive orders or
‘non-discursive presuppositions’, which lie in the performance of statements.
The basic argument is that the notion of language as a code has to be abandoned
since it then becomes: “The condition of possibility for all explanation”.

The same goes for the notion of language as communicational, in the sense of a
transmitter of information. Another consequence is that linguistic categories like
syntactics and semantics and even phonematics cannot be studied as scientific
zones excluding pragmatics - the non-discursive prolongation, which create the
redundancy of the signifier. Rather pragmatics must be put in position as pre-
supposition, as the one that destroys the idea of the one to one correspondence
between signifier-signified. The third consequence concerns the split between
language and talk, which cannot be upheld, because only language in use is lan-
guage, featuring its presuppositions of actions.

The consequence is a theory of language treating pragmatics as an integral part

of the language system, which views presuppositions as prior to any linguistic
structure159.

We are here addressing the very core of a political analysis of language, where
the concept of language is reterritorialised, insisting that pragmatics is an integral
part of language (rather than exterior to language). This is the fundamental sub-
versive potential of pragmatics or schizoanalysis.

In this regard it has been attempted to show an outline of this analytic attitude:
The discovery of mixed semiotics of the social and discovering the threshold of
dispersion of machines and their networks. A mapping out of these assemblages
is what gives us the potential of counter-signifiers. This aspect will be elaborated
on in the following section.

159 This means that: ”….Each effectuation of the statement is an actualised variable of a virtual line of continuous variation immanent to

the system, a line that remains continuous regardless of the discontinuous leaps made by the statement, and that uproots the statement from its
status as a constant and produces its placing-in-variation” Deleuze, Gilles: Essays Critical and Clinical. Verso. London, 1998.
Xlix.

80
 Section 4 - The Schizo-Nomad

“It is not enough to affirm that the war-machine is external to the State apparatus. It is necessary to reach a point
of conceiving the war machine as itself a pure form of exteriority, whereas the State apparatus constitutes the form
of interiority we habitually take as a model, or according to which we are in the habit of thinking”
(Deleuze & Guattari: A Thousand Plateaus, p. 354)

This section will continue to elaborate on the nomadic 'stance' and how it ap-
plies to the war-machinic/intervention. Further the section will approach a rhi-
zomic strategy of analysis embedding the nomadic stance. This nomadic stance
will be related to psychiatric practice through a reading from 'geo-psychiatric'
perspective inspired by the writings of Guattari.

Archaeology is as indicated above merely a pragmatic methodological starting-

point where the expression side is in focus. It is the expression and the territory
of the State. However, archaeology defined from history turns the focus of an
archaeological survey towards assemblages of artifacts (tools) to be judged and
valued as scientific potential according to classifications and known categories
(order-words according to historical facts). It is the model of the State that is at
work. However the primary archaeological potential is exterior to the State, war-
cries belonging to the de-territorialisations of the war-like cattle raising no-
mads160. The nomadic assemblage inhabits the steppe, smoothspaces or milieus
without horizons, which they decode or territorialise according to an itinerant
mode of production. The territory thus can be said to make the assemblage. The
cattle raisers appropriate the power of the animal. Rather than arresting the mo-
vement of a hunted animal, the cattle-raiser joins the kinetic energy of the ani-
mal. The war-machine implies a release of a speed vector, that becomes a free
and independent variable, which is contrary to the hunt where speed belongs to

160The concept of ‘the nomadic’ goes back at least to ‘Difference & Repetition: « The different outcomes are no longer
separated according to distribution of the hypotheses which they carry out, but distribute themselves in the open space
of the unique and non-shared throw : nomadic rather than sedentary distribution ». Deleuze, G: Difference & Repetition,
p. 283. 1994. Columbia. New York.
See in general about the war-machine and the nomadic: Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone.
London, 1988, pp. 351 ff, and Paul Patton: Conceptual Politics and the War-Machine in Mille Plateaux. In: SubStance 44
http://www.substance.org/44/o5patt44_R.html.

81
the hunted animal. In the hunt, the hunter arrests the movement of the prey, in
the war-machine the warrior :
[B]orrows from the animal .. more the idea of the motor than the model of the prey. He does
not generalise the idea of the prey by applying it to the enemy, he abstracts the idea og the mo-
tor, applying it to himself »161.

It is a new relation of war, were the relation of man to man is not to equal with
the hunter and the hunted. When man appropriates the force of the hunted
animal, this relation become one of warrior-enemy.

The war-machine is said162 to feature a new economy or projectile system, where

horseback-riding was the first projector – a becoming animal. In this way the
war-machine features the release of a speed vector, a free and independent va-
riable. The important thing is to see this model not as tied to sedentarity and the
State, but to see this as a pure nomadic economy - co-extensive with the State. It
is important to see inventions as growing out of tendencies or assemblages, ra-
ther than through developments of a lineary type where sedentarity and the State
are the model.

Tendencies and Assemblages

The machinic evades any capture, organisation or stratification - the judgement
of god: to echo Bergson it is not the thing situated according to causal laws, but
the tendencies of things to change, which should be in focus. The forms we give
to things by way of signifiance dominated by demands of calculability – organise
our perception and helps our directing of actions in the world. These forms
however has nothing to do with change in itself, rather they serve as the arrest-
ing, the breaking up of reality into bits that can be handled according to the bi-
nary logics, which serve the programs of ‘the human condition’ contained in the
model of the State: The form of the flower and the form of the seed cannot
contain the movement from seed to flower. When you want to answer the ques-
tion where does the flower start and the bee end? Already you are caught in the

161 Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone. London, 1988, p. 396.
162 Ibid.

82
signifying and interpreting of the State. The flower in this context is an object,
which is represented and captured by the linguistic form, allowing it to be in-
serted according to classification systems and their causalities (the bee helps the
pollination of the flower etc.).

As mentioned by Chia and King163 the Newtonian heritage is present: movement

is seen as a causal chain where things are caused to move by intervention from
the outside rather than through auto-force or movement from within (tenden-
cies to change).

When we talk of movement from within it gives no longer any meaning to con-
sider things in themselves according to a logic of representation, rather we have
to consider assemblages of things and persons and study their becoming, their
tendencies to change - their machinic components. In the model of the nomad
and war-machine everything becomes, nothing starts or ends.

Accordingly Schizoanalysis and the rhizomatic thought of D&G is qualified

above the root tree logic where the world is divided by means of representation
and binary categorisation in the rule of the despotic signifier and the interpreta-
tion function. In this line of thought things never start to become, but are always
becoming, which is contrary to the Newtonian axioms where rest is considered the
norm.

In opposition, Schizonanalysis is a mapping out and a study of passional assem-

blages:
“Assemblages are passional, they are compositions of desire. Desire has nothing to do with a
natural spontaneous determination: there is no desire but assembling, assembled desire”164.

However, assemblages can mobilise passions of different orders e.g. the order
associated with the State and the appropriation of the war-machine, where

163 Chia, Robert & Ian W. King: The Organisational Structuring of Novelty. In: Organisation vol. 5 no. 4 1998.
164 Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone. London, 1988. P. 399.

83
weapons are transformed into tools, resistance into work etc. The assemblages
of war and the assemblages of work bring about passions of different orders.

The Contribution of Schizoanalysis

“A schizophrenic out for a walk is a better model than a neurotic
patient lying on the analyst’s couch” (Deleuze & Guattari in: Anti-Oedipus)
Schizoanalysis and the rhizomatic features throughout the major work of
Deleuze & Guattari: ’A Thousand Plateaus’. The work is an attempt to produce
an analysis, which is at the same time subversive and creative. The form of the
book is very challenging as it leaves a space open for the reader to create his
own articulations and refrains from the different plateaus (chapters). These are
all somehow dealing with the possibility of reterritorialing different social and
scientific institutions in a subversive and creative manner. The work embeds the
whole idea of rhizomatics at the same time as it touches upon the idea in a more
explicit manner. Rhizomatics implies a special style of writing, which so to say
displays immediate connections with the outside. D&G give examples of the
works of Kleist, Kafka, Artaud and Nietzsche as book assemblages embedding
rhizomatic principles. These are as it is said animated by a movement which
comes from without, an external force of intensity in the sense that: “[S]omething
jumps from the book, entering into contact with a pure outside”165.

Accordingly, I will interpret schizoanalysis and rhizomatics or simply pragmatics,

which is the reterritorialised term applied, as an attempt to embed a micro-
politics of desire inside an analysis of the social character/subjectivity. As indi-
cated, this takes, to echo Guattari166, a reterritorialisation of language and the po-
litical in favour of experiments with machinic functions, signs, and assemblages
of things and persons.

165 « We will ask what it functions with, in connection with what other things it does or does not transmit intensitisities, in which other multiplic-

ities its own are inserted metamorphosed, and with what other bodies without organs it makes its own converge ». Deleuze, G & Felix Guat-
tari: A Thousand Plateaus. Athlone. London, 1988. p. 4.
166 Guattari, Felix: La Revolution Moléculaire. ENCRES. Fontenay-sous-Bois, 1977. P. 248.

84
Transversality - Towards a Geopsychiatry
“It’s not just a matter of speaking in the first person. But of identifying the impersonal physical
and mental forces you confront and fight as soon as you try to do something, not knowing what
you are trying to do until you begin to fight. Being itself is in this sense political”
(Deleuze about Guattaris concept of transversality in: Negotiations,1990, p.88).

By referring to the schizo as a better model than the neurotic, it is indicated how
the schizo out for a walk should be a model for the subversive or creational po-
tential inside the coding forces of the settlement. The schizo-model accounts for
the very pragmatic character of subversion and the posibility for the resingulari-
sation of individuals.

In this context, the notion of transversality originally coined by Guattari can be

seen as important for the purpose of the present text as it connects the schizo-
nanalytic program with the original concerns of Guattari. These were first of all,
the psychiatric clinic and the possibility for patients to create for themselves new
ways of existence in an outside of the clinic.

Accordingly, Guattari’s notion of transversality was motivated by his interest in

having people speak for themselves. A critique of interpretation and closed per-
sonological analytic models in therapy led him towards a transformation of the
hierarchical relation of the analyst-analysand. This relation is usually called trans-
ference, which should become vehicular breaking the monopoly of the institu-
tional traditions. With Guattari, the relation becomes more focused towards
group relations and ‘transversality’ in the group becomes directed towards an in-
stitutional analysis avoiding normalisations and professionalisations. In this con-
nection, he mentions the inherent conservatism inside the clinic, which he re-
garded as: “An interiorisation of bourgeois repression” 167.

Gary Genosko refers to the aim of transversality in the following way:

“Transversality is opposed to and attempts to overcome vertical hierarchies and horizontal in-
tra-ward relations (the hospital is one fence, the ward another) by maximizing (that is bringing

167 See Felix Guattari : Psychoanalyse et Transversalité, p.79. Paris. Maspero. 1972.

85
to light through analysis the latent coefficients of tranversality in the group, its unconscious de-
sires), inter-level and extra-level communications, thus enabling meanings to proliferate and
pass between the levels, the personnel, the patients, and whatever may be of interest outside the
hospital168”.

The focus is to make a group of people (for instance mad people) generate mo-
lecular revolutionary potentials to serve their own interests and to avoid molar
aggregates. These groups are referred to as subject groups in opposition to sub-
jugated groups, which are not able to channel their desiring production into
revolutionary measures since these groups are always subordinate to exterior
sources. This observation has been a core idea in Deleuze and Guattari’s notion
of micro-politics169.

Schizoanalysis as mentioned must be considered the meta-model of this political

project starting out in ‘Anti-Oedipus’ and picked up in ‘A Thousand Plateaus’.
Later in 1992, Guattari elaborated170 the schizoanalytic meta-modelisation in
some of his last writings before his death. I will take inspiration from this pro-
ject as I see it as a possibility to combine a basically philosophical frame of the
becoming coupled with a concrete analysis of subjectivity. Subjectivity (rather
than the subject) becomes the nexus of an analysis, which is both concerned
with the discursive conscious and the desireal unconscious.

As phrased by Guattari: “ So we are proposing to decentre the question of subject onto the
question of subjectivity. Traditionally, the subject was conceived as the ultimate essence of indi-
viduation, as a pure, empty, prereflexive apprehension of the world, a nucleus of sensibility, of
expressivity – the unifier of states of consciousness. With subjectivity we place the emphasis in-
stead on the founding instance of intentionality”.
We are rather trying to: “Delineate a subjectivity, which is far from dominant equilibria, to
capture its virtual lines of singularity, emergence and renewal171”.

168 Genosko, Gary: Undisciplined Theory, p.113. SAGE. Guildford, 1998.

169Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone. London, 1988. Chapter 9.
170 See Felix Guattari: Chaosmosis – An Ethico-Aesthetic Paradigm. Power Publications. Sydney. 1995 (1992).
171 Guattari Felix: Chaosmosis-An Ethico-Aesthetic Paradigm. Power Publications. Sydney, 1995 (1992). p. 22.

86
Basically, Schizoanalysis can be seen as ‘a project of desire’ to make desire ap-
pear from the other side of the norm. It thus appears as a political project, a pro-
ject of resistance and emancipation proceeding from a materialistic an experi-
mental front. Rather than being critical toward a dominant reality of representa-
tion, it attempts to exploit the signifying potential from within signifiance. As a
meta-model it is not concerned with rejecting other models. In this sense, the
aim has not been to overcode other models rather he attempts a kind of auto-
modelisation : «.. [W]hich appropriates all or parts of existing models in order to construct
its own cartographies, its own reference points, and thus its own analytic approach, its own
analytic methodology »172.

Originally, this approach was a riot against freudian and institutional theories
applying a closed approach tied to personological and familial frameworks. The
interest was shifted towards assemblages of enunciation and their machinic as-
pects173. It was seen as necessity to deal with the focus on interpretation and
sense, though this should not be accomplished by: « Miming schizophrenia, but in
crossing like in the barriers of non-sense, which prohibit access to a-signifying nuclei of subjecti-
vation, the only way to shift petrified ways of modelisation »174.

Schizonanalysis is transcendental (not transcendent), which means that meaning

is nothing but use. Guattari mentioned in L’Inconscient machinique, that ‘do it’
should be the watchword of micro-political schizoanalysis175. A text, a work can
mean everything and the point is that it is machinic, meaning has to be judged
according to immanent rather than to transcendent hypothetical criteria. A tran-
scendental analysis entails exactly such an establishment of immanent criteria
that is criteria immanent towards the unconscious. The conscious, habit and
memory are all dependent on signifiance and representation, which leads to the
condition of the existence of the past in the present. This, however, is not an ar-
boresque binary programming, since schizoanalysis is anti-genealogical contrary
to the practices of psychoanalysis and structural linguistics where binarism rules.

172Guattari Felix: Chaosmosis-An Ethico-Aesthetic Paradigm. Power Publications. Sydney, 1995 (1992). P. 61.
173 See Felix Guattari: Institutional Practice and Politics. An Interview by Jacques Pain. In: Gary Genosko. The Guattari
Reader. Blackwell. Oxford, 1996.
174 Guattari Felix: Chaosmosis-An Ethico-Aesthetic Paradigm. Power Publications. Sydney, 1995 (1992) p. 68.
175 See Gary Genosko: The Guattari Reader,. Blackwell. Oxford, 1996. p. 17

87
Guattari infers: “The principle reproach that we have to address to psychoanalysts is, in ef-
fect, that they do not engage in analysis. They take refuge in their offices and hide behind trans-
ference so that the treatment unfolds in isolation, so that nothing from the outside creeps in.
They have turned analysis into an exercise of the pure contemplation of sliding signifiers, ac-
companied by a few interpretations which are, most often, only games of seduction without con-
sequence176”.

Rather the potential of making transference vehicular and embedded in a new

psychiatry of the sector, geo-psychiatry also shifts the focus of analysis to embed
a balancing of discursive and desireal analytic sensitivity. For instance, psycho-
farmachology must be considered in conjunction with the despotic signifying
semiology tying mental disturbance back to closed categories. As mentioned by
Guattari, this led anti-psychiatry (mistakenly) to condemn psychopatological
semiology as a whole. The focus should rather have been to address the repres-
sive modes surrounding psychofarmachology, its tie with the laboratory, a
stereotyped patient-doctor relation etc. In this way, psychofarmachology could
help individuals to regain their potential. As mentioned by Guattari: “Psychofar-
machology could just as well orient itself toward the constitution of an a-signifying semiotic –
freed from medical overcoding, the State, power, multinationals, etc”177.

Schizoanalysis is in Anti-Oedipus178 referred to as both transcendental and mate-

rialistic. It is aimed at an investigation of ‘the transcendental unconscious’ rather
than a metaphysical unconscious, an unconscious which is more material than
ideological: schizophrenic rather than oedipal: non-figurative rather than imagined:
real rather than symbolic: machinic rather than structural. All in all, the uncon-
scious can be referred to as molecular, microphysic and micrologic rather than
molar and assembled179 (see section 5). Genealogy does as such feature in

176 See Felix Guattari : The Place of The Signifier in The Institution. P. 153. In : Gary Genosko: The Guattari Reader.

Blackwell. Oxford, 1996.

177 See Felix Guattari : The Place of The Signifier in The Institution. p. 154. In : Gary Genosko: The Guattari Reader.

Blackwell. Oxford, 1996.

178 Deleuze, Gilles & Felix Guattari: Anti-Oedipus. Capitalism and Schizophrenia. Univ. Minnesota Press. Minneapolis,

1983. p. 109.
179 The terminology relates to organic strata where the molecular refers to content (form and substance) and the molar

expression (form and substance) Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone. London, 1988. p. 57.

88
schizoanalysis, but as tracings and mappings, as assemblages rather than trace-
able finalities.

The Four Rhizomatic Components

A pragmatic analysis should set out from the expression side as though it had
autonomy. From here you can study how regimes of signs are translated into
each other. This activity is a generative one in which counter-signifiers can insert
themselves e.g. where the entrenchment of a subject of enunciation, can be stud-
ied as an over-coding accomplished by an order-word machine. You can also
view this feature as de-stratification accomplished by a network of machines,
which sweeps signs into particles, leaving behind only a weak and primitive
foundation – rigidified strata. In response to this, the counter-signifier seeks to
retain enough sign potential by postponing or suspending de-territorialisation
and reterritorialisation. A counter-signifier so to say inserts itself vertically on as-
semblages of enunciation and their expression: it makes a block, a delay and re-
tention toward machinic assemblages.

However, this is only the first step, from distinguishing the points where regimes
of signs are translated into each other, you will also discern transformational po-
tential and creational buddings, potential machines and machines as effective
emergences.

Thus a point of disappearance can be followed through time, in the case when
singularities e.g. become written out or overwritten by de-territorialisations and
re-territorialisations of networks of machines. These expressions can be dis-
cerned within the discourse of de-centralisation of psychiatry. It is an interesting
case, which show how the trustworthiness of the signifier is created and sus-
tained accomplished by a stereotyping over-coding. How madness and reason is
reproduced as categories in ‘a humanistic disguise’, which suits the self-image of
The Welfare State.

The expression of the statement of decentralisation and collaboration has

changed through time: modernisation, liberalisation, cost-reduction, respect of

89
the individual, normalisation, de-psychiatrification, multi-paradigmatics, democ-
racy, ethics, humanity, co-determination and dialogue etc. At the same time, the
actions and passions associated with becoming a patient as citizen and vice versa
have been multiple, however only emerging through the objectifying over-
coding of the order-word machine of de-centralisation. The words, phrases and
propositions, which belong to the expressions of the statement of de-
centralisation sustain the functioning of the order-word-machine driven by ‘a
desire’ of management and governance.

The four components180 are circular markings of texts working together, bud-
ding, making the rhizome, territorialising, de-territorialising and even re-
territorialising playing the game of signs.

These are the generative component, the transformational component, the dia-
grammatic component and the nomadological or machinic component.
The components have been applied to analyse the assemblages of ‘Sectored-
Psychiatry’ in Denmark. These analyses are written out in sections 7-9.

The Generative Component

Under this component, priority is given to the form of expression: how a form
of expression located on the language level always appeals to several combined
regimes. Emphasis is placed on concrete mixtures of semiotics on each language
stratum showing variants and how they combine. Placing emphasis on the form
of expression and the mixed semiotics, one can most successfully abstract forms
of content. The tracings of these generative aspects are undertaken by studying
how regimes of signs come together as mixtures when certain social issues are
considered181. The issue is to be open to the experimentation by focusing on in-

180 Schizoanalysis is said to rest on four steps: 1) a tracing of the mixed semiotics, 2) making a transformational map of

the regimes with their possibilities of translation and creation, for budding along the lines of tracings, 3) making a dia-
gram of the abstract machines in play, either as potentialities or as effective emergences, 4) outlining the program of the
assemblages, that distribute everything and bring a circulation of movement with alternatives, jumps and mutations
Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone. London, 1988. D&G, 1988, p.146.
181 “As Foucault clearly shows regimes of signs are only functions of existence of language that sometimes span a number of languages and are

sometimes distributed within a single language: they coincide neither with a structure nor with units of a given order , but rather intersect them
and cause them to appear in space and time. This is the sense in which regimes of signs are assemblages of enunciation, which cannot be ade-
quately accounted for by any linguistic category: what makes a proposition or even a single word a “statement” pertains to
implicit presuppositions that cannot be made explicit, that mobilise pragmatic variables proper to enunciation (incorporeal transformations) p
Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone. London, 1988..140.

90
tersecting semiotics. Maps (performance) are like laboratories where tracing
(competence) experiments are made to interact.

In L’Inconscient machinique, Guattari describes182 the role of a generative

pragmatics in the following way:

“[T]he role of the components of passage will be limited to putting into play only weak interac-
tions between the assemblages, with the goal of loosening, untangling if possible their alienating
mechanisms, their stratifications and their oppressive redundancies, their black hole effects, in-
deed, even of averting or deferring the threats of catastrophe hanging over them”.

What is being done under the generative component is to make the tracings or
analyses of the recent past. As indicated they serve to line out competencies,
which can be put to work through the other rhizomatic components. For the
present project, the different expressions, which in a heterogeneous way are dis-
tributing the concept of Social-Psychiatry or the collaborating psychiatry, are
traced. It entails a meticulous reading of material on psychiatry in general, out-
patient treatment, crime and mental illness, government plans and legislations
etc.

The main focus is how the patient is transformed into citizen by different tech-
nologies. The construction of patient is at the same time the study of the distri-
bution of different positions, and how different professions are granted access
to participate in the game. In one such game, the collaborating-psychiatry can be
seen to be entrnched by one giant signifier of decentralisation. The different ex-
pressions of this statement sustain the strategy towards an imaginary united Sec-
tored-Psychiatry, a kind of promised land, which seems only to be reachable by
the means of exclusion and reduction. This analysis will show how blockage of
lines of subjectification is an important connecting point to lance the strategies
of madness, the counter-signifying, the rhizomatic strategies. The attempt is
made to show how the signifier ‘patient’ is decomposed through time through a

182 Guattari, Felix: L’Inconscient Macinique. Essais de Schizoanalyse. ENCRES. Fontenay-sous-Bois, 1979. P. 192.

91
complex interplay between regimes of signs. This is different from a pure de-
constructive approach working with fixed categories according to a binary
scheme, which can be described by lining up concepts and counter concepts
through time. The counter-signifying potential of anti-psychiatry is broken down
by management thinking, accomplishing a deterritorialising of the signifier ‘pa-
tient’ as the clinic is slowly abandoned in favour of civil society. As mentioned
throughout this body of text, we can no longer satisfy ourselves with meaning
being attached to fixed categories installed by the rule of the signifier. Pragmat-
ics is about how we have to work with mixed semiotics as rupture of meaning
within the efficient over-coding forces of the fantasies of the sectored psychia-
try. Madness must bend the lines of subjectification issued from the mighty sig-
nifier of reason and normalisation, which unilaterally defines madness as a resid-
ual. This is where the diagnostics of the transformational component enters the
laboratory, making tracing-experiments interact.

The Transformational Component

Transformation can be seen as an incision, stopping the world, stopping the
endless chains of signifying and interpreting (the function of the signifying re-
gime). The world must be stopped by a set of circumstances, which are truly
alien to the flow. These transformations must be seen as relying on both exter-
nal variables as well as variables internal to language, internal to statements - a
true semiotic transformation in this sense appeals to all kinds of variables183.

A transformational map is created lining out: “[P]ossibilities for translation and crea-
tion for budding along the line of the tracings under the archaeological component”184. Thus
the transformational is the first step towards a diagnostics of the becoming.
Guattari mentions how a schizoanalytic pragmatics of collective assemblages of
enunciation will constantly oscillate between generative and transformational
micro-political semiotics. Diachronic outcomes and synchronic states will both
figure in it’s questioning of the inclusions, confusions, and refusions of assem-
blages. A generative schizoanalytic pragmatics will concern itself with a pre-

183 Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone. London, 1988. P. 139.
184 Ibid.

92
existing assemblage (or the recent past), while a transformational pragmatics will
create new assemblages185.

A transformational pragmatics will be involved with the radical modification of

intrinsic mechanisms in the nuclei of assemblages and thus the creation of new
assemblages. In this way the transformational pragmatics will work from ma-
chinic nuclei. In this way the difference between the generative and the trans-
formational lies in the shift from putting into play of ‘molar relations of subjec-
tion’ to ‘molecular vectors of machinic subservience’186.

The transformational component singles out events from the lines of the gen-
erative component and transforms them into nodes or points of transla-
tion/creation. In this way it is shown how regimes of signs are translated into
each other, especially when there is a creation of a new regime187. This transla-
tion can be studied around certain themes, embedding critical issues related to
the conception and practice of sectored-psychiatry. Under this component, data
from conversations are used to experiment and fine-tune the lens that is used to
single out these translations. This is done by making certain agendas for these
conversation sessions inspired by some of the mappings undertaken under the
generative component. The conversation session material is used to reread ar-
chive material, with the opportunity of discovering new aspects with a new crea-
tion potential.

What it takes is, first of all, to create some directing arrows in the interstices of
the social field. In this regard, the following is a description of this process of
creating direction. This directing activity can as already indicated only be con-
ceived as the preliminary step towards the real (critical) inquiry. It will only ap-
proach the field from the discursive.

185Guattari, Felix: L’Inconscient Macinique. Essais de Schizoanalyse. ENCRES. Fontenay-sous-Bois, 1979. pp. 190-191.
186Guattari, Felix: L’Inconscient Macinique. Essais de Schizoanalyse. ENCRES. Fontenay-sous-Bois, 1979. P. 193.
187 « Although a mixed semiotic does not necessarily imply effective creativity, and may content itself with combinatory possibilities without veri-

table transformations, it is still the transformational component that accounts for the originality of a regime as well as for the novelty of the
mixes it enters at a given moment in a given domain. This component is therefore the more profound (to the generative), and it is the only
means of measuring the elements of the first component”. Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone. London,
1988. P. 139.

93
The study of the becoming of these stratifying movements around themes or
nexi of interest is done according to the main focus of the investigation: which
could be phrased as the becoming social of psychiatry or the becoming psychia-
try of the social.

This activity has been directed in conversations with key-persons, centred

around themes of cross-professionality, cross-sectoriality and becoming citizen
of the patient. The focus has here been professionals of both counties and mu-
nicipalities. The aim has been to encircle how quality of the psychiatric service
can be improved through a new combination of professional efforts across sec-
tors and professions. This agenda has produced a lot of themes which have
functioned to position each profession or system towards the others. One ex-
ample is the rule of silence, which is stipulated in the Danish act of administra-
tion, the purpose of which is to protect delicate information to be transferred
between authorities. These themes can be considered nexi of communicative
transformation and development represented by the struggle between different
ways of creating objects. This game of signs or de-territorialisations and reterri-
torialisations is more specifically dealt with under the next component.

The Diagrammatic Component

Under the diagrammatic component, it is shown how all mappings and cre-
ational buddings are preliminary fixtures or helping devices. This should be done
by stripping expression and content from the forms embodying them188. This
component becomes one of tendencies and abstraction. The assemblages or
mappings are tipped to favour the machinic abstract sides in opposition to the
enunciative and concrete side.

Accordingly, a diagram of the machines that are in play is drawn, in each case ei-
ther as potentialities or as effective emergences. This idea links directly to the

188“It consists in taking regimes of signs or forms of expression and extracting from them particles - signs that are no longer formalised but in-

stead constitute unformed traits capable of combining with one another. This is the height of abstraction, but also the moment at which abstrac-
tion becomes real: everything operates through abstract real machines (which have names and dates).
One can abstract forms of content, but one must simultaneously abstract forms of expression: for what is retained of each are only unformed
traits. That is why an abstract machine that would only operate on the level of language is an absurdity. It is clear that this diagrammatic
component is in turn more profound than the transformational component: the creations-transformations of a regime of signs operate by the
emergence of ever-new abstract machines” ” Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone. London, 1988. P. 145-
46.

94
distinction made earlier on between the real and the possible and what Leibniz
as mentioned above referred to as compossible worlds. An effective emergence
is what is actual-real, while potentialities are possibilities still actual but not real,
only virtual-real. Potentialities are the reserve like in the Malcolm X example
above, a reserve belonging to the event, a position of awaiting on the plane of
consistency. What one is looking for is these combining traits mentioned above,
which help to define what attracts an abstract machine189. The machines are said
to work on the diagrammatic level where only particles and traits exist. As such
they work on the plane of consistency rather than on strata. However as men-
tioned above they have one vector pointing towards strata and one towards the
plane of consistency.

Having lined out the abstract machines in this way being co-extensive with the
field, the next step is to study how matter as sediment becomes folded into sedi-
mentary rock in stratifying and de-stratifying movements. For this purpose, texts
have been deconstructed according to the distinction patient-citizen. More
specifically it is studied how the distinction patient-citizen is sprouting of differ-
ent forms of argumentation creating objects and subjects of enunciation, when
different issues are put into play by the text in question. The main questions to
be asked is who and what is the addressed, what is the context, that is what cor-
pus of text is related to explicitly or implicitly, what is the logic of reference (that
is either a passive reference to established norms and rules or is it attempted to
establish new strategies reference to past or future).

However, not all texts are treated according to this model as not all texts have a
substance, which can justify that degree of specificity, but all texts are studied
from the basic scheme of direction public space/private space. These basic cate-
gorisations should establish the foundation for a closer examination of these
texts, to establish the effective emergences as well as the possible ones centered

189 D&G writes: “ We define the abstract machine as the aspect or moment where nothing but functions and matter remain. A diagram has

neither substance nor form, nor content nor expression. Substance is formed matter, and matter is substance that is unformed either physically
or semiotically. Whereas expression and content have different forms, are really distinct from each other, function has only “traits”, of content
and of expression, between which it establishes a connection: it is no longer even possible to tell whether it is a particle or a sign. A matter-
content having only degrees of intensity, resistance, conductivity, heating, stretching, speed, or tardiness: and a function-expression having only
“tensors”, as in a system of mathematical, or musical, writing” 189” Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone.
London, 1988. p. 141-42.

95
around the becoming citizen according to different agendas. These agendas are
directed towards different client spheres and professional spaces. The different
issues being studied are tracked from the general theme of the imaginary unity of
social-psychiatry or the sectored psychiatry and the study of becoming citizen of
the patient. The circularity of this analytical activity is finally to be channelled
into one disjunctive synthesis. By doing this, we have favoured the analytic un-
der the three mentioned components. Schizoanalysis is finally tipped in favour
of the artistic and revolutionary. This aspect will be dealt with in the following
section 5.

96
 Section 5 - The Void of The Post-human
The Nomadological Component

“Schizoanalysis has one single aim-to get revolutionary, artistic,

and analytic machines working as parts, cogs of one another (..)
analytic schisis as opposed to the despotic signifier”.
(Deleuze: Negotiations, 1995, p. 24)

The War-Machines of Madness

This body of text and its nine sections is an attempt to create assemblages, be-
comings. Even when it still is a text that must lend itself to the academic form, it
attempts to present itself as an open text – or what in Deleuzo-Guattarian terms
could be phrased a rhizomatic text. This section will attempt to further establish
the link between schizoanalysis, the nomadic/war-machinic and the transforma-
tion of psychiatry. At the same time it will attempt an extension, of the meth-
odological remarks made in the preceding section.

An open text! This might sound like a contradiction in terms: how to be ‘open’
and still claim a voice in a scientific discourse? This should be a balance between
having a critical voice on the cutting edge of a scientific discourse and ostracism.
It is a question of evaluating a dominant reality and making your writing a strat-
egy accordingly. However this strategy must be an emerging incremental one as
the points of balance only appear in the process of writing. It is in this process
that these points become active creation potential, rather than pure fix-points of
negation (which would be an accumulative scientific approach). Writing thus
gets an experimental touch and a way to go beyond the despotic signifier - the
creator of absolute dead-ends. These forces feature the tendency of the ‘modern
human’ to create modes of programming and defining spaces in order to make
up a manageable future. We get trapped in memory and fantasy, rather than liv-
ing the real or the real time of becoming.

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This incremental strategy could be referred to as a ‘passage of life’, entering a
‘zone-which-neighbours-on’. Writing is not bound up with memory or experi-
ence, but is pure process that traverses both the lived and the liveable. One is
always in the middle: which allows escaping personal (programmed) modes and
enter into connection with ‘the force of the impersonal’. This frees us from the
first and second person not as a generality, but as a singularity: a man, a woman,
a child – or what is also referred to as a haecceity190 given in the creative mo-
ment freed from discursive time.

However, this project must not be seen as an artistic project in its own right
lending itself easily to habit and memory191. Rather it must be creation on the
cutting edge of received realities, remembering the Blanchot quote in the begin-
ning of this body of text:

”How can one write in such a way that the continuity of the movement of writing might let in-
terruption as meaning, and rupture as form, intervene fundamentally?192”

This idea of performance reminds of de Certeau193 and his ideals about interven-
tions into social norms of values as ‘tactical’ marking the abandon of ideology
and transcendent ideals. Transformation is seen as an issue of addressing social
norms through provocation. The goal rather of a text or a work of art according
to this line of thought can be seen as an installation of a disruption, a distur-
bance that creates moments of estrangement to normal social experience. As

190 Deleuze, G: Literature and Life 1996 p. 226 as quoted in Marks, John: Gilles Deleuze. Vitalism and Multiplicity. Pluto

Press. London, 1998. p. 125. Or as Foucault states in an interview in Nouvelles Littéraires, 17 march 1975: “ To write is to
struggle and resist: to write is to become: to write is to draw a map: ‘I am a cartographer”’.
One also comes to think of Antonin Artaud who in fact was put in ‘a bracket’ as madman here transformation into the
impersonal gets a special ring, he states: “I am he who in order to be, must whip his innateness” Susan Sontag adds the
following: “Work derives its credentials from its place in a singular lived experience: it assumes an inexhaustible personal
totality, and inadequately expressive of that totality. Art becomes a statement of self-awareness-an awareness that pre-
supposes a disharmony between the self of the artist an the community” . Antonin Artaud and with him his original pro-
duction of literature and theater would most likely never have seen the world if it would not have been for the existence
of asylums to where he could retreat outside reach of society and the over-coding forces of normalisation Artaud, An-
tonin: Selected Writings. Susan Sontag ed. Univ. California Press. Los Angeles, 1988.
Li).
191 ”Art is never an end in itself”…. ”It is only an instrument for tracing lines of lives, that is to say all these real becom-

ings that are not simply produced in art …. But rather sweep it away with them toward the realms of the asignifying and
asubjective” () and as Daniel W. Smith adds: ”This is the point at which ”critique” and ”clinique” become one and the
same thing, when life ceases to be personal and the work ceases to be merely literary or textual: A life of pure imma-
nence”. Deleuze, Gilles: Essays Critical and Clinical. Verso. London, 1998. Introduction by Daniel W. Smith.
192 Blanchot, Maurice: The Infinite Conversation. Univ. Minnesota Press. Minneapolis, 1997. p. 8.
193 See Glenn Harper in the introduction to: Interventions and Provocations Conversations on Art, Culture, and Resis-

tance. Glenn Harper ed. New York, 1998.

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such a text as well as a work of art must insert itself outside the control of the
memory of any given (imaginary) subject-object relations.

Dead-ends or deadlocks exist only in memory and representations, in pictures

we create and sustain as finalities, mirrors of what life can be. Everyday we must
whip ourselves to get rid of this terror and we must believe in resistance and the
potential of the performance of ideas in action working the borders to appear in
front of us, as a living potential to work with.

The act of writing as emancipation or resistance features the writer selecting in

the constant flow of voices entering his space, where the owner or timing in
“the now” is always indeterminate: because one can never establish who is doing
the talking. This is the real moment of creation, which does not involve the uni-
verse of reference:
“[I]ncorporeal domains of entities we detect at the same that we produce them, and which ap-
pear to have been always there from the moment we engender them” – as such they are:”
[N]uclei of eternity lodged between instants”194. In this regard, you can talk about the
grand impersonal murmur, which surrounds you and from where you can ex-
tract a voice-that you can call yours, but which will always remain impersonal – a
haecceity. The event of writing or composing as a nexus of impersonal voices
frees us from the tyranny of signification195.

When you see the event as mediator of all experience, creating this kind of text
becomes the act of addressing the endless stream of events coming your way, as
a condition for what you could term inventing new space-times196.
These acts of addressing197 to follow D&G, can not be driven by explicit “fast”

194 Guattari Felix: Chaosmosis-An Ethico-Aesthetic Paradigm. Power Publications. Sydney, 1995 (1992). p. 17.
195 Writing, creating text, making rhizomatic war machines as a political/interventionist project, is as I see it a central
theme in D&G´s schizoanalytic project: as it is bluntly stated in Deleuze Gilles: Negotiations. Columbia Univ. Press.
1990. p. 24
“Schizoanalysis has one single aim-to get revolutionary, artistic, and analytic machines working as parts, cogs of one another…… analytic
schisis as opposed to the despotic signifier
This is also a point demonstrated in the book on Kafka: Deleuze, G & Felix Guattari: Kafka. Toward a Minor Literature.
Univ. of Minnesota. 1986. where the concept of minor literature is presented for understanding how critical language
operates within a dominant language. Such writing must according to D&G be seen as basically political in nature, inti-
mately concerned by the relation between language and power. In this sense all literature is minor.
196 Deleuze Gilles: Negotiations. Columbia Univ. Press. 1990, p. 172
197 Compare with the Bakhtinian notion of adressivity in his theory of the novel. Here the oeuvre is constructed in the

dynamic interplay between the authors heroes and the reader, where the absence of the author becomes the pre-
condition for this as such the author interchangingly speeks through his heroes. Dialogism, which is a tag you can put on

99
motives (pleasure), but are actualisations or things you can experience directly, in
the sense that “slow motions” are driven by what is “important” (desire), by
what can fill the open space of the text to be created. An example could be the
event of making a movie, when movie director Ingmar Bergman198 says that
what is important, is being in a state of awaiting for the invitation of becoming
text. In this way, making a movie has no reference-point outside the event, out-
side the timing of the melting together in the event. It is a momentarily opening
into a vacuum. This is where the text becomes the writer and the writer becomes
the text in a response to the flickering of matter and the vibration of function.
No splits between subjects and objects to ‘enact’ experience (no reference to any
essence), only pure intensity, pure desire as the work of the artistic machine.
This is where time enters featuring the virtual, difference-in-itself.

When the Danish philosopher Ole Fog Kirkeby199 talks about the body-mind
replacing the cogito (that is reflection as a privileged activity) with “I can” (that
is: I am what I can) he captures what he terms the double historicity of intext
(body-mind) and context (the event) together. This articulation or creational
move makes problems of representation disappear in the melting together of
body-mind since the event mediates all experience with no pre-determination.
This stratification or lobster activity of joining the recent past with the becoming
is the moment of creation, which never exhausts the event and its virtuality, the
possibility of transforming into folding materials. As expressed by Deleuze &
Guattari: “.. The event is immaterial, incorporeal, unliveable: pure reserve”200.

However, it is important to note that the artistic machine can nowhere be part
of resistance without other machines, which are revolutionary or analytic. This is
where many critical projects fail in their overemphasis on artistic forms to ac-
complish disruption of dominant realities201.

Bakhtins work, which however does not do justice to the heterogenousity of his ideas, can be accused of not getting rid
of the high rank of the face, the body of the signifier. It has like in the philosophy of dialogue (Levinas and Buber) a re-
gress to the speaking subject. In pure becoming you find only singularities, the impersonal. See also Holquist, Michael:
Dialogism. Bakhtin and His World. Routledge. London, 1990.
198 The statement was made in a Swedish television interview in 1999. See also his autobiography: Bergman, Ingmar: His

Autobiography. The Magic Lantern. Penguin. 1988.

199 Kirkeby Ole Fog: Begivenhed og Kropstanke. 1994. Århus.
200 Deleuze, G & Felix Guattari: What Is Philosophy? 1993. Verso. London.
201 You see in this category all kinds of ‘critical social studies’ calling themselves post-modern, jumping on to artistic

modes without any connection to the dominant reality, which they are part of.

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The Schizo and The Post-Human
The model of the schizo is the first step towards an understanding of the post-
human, the challenge of the human condition by working on the cutting edge of
the body/signifier split, which comes to function as the ultimate organiser and
coder of life. This implies the abandonment of the human-body as an organism
that is as an entity measured and defined according to transcendent criteria.
Rather emancipation on the plane of consistency implies the organism/sign split
is challenged as the absolute border.

In the world of the schizo or the post-human, life is a stream of impersonal

flows. The post-human is the x for becomings, articulations inside the flows of
haecceities, affects and percepts. The stream and its forces are at the same time
threatening and liberating, and form a possibility of resistance. Like the fish,
finding the crevasses, the rocks in the stream give it the suspense for further en-
counter with the stream. The fish never extracts itself out of the stream, if it re-
tires into a deep-black crevasse it is only to lance a new attack into the forces of
the stream. The fish is never at rest as it plays with the forces of the stream.

To resist, to work with your own becoming as an individual, to work life from
within, is articulating within the enunciative assemblages and formalisations of
contents accomplished by machines and their assemblages. Signs work things
before representation. So we should follow Guattari and work with the residuals
of transversal flows. We are stratified, assembled, articulated – so we should cre-
ate new assemblages. You cannot escape the stream, what you can do is to work
with the qualities, the intensities or the tendencies of things to change.

This invites the reader to consider the post-human as the becoming fish, the be-
coming other. It requires going beyond the human condition and the tendency
to create mechanistic models where we can only be beings as difference in de-
gree. This becoming other is an invitation to meetings with the forces of the
nomad. These are the forces that break open words and things to turn them

101
against themselves, to transform any resting-point into lines-of-flight - pure in-
tensities.

No selection, no choice is a non-choice –our existence is exclusion, it seems,

locking it self in a deadlock closing in on itself as it creates two nihilisms: one of
accepting a historical programming of the future just waiting for better times to
come and one of creating imaginary futures from a selection of given ideas ac-
cording to a desired state of affairs.

This would be the agenda set by the disciplining functioning of discursive tech-
nologies, setting up the condition of possibility of subjects sucking out resistance
leaving behind docile bodies, which are transformed into cogs, as stunned exis-
tence in the machinery of discourse (to paraphrase Foucault). The body, the
working surface of discourse inscribing segregation, is however also the locus of
hope, the force of resistance, a way out in-between the two nihilisms.

“We do not even know, what a body can do” was the Spinozist phrasing (however not
only talking about the human body), which Deleuze chose as his take off in his
essay on reactive and active forces202. Science always follows the path of the
reactive forces of consciousness, whereas the great principal activity is uncons-
cious203.

On the plane of consistency only forces and bodies exist: thus the body of the
state, the body of chemical science, the social body. Bodies becomes what forces
can pass through Deleuze refers in his book on Nietzsche to two forms of
forces: the active and the reactive. It is said that it is the relation between these
dominating and dominated forces, which defines a body. The body is in this way
always: “The fruit of chance, which makes it more beautiful than both consciousness and

202 Deleuze, Gilles: Nietzsche and Philosophy. Athlone. London, 1996.

203 “Consciousness merely expresses the relationship of certain reactive forces to the active forces, that dominate them. Consciousness is essen-
tially reactive, and this is why we do not know, what a body can do, or what activity it is capable of. And what we say of consciousness we
must also say of memory and habit” Deleuze, Gilles: Nietzsche and Philosophy. Athlone. London, 1996.

102
spirit”204 (chance is contrary to continuum like in the Nietzschean eternal return)
205
.

The Dionysian and The Apollonian - Ariadne

In ‘The Genealogy of Morals’, Nietzsche was concerned with countering or ne-
gating two forms of morality: the supremacy of man as the good, benevolent
and beneficient and the decadence of Christian morality.206 The creative project
of destroying and overcoming morality was also his aim in Zarathustra described
as: “The self overcoming of morality, out of truthfulness: the self-overcoming of the moralist,
into his opposite-into me - that is what the name Zarathustra means in my mouth”207.

In the late Nietzsche (‘Beyond Good and Evil’), this creative project was ex-
pressed in the Dionysian, which is not any longer the counter picture of the
Apollonic, but has obtained the status of anti-christ.- Dionysos against the cruci-
fied208. Nietzsche was in the end interested in the neutral vitality of life or the
event-like, that is, he was interested in destroying the parasitical priest-like char-
acter of humanity, which negates life209. The Dionysian principle was aimed at
disturbing this ‘human ego’ in the movement towards the Self.

The Dionysian was an expression of the will to power, that is the force which is
unfolding in sensuous life producing an infinite flow of perspectives210. Diony-
sus confronts death, certain of the over-fullness of life and his own re-creative
power. “The desire for destruction, change, becoming, can be the expression of an over-full
power pregnant with the future (my term for this, as is known, is the word ‘Dionysian): but it
can also be hatred or the ill constituted, disintegrated, under-privileged, which destroys has to

204 Deleuze, Gilles: Nietzsche and Philosophy. Athlone. London, 1996. p. 40.
205 Ibid. p. 47.
206 Nietzsche, Friedrich: Ecce Homo. Vintage. New York, 1969. p. 328.
207 Ibid.
208 One of the last remarks of Nietzsche before he was sent to a mental institution was: Finally-this is what is most terrible at all-the con-

cept of the good man signifies that one sides with all its weak, sick, failure and suffering of itself-all that ought to perish: the principle of selection is
crossed-an ideal is fabricated from the contradiction against the proud and well turned out human being who says yes, who is sure of the future, who guar-
antees the future-and he is now called evil. And all this was believed as morality! Ecrasez Linfame!
Have I been understood? Dionysus versus the crucified”. Nietzsche, Friedrich: Ecce Homo. Vintage. New York, 1969. p. 335.
209 Nietzsche, Friedrich: Ecce Homo. Vintage. New York, 1969. p. 333.
210 See introduction to: Nietzsche, Friedrich: Tragediens Fødsel (Die Geburt der Tragödie). Samleren. København, 1996.

p. 23 by Isak Winkel Holm.

103
destroy, because what exists, indeed existence in itself, all being itself, enrages and provokes
it”211.

The Dionysian ideal is a real overcoming of the individual by way of meta-

morphosis, a self-transformation by steadfast affirmation (i.e of the will to
power). “The word ‘dionysian’ means (…….) a reaching out beyond personality, the every-
day, society reality, across the abyss of transitoriness”212.

The labyrinth is a symbol of chaos: it signifies not nothingness, but the absence
of predetermined organisation. It thus features the possibility of self-
metamorphosis: “A labyrinthian man does not look for truth he forever seeks only his
Ariadne (the golden equilibrium of all things)"213 (Ariadne symbolising the human fig-
ure, which is removing the distance between man and Dionysus).

Nietzsche often identified himself, not only with Dionysus, but also in his last
letters sometimes with the crucified and other historical persons. Was this
merely the product of a mad-man’s delusions, a man, who actually took himself
as being Dionysus or was it merely a quest for self-metamorphosis. As stated by
G. Morels:
“How are we to understand that Nietzsche is essentially all names of history? In its positive
aspect this proposal that an individual really becomes a self only by loosing its given identity, by
passing through ever-changing alterations. Only in this way can eternity be life: the metamor-
phosis of one countenance out of several completely different ones”.214

Nietzsche installed in his last work this neutral eternity of a life beyond good
and evil and the eternal return. Deleuze picked up a life in probably the last
thing he published215. Nietzsche dragged on for ten years in darkness and insan-
ity before he died of old age, Deleuze was probably sane when he killed himself
in 1995. These facts should make us keep in mind how vitality is beyond the

211 See Nietzsche, Friedrich: Will to Power § 846. Walter Kaufmann ed. Vintage Books New York, 1967.
212 From ’Will to Power’ § 1050 as quoted by Paul Valadier. Dionysus vs. The Crucified. p. 248. In: The New Nietzsche,
David B. Allison ed. MIT. Press, 1995.
213 From letter to J. Burckhardt January 4th. 1889 signed ’Dionysus’. Quoted in Paul Valadier. Dionysus vs. The Crucified.

p. 251. In: The New Neitzsche, David B. Allison ed. MIT. Press, 1995.
214 As quoted by Paul Valadier. Dionysus vs. The Crucified. p. 252. In: The New Nietzsche, David B. Allison ed. MIT.

Press, 1995.
215 Deleuze, Gilles: Immanence: A life... in: Culture and Society vol. 14 no. 2, may 1997.

104
person and ‘individual’ destinies, beyond representation and interpretation.
Meta-morphosis is exactly the potential of the neutral, of singular being or all
persons of history like the Dionysian labyrinthian man or the schizo-nomad
freeing desireal flows from codings of settled people. We can all be Dionysians,
we should not personify this role to e.g. people who are mad. The notion of the
infinite not realised potential of ‘the mad-philosopher’ is a misunderstanding.
Like Guattari has demonstrated with his practical clinical concept of transversal-
ity or like Deleuze & Guattari proposed a schizoanalytic practice or model: We
have to experiment with signs, machinic functions and assemblages of things
and persons:
”Avec quoi fait-on de l’interpretation? Avec de la parole! Avec quoi fait-on de
l’experimentation? Avec des signes, des fonctions machiniques, des agencements de choses et de
personnes”216.

The Madman Versus Oedipus

When you are first given the inscription of being mad and as such sent to an asy-
lum or whatever you call an incarceration in a hospital, you have your body
taken away as it is of no concern. It is subjugated to a disciplining apparatus un-
der the jurisdiction of the priests of mental health. However, the body is never
lost, but only in suspension, in a position of awaiting however not realised as it
is subjected to representational language – fixed in categorical thinking, seem-
ingly canonising what is only historical contingent projections.

History reaches out, grabs us and flings us against the wall. Sometimes we want
to protest, but we have not got the words as we are only given the words of yes-
terday: how can I know what “I” want anyway, when the language, which “I”
thought was “mine” (which I am constantly lured into thinking it is) is hegemon-
ized, transforming me into an object of political bargaining? This challenges the
trustworthiness of our everyday language and forces us to think of the possibili-
ties of the body as resistance. ‘The Other’ or ‘Otherness’ is not tied to some
imaginary subject, but is the tension that we can only sense in a split of a second,

216 Guattari, Felix: La Revolution Moléculaire. ENCRES. Fontenay-sous-Bois, 1977. P. 248.

105
when we start to work the borders, when we start to act, to resist. As soon as we
start to look back and reflect with the intention of making strategies for the fu-
ture, we find ourselves trapped in the language of yesterday, as such we bracket
ourselves as pseudo-strategisers - masters of time and space.

In this way, we use or rather abuse history as an instrumental projection of the

present. History as our common lived past becomes reduced to dead sediment, a
burden rather than a critical potential of a future, a continuous folding217. That
was already the point that Nietzsche made in his small book on history218 and
which might have been of major inspiration to Foucault’s project219.

This stigmatising functioning of the past makes one think, how can one not
think of the political, of how the struggle of becoming and of transforming one-
self as a subject, can be thought of as excluded from our everyday practices? The
struggle is an everyday struggle where timely and spatial categorising is the work
of the subtle forces that make our seeing and speaking communicate making up
the territories that we can settle on and call home for some time220. Like Guattari
opted for a more schizo unconscious: ”… [T]urned more towards actual praxis than
towards fixations on and regressions to, the past. An unconscious of flux and abstract ma-
chines, rather than an unconscious of structure and language” 221.

The consequence is that, what I will call ‘the real struggle’ is a struggle,
which cannot be tied up in any structure defined by timely and spatial
categorisation, but one that must be addressed in ‘the event’ of marking
the in-between-space of inscription and bodily resistance.

217 E.g. when first given the inscription of patient with rights to treatment you are subjugated to the normalising appara-

tus attached to ’becoming’ a citizen, when the patient is pushed into the local community. Making madness speak for it-
self rather than being manipulated by de-institutionalised normalising technologies takes a going beyond discursive tech-
nologies as it was already mentioned by Foucault in Madness and Civilisation.
218 Nietzsche Friedrich: Historiens Nytte. Gyldendal. København, 1962.

Friedrich Nietzsche: “Vom Nutzen und Nachteil der Historie für das Leben” (“Unzeitgemässige Betrachtungen”).
219 See also: Deleuze, Gilles: What Is a Dispositif? In: Michel Foucault Philosopher. Harvester Wheatsheaf. 1992.
220 Deleuze mentions the fights of the sixties, that he and Foucault were engaged in forming information groups etc.: He

points here to Guattaris notion of transversality, the possibility of people to speak for themselves, rather than being part
of hierarchical groups with one or only a few persons doing the speaking: “It’s not just a matter of speaking in the first
person. But of identifying the impersonal physical and mental forces you confront and fight as soon as you try to do
something, not knowing what you are trying to do until you begin to fight. Being itself is in this sense political” Deleuze
Gilles: Negotiations. Columbia Univ. Press. 1990. p.88.
221 Guattari Felix: Chaosmosis-An Ethico-Aesthetic Paradigm. Power Publications. Sydney, 1995 (1992). p. 12.

106
As such a nomadic intervention tries to escape representation and memory by
maintaining the tension between the body-sign split and the movement of mat-
ter.
Accordingly, the present project will be a political one in this broad sense
addressing “change” or “development” from within, showing how claims of the
fixation of discourse from imagined “positions” outside discourse is a play with
our imagination promoting our pseudo-strategy function.

107
 Section 6 - Intervention as Folding

“Some voyages take place in situ, are trips in intensity. Even historically, nomads are not necessarily those who
move about like migrants.
On the contrary, they do not move: nomads, they nevertheless stay in the same place and continually evade the
codes of settled people”.
(Deleuze: Nomad Thought in Allison ed. 1995 p. 149)

Pure Becomings
Becoming should be seen as an “in between space” or “meanwhile”, that be-
longs nor to time nor to eternity. As such it is a dead time, a tension, vibrating in
an infinal awaiting. Mean-whiles can be said not to follow each other, but to be
superimposed on one another as they exist outside chronological time222.

The issue is composite becoming, the event being that double structure which
makes its escape from history:

”Leaving history behind only in possession of its effectuation in states of affairs or in lived ex-
perience”.

“The actual is not what we are, but what we become, what we are in the process of becoming,
our becoming-Other. The present on the contrary is, what we are, and thereby, what already we
are ceasing to be”223.

This pure change, which is so difficult to grasp makes Deleuze and Guattari de-
scribe the event as more geographical than historical in the sense224, that the
event has beginning nor end. It rather inhabits ‘a milieu’ or ‘a smooth space’,
contrary to ‘a striated space’225. Becoming can be said to be assemblages, double

222 “In every event there are many heterogeneous, always simultaneous components, since each of them is a meanwhile that makes them commu-

nicate through zones of indiscernability: they are variations, modulations, intermezzi, singularities of a new infinite order. Each component of
the event is actualised or effectuated in an instant, and the event in the time that passes between these instants: but nothing happens within the
virtuality that has only mean-whiles as components and an event as composite becoming. Nothing happens there, but everything becomes, so
that the event has the privilege of beginning again when time is past” Deleuze, G & Felix Guattari: What Is Philosophy? 1993.
Verso. London. p. 158.
223 Deleuze, G & Felix Guattari: What Is Philosophy? 1993. Verso. London.p.112
224 Deleuze, G & Felix Guattari: What Is Philosophy? 1993. Verso. London. p. 110.
225 Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone. London, 1988.

108
articulations, stratifications: the flower-bee assemblage, the bird-seed assemblage
etc. Becoming is pure qualities or percepts and affects, what characterises it is
not its being in chronological time, but its tendency to change: the becoming bee
of the flower and the becoming flower of the bee etc.

The continuous side-stepping of the present, which is the product of pure be-
comings of the event, is on the level of ontology about an existence of pure af-
fect and percept, about pure singularities.

However, if we use the nomadic in a more epistemological sense, we should try

to conceive how an intensity is not a movement away (or a from-to movement)
from something but movement-in-itself:

“Even historically, nomads are not necessarily those who move about like migrants. On the
contrary, they do not move: nomads, they nevertheless stay in the same place and continually
evade the codes of settled people”226.

We should consider organising as a nomadic enterprise, intervening, inserting it-

self between the past and the future, never in the present. This event-making ac-
tivity is a nomadic intervention, an activity, which acknowledges the representa-
tional character of everyday language at the same time as it attempts to go be-
yond such a mode. It is an issue of developing a subversive mode of reterritori-
alising.
Here the heritage of Foucault, the new pragmatist, shows itself., He would join
the schizo-nomad and ask227, what can I do with this major language, which I am
part of in my everyday practices? The answer would be: you do not know until
you start doing228 and working with signifying and counter-signifying potentials
making lines of subjectification impend on themselves. This is the very activity

p. 379.
226 Gilles Deleuze, Nomad Thought in: Allison David B.: The New Nietzsche. MIT Press. Cambridge Mass. 1995.
227 The abstract machine is attracted by a certain desire as it works through particles of signs on the plane of immanence

the absolute horizon of all events. The machine works out of a desire to create rather than to fixate such a machinic as-
semblage moves around like nomadic tribes without settling, without dividing the plane of immanence.
228 Writing as a way of connecting with the voices operating in the unconscious, in the sense that I depend on an molecu-

lar assemblage of enunciation, which is not directly within reach, writing is a way of connecting which this assem-
blage,...”to select the whispering voices….. to extract something I call my self (Moi) Deleuze, G & Felix Guattari: A Thousand Pla-
teaus. Athlone. London, 1988. p.84.

109
of self-folding, creating individual multiplicity, singular points of view of the
world.

Counter-Signifying as Intervention
It follows from the strategy of analysis as sketched above in section 4, that a
psychiatric patient is nothing apart from its ‘event’, its singularities, its becoming
minor within the major.

It is a folding of material, experiments, which makes the creation of an identity -

a self-folding, a playing with counter-signifying against the wall of signifying.
One promotes jumps between shifting points of subjectification. As mentioned
in the earlier sections, mixed semiotics, e.g. the one of mental health or of psy-
choanalysis, creates these points having the following characteristics

“… from the point of subjectification issues a subject of enunciation, as a function of mental

reality determined by that point. Then from the subject of enunciation issues a subject of the
statement, in other words, a subject bound to statements in conformity with a dominant real-
ity”229.

Normalisation works by points of subjectification.

An example230 given by D&G is the patient as analysand who is a partial subject
of enunciation, but who is subjected to the technologies of the psychoanalyst,
and as such becomes subject of the statement (the dominant reality).

Normalising technologies pose the condition of the individual of either annihila-

tion in a black hole or the change of plane, opening towards the diagrammatic
function. Consequently, Deleuze has phrased the problem of resistance and self-
folding in the following way:

”How can the individual transcend its form and its syntactical link with the world in order to
attain the universal communication of events?”231

229 Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone. London, 1988.p.129
230 Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone. London, 1988.p. 130-131.

110
The form, the stratified or territorialised body, which is the working surface of
normalising technologies, must be viewed as folding material, which constitutes
the syntactical link and the retention of sufficient amounts of signification. This
is the condition for turning the dominant reality against itself and to make lines
of creation.

We can think of such a resistance or intervention into the fixations of life as a

continuous folding like Deleuze developed the idea in his books on Foucault
and on Leibniz and The Baroque. Foldings avoid finalities stressing the tension
between the inside and the outside, and the creation of continuous folding.
Counter-signifying is exterior to the coding of the State, which extracts its terri-
tory from decoded milieus. As pointed at earlier in section 4, counter-signifying
is co-extensive with the State (as the rhizomatic exterior), because the exterior is
folded towards the interior (the State). This is what makes the counter-signifier
an inside of the signifier. The concept of the folding illustrates that becoming is
not about an imaginary flow of ideas, but about the insertion of the human body
in a textual corpus, which creates certain conditions of possibilities for an em-
bodied emancipation. The preliminary functional structure set up by the expres-
sion of the statement conditions (folds) the materials of incorporeal actions and
passion. The folding is conditioned by a counter-signifier, which slows down de-
stratification. This accomplishes continuous folding rather than rigidified of
strata. It is about the immanent conditions taken over from the past, which pro-
trudes and gnaws into the future, where the self-folding is the event of making
these conditions appear as creation potential. This potential as mentioned is de-
pendent on the counter-signifier inside the signifier-post-signifier.

When Deleuze & Guattari refer to ‘the body without organs’ as the field of im-
manence of desire, the plane of consistency specific to desire, they refer to these
emancipatory forces:

231 Deleuze, Gilles: Essays Critical and Clinical. Verso. London, 1998.p.xxix

111
“..(With desire defined as a process of production without reference to any exterior agency,
whether it be a lack that hollows it out or pleasure that fills it).
To illustrate D&G infer the example of the masochist:

” ..The masochists suffering is the price he must pay, not to achieve pleasure, but to untie the
pseudobond between desire and pleasure as an extrinsic measure”232.

To enter the zone of becoming is to be able to roam around on the body with-
out organs creating lines of flight. However, the becoming, as has already been
elaborated in the earlier sections, is on the level of semiotics and assemblages
and should be linked to lines of creation accomplished by the counter-signifier.
We can talk of foldings or the slowing down of pure becoming.

This in-conclusiveness of the signifying game illustrates how folding and move-
ment is an immanence creating its own criteria. It is war-nomadic. The nomad
lives more in the future than in the present, he negates as he steps in the middle
of territories, which are shielded by hierarchies and institutions. He inspires us
to think of intervention as this continuous side-stepping of the present: demon-
strating it when he escapes the codes of settled people and when he inscribes
death not as an finite limit - something in itself, but only as the outside of the in-
side - death is, like history, a border to play with, an invitation to stay in the fold
with a continuous folding, the moment between life and death where only the
impersonal, the singularity of a life plays with death. A life that releases a pure
event freed from subjectivity and objectivity, so to say a life neutral beyond good
and evil233. The plane of immanence as the absolute horizon of all events con-
tains the experimental flows of the body without organs with its productions,
which are constantly being folded into one another. There is effect and effect,
rather than cause and effect.

232 Deleuze, G & Felix Guattari: A Thousand Plateaus, 154-155. Athlone. London, 1988.
233“A life should not be contained in the simple moment when individual life confronts universal death. A life is everywhere, in all the moments
a certain living subject passes through and that certain lived objects regulate: immanent life carrying along the events or singularities, which do
nothing more than actualize themselves in subjects and objects. This indefinite life does not itself have moments, however close together they
might be, but only mean-times (des entre-temps), between moments” (Deleuze: in: Culture and Society pp. 4-5 may 1997).

112
Counter-signifying or intervention as folding embeds Guattaris notion of trans-
versality, the possibility of people to speak for themselves, rather than being part
of hierarchical groups with one or only a few persons doing the speaking:

“It’s not just a matter of speaking in the first person. But of identifying the impersonal physical and mental forces
you confront and fight as soon as you try to do something, not knowing what you are trying to do until you begin to
fight. Being itself is in this sense political” 234.

In this sense what I choose to call ‘the real struggle’ or an intervention can be
said to embody a principle of transversality. Its a principle which touches the
other silence, the silence within the silenced.

The event, more geographical than historical, forms a milieu, simultaneously sur-
rounding, medium and in the middle. It is here that machinic transformations
are conjugated or folded, synthesized into a program. It is from here stratifica-
tion works by de-coding flows and from here territories are extracted by coding.
I will see intervention as addressing this “milieu” of de-codings and codings, as
it picks up and lays down rhythms creating ‘a vitalised voicedness’, difference-in-
itself - a nomadic intervention.

234 Deleuze Gilles: Negotiations, p. 88. Columbia Univ. Press. 1990.

113
 Section 7 - The Becoming Citizen of The
Patient
The Seventies and Eighties

The following sections 7, 8 and 9 will treat in detail the de-institutionalisation of

psychiatry in Denmark according to the analytical principles given above. They
will attempt to line out the different traits of the recent past, which can be car-
ried into new assemblages of a becoming of psychiatry and a becoming mad of
the patient.

To repeat, the specific interest is not to make a deep investigation of causal rela-
tions and to produce conclusions concerning successes or failures, which can be
attributed to certain actors, institutions etc. Rather the inquiry will be dealing
with ‘an organisational issue’, the sectored psychiatry, as an emergent field of
tendencies. The application of different documentary sources is used to trace
and map out these tendencies (regimes of signs, effective and potential ma-
chines), rather than to attempt a thorough and deep coverage of certain social
fields and their institutional complexes. The first part of the account in the sec-
tion will be rather descriptive accumulating different documentary sources.
These descriptions are then analysed as tracings of mixed semiotics. As genera-
tive pragmatics, these tracings are made to interact according to the principles of
transformational pragmatics. Finally, these maps are treated in an abstract per-
spective, where forms of content and forms of expression are abstracted accord-
ing to the principles of diagrammatic pragmatics. This scheme will also feature
in the following section 8.

Thus the aim in this part is to trace the mixed semiotic of the sectored psychia-
try to extract from it the potential for new statements. The two concepts social-
psychiatry and the sectored psychiatry are used alternately to indicate an emerg-
ing field of a community centred psychiatric service. This trend has a history of

114
at least 25 years, and has been expected to produce new and more qualified ways
of dealing with mental illness.

To further study the sign-potential within this emerging sectored psychiatry, we

should study the dynamics of how professions become ‘functionaries of con-
sent’ and consequently how ‘the madman’ is silenced now as ‘citizen’. This
should be a study of a complex interplay between different bodies of society:
governance, law, profession, dissidence and citizenship in short a study of ma-
chinic assemblages and the abstract components associated with them. These
analyses will feature in the present and the following section. In section 9 the last
rhizomatic step is taken as these analyses are reframed as they are organised into
a program.

The Birth of The Asylum Revisited

In the year 1683, The Danish Law (‘Danske Lov’) stipulated that the autocratic
state was responsible for the incarceration of ‘furious madmen’ in what was
designated as ‘madhouses’. These consisted of small wooden boxes with a hole.
The responsibility for the care of the mad persons had until that time been
resting with the relatives. Inhuman ways of treating the mad, only considering
what you could call the public safety rather than the individual existence of the
mad person, were to be changed with the age of enlightenment. However until
the end of the eighteenth century still a lot of mad persons were living in the
local community as only people who were considered dangerous were admitted
to the madhouses. As a body of reforms were carried through in 1787 and 1788
(‘Den Store Landboreform’ and ‘Stavnsbåndets ophævelse’) the structure of the
near community changed. Farmers and their families were not tied to the same
estate for their whole life, which had been the case for centuries, though only
formally since 1733. This put a pressure on the local poor-law authorities to care
for these people who had formerly been taken care of by the community. In
1803, a law was established stipulating that the support of these people was the
responsibility of the local poor-authority. This showed out often to be a
considerable task as these people should be supported with shelter and food and
some times special guardian measures had to be applied. The task was often
impossible not at least financially for the local authorities. The existing mad-

115
at least financially for the local authorities. The existing mad-authority however
was incapable of relieving the local authorities of their burden as these facilities
were already in a very poor condition. In 1831, an estimated 958 were in need of
special treatment.

The attitude of the bourgeoisie and the authorities was that institutions were
needed where these people could be cured, while the broad population had a
more traditional attitude. As it were, the attitude among the local population was
that these people should be segregated only when dangerous. However from the
1830ties you see a growing promotion of bourgeois ideals of humanity, industry
and economic freedom. The focus was shifted towards the individual life of all
citizens including deviants, who were considered on the one hand miserable and
worthy of compassion and on the other hand a nuisance and a burden to the lo-
cal community. The solution was institutions and the liaison with doctors who
delivered the medical arguments. The theory of one doctor (J.R Hübertz,
1843)235 was that the miserable conditions of the mad-authorities accounted for
the bad conditions offered to these mad people. Rather it was important to take
them away as fast as possible and treat them: “With humanity, activity, order and sat-
isfaction”.

In the beginning it was feared that the general population was reluctant to segre-
gate the mad persons in need of treatment. However it was soon to be the case
that the majority of the persons admitted to the hospital originated in the lowest
social class. The institutionalisation was a process of big impact. In 1847 before
the process started, 3756 mad persons were registered of which only 849 were
segregated and subject to public measures (in 1909 this number had gone up to
5552 mentally ill persons236).

This process led to the establishment of the big asylums, which by their func-
tions cared for and guarded and isolated the mentally ill from the rest of soci-

235 See Morten Lundby Jensen: Fra Landsbytosse til Psykiatrisk Patient - Holdningsændringer overfor Galskaben og Be-

handlingen af Gale i Danmark 1700-1900, in: Den Jydske Historiker. Tema: De andre – udskillelse og Anderledeshed. Nr
41, 1987.
236 Ibid. pp. 34-35.

116
ety237. This fact signalled to a large extent that the big state-operated hospitals
were a world of their own. The progress within medical science and the general
demands of society for efficiency created the basis for psychiatry and the hospi-
tal to develop into a distinct medical field from the beginning of the nineteenth
century.

The function of medicine had established madness as disease. This segregation

can be said to be reaction of a development driven by economical and moral ar-
guments. The responsibility was gradually handed over from the private sphere
of the local community to the institutions of the state and its specialists. The
mad-man was contrary to the bourgeois ideals of reason such as industry, self-
control, intimacy. As such it became the task of psychiatry on one hand to pro-
tect society against madness and on the other hand to create results, that is rec-
reating sane human beings.

With these historical explanations in mind it is not difficult to make a parallel to

the recent de-institutionalisation in Denmark. These efforts can to last extent be
explained by moral and economic arguments sustained by the authorities similar
to what happened in the beginning of the nineteenth century. In the nineteenth
century these arguments were used to establish institutions, now these argu-
ments are applied in order to abolish institutions. The experience with institu-
tions through the twentieth century has not somehow been in tune with the
general public mind. The expectation that mad people could be cured in institu-
tions has failed. Rather mad-people were put away most of their life often with
no chance of recovery.

The fact that this life-long storage was taking place under miserable conditions
has given medicine a problem of legitimating itself as it has given society in gen-
eral a huge moral problem. The fact that psychiatry as a discipline has been
given low priority in governmental funding should also be considered as a con-
sequence of its inability to produce results that is cure. This is the historical con-
text and the overall official explanations for the de-institutionalisation.

237 See also: Ralf Hemmingsen: Forudsætninger for 1990´ernes distriktspsykiatri p. 38. in: Lasse Nilsson red. 1988.

117
However as argued at length above it seems reasonable to further investigate the
conditions of possibilities of de-institutionalisation in order to get insight into
the processes of how subjectivity is a process of articulation or stratification.

This takes a study of how different acts and passions affect different bodies of
society and how they relate to different expressions. More specifically this will
involve a microanalysis of machinic assemblages, concrete manifestations of
government and abstract components of normalisation.

Decentralisation – Integrating Body and Soul

In Denmark sectorisation and de-institutionalisation thinking can be traced back
to the nineteen fifties where a process was initiated aiming at de-
institutionalising mentally ill persons. The final goal was that the mentally ill per-
son should have the opportunity to live a life as close to ‘the normal’ as possible.
Already at that time there was awareness of the importance of attaching and co-
ordinating the somatic hospital service with the one of psychiatry, which can be
seen in The Law of The Psychiatric Hospital Service from 1953238.

With a new act (‘Udlægningsloven’) from 1976 the Danish counties took over
the responsibility of the psychiatric hospital service, which as mentioned until
now had been governed and financed by the state. It was a product of the gen-
eral restructuring of the Danish municipalities and an attempt to follow the gen-
eral attitude of the government239 to cut the growth of the public sector. Even if
it was costly to have people stored in hospitals for years with 24 hours profes-
sional service, psychiatric institutions did not have high priority in relation to the
total budget spent on health care.
It should not be underestimated that the reduction of public spending was part
of the agenda as the psychiatric service consisted almost exclusively of ‘hospital
beds’, which was considered very costly. The act however officially had two
main objectives:
238 The essence of this law was that future psychiatric hospitals were supposed to be placed as close as possible to the
general hospital. See Anders Kelstrup: Galskab, psykiatri , galebevægelse - en skitse af galskabens og psykiatriens historie,
s. 222. 1977.
239 These principles were stipulated in: Perspektivplan 2. Indenrigsministeriet, 1972.

118
1) To bring the psychiatric hospital function closer to the everyday life of the
citizen and in this way contribute to a more tolerant view on mental illness
among the general population, and 2) To obtain the closest possible collabora-
tion between the medical professions and lower the sharp distinction between
somatic and mental illness.

This was also underlined in The Circular of 1977 from The Ministry of Domes-
tic Affairs concerning the planning of the psychiatric hospital function:

“.... [T]hat the remotely situated psychiatric special care, is situated far away from the dwelling
of the patients and from other specialised hospitals has become a less fortunate type of institu-
tion for a growing part of the patients. The remote location can cause problems for relatives and
friends and it serves to isolate mentally ill persons in an unfortunate way....” 240

It was stressed that the talk was of patients, who were not considered in perma-
nent need of hospitalisation.

The abandon of the psychiatric hospital service of the state in the end seventies
created the ground for new directions for the treatment and care of the patient:
the reform was made visible in a drastic reduction of hospital beds, while Out-
patient Treatment was still in its infancy. This resulted in the counties initiating a
drastic process of de-centralisation. This process was unfolding in the years after
1976, however in rather different ways. That is the counties, which until now did
not operate any of the formerly state-hospitals, were more free to decide how to
organise their services. Others had more or less to start from scratch.

In the guidelines little effort had been done concretely to define, how Out-
patient Treatment should be organised. This task to a large extent was to be un-
dertaken by each county, with the argument, that a local planning of the psychi-
atric service, had to be anchored in respect of the difference of the counties.

240Vejledende Retningslinier for Planlægning af Psykiatrisk Sygehusvæsen, Inderigsministeriets cirkulære af 4. april

1977, i: Galskab, psykiatri , Galebevægelse - En Skitse af Galskabens og Psykiatriens Historie, Anders Kelstrup, s. 219.
1977.

119
However it was stressed that the counties ought to seek to work towards be-
coming self-supplying with psychiatric service and to organise the psychiatric
service according to Out-patient Treatment principles241. These principles were
referred to it seems as a rather uniform concept, which self-evidently could be
applied to the existing paradigms within the field. The counties were to finish
their planning of their psychiatric service in April 1977, consequently 1976 fea-
tured a conference arranged by The Danish County Association242.

One of the issues was clearly that a better collaboration between the primary
sector (the municipalities) and the secondary sector (the counties and its hospi-
tals) could justify a reduction of the capacity of the hospitals. The collaboration
between sectors was not considered very problematic, however it was men-
tioned that it should be possible to treat concrete cases across the sectors, in
sense of co-ordinating the efforts when a patient is discharged243. The overall
picture judging from the reports from the different counties throughout the
country was that the actual development of a new decentralised model would
not pose huge problems. This was also the case when principles of out-patient
treatment were debated, the conclusion was that a successive model should be
applied.

Only one of the conference participants a county Social-director saw a potential

problem concerning the cross-sectored collaboration. First of all he saw the de-
centralised model as a possibility to focus on the function of the patient/citizen
in his local environment. This should then be the point of departure for judging
the need for hospital and other facilities. In this argument you can trace the
point of view that too much determination is attached to the hospital and the
doctors and their point of view concerning planning, organisation and priority of
services.

241 90`ernes psykiatri. Oplæg til temarunde 1989-90, Sundhedsministeriet 1988, s. 16

242 Kr. List. Den Psykiatriske Service og Planlægning til Debat. In: Danmarks Amtsråd. vol. 8. no.21. 1977.
243 The Chief Psychiatrist E. Sarauw Kristiansen. Den Psykiatriske Service og Planlægning til Debat. In: Danmarks

Amtsråd. vol. 8. no.21. 1977.

120
In the same period a line of reforms in the social sector was accomplished, with
The General Legislation on Social Welfare244 (bistandsloven) being effectuated.

This seems to have contributed to the vast body of services, which has been
made available not only for mentally ill, but also for other marginalised groups
of citizens245.
Argumentation related to de-centralisation was dominated by statements like the
following:

“.... [T]o create the foundation for an integration of the psychiatric hospital service in the nor-
mal municipal hospital service”

Moreover the opinion was that de-centralisation except from producing some
practical and economic benefits would be of:

“.... [P]sychological value that it in concrete way is conveyed that the treatment of mental illness
is at the same level and priority as other kinds of illness...” 246

From this it is clearly seen that psychiatry and somatics are given equal priority.
Psychiatry is considered a strict medical discipline and the citizen suffering from
mental illness is rather uniformly considered a patient. At this point the argu-
ments around ‘integration’ do not contain anything concerning cross-
professionalism and cross-sectors. The hospital is seen as the ‘natural’ entity,
which can program the treatment of the mentally ill person. Out-patient Treat-
ment is consequently considered as based in the hospital.

Anti-Psychiatry and The Sectorisation of Psychiatry

This period was dominated by harsh attacks by anti-psychiatric debaters against
‘the alienating psychiatric paradigm’. However the debate on the organisation
and direct implication of the decentralisation trend was not discussed by other

244 This general legislation was amended in July 1998 with the effectuation of a complex of three new acts see further in

section 9.
245 See “90`ernes psykiatri. Oplæg til temarunde 1989-90, Sundhedsministeriet 1988, s. 17”
246 Den psykiatriske sygehusfunktion, betænkning nr. 826, 1977, s. 26

121
than planners and politicians. Two psychiatrists (Moxnes & Ghaffari) argued247
against the anti-psychiatric trend by stating that anti-psychiatry in the long run
must be doomed to impotence and to become a banality. The argument was that
within the frame of anti-psychiatry (especially referring to Laing) the psychiatrist
is produced as a wise-man, who is able to disalienate himself as well as the pa-
tient. The blame is unilaterally put on society and its sick institutions as this per-
spective, it is argued, creates the problem of assimilating the patient to society
again.

The argument is a bit simplified, but the message is pretty clear: anti-psychiatry
as presented within this frame excludes itself from having any impact on the ac-
tual development of the psychiatric discipline. As will later be elaborated you can
find several versions of what is labelled ‘anti-psychiatry’, however the version re-
ferred to here marks how the trend is received by traditional psychiatrists. This
strict marxist interpretation of anti-psychiatry was countered by a Danish psy-
chiatrist248, who as he mentioned had declared himself anti-psychiatry supporter.
He stated that he did not like the Cooper concept of anti-psychiatry, as he
stated: “ A psychiatrist is not able to be an anti-psychiatrist as well as a bird cannot be a
fish”.

He interpreted anti-psychiatry as a hermeneutic existentialist movement rather

than a structuralist movement. Consequently the central question in treatment is
the insistence on understanding the personal experience in a hermeneutic proc-
ess between professional and client. This stands in opposition to the outsider
situation where the professional is the master of the mechanisms of alienation.

The above exchange of points of view mirrors how anti-psychiatry is adopted

and reproduced within different frames.

This can be seen as a direct consequence of the degree of fragmentation within

anti-psychiatry, but also how different psychiatrists view the threats/possibilities

247 Ali Ghaffari & Paul Moxnes, in Nordisk Psykiatrisk Tidskrift vol. 27 no: 1, 1975.
248 Mogens Jakobsen: in Nordisk Psykiatrisk Tidskrift vol. 27 no: 1, 1975.

122
of anti-psychiatry. To further understand this relation it is relevant with a small
note on anti-psychiatry and the development of the sectored psychiatry.

In Europe, the sectorisation of psychiatry for sure had different elements of

anti-psychiatry attached to it, especially rooted in different radical movements in
the sixties. These movements must be seen in conjunction with the general po-
litical consciousness of that time, making psychiatry another symbol of the re-
pression of capitalist society. At the same time the character of psychiatry as a
scientific medical discipline was considered dubious in the public mind. This im-
age was first of all a result of the experimental culture associated with psychiatry
and its institutions. A culture249, which in many senses was considered a modern
version of the superstition and trial and error associated with more distant his-
torical approaches to mental disturbances.

Anti-psychiatry can be said to be a common denominator for different trends,

which opposed the established systems and professions included in the psychiat-
ric discipline. However the different approaches only shared this broad pro-
grammatic declaration, whereas they differed in many ways concerning both
theory and practice. In this sense anti-psychiatry as a unity is more the product
of the strategies developed by an establishment of some psychiatrists.

The Anti-Psychiatric trend in Britain was represented by: Cooper, R.D Laing
and Maxwell Jones. In France by people like: Francois Tosquelles, Felix Guattari
and Jean Oury and in Italy by people like: Basaglia, Rotelli and the movement of
Psychiatria Democratica. In Germany, by: the polyclinic of Heidelberg and
Sozialitiches Patientencollectiv250. These diverse tendencies were however rooted
in different approaches to psychiatry and its role in the reforms of sectorisation.
For some radical voices, psychiatry was merely a myth (Szasz251) that needed a
challenge by models where medicalisation was not included opening towards so-
cial critiques of social alienation.

249 A culture, which in includes the psychosurgery experiments in the middle of the twentieth century (see Freeman, W.

& Watts, J.W: Psychosurgery. Springfield. Charles C. Thomas, 1942), experiments with electrostimulation and different
drug treatments.
250 Gary Genosko ed.: The Guattari Reader p. 4ff. 1996.
251 T. Szasz: The Manufacture of Madness. Frogmore, St. Albans. Paladin Books, 1973. & Ideology and Insanity. New

York. Anchor Books. 1970.

123
Guattari and Basaglia252 opposed this trend, which they saw as rooted in a misin-
terpretation of how psychiatry could play a role under new conditions rather
than being functionaries of consent in ‘a psychiatry of sectorisation’. Rather the
focus should to abandon the big programmes of the hospital and the imaginary
sectorisation, in favour of focusing the everyday life and the public opinion at
large253. In this regard, a lot of inspiration could be traced from the experiments
in Italy where traditional hospitals have been abandoned on a large scale in fa-
vour of different ‘patient’-communes in the local communities.

The establishment of a political role of psychiatry inside the sectored psychiatry

has not been an issue of interest for the established psychiatry in Denmark. The
commitment has been dominated by ideological or professional statements,
rather than by a presence in the political reality of the sectored psychiatry. Only
a very few exceptions can be found concerning this issue (see e.g. Reisby & Ach-
ton Nielsen below).

Out-Patient Treatment - Co-ordination of Systems

Through the eighties it became more visible that the development of psychiatric
service through Out-patient Treatment principles created a need for collabora-
tion with the local municipal system. There seemed to be a strong need for both
housing facilities as well as special social facilities, occupational facilities in gen-
eral and leisure activities. Except from a dramatic reduction of hospital beds, the
emphasis on Out-patient Treatment meant that patients were discharged faster
than before. This implied that treatment as hospital care was abandoned in fa-
vour of a more loosely coupled medical surveillance. This also meant that re-
hospitalisation was of shorter durance than had been the case earlier.

This new focus in the organisation of the psychiatric service also occupied the
minds of psychiatrists, however not many psychiatrists participated in the public
sphere on these issues, which were crucial for their general work-conditions.
However this should not be interpreted as an expression of consent as psychia-

252 Gary Genosko ed.: The Guattari Reader p. 4ff. 1996.

253 Felix Guattari: La Revolution Moléculaire, 1977 p. 159.

124
trists for sure felt that they were given fewer resources and that their paradigm
was under a pressure not at least from new therapeutic trends as from more so-
ciologically oriented approaches. In this regard it was time for reflection: one
Doctor Niels Reisby asked a provoking question on the 23 of April 1980, as he
was accepting a professorship in general psychiatry at The University of Århus,
he asked: Psychiatry – science or workmanship?254 The speech was an attempt to give
some ideas as to how psychiatry could develop through the new trends and how
inspiration could be retrieved from the different experiments, which had been
going on for some time in Italy and England.

The point of departure was the obvious discrepancy between the frequency of
the occurrence of mental illness in the population and the apparent low priority
given to psychiatry from administrators and politicians. This fact was seen as
rooted in the doubtful status of psychiatry as a strict medical discipline. In this
regard he went so far as to propose, that anti-psychiatric thought could be used
for creating visions of reforming psychiatry.

These arguments of course were countered, another Doctor (Knud Nørgård)255

commented in a fierce way in the leading Danish medical journal (Ugeskrift for
Læger) that this questioning would lead to the final decay of the psychiatric dis-
cipline. The ultimate argument was a reference to the basic paragraph in The
Legislation on General Practice of Medicine (‘lægeloven’) stipulating the profes-
sional obligation of the doctor to care for and save human lives. This argument
was backed up by reference to a legal study conducted by a law professor, on the
legal problems associated with the practice of Anti-Psychiatry256. In this regard
he emphasised the importance of preserving a critical scientific stance as: “Pa-
tients will be harmed least if doctors take care of them” (p. 718). He stressed the danger
of doctors becoming infected with an anti-psychiatric ideology, acting as
psychologists without practical insight in the specific human, which you only can
get by joining body and soul (again referring to Ross257).

254 Niels Reisby’s inaugural speech at The University of Århus printed in: Ugeskrift for Læger årg. 143, no. 10, 1981.
255 Knud Nørgård in: Ugeskrift for Læger årg. 143. no. 11, 1981.
256 Alf Ross: in Bibl læg. Opgør med Anti-Psykiatrien. 1979: 171: 241-268.
257 Alf Ross: in Bibl Læg. Det Psykopatologiske Sygdomsbegreb. 1980: 172: 1-23.

125
This positivist fundamentalism expressed by Nørgård where mental illness must
be contained in a traditional ‘medical science’ was responded to by Niels Reisby
stressing the necessity of considering the future role of psychiatry under influ-
ence of sectorisation. He stressed the necessity of participating in this political
game rather than retiring into a dogmatic paradigmatic shell.

The case shows how two positions of doctors create different versions of what
were the possibilities of sectorisation and Anti-Psychiatry. Anti-Psychiatry in its
most radical form creates counter-pictures, which are easily transformed into
horror pictures by positivist fundamentalist arguments.

Knud Nørgård mentioned in his reply in a sarcastic way that psychiatrists might
not be the brightest intellectuals in the sense of being able to position their pro-
fession in an overall societal, say political context. As such it can be argued that
the profession of psychiatry in its nature is incapable of transformation, because
the people practising psychiatry traditionally do not possess the qualities of what
Gramsci have referred to as organic intellectuals. Organic intellectuals possess
an ability, to put their ideas to work in a political field, whereas traditional intel-
lectuals maintain the structures of a given paradigm (joining body and soul in the
hospital)258.

Some of the reforms in Italy have been misconstrued as Anti-Psychiatry in the

sense of disregarding the whole medical part of modern psychiatry. This could
be suspected to stem from a traditional intellectual interpretation of these
trends, bulking them together thus legitimating existing paradigmatic structures.
One example is Knud Nørgårds reference to a statement by Basaglia as a dialec-
tic mystification: “Wir negieren die Institution und gleichzeitig verwalten wir sie: wir
klammern die Krankheit aus und gleichzeitig behandeln wir sie: wir lehnen die Therapie ab
und gleichzeitig wenden wir sie an etc.”259. A statement like this must remain ‘a mystifi-
cation’ in a positivist fundamentalist world whereas Reisby seems to expose an
ability not to view sectorisation necessarily as Anti-Psychiatry, but rather to see it
258 C. De Leonardis & D. Mauri Instituzione Psichiatrica: Politica Sociale e nuove forme di controllo e legittimazione.

Unpublished manuscript, Departments of Sociology, Univ. of Salerno & Univ. of Milan. Quoted in: Mollica Richard:
From Gramsci to Basaglia. International Journal of Mental Health. No.14 1-2. 1985.
259 Knud Nørgård in: Ugeskrift for Læger årg. 143. no. 11, 1981.

126
as a possibility to reform and experiment without the domination of traditional
structures260. The above quote also exposes that Psichiatria Democratica should
not be labelled ‘Anti-Psychiatry’, in the sense of a consequent negation of the
whole professional tradition of psychiatry.

The focus of Anti-Psychiatry on the abolition of the medical concept of illness

in favour of different degrees of life-problems is a deathblow to the psychiatric
profession. In that sense Anti-Psychiatry is not productive, because it produces a
counter-discourse, which is not suited to challenge the tradition of psychiatry
‘from the inside’. Rather it seems to create regression and further rigidity of ex-
isting structures. This tendency must lead to loss of opportunities in relation to
what seems anyway to be a ‘fait accompli’ namely the sectorisation of psychiatry.
Anyway, the Italian experiments were studied in Denmark with the aim of ex-
tracting some experience to the efforts of reform in Denmark.

However, the conclusions were that the reform had failed. A psychiatrist (Poul
Munk Jørgensen) concluded in an article261, that too many cases showed that the
load was put on the family in the absence of proper hospital facilities. At the
same time, he mentioned that the cross-professional approach and the experi-
ments with different sciences could create a cover up concealing ignorance and
professional incompetence. The Italian reform at this point was still in its ex-
perimental phase seven years after the amendment of the law, this fact however
was not acknowledged by the result oriented Danish delegates.

The anti-psychiatric movement was very active in the first half of the eighties in
its critique of the medical profession and its abuse of power by ‘psychiatrifying
social-problems’ like e.g. unemployment. The link was made between the
capitalistic motives of medical firms and the doctors’ testing of these products in
the clinics. It was stressed how these drugs could be used both to treat
symptoms and to verify diagnoses by experimenting with different drugs262.

260 This fundamental discrepancy between two forms of intellectuals could explain some of the fierce battles between

psychiatrists from the universities and practitioners, which took place in Italy in the sixties and seventies.
261 Poul Munk Jørgensen: Italien – foråret 1984. Et rejsebrev. In Agrippa. 7: 76-83. 1985.
262 Anders Kelstrup: Om Magtens Ideologi og Maskering af Samfundsproblemer, in: ’Gale mod Magt mod Gale’. Amalie.

1985

127
One tricky thing is that it is often mentioned that psychiatrists should not psy-
chiatrify social-problems in the sense of reducing the social to bare medical facts:
the focus should rather be to make patients act. As The Mad Movement puts it
in a powerful statement: Vi vil handle, ikke behandles263 (we want to act rather than
being treated). This however takes, and that is the tricky part, an involvement of
the psychiatrist (and all others who could be involved with treatment) in the re-
formulation of psychiatry in a socio-political context. This is the real challenge
and it might take very special people (like e.g. Basaglia and his group) to create a
vanguard for developing new theories and methods for such a new Social-
Psychiatry.

The anti-psychiatric movement seemed in this period to make a polarisation,

which did not encourage the necessary involvement of psychiatrists in the sec-
torisation efforts264. The focus was to see psychiatry and the clinic as an anach-
ronism, which was fundamentally repressing and anti-democratic. It could very
well be said that when the Danish Movement of Madness accused psychiatry of
being a-historic, asocial etc. they reproduced the same logic by ontologising their
own ‘mad’ voice stating that the bare fighting of repression by what was termed
‘counter-power’ could restore madness. It could here be argued that the emanci-
pation of the madman failed, because psychiatry was produced as a stereotyped
monster. Emancipation was not seen as a joint societal issue in the sense of cre-
ating environments of joint experiments.

Rather reform workers were further encouraged to blame the professions for
lack of co-ordination and collaboration creating dysfunction of the service. In
this trend you could see psychiatry be used as a scapegoat, which was certainly
not productive in the sense of establishing a new experimental culture. A psy-
chiatrist265 explicitly referred to the danger connected with the tendency of de-
valuating the psychiatric profession. He emphasised the role of the media deliv-
ering undifferentiated messages connected with the humanitarian discourse pro-
duced by The Mad Movement. Doctors and other personnel often seemed to be

263 Henning Nielsen: Galebevægelsen – fra Afmagt til Mod-Magt, p..23 in.: ’Gale mod Magt mod Gale’. Amalie. 1985
264 See e.g. the publications of ’The Mad Movement’ (Galebevægelsen) Amalie no: 1, 3 and 4: 1983.
265 See Ulf H. Vaag: ’Devaluering af et speciale’ in: Ugeskrift for Læger 144/33. August 1982.

128
unable to answer back in situations where different cases were used to criticise
the system, because of restrictions of confidentiality rules stipulated in The Gen-
eral Act of Administration (‘forvaltningsloven’).

One paper by a left wing politician Preben Wilhjelm touched upon the relation
between the public sphere and psychiatry266: The subject was the often double
bind demands of the public put on psychiatrists, one moment accused of apply-
ing unnecessary force, the other moment of discharging dangerous people. The
problem attached to the application of legal force is difficult and it should be in
a democratic state. However, psychiatrists should not exclude themselves from
discussing these issues, rather this activity should be as much part of the practice
of their profession. This failure to participate in a discussion of the more broad
societal implications of practising psychiatry could account for the building of
myths and speculation.

A general argument being promoted by psychiatrists were according to Mr.

Wilhjelm, that: “You should not submit yourself to the paranoid reactions of the public”, an
attitude, which in the long run can only create more paranoid reaction. This
claimed lack of public participation of psychiatrists was the specific focus of a
study conducted by Reisby and Achton Nielsen in 1984267. They recorded issues
relating to psychiatry in the public press in a period from June 1982 to Septem-
ber 1983. The main issue being treated in this period was Out-patient Treatment
18,6 % of the total material of 1200 articles. However only 15% of this material
was based on the participation of psychiatrists and only 4 articles were the prod-
ucts of a direct initiative of psychiatrists. The two authors concluded that these
issues, which specifically concerned future psychiatry should produce more
commitment by psychiatrists.

They explained the lack of commitment by either a fear of administrators or

politicians and a priority of alternative ways of affecting decisions through ‘in-
formal channels’ e.g. in the county board. Another explanation was the one of

266 Preben Wilhjelm: Psykiatrien og Offentligheden, in: Agrippa: 6: 47-54. 1984

267 Jørgen Achton Nielsen & Niels Reisby: Dagspressen og Psykiatrien, in: Agrippa. 6: 76-88. 1984.

129
doctors having a status as being the experts creating an expectation of reliability
in the public mind making it difficult to be experimental and open-minded about
things.

Anyway, it was emphasised, that the participation in the public debate should be
a part of the profession of psychiatrists. It was mentioned how psychiatrists
could produce a lot of arguments against reductions of resources and the exist-
ing poor prescriptions of personnel in the psychiatric departments.
These arguments however seemed to be excluded to the internal sphere of psy-
chiatrists and were never made public. A few exceptions however can be found,
which will be referred to below. This sustains what has already been indicated:
In the first half of the eighties the debate on Out-patient Treatment was rather unbalanced and
dominated by a tendency of blind de-institutionalisation and Anti-Psychiatry.

The initiative was solely in the hand of administrators and politicians backed by
a public demand of challenging the old monopoly of psychiatry. However ex-
ceptions could be found: a chief psychiatrist Finn Jørgensen from the big mental
institution Skt. Hans, mentioned268 the paradox of over-utilisation of hospital fa-
cilities connecting it to the tendency of psychiatrifying social problems. He re-
ferred to statistic evidence from the period 1973-1983 where the reduction of
hospital capacity had been going down without the rate of exploitation going up.
The bare fact of people being given a diagnosis creates an expectation in the
public mind of more treatment facilities.

The author argued, that this extensive use of psychiatric facilities should be re-
duced by more emphasis on an analysis of socio-economic factors involved in
the different cases, in order to apply less drastic measures as e.g. hospitalisation.
This all pointed towards developing measures, which were more qualitative than
quantitative pointing towards a new function within psychiatry – a ‘Social-
Psychiatry’. The point was that reduction of hospitalisation could not be accom-
plished without corresponding diagnostic measures, which could install proper

268 Finn Jørgensen: Det Psykiatriske Systems Funktionmåde: Veje ind, ud og tilbage. Ugeskrift for Læger. 2889-91. 12.

September, 1983.

130
expectations of treatment in the public mind. A unilateral cut down on hospital
capacity would otherwise be experienced as producing inadequate treatment fa-
cilities.

Another doctor, Erik Brandrup mentioned269 the fact that psychiatry is treated as
a stepchild when it comes to the availability of resources. This can be seen from
the simple fact that every single hospital-bed in the psychiatric hospital has only
at its disposal a third of the personnel resources of the somatic hospital. This
fact was explained by the author as stemming from the inconclusive nature of
psychiatry as a discipline, as mental illness cannot be mapped out and conse-
quently cured, but is caused by a complex of internal and external causes. This
creates problems as resources are attracted by quantifying results according to
visible successes like in somatic treatment.

Another author Hans Henrik Brydensholt270 also pointed at the debate on the
amendment of the general legislation on psychiatry. He stressed that most atten-
tion had been put on the application of force in relation to hospitalisation and
treatment, whereas the debate on the quality in general including the application
of resources, responsibility and competency of treatment had been put aside.

The tension between the professional responsibility for taking decisions in this
way violating the free will of the patient and the focus on the stipulation in the
law on the application of force was in this way touched upon. He saw a ten-
dency of professionals to focus more on the law rather than the concrete cases
where decisions are made with the risk of failure. However the professional re-
sponsibility includes this action (and a concrete evaluation), it could be that too
much force is used and certain values attached to the fragile mind of the patient
are lost, but a decision has to be made accepting the risk of mistakes. The de-
crease of forced detention in the hospitals might not only be explained by a de-
crease of cases where force has to be applied. The decrease could also be ex-
plained by a larger gap between patient and professional where the abstract laws

269 Erik Brandrup: Psykiatriens vilkår. In: Politiken August 31. 1983.
270 Hans Henrik Brydensholt: ”Legitimationsproblemer ved Indgreb Overfor Individet”. Agrippa: 6: 41-46.

131
are used to legitimate give up engaging in concrete cases. This trend can be seen
in many cases analysed for the present study, which will be exposed in section 8
below.

In 1981, the head of The Danish Psychiatric Society, Tove Aarkrog,1 however
warned against the Out-patient Treatment trend arguing that the lack of social
network of many of these patients would create no real prospects for the recov-
ery of these patients. Furthermore she mentioned how a more focused effort
during hospitalisation followed up by housing facilities especially designed for
these patients. She saw a tendency of minimising the seriousness of mental ill-
ness, while focussing on outpatient treatment and abandoning the model of the
hospital. Here the issue of continuity in the course of treatment was stressed
also emphasising that psychiatrists are trained in psychotherapeutic techniques
as a specific part of the treatment as a psychiatric specialist.

The author also pointed at the mixed character of psychiatric research integrat-
ing the humanities and the natural sciences and that this fact was often neglected
in the debate. Rather she saw a tendency of stereotyping psychiatry as a pure
natural scientific discipline with no potential of ‘renewing itself’. As an interest-
ing point of view the author proposed that the focus on the social causes of
mental illness were produced by people who were not brave enough to criticise
the system themselves. Rather they have used mental illness as an expression of
their uncertainty associated with the development of current society. Rather the
focus should be on the real problems of the discipline including lack of re-
sources to improve physical facilities and education. This point of view marks in
a fundamental way the polarisation between some fractions of anti-psychiatry
and the establishment of psychiatry.

Through the eighties the media reported many cases, which documented ‘sys-
temic dysfunction’, creating miserable conditions for the mentally ill. These peo-
ple either became homeless and isolated or were living in poor conditions in the
hospitals. To this you could add fatal cases of manslaughter committed by men-
tally ill persons, which all pointed in one direction – a failed reform. Many ex-

132
periments were initiated in the end of the seventies and start eighties with Out-
patient Treatment especially in Jutland271 and the trend was gradually diffused to
the rest of the country.

New signifiers for the unfortunate group of patients were created, these people
were: the ‘expelled’, ‘abandoned’ or ‘marginalised’.

Experience from abroad showed evidence that Out-patient Treatment reforms

featuring reductions of hospital facilities without a compensating effort in alter-
native housing facilities and occupational activities, create a risk of psychotic
people with a psychiatric hospital history come to live a life in isolation being
potential criminals. A similar situation as in Denmark was reported from the
US272 were the talk was of the big dumping, however this was also the platform
for the development of new experiments in the local communities. This experi-
mental tradition seems not to have been present in Denmark rather reforms
seem to be a rather unilateral top-down governed process. Likewise after the
1978 reform in Italy, there was recorded a corresponding problem with ‘aban-
donati’ - homeless people or just people who were left with their family to take
care of them without any professional back-up. This however was mostly the
case in the poor regions in the south and regions, which had not been influenced
by the efforts of Psichiatria Democratica predating the reform.

In Denmark, the general slide of tasks from the counties into the municipalities
meant pressure on the municipalities to take upon them tasks, which formerly
had been undertaken by the hospitals. On the other hand, the counties felt that
the reforms initiated by the central administration in the hospitals were difficult
to carry through without the right municipal efforts. Out-patient Treatment had
already been questioned under the headline of the final decay of psychiatry: “Is a
given society able to create measures to counter its own detrimental effects”?273

271 Lars Ole Ejsing: Distriktspsykiatrisk forsøgsprojekt i Kommunerne Brørup, Vejen og Holsted i Ribe amt. In Ugeskrift

for Læger 143/46. 9. november 1981.

272 Mikael Sonne: Psykiatriske Alternativer. Et Rejsebrev fra Californien. In: Agrippa. 1984: 6: 118-127.
273 See also the conclusion in: Psykiatriens sammenbrud? 4. Social-psykiatriske seminar på Skt. Hans Hospital. June 12-

14, 1981: in Agrippa, årg. 3, nr. 4 73-80. 1981.

133
When you abandon institutional psychiatry as an independent system, a gap
arises to be filled by a new independent system. In this sense, it was a comment,
which embraced a lot of anti-psychiatric criticism, at the same time as it reflected
lot of the frustrations linked to de-institutionalisation. New ‘diagnostic tools’ are
needed to accomplish a new social-psychiatry. However, these should not be
bare sociological or psychological appendixes to an existing paradigm of natural
scientific facts and etiology, but integrated through a developing praxis.

This would entail a larger degree of social-psychiatric experimentation, which

could be retrieved from the experience with the radical sectorisation efforts in
Italy.

The Italian Experiment

A Doctor recorded his experience from a three months study activity in Italy in
1984274 and a research unit attached to the Danish counties arranged a study trip
to Italy275. These records were characterised by being inconclusive, as the au-
thors at this point seemed to be unable to extract any general message as to how
to apply them to the Danish reform process.

The experimental character of the Italian reforms and the different ways in
which it had been implemented in the different parts of the country made it dif-
ficult to extract a conclusion. In this regard, it was mentioned how the failure of
the Italian reform could be traced to the bare lack of resources. Further, it was
mentioned that difference in culture between the two countries affecting the
ability to embrace people who are different in the near community could be a
crucial point. At the same time it was mentioned that the willingness in the es-
tablished psychiatric community in Denmark to adopt experience from Italy did
not seem realistic276.

The reference to extreme cases with a disastrous outcome creates the picture of
a failed reform. At the same time it was the opinion of these people studying the

274 Munk-Jørgensen, Povl: in Ugeskrift for Læger årg. 146 nr. 44, 1984.
275 Jens Albæk. Italiensk Psykiatri. DSI Rapport 87.04.
276 Ibid.

134
Italian reforms, that they were (too) much connected with the political climate
with communism and labour market organisations as driving forces277.

This fact also explained some of the reluctance to accept individualistic treat-
ment methods including psychotherapy and electrostimulation. Traditional
pharmaceutical drugs had not been abandoned, as one doctor remarked, he was
surprised to see the high doses being applied. In the regions informed by Psi-
chiatria Democratica, medication was used to help people get on with their lives
in the local community and all efforts were used to make people independent of
institutions278.

The fact that the Italian reform was deeply rooted in the general political climate
of the country of that time has been thoroughly documented in a study of the
theory and praxis of Psichiatria Democratica as therapeutic trend, which is ex-
plicitly oriented towards a political agenda279.

The Italian political situation and the domination of the communist party to join
together the labour movement into one unity of solidarity also comes to include
the emancipation of madness. This was strongly manifested as the Psichiatria
Democratica made a formal alliance with the communist party against the exclu-
sion of madness. This however was a development, which had been on its way
since Basaglia had taken over the management of the clinic in Gorizia in 1961.
Psychiatria Democratica with Basaglia and the reform of Gorizia in the sixties
and later Parma and Trieste in the seventies was to a large extent built on local
negotiations and experimentations. The communist party was actually in the be-
ginning against the principles of PD, and supported the development of a Na-
tional Health Service280.

This would later change. Basaglia’s efforts from the beginning of the sixties pre-
ceded the reform law of 1978 (law 180) by almost two decades. The experiment

277 Povl Munk Jørgensen, in: Agrippa. Psykiatriske Tekster. 7. årg., nr. 1 juni 1985.
278 Ibid.
279 See Norbert Windisch: ” Die Praxis-Theorie der Psichiatria Democratica”. Dissertation. Salzburg Universität. 1978.
280 Tim Kendall: Trieste. The Current Situation. A Plenary address to The Third International Conference on ’Psychosis

– Integrating The inner and Outer Worlds. University of Essex, Colchester, England. September. 1996.
http://www.human-nature.com/hraj/trieste.html.

135
thus had to be undertaken gradually in negotiation with local authorities.
Basaglia came directly from a position in the university and did not have any ex-
tensive clinical experience from within the institutional system. The first experi-
ence from Gorizia was only considered a partial success due to resistance from
the local authorities.

It was not until the seventies where enough experience had been gathered and
the different professionals, authorities, former, patients, families and local com-
munities had adjusted themselves to a new situation, that a petition for the re-
form law was established. This was done supporting The Radical Party, a party
dedicated to the defence of human rights, to collect three-quarter of a million
signatories for a petition to reform The General Mental Health legislation281.

This experience stresses the clear difference between the Italian experiments and
the ones e.g. in Denmark. The main difference apart from all the more specific
contextual variables282 is the experimental culture driven by Psichiatria Democ-
ratica. The incremental mutual learning or negotiated ordering, which results
from the becoming politics of psychiatry affecting a vast array bodies of society
is a contrast to the development in Denmark driven by legal and administrative
tools. As such, the Danish reforms have been driven by a management rhetoric
establishing expectations of driving a whole social field towards adjustments.

It should not be understated how the general anti-institution trend was a reac-
tion against the horrible conditions of the existing institutions. However the ac-
tivists were merely psychiatrists, who like Basaglia were outsiders to the estab-
lished hospital system. The same trend can be seen in Denmark: psychiatrists
who take inspiration from anti-psychiatry are accused of not belonging to the
system and as such not having anything at stake or any insight into the reality of
the profession.

281 Tim Kendall: Trieste. The Current Situation. A Plenary address to The Third International Conference on ’Psychosis

– Integrating The Inner and Outer Worlds. University of Essex, Colchester, England. September. 1996.
http://www.human-nature.com/hraj/trieste.html.
282 This includes the fact that psychiatry had until late in the twentieth century been a subdiscipline of neurology.

136
Franca Basaglia in 1985 described283 how the unfinished Italian psychiatric revo-
lution had developed differently in different parts of the country since the re-
form law of 1978. The law stipulated that asylums gradually should be faded out
and that no new admissions to asylums were allowed.

At the same time the psychiatric function should be integrated in the general
hospitals and emergency facilities should be established in the local communi-
ties. What on an overall scale can be learnt from the Italian reforms and experi-
ments is that a new treatment culture cannot be governed and legislated into ef-
fect. Rather different local professional conditions, traditions and the general fi-
nancial situation of different regions determine the different experiences.

However one tendency can be seen: the closing down of asylums presupposes a
readiness outside the hospital in the local communities, in the family etc. De-
institutionalisation presupposes another ‘culture of treatment,’ which can only
be established by different experiments without the preserving frame of institu-
tions. In this way it becomes a double-bind situation. This situation has had
negative effects especially in the southern part of the country where other de-
centralised facilities had not been available concurrently with the abandon of
asylums. This stages the fact that in ‘the poor eighties’ de-institutionalisation was
seen as a way to save money while experience shows that a real transformation
of psychiatry in the communities is likely to cost more money than the old asy-
lums.

A community based psychiatry can as illustrated not be seen as a legislative issue

and a structural organisational issue. It is a political issue in the broadest sense
where professionals should not exclude themselves. The establishment of a new
culture of treatment presupposes that professionals do not just take the tasks
given to them, determined by the legislative authorities (what Guattari referred
to as functionaries of consent).

283 Italy’s Aborted Psychiatric Reform. International Journal of Mental Health, vol. No. 1-2. 1985.

137
From Patient to Citizen
With reference to “Report on co-ordination within the Public Health System”
(‘Betænkning 1044’, 1985), the Minister of Social Affairs established a committee
with the aim of investigating the possibilities of cross-sector collaboration with a
special emphasis on the admission and discharge of patients who were in need
of municipal services. The committee put forward a selection of proposals as to
how within the frames given at that time the collaboration could be furthered284.

In the preliminary considerations of the committee, it was stressed how ‘the citi-
zen’ with a mental illness must be put in the centre and liberated from the objec-
tifying gaze of the professions. The talk was of a (professional) tendency of cre-
ating clients and patients rather than free and independent individuals. A new
linguistic formula was suggested including expressions like ‘The mastering ability’
of the citizen and attention to the needs of the citizen anchored in the ‘Total
situation of the citizen’. The attempt thus was to create a holistic and cross-
professional development uniting the resources in one focused strategy. This fo-
cus on the patient as citizen with specific needs, which could not be determined
uni-laterally was stressed as an important impetus for the cross-professional and
cross-sectored collaboration. The only way out of a history of alienation had to
be accomplished by this systemic fusion of collaboratory efforts. The attempt
was made to focus on blockages for the correlation concerning the way munici-
pal and county services were conducted and administered.

This attempt was made on the ground of experience and concrete examples
from the whole country. From this a catalogue of ideas was made, which should
serve as new inspiration in the development of the services in counties and mu-
nicipalities.

284 ‘The Citizen between Municipality and Hospital’ was a report filed by a committee established by The Minister of So-

cial-Affairs concerning collaboration between municipality and county, including general practitioners and hospitals. The
focus was discharge and admission of patients in need of municipal services. Socialstyrelsens Informations- og konsu-
lentvirksomhed. 1988.

138
Even though these examples were extracted from the work-zone of elderly per-
son’s services, it was stressed that the models should serve as a general inspira-
tion for the service of other groups of citizens285.

It is pointed out that there is really no need for formalised collaboratory agree-
ments and that ends have to be reached through better correlation and common
goals. It is rather suggested that this work has to be initiated setting out from the
problems that locally seem important rather than at some general level.

Further it is pointed out very firmly that the will to correlation has to be marked
out by management and the politicians in agreements and that it is the task of
management and politicians to broaden out the spirit of these agreements and
communicate them to the organisations.

This means at the same time that every single employee should take upon him
the responsibility to correct bad routines286.
In the report of the work-group you see a clear shift in argumentation compared
to the seventies. The approach to the citizen is more holistic. He is no longer

285 As a central part of these goals, which were recommended it said:

-the codetermination of the citizen in the planning and the concrete course of treatment and the activation of the resources of the citizen
- that the social- and health administration in the municipalities distribute information about medical care/nursing and
the social situation of the citizen
-that the discharge is planned and that the citizen gets information about the municipal services.
that the citizen by discharge from the hospital has relevant information given about his need of care and a letter of dis-
charge is given to his local general practitioner.
-an evaluation is conducted, which includes social- and medical professions.
286 In relation to the discharge of the patient from the hospital it was suggested that a co-ordinator in the municipalities

should participate in discharge meetings with the participation of the social- and health administration of the municipali-
ties. All parties were urged to show a will of openness in this process to seek for individual solutions (rather than general
solutions).
In a special section the differences of culture and the creation of myths between the systems are mentioned.
It is stressed how the creation of myths will block collaboration, which will sustain a self-contained attitude in each camp
and blame the cause of problems on the other party.
The autonomy of doctors to make a final judgement on the patient’s cure and discharge from the hospital is considered
problematic as there is no unilateral definition of when the patient is cured. ‘A dialogue’ should be initiated on the local
level between the collaborating partners, where the focus is ’the concrete’ common tasks and action-plans for the further
treatment of the patient is elaborated in collaboration.
It is underlined that management and the political level have got the overall responsibility for the accomplishment of
cross-professionalism and that myths are exposed.
On the political and administrative level narrow minded financial speculations are mentioned as a stumbling block for
this ‘collaborating psychiatry’. It is stressed that it is important to expose the benefits and savings for both sectors, which
can be obtained from collaboration and common initiatives.
The difference in administrative culture in the social- and health administration in the municipalities and the health ad-
ministration in the counties is also mentioned. In the municipalities the management of the administration have the pos-
sibility to dig into single cases, which is not the case in the counties where the political- and administrative management
often has a weak position toward a strong medical expertise.
As a concluding remark it is stressed that better correlation is not only a question of developing new techniques, but
equally a political problem and that is why the central politicians also have to participate.

139
merely a patient who passively receives treatment, but an active co-player who
has the right to ‘co-determination’.

The cross-sectored collaboration has moved into the foreground because of the
first experience with de-centralisation. The potential solutions are first and
foremost to be extracted from management efforts and political statements,
where professions have to fill out these broad intentions. The professions thus
are pushed into taking a responsibility, which breaks a long tradition of sectored
and professional split. It is emphasised, that it has to be made visible, how corre-
lation can create savings and benefits in both sectors.

These arguments have a clear reference to the systems in themselves and are an
expression of the general efficiency discourse running through the eighties. The
focus is on structures and ends fused into narrow financial schemes sweeping
the public sector in these years under the parole of modernisation, cheaper and
better.

The end eighties and start nineties also reflected a move away from anti-
psychiatric discourse in favour of a more appreciative attitude towards biological
psychiatry. One example stems from an article in which one of the Chief Psy-
chiatrists287 from Rigshospitalet (the national hospital of Denmark) describes
how new technologies to map out brain processes create new opportunities for
treatment. It is directly argued how anti-psychiatry with Laing and Cooper has
been wrong, as it was riding on a wave of revolt in the seventies. In this stance it
is mentioned how environmental and developmental factors have been overem-
phasised neglecting how the brain is as much bare chemical processes, a fact,
which it is claimed is hard to accept in humanistic camps. Michael R. Trimble288
took a similar approach, describing new brain-scanning (PET) methods. These
new methods were presented as crucial for an innovation of medical psychiatry
including the development of drugs with fewer side effects.

287 Marianne Juhl: Angsten sidder også i hjernen. Article in Weekend Avisen. Oktober 5. 1990. Features an interview with

a chief psychiatrist Tom Bolvig who is known for maintaining a biological fundamentalism.
288 Michael R. Trimble: Nyt Syn på Hjernen. Week-end Avisen. 27. 4 1990.

140
At this point, a chief psychiatrist Villars Lunn289 had already 1 1/2 years before
answered to what he saw as a revitalisation of anti-psychiatric provocations. He
saw a trend where the psychiatric hospital was under a hard pressure from ideas
of sectorisation/Out-patient Treatment. The argument was above all that ex-
perience from the US and Italy had shown how vulnerable patients are without
the asylum-function of the hospital, as patients are reluctant to seek help on
their own initiative. In this regard, he was arguing for the patient’s right to
treatment. He also put doubt to the operational base of the clinical collective,
this ‘multi-headed monster’ would be over-professionalism rather than the pres-
ence of a human being. Above all everything would be professionalised and spe-
cialised without the presence and commitment of a single person as it was said:
“The total is smaller than the parts”.

The treatment community of the sector for sure was in the foreground in the
end eighties and it is striking how the rhetoric of the sector distributes the re-
sponsibility to the professions urging them to find a concrete level of collabora-
tion. Many examples can be found in the general debate in both newspapers and
especially the leading medical journal ‘Ugeskrift for Læger'.

One example is an article by a chief hospital psychologist, which touches upon

the fact that cross-professionalism is thriving within the hospital, whereas a lot
of myths are created between the professions in and around Out-patient Treat-
ment centres290. It is mentioned how multi-paradigmatics seems to be a surface-
phenomenon whereas the deeper structure separating paradigms is still intact.
The fundamental split in orientation between biology and psychology creates
different priorities and different explanations affecting methods of treatment
and care. However it is stressed that psychiatry is not a closed and immune dis-
cipline as it used to be. This fact it is mentioned is very likely to be the result of
anti-psychiatric voices and The Mad Movement (‘Galebevægelsen’). The author
mentions that the polarisation between psychiatry and anti-psychiatry has loos-
ened up, e.g. the Mad Movement is not claiming that they want to act rather than be-

289 Villars Lunn: Asylets Jammersminde. In: Week-end Avisen 16.12 1988.
290 Birgitte Bechgaard: Vi må væk fra fjendebillederne, in: Ugeskrift for Læger 151/26 June 26th 1989.

141
ing treated. Their new slogan is rather: We want to be treated in a decent way! Still, it is
stated, psychiatry seems pretty closed towards their clients and their organisa-
tions compared to other medical disciplines.

Narrowing the gap between paradigms was an issue in the debate of the end
eighties under different labels. In a leading article in ‘Ugeskrift for Læger’ the
same year, a general concern for the future of psychiatry was uttered based on
the experience with Out-patient Treatment. The general impression that the
psychiatric service was in bad condition was stressed, as a scenario was sketched
indicating the lack of resources and the tendencies of marginalising the role of
the hospital291. In this regard, it was also mentioned how the criminal rate had
gone up among mentally ill patients, with a still higher ratio populating the pris-
ons.

With the experience of the Out-patient Treatment during the eighties, the Minis-
try of Health took a new initiative within the planning of the counties: the
theme-planning process292.

The planning process can be regarded as an extension of The Advisory Guide-

lines for Planning of Psychiatric Service (The Ministry of Domestic Affairs,
1977). Likewise it extends the proposals in The Planning Report from 1983 (The
Ministry of Domestic Affairs and The Government of Health) and can be con-
sidered an implementation of the ideas contained in the report filed by The
Committee of Correlation (Report no. 1044, 1985)293.

“Preliminary Proceedings of The Theme-planning Process (TTP) 1989-90

(Oplæg til temaplanrunde 1989-90)” was intended as a frame of the planning ac-
tivities of the psychiatric service, where the subject of psychiatry was selected
with an emphasis on Out-patient Treatment.

291 Dansk Psykiatris Udvikling. Editorial: In Ugeskrift for Læger 151/35. August 28th 1989.
292 See below: Out-patient Treatment in county X.
293 As a follow-up on report no. 1044, 1985 The Minister established a committee to inquire into the foundation for col-

laboration between municipalities and counties including general practitioners and hospitals. The special focus should be
admissions and discharges of patients in need of municipal services.

142
The purpose of the preliminary proceedings was to stimulate the process of de-
centralisation, which was already in progress. At the same time it was the inten-
tion to gather the preliminary experience with the aim to focus the development
concerning the organisation of the decentralised psychiatric service.

The theme-planning process was an innovation within the organisation and

planning of hospital service294. The process intended to focus de-centralisation,
which in it self was not a new feature. The real innovation of the planning proc-
ess, which was conducted referring to the rules in The Hospital Act paragraph
11, was that the theme of psychiatry was selected and was governing a cross-
sectored planning project.

The need had been recognised that a strengthened collaboration between the
sectors was necessary for a successful planning of the psychiatric service. For
that reason the inter-sectored community was invited to participate (hospital
sector, health-sector, social-sector in both the counties and the municipalities) in
the process participating with each their experience.

This very broad inclusion of stakeholders was among other things accomplished
during a two days conference where experience was shared concerning local
Out-patient Treatment experiments295. The opinion of one of the chief psychia-
trists (Ralf Hemmingsen) was that the conditions for establishing Out-patient
Treatment in Denmark were very good. Compared to other countries he consid-
ered Denmark as having accomplished a gradual development towards Out-
patient Treatment. However he saw still a lot of work to be done in evaluating
the different centres throughout the country and in training the personnel for
the new tasks.

Other doctors (Overlæge Anton Aggernæs) also criticised the unilateral way that
the experiments were evaluated: “The politicians in the counties only ask how modern is

294 An amendment in 1985 of the general legislation on hospitals stipulated that future planning of Out-patient Treat-

ment should be following a method inspired by ’The Theme Planning Process’.

295 The primary results of the conference have been published in a report from The Danish Institute of Hospitals (Dansk

Sygehus Institut) with the title ’Psychiatry in Transition’ (Psykiatrien under omstilling)

143
it and how cheap is it? They don´t ask how it affects the quality of life of the patients”296. An
important theme of the conference was the one of target group. It appeared that
the different experiments throughout the country used the advisory guidelines of
the authorities in different ways.

The official focus of outpatient treatment as stipulated by The Association of

The Counties (‘Amtsrådsforeningen’), The Association of The Municipalities
(‘Kommunernes Landsforening’) and The Central Administration, should be
people with a psychiatric disease rather than people in a mental crisis. The dif-
ferent practitioners from Out-patient Treatment argued in different ways for a
more pragmatic approach and that target-groups should not be fixed as needs
for treatment and care are dependent on the development of general social con-
ditions297.

Later on cross-sectored collaboration and communication between different

professions has acquired considerable attention in the debate on the develop-
ment of Out-patient Treatment. This can be seen from the reports accomplished
by the theme-planning process and from the theme-plans of the counties. The
original document, which initiated the whole process must be considered of
great importance and must have been intended to have a great impact on the
planning in the counties298.

Commenting on TTP representatives from The Mad Movement focused on the

domination of the medical paradigm and that Out patient treatment in itself
would not challenge this domination. The mentioned domination was supposed

296 SIND no. 2, vol. 18 1989. Article concerning The Theme Planning Process.
297 The chief psychiatrist Lars Ole Ejsing from the team in Brørup, Jutland. In: SIND no. 2, vol. 18 1989. Article con-
cerning The Theme Planning Process.
298 Regarding Out-patient Treatment and the cross-sectored collaboration the considerations were as follows:

“Out-patient Treatment as a general objective for the organisation of psychiatric services has joined forces with the ho-
listic view of the law on social-services (bistandsloven). It should now be possible to correlate the treatment facilities of
the hospital with the services stipulated in the social legislation. This should be considered the frame for integrating the
patient in society as the patient can benefit from the normal social services”
The preliminary experience from decentralising treatment and experiemnting with cross-sectored collaboration was:
*Out-patient Treatment and hospital facilities should not be contrasted.
*The precondition for proper treatment and care for a lot of patients is the coordination of Out-patient Treatment with
the services of the municipalities as well as with the psychiatric departments in the hospitals.
*The solving of these tasks takes an establishment of cross-professional and cross-sectored collaboration in the counties
and between the municipalities and counties.
*There is a need for both organisational, educational and advisory measures.
90´ernes Psykiatri - Oplæg til Temaplanrunde 1989-90, s. 11. Sundhedsministeriet 1988.

144
to be challenged by the introduction of new professions with more emphasis on
psychotherapy. Other representatives from the same organisation mentioned the
lack of education of personnel and the lack of focus prevention and the causes
of illness. Their approach was dominated by a negation of the concept of illness
and thus the hospital. Rather the focus should be ‘the life-world’ of the single
individual rather than discussion of target-groups and diagnoses, which was con-
sidered a bare systemic discourse.

In all, the preliminary proceedings were criticised for not considering the peda-
gogic, cultural and psychological angles299.

This criticism was put forward even if it had been stressed in the preliminary
proceedings that concerning both form and contents the theme-planning proc-
ess was supposed to be a break away from earlier efforts in the planning of hos-
pital-service. This meant that financial figures were considered to play a minor
role in relation to ‘the process’, which was now in progress.

The essential breaking point was here considered to be the possibility for differ-
ent professions, sectors and administrative fractions to share information and
points of views.

Especially concerning the cross-sectored development it was stressed that the

planning-process could contribute. As it was stated in the introduction:

“The general impression from the reports and plans on psychiatry, which has been elaborated in
the municipalities during the last couple of years, is that the co-ordination problems between the
hospital-sector and the social-sector and the relation with the general practitioner, has to be
sorted out. In connection with the theme-planning process it is called for a clarification of the
distribution of roles and tasks between the different sectors and levels”. 300

299 Karl Bach Jensen. In: SIND no. 2, vol. 18 1989. Article concerning The Theme Planning Process.
300 90´ernes Psykiatri - Oplæg til Temaplanrunde 1989-90, s. 12. Sundhedsministeriet 1988.

145
Further the stage was set for collaboration with the municipalities concerning an
estimate of the services needed to improve the social-welfare of discharged pa-
tients.
This involvement of the municipalities should include the general practitioners
and be concerned with issues like: counselling, supervision and education of per-
sonnel groups concerning the development of Out-patient Treatment and the
cross-sectored collaboration.

These considerations should be included in the principle part in the theme-plans

of the counties301.

In addition, development and reorganisation of the social services and elabora-

tion of concrete agreements between the county and the municipality should be
adjusted to the conclusions of the analyses of the patients’ needs for social-
services.

The conference on TTP ended with a speech by the county mayor Erling
Tiedemann where he warned against ‘the Italian disease’: “We should be more con-
cerned with contents and behaviour than with work distribution between the social sector and
the health sector. We do not accomplish a change of behaviour by changing sector. Lets keep
some of ‘the madness’ in the actual organising of work, rather than throwing ourselves into to-
tal chaos by demolishing structures, which can only be replaced by something in our imagina-
tion”302.

Social-director Flemming Jensen from the municipality of Randers stressed the

importance of having a development where the municipalities feature as equal
partners rather than as subordinates of the health system. Consequently the fo-
cus should be mutual respect and education to gain knowledge for the new chal-
lenge303.

301 The part of the plans treating goals should include a definition of target-groups, team-formation and personnel educa-

tion in all levels with the aim of developing new functions.

302In: SIND no. 2, vol. 18 1989. Article concerning The Theme Planning Process.
303 In: SIND no. 2, vol. 18 1989. Article concerning The Theme Planning Process.

146
The Minister of Health Elsebeth Kock Petersen ended the conference by warn-
ing against an increase of persons with a psychiatric diagnosis (of ‘psychiatrify-
ing’ social cases): “There is something evident about the initiatives on Out-patient Treat-
ment: proximity between the services and the patient not to mention the principle of de-
institutionalisation. However we have to make sure that we do not involve more patients in
treatment. We should have room for a bit of insanity. We should not go as far as asking a per-
son to go and see a treatment centre just because he kicks over the traces and do not fit into
given norms of conformity”304.

As mentioned the planning process seems to mark a challenge of the planning

activity, which had so far been undertaken. From now on the counties should
promote cross-professional and cross-sectored collaboration and processes,
rather than resource allocation and structural adjustments.

However it is remarkable how ‘process’ and ‘organising’ are concepts submitted

to a logic of ’co-ordination’ and ’correlation’ of the efforts systems.

This seems to indicate the sharp distinction between the systems, where each
system has a narrow programmed function rather than being part of the creation
of new functions.

This split between systems, which had been a major theme during the eighties
was now and again put forward by patient organisations.

The organisation SIND consequently put forward their vision for the nineties305.

One of the major arguments for Out-patient Treatment had been the proximity
of the services and the ability to prevent mental illness. This theme was treated
in a number of articles around year 1990 focusing on the preliminary experience
from the seventies and eighties and how prevention should be the future focus.

304 In: SIND no. 2, vol. 18 1989. Article concerning The Theme Planning Process.
305 This is summed up by the following: 1) Psychological and social 24 hour service 2) General public information strategy, 3)
Focus on prevention, 4) Special occupation and work facilities, 5) Use SIND and its users as a resource, 6) The autonomy of
sectors should be challenged in favour of collaboration, 7) The psychiatric system is self-centred we want more love, compassion, ide-
alism and confidence rather than the usual professionalism. In: SIND no. 4, vol. 19 July 1990 p. 17.

147
One article306 describes the Case-Manager Model, which is supposed to remedy
the lack of continuity of treatment. The author a hospital-psychiatrist records
the experience from the US of having specific treatment units based on the psy-
chiatric profession to take care of the total treatment course of the patient out-
side the hospital. He goes on to apply them to the Danish experience with Out-
patient Treatment and how it can improve services. The main argument is not
reduction of total costs, though it is mentioned how prevention of hospitalisa-
tion can be obtained, but rather on the improvement of decentralised services.

It is stressed that occasional hospitalisation should not necessarily be considered

an evil, but rather a necessity and a service, which should be provided when
needed. It is a new trend, that a psychiatrist is occupied with the planning and
organisation of the psychiatric service. The main message is that traditional Out-
patient Treatment has not been able to create sufficient co-ordination between
the different services in the hospital and in the municipalities. At the same time
treatment has not been directed towards the specific individual needs of the pa-
tient as well as the efforts have not been active enough. Another focus is the
long-term relation and the possibility of having one person from a treatment
team to follow the same patient in the course of treatment, a model already ex-
isting in the hospital.

The article is at the same time a critique of the traditional models as it is a very
concrete and constructive attempt to approach new solutions. It is discussed
how a more active effort also actualises new strains on the personnel involved as
well as problems regarding autonomy of the patient and issues regarding infor-
mation distribution. This tendency is a move away from the silent role of psy-
chiatry from the eighties, towards a more integrative and constructive approach
to the sectored psychiatry and its possibilities. It is also an attempt to centre the
psychiatric profession in the coordinating function and the integrating activities,

306 Per B. Vendsborg: ”Case Manageren i Distriktspsykiatrien” – en gennemgang af begrebet. In: Ugeskrift for Læ-

ger154/40. 28. September 1992.

148
a task, which could be suspected to gradually slide into the jurisdiction of other
professions e.g. Social-Workers.

This trend can be seen as sustained by the discourse on prevention and Out-
patient Treatment contained in two articles from 1990 and 1991. The occasion
was the prevention programme filed by The Ministry of Health in 1989. The so-
called work-group of the Committee of Hygienic Issues (Hygiejnekommiteen)
stressed307 the importance of applying the psychiatric profession in the preven-
tion of mental illness. Early intervention it is mentioned can only be obtained
when the patient and his network is evaluated by a person with the relevant psy-
chiatric training.

The article is a fierce defence for the psychiatric profession and its ability to re-
form itself and integrate new relational tools as e.g. psychotherapy. As such it is
an attack on the trend of the nineties as it is stated (p.1770): “In the name of nor-
mality it has become almost odious to be a dissident or to suffer from an illness and to seek
treatment in a hospital. The talk is rather of guidance or counselling, client or user rather than
treatment and patient”.

This it is claimed can lead to lack of preventive efforts, because a developing ill-
ness is not recognised. This it is said is a tendency, which is rooted in a stereo-
typed and outdated view on psychiatry and its potential. This unrecognised po-
tential in relation to prevention was further stressed in an article by psychiatrist
Bent Rosenbaum, who described in details how psychiatry has a role to play in
the decentralised prevention work. Now and again he stressed the importance of
allocating more resources to psychiatry in and the decentralised efforts, while
comparing it to the comparatively much better conditions of the somatic hospi-
tal.

These points of view were supplemented by The Mad Movement: In an editorial

from march1990 leading members commented308 on a hearing arranged by The

307 Distriktspsykiatri og Forebyggelse, In: Ugeskrift for Læger 152/24 11.juni 1990.
308 Amalie-Galebevægelsens Blad årg. 12 no:2, March 1990.

149
Movements department in Roskilde on Out-patient Treatment on February 14th..
The focus was first and foremost the current state of the psychiatric service,
shadowed by the many fatal cases of social alienation and suicide. The argument
was that an improved quality was dependent on more resources for day-care
centres and alternative housing facilities and more emphasis on an Out-patient
Treatment under the jurisdiction of the social-service authorities rather than the
health authorities. The attitude was very hostile towards psychiatrists, who were
being accused for lack of fantasy and ideas stubbornly clinging on to pathologi-
cal concepts. Psychiatrists within this frame are viewed as locked in with the sys-
tem: “If we do not use the predicates mental illness, psychiatric disease etc. we do
not get any money”.

In this sense it is obvious how psychiatrists and The Mad Movement would
have a hard time becoming working partners in the reform of the psychiatric
service.

The hostility of The Movement can be seen as reaction to a system, which in

many senses can be said to be anachronistic in its approach. The treatment of
psychiatric patients in many senses has been one of low priority, a tendency,
which can be traced to many different variables. What however is important to
notice is that the attitude of the movement blocks the potential liaison between
professionals and patients, which could open towards a radical reform of the to-
tal psychiatric system.

The Generative Component

What has been pursued so far in this section has been to accumulate the differ-
ent expressions related to the sectored psychiatry during the last 25 years. In
short, the social field we are interested in is the sectored psychiatry and all its
heterogeneous statements.

This is what we in short will refer to as the mixed semiotics. The second part of
the tracing experiment, which is to trace how different statements are translated
into still new regimes of signs, that is primarily how a signifying semiotics is

150
translated into a post-signifying semiotic. These points of translation are the
points of departure for the mappings under the transformational component.

I proceed by grouping expressions related to the sectored psychiatry. The differ-

ent propositions belonging to different groups i.e. professions can be seen to be-
long to different statements as they can be picked up by different regimes of
signs. That is the question is what is the underlying logic (regime of sign) making
this proposition belong to a certain statement and not another. What is done
next is to look for the possibility of one regime of signs being translated into an-
other that is either referring to a signifying center or belonging to a passional re-
gime of subjectification or distributive logic of a counter signifier.

The concern is first and foremost how these regimes of subjectification can be
seen to create the possibilities for new statements and new patient-refrains. Thus
we are interested in how sectorisation is translated into a passional regime in this
way creating new possibilities and new dangers! First of all we are interested in
studying how psychiatry and the patient is translated into the post-signifying of
the sector. We are looking for how lines of flight are set free as we are interested
in how statements produce points of subjectification, rather than centers of sig-
nifiance. The concrete method is to read documents and extract statements,
which in one way or the other produce a frame or a system within which the pa-
tient or psychiatry can emerge.

Between these movements you see the subject of enunciation and the subject of
the statement recoil into each other creating points of subjectification. The cen-
ter of the signifier is consequently, replaced by the point of subjectification. The
relative deterritorialisation of the institutional psychiatry features in the last part
of the seventies and first years of the eighties. The culmination of the different
administrative and political statements is still contained in the logic of the
autonomy of the psychiatric clinic being integrated into the general hospital.

These points of translation can be studied and indicated around certain themes,
for instance how the patient as an object is distributed in space according to the

151
work-zones of professions. Or by studying how professions emerge as segments
in relation to the decentralisation rhetoric of the collaborating psychiatry.

Counter-signifying must be extracted somewhere within these games of signifi-

ance and subjectification and absolute deterritorialisation on the body without
organs.

That is why a war-machine of madness must retain enough sign-potential to

lance new arrows. The deterritorialisation of the counter-signifier is one of active
destruction and abolition albeit still creational.

The war-machine of madness is dependent on the mapping out of mixed semi-

otic, and points of transformation and the lining out of possibilities for change
of plane by de-blocking, opening up to parallel worlds, creating new refrains,
new articulations inside enunciative assemblages. In Schizoanalysis it is the pro-
longations and modifications, the creation-potential of tradition, which is in fo-
cus. This is the only way, that creativity and buddings can be maintained. This
tracing is a tripartite of: the signifier, points of subjectification and the counter-
signifying, which creates potential by destruction and distribution and which
makes up the war-machine. Though the counter-signifier is the primary force
creating this potential, it needs the signifier as a temporary wall.

The mappings of these mixed semiotics, translational points and creational bud-
dings are fused into a program of machines, tendencies, qualities or just sign-
potential. This is done under the nomadological component.

Under the generative component the aim is to trace (competence) the mixed
semiotics of the sectored psychiatry from the seventies through to the nineties.
The emphasis has been the different expressions related to the sectored psychia-
try. The focus is the black hole – white wall scheme that is of how points of
translation are created between the signifying and post-signifying regime.

152
The Seventies and Early Eighties
An example: in the seventies the hospital and the medical profession are undis-
puted reference-points, when the issue is treatment. Historically it has been
shown how the profession of psychiatry is closely associated with the hospital
and the traditional role of the doctor as the curer of illness. One of the explana-
tions for the de-institutionalisation of psychiatry has been that the profession
has been unable to produce results. This however seems to be a very narrow ex-
planation. Rather mental illness has for many years been given low priority both
in Denmark and a broad psychiatry has developed into a pseudo medical disci-
pline, sustained by the creation of myths because of its closed nature. The many
odd experiments, which have been revealed during the years, mirror the frustra-
tions of the discipline, which for sure has produced the counter discursive,
which can be noticed during the sixties and seventies.

The tendency of the start eighties is to view the reform of psychiatry as a pure
structural issue to get rid of the costly total institutions. In this sense resources
in general and the improvement of quality of treatment is not the concrete fo-
cus. The issue of decentralising the hospital is first of all an issue of integrating
the psychiatric services with the somatic treatment in the general hospital.

However the integration of psychiatry with somatics was supposed to signal on

one hand the equivalence of psychiatry and somatics and on the other to bring
the hospital closer to the patient and his family.

At the same time the sector is framed as a strict structural and resource issue as
the actual collaboration between hospital and local-authorities is argued to be a
minor issue.
The idea that the new tasks of the counties could be used to a reformulation of
the psychiatric service based on the needs of the patient in his local environment
is given minor attention in 1977 when the future planning of psychiatry was de-
bated.
This reflects a view of the systems as autonomous and as being able to define
their new roles and resource adjustments according to the broad intentions of

153
the sector. In this sense the professions are left alone to make their own pictures
of a future sectored psychiatry, as it is signalled in 1976 that the principles of
out-patient treatment are the future. The seventies also featured a very harsh
anti-psychiatric reaction against the established psychiatric system, which seem
to have served to entrench the systems. The referents of these attacks were first
of all a very stereotyped reaction to the historical horrors of psychiatric practice.

Psychiatrists used the (failed) Italian experiments as proof of the inadequacy of

anti-psychiatry and a radical sectored psychiatry. Stereotyped projections of anti-
psychiatry were used to establish it as a product of a few political activists, who
used psychiatry as a scapegoat in their attack on capitalist society. The picture of
psychiatrists as functionaries of consent working behind the protecting walls of
the hospital, without commitment in the actual transformation was thus sus-
tained as attempts were made to re-professionalise and de-politicise psychiatry
(Ghaffari & Moxnes).

However, also more open interpretations could be seen (Mogens Jacobsen).

This attitude opened towards a more constructive use of anti-psychiatric
thought. The psychiatrists for sure felt that they were under a pressure, given
fewer resources etc., however this dissatisfaction was not uttered. Rather a ten-
dency to retire into a reductionist paradigmatic shell seemed to sustain this im-
pression and even to accelerate the creation of myths. As such, the seventies and
eighties featured first of all a structural management logic focusing on the reduc-
tion of permanent hospital facilities in favour of out-patient treatment.

This is in opposition to some of the trends of the Italian ‘anti-psychiatry’ move-

ment309, which argued for psychiatrists becoming more committed in the
development of experiments with sectorisation. This commitment was more or
less absent in the seventies and eighties in Denmark, as more efforts were used
to prove the justification of psychiatry by referring to the biological essence of
mental disease. The propositions associated with these arguments are reflecting a
counter-signifier, which disrupts the traditional logic associated with the psychia-

309 Basaglia and Psichiatria Democratica.

154
trist and his medical approach. At the same time it challenges the split between
the management of the sectored psychiatry and the possibilities associated with
it and the different professions. The Italian discourse in this sense represents a
real counter-signifying potential.

However as indicated this potential is assimilated by an underlying logic (order-

word machine/statement), by referring to it as anti-psychiatric romanticism,
which cannot produce any real alternatives. In this way psychiatry is locked back
on its old function as curer and protector of society, rather than having a par-
ticipatory and proactive role according to the trends of the sector310.

It can be concluded that psychiatry in the seventies and start eighties is caught in
its focus on treatment and medicine in order to maintain and attract resources to
the hospital. This creates a lock-in situation between psychiatry and the struc-
tural resource thinking of the county management.

The reference of anti-psychiatry movements is these historic truisms, which are

caught in the interpreting of signifying regimes. This can be seen from the refer-
ences to the application of force in general and the repressive character of the
psychiatric profession. The attitude of the former or potential patients from the
mad-movement is easy to sympathise with, but it is hardly beneficial for the re-
newal of the psychiatric system. The focus on replacing psychiatrists with social-
workers could in the short run mean that less resources are allocated to the
treatment and care of people with a mental illness. As experience has shown de-
centralisation has meant that not sufficient resources have been provided to cre-
ate new facilities in the local environment.

The de-psychiatrification of madness in this sense has, in the absence of new

theories and methods, legitimated a drastic cut down on the total services. The
emergence of new social-psychiatric theories and methods through a more ex-
perimental bottom up focus was not initiated until the first half of the nineties.

310 See the arguments of Nørgård and Reisby above.

155
However the departure of a passional line of subjectification can be discerned as
the centre of signifier is replaced indicated by some propositions from the be-
ginning of the eighties. This is the case as the status of psychiatry as an autono-
mous system is deterritorialised as governance technologies are accelerated un-
der the slogans of modernisation.

Accordingly, the eighties feature a trend were more power is distributed to ad-
ministrators and professionals with managerial tools to create improved effi-
ciency. The deterritorialisation of traditional psychiatry seems to be manifested
in psychiatrists hiding themselves rather than engaging in open debate. They
rather, as some commentators have claimed, rely on influencing the system
through informal contacts to the political level in the counties and central ad-
ministration. This fact seems to have had very detrimental effects for the devel-
opment of the sectored psychiatry in praxis and on the more general level of
theory and method.

The Mid-Eighties to Start Nineties

The tendencies from the beginning of the eighties were accelerated focusing on
the sector and its potential for renewing psychiatry as a whole. However as
shown above this challenge was not taken up by the psychiatric system, even
Reisby in 1981 had defended anti-psychiatric thought and how it could be used
in a constructive way.
The Italian experiments were considered very narrowly and often not placed in
their proper context namely as a possibility to experiment (see e.g. the state-
ments of Munk Jørgensen). The experiences were quickly interpreted as the re-
sult of an unrealistic and irresponsible strategy, which was destined to fail. The
potential counter-signifier is over-coded and subordinated by a traditional pro-
fessional logic.

The Danish mad-movement can be seen to still be very active in negating the
clinic and psychiatry en bloc. This attitude sustains the traditional opposition be-
tween psychiatrist and patient. In this sense clear polarisation can be seen, which
is reactive rather than proactive. However as also stipulated by one author (Mr.

156
Wilhjelm), psychiatrists have a responsibility to create a better communication
with the public in general - professional arrogance and know-all attitude can only
be a setback. The development of the sector, it is clear, stages another agenda,
which includes a more active dialogue with the broader public. This proposition
is clearly part of a line of subjectification, deterritorialising the strict professional
and non-political role of the psychiatrist. It stages the fact that the active effort
of self-transformation is a clear precondition for the development of a sectored
psychiatry. It can for sure not exclusively be an issue of management and regula-
tion.

The lack of this dialogue and participation of the broad population and psychia-
trists and other treatment personnel meant that the initiative through the eighties
was in the hands of the administrators and politicians supported by anti-
psychiatric voices. This rigidified situation meant that the patient was merely
produced referring to known categories that is traditional psychiatry and the in-
terpretations made according to such management logic. The result was a drastic
reduction of permanent hospital facilities. Patients were increasingly just aban-
doned in the name of liberalism and personal autonomy, in this way actually
trapped in an existential vacuum.

This trend is also reflected in the discussions on the general law on Psychiatry
where personal autonomy and the application of force are the main issues,
rather than the actual resources or quality of treatment of future psychiatry in
general.

It is a special feature how the law functions to make professions refrain from
concrete estimates, which in some cases lead to neglect of the professional re-
sponsibility. In this sense regulation merely serves to create a legitimate founda-
tion for self-containment thus abstracting, the concrete relation with the patient.
The reliance on law and regulation in itself cannot compensate for this lack.

One commentator (Mr. Lunn) reflected exactly on this issue of multi-

professionalism resulting in a multi-headed monster of over-professionalism.

157
The acceleration and the general acceptance of the out-patient treatment model
made him very pessimistic arguing that the patient’s right to treatment was vio-
lated. Cross-professionalism (over-professionalism) was seen as a monster (of
fantasy according to Lunn) rather than the presence of one human being. This
line of subjectification indicates a deterritorialisation of the reliance on govern-
ance and planning and abstract measures of coordination.

The failure of the systems’ ability to establish out-patient treatment and a proper
effort by the local authorities led to a confrontation between counties and local
authorities.

One problem of course was financial and structural, another more subtle and
not realised was paradigmatic. Too much optimism had been attached to the ef-
fects of structural developments and reallocations of resources. This exposed
that a social-psychiatry was needed as an integrator of the different efforts to-
wards the patient in the local environment. A new diagnostics based on new
theories and methods were needed. To accomplish this, experiments were
needed. This however also actualised the question how to evaluate experiments,
and still to be open to the real function of experiments challenging the known
opening towards the unknown.

The experience from Italy might have indicated that more active measures in the
sector had to be applied. This also put more in the centre how the processes of
collaboration and cross-professionalism must create the incremental movement
towards a new operational base. Accordingly, experiments and their evaluation
are an important variable to accomplish these goals. It should be attempted not
to program the outcome on beforehand, but rather to use experiments to gather
experience in an explorative way.

Accordingly, the tendency from the mid-eighties was to focus more on ‘the pa-
tient as citizen’ in the local environment rather than on the systems and their ex-
isting potential.

158
Another tendency was that the mad movement became more interested in being
treated in a decent way. At the same time it was argued how multi-
professionalism is a surface phenomenon, a definition of something existing
only on paper and not in real life as still too many myths are present. This
statement represents another line of flight as multi-professionalism is phrased as
a fantasy, which is planned or governed into existence.

The real step towards integrating planning across sectors was initiated in 1989.
The preliminary proceedings were afterwards criticised of being too much fo-
cused on management and economy rather than on how the actual quality of
treatment could be developed. Even if it was intended to break away from the
tradition of financially governed planning process, the arguments from the pre-
liminary proceedings of the planning process seemed still to be very structuralis-
tic and systems oriented. However the proposals for the planning in the counties
were also focused towards the operational parts especially education of employ-
ees. In this connection it was mentioned by county Major Tiedemann how struc-
tures and change of sector do not accomplish change in itself.

The Minister of Health warned: “We should not include more people than necessary in
the target group”. This is one example of the liberal trend of the eighties of turning
down the public services, de-professionalising and repairing the eventual nega-
tive consequences, through broad declarations of intentions directed towards the
treatment systems.

However this trend seemed slowly to change with the broad bottom up inten-
tions of the theme planning process.

Narrowing the gap between systems was the focus of many actors also of SIND
the moderate patient organisation. The tendency of the start nineties to focus on
an out-patient treatment model based on a cross-professional psychiatric team is
a step towards a more active role of psychiatrists. This trend is opposed by a
trend towards the end eighties of traditionalists to promote the results of new
scanning methods, electrostimulation and medical treatment. It is a focus to-

159
wards a more active role of the psychiatrist and the possibility of prevention and
early intervention.

These are clearly trends pointing towards something new. However many indi-
cators can be found showing how the memory of past times still frames a lot of
creation potential e.g. the statement we do not get money if we do not call it
treatment and disease. However the eighties on an overall scale feature a lot of
lines of subjectification pointing towards more bottom up approaches.

It is the statement or order-word of structure and unity, which prevails, coordi-

nation and measurement based on strict top-down governance principles. This is
the statement, which spans the different regimes of signs in the seventies and
eighties: De-professionalisation and de-institutionalisation is driven by a struc-
tural vision of co-ordination through a top down governance process. This lack
of concern for the actual processes, paradigmatic bases and specific history of
the psychiatric-field creates a state of alienation and crisis.

De-institutionalisation thus never acquires the status as an experiement from

where experience can be retrieved to qualify future efforts. De-
institutionalisation is locked in by the logic of governance, where abstract meas-
ures of rules and regulation is the frame used to interpret and act.

The Transformational Component

The following will be a mapping (performance) of the points of transformation.
As mentioned earlier a transformational pragmatics is concerned with the inter-
action of the tracing experiments done under the generative component. The
generative pragmatics is concerned with pre-existing assemblages and the trans-
formational pragmatics is concerned with the creation of new assemblages, ma-
chinic buddings and potential machines. We are as mentioned first of all inter-
ested in the lines of subjectification, which indicate lines of flight and creation.

The Danish development is just one example of how western society has been
dealing with madness influenced by shifting attitudes towards ‘unreason’ or ‘the

160
abnormal’. These attitudes have been segregating groups of people by moulding
them into certain immediate scientific and paradigmatic cultures or more gener-
alised social tendencies. The differentiation of different social functions associ-
ated with the modern state has slowly made this segregation even more accentu-
ated though in a subtle sense and not only associated with the institution in a
narrow sense. The narrow focus on the institution or to abandon the institution
can be argued to stem from a linear functional way of considering the institu-
tionalisation of madness. Incarceration seeks to be explained by a change of atti-
tude towards madness, where institutionalisation and psychiatry is applied in an
instrumental way. This linear way of arguing misses the dynamic point, that insti-
tutionalisation in itself influences a lot of different bodies of society, legal-,
medical-, civic-, industrial-311, creating situations of lock-in or sedimentation.

Consequently, de-institutionalisation cannot be considered a short term, easy to

limit and linear process. It is rather an incremental self-referential process creat-
ing its own consistency, which reaches far beyond the narrow functional framing
of de-institutionalisation and the sector.

Michel Foucault showed in ‘Madness and Civilisation (M&C)’312 how madness is

isolated from other aspects of unreason from the end of the 18th century, thus
starting the process of creating madness as a medical and psychological phe-
nomenon. This process it is argued started, when a new perception of poverty
emerged in the beginning of the 18th century. Thus medical science did not ‘cre-
ate’ madness as an illness because it was a science, which was available at a cer-
tain time, rather certain more general conditions of possibilities were part of this
process313. Foucault excludes himself from any functional explanations of how
capitalism had a decisive influence on the internment of these mad people. It
seems that he even by giving examples from medieval Islamic practices of hospi-
talisation argues against this thesis314. It is possible that a kind of hospitalisation
could have taken place as early as the seventh century in Fez and later on per-

311 E.g. consider the lock in between the medical profession and the drug industry.
312 Foucault, Michel: Madness & Civilization. A History of Insanity in The Age of Reason. Vintage Books, 1973.
313 See also Madness & Civilisation cpt. 8.
314 This argument is included in a chapter, which was not included in the original translation of M&C. The chapter can

now be found in: History of The Human Sciences, vol. 4, no. 1 February, 1991 pp. 1-25. The chapter is titled: ”Experi-
ences of Madness”.

161
haps by the end of the 12th century in Baghdad and certainly in Cairo in the
course of the 13th century.

This far history aside Foucault’s project has been used by current anti-psychiatry
(including The Mad Movement) in Denmark and Marxist movements as a
documentation of how madness has been institutionalised and reduced to an ob-
ject of medical and psychological practices. Madness has within this frame des-
ignated an almost natural pre-social state, a perspective, which still informs a lot
of romantic fractions of Anti-Psychiatry discourses. Accordingly madness is pre-
sented as an imaginary resistance somehow surviving the traces of shifting social
conditions.

Accordingly psychiatry has often been framed with influence from early Fou-
cault and Anti-Psychiatry as a case of social-control and governance, which
however is only the case in the sense, that psychiatry is part of a social field to
which you find immanent forces315. In Discipline & Punish316 these
forces/abstract machinic aspects was featured as self-control or surveillance
(Panopticism or The Panoptical Machine)/the diagrammatic317. This aspect can
create a lot of insight into the segregation of madness or delinquency from the
rest of society. This however not just by stressing the discursive embeddedness,
but also by going beyond the dualism of the non-discursive and the discursive
stressing their complex and productive interplay where the aim:
“[I]s not a matter of suppressing the distinction, but of finding a reason for their relations….
In place of repression or ideology Discipline & Punish formulated a conception of normalisa-
tion, and of disciplines”318.

Psychiatry and its institutions are often argued to have played a ‘masque’319,
which is a picture of the cynical and inhuman part of social control. Conse-
quently, Anti-Psychiatric voices have called for a gradual demolition of psychia-

315 See Andrew Scull: Psykiatri og Social Kontrol i Det Nittende Århundrede, in: Social Kritik nr. 40/41. 1995. See also

Bjørn Hamre: Wilhelm Frydendahl En Modig Patient. Ibid.

316 Michel Foucault: Discipline & Punish – The Birth of The Prison. Penguin Books. 1977 (1975).
317 See also Gordon W. Coonfield on post-panopticism on the D&G mailing list November 19th 2000.
318 Gilles Deleuze: Desire and Pleasure, p. 184. In: Arnold I. Davidson: Foucault and His Interlocutors. University of

Chicago Press. 1997.

319 Psykiatriens Maskespil. Social Kritik nr. 40/41. 1995.

162
try to accomplish democratisation and restoration of madness. The way to
pierce through the masque, which has often been covered up by the shield of
science and professional tradition, has been to negate the psychiatric discipline
and its institutions.

There can be many good reasons for addressing a field of praxis, which includes
a history as dark as the one of psychiatry. However it is hard to link the a-
historic perspective of anti-psychiatry with the tendency of our times of re-
introducing madness as a politics of resistance cultivating deviation in a concrete
socio-political setting. The fact is that madness has never emerged as a political
actor, due to the bare fact that madness by definition cannot act (as it can only
emerge as a residue within the regime of the signifier e.g. normal/abnormal).
This is also the consequence of the Foucauldian project even if it has been in-
terpreted as project of giving voice to madness, rather it was concerned with the
complexity of the discourse on madness.

However Madness & Civilisation on one hand shows how the construction of
madness is relativistic, on the other hand it operates with one true concept of
madness. This tendency of ontologising madness has been criticised also by
Foucault himself in his later work: The Archaeology of Knowledge, here he
states on page 47:
“ We are not trying to reconstitute what madness itself might be, in the form in which it first
presented itself to some primitive, fundamental, deaf, scarcely articulated experience, and in the
form in which it was later organised (translated, deformed, travestied, perhaps even repressed)
by discourses, and the oblique, often twisted play of their operations”……”But what we are
concerned with here is not to neutralise discourse, to make it the sign of something else, and to
pierce through its destiny in order to reach what remains silently anterior to it, but on the con-
trary to maintain it in its consistency, to make it emerge in its own complexity”.

The Foucauldian project is clearly intended as a project dealing with discourse320

in its own right. The question of the mad voice or real mad existence as a discur-

Where ‘discourse’ in the Foucauldian sense might be closest to the concept of ‘stratification’ or ‘capture’ applied by
320

Deleuze and Guattari.

163
sive anteriority has never been intended to be part of the scientific project.
However the doubleness, which can be seen in Foucault’s writing, can be inter-
preted as a sign of his sympathy for the anti-psychiatric voices prevailing in the
sixties calling for a liberation of the mad voice. However, a pragmatics of mad-
resistance cannot be extracted directly as a question of getting rid of the con-
crete manifestations of force e.g. psychiatry and its institutions. However, when
the later works of Foucault are included in the argument (e.g. Discipline and
Punish), it becomes apparent how abstract aspects e.g. the panoptical machine is
part of the ‘dispositifs’ or ‘machinic assemblages’, within which subjectivity
emerges.

These abstract aspects it will be argued are the forces of normalisation, which
constantly change the conditions of mad resistance. As an example you can con-
sider how psychiatry as mentioned in the beginning of this section came to-
gether with bourgeois ideals and humanistic intentions during the time of what
has been later referred to as the period of incarceration. Now the same ideals are
used with some modification to free the patient from the institutions.

In spite of all this, Anti-psychiatry has used M&C as a manifest to work against
psychiatry and its institutions. Though these arguments might have played a role
like it is often argued in relation to the general public opinion, it does not seem
to have been very productive on the concrete level of organisation and action
with the aim of ‘the inclusion of madness’321. The reason is that it produces its
resistance as a negation of historical practices where the positive energy is
merely spiritual or a reference to an imaginary state of affairs.

The value of these energies should not be understated in the sense that they can
create relief of pain and distress, but they prevent madness from inserting itself
as a concrete praxis inside a social field, which contains its destiny. To echo the
examples given above concerning black resistance as a becoming black as a repe-
tition with a difference rather than a repetition linked to a logic of representation
321 Consequently an analysis, which sets out to investigate the potential of mad resistance must as argued at length in the

preceding chapters, be concerned with the way in which madness is able to emerge in the interstices or translations of
different regimes signs, rather than from the despotic signifier.

164
and the same: real becoming must be generated from the very inside of repre-
sentation.

This is reflected by the discourse on the sectored psychiatry as well by the dis-
course on the psychiatric paradigm in general. In general two versions of anti-
psychiatry are referred to by psychiatrists: one, which is structural blaming psy-
chiatry as a loyal allied of a sick society and another, which intends to create a
new sectored psychiatry through the renewal of the psychiatric discipline by em-
powering the patient.

The first version however is the one, which prevails when psychiatrists in gen-
eral expose their fear of the devaluation of their discipline.

The negative approach to psychiatry is argued to devaluate the discipline and

thus make the real qualitative improvement more difficult as it becomes more
legitimate to cut down the public funds.

In this regard the focus on patient-rights concerning autonomy has neglected

the focus on the material rights to proper treatment.

On the other hand psychiatrists have played a very passive role and have not
been able to innovate themselves in a self-reflective manner. Rather they have
only reacted to the self-made reductions of anti-psychiatry to pseudo-humanistic
fantasies. This has been documented by a study from the beginning of the eight-
ies by Niels Reisby (see above), who himself produced a lot of reflection and in-
sight. This tendency is also supported by the study by Mr. Wilhjelm from the
first half of the nineteen eighties. The lack of public debate on the concrete chal-
lenges can as argued be one of the reasons why the renewal of psychiatry seems
to have entered a vicious circle in the eighties with fewer resources, increased
criticism and a devaluation of the discipline in the public (and political mind).

Psychiatrists have mostly been engaged with generalised paradigmatic debates

rather than a constructive approach to the possibilities of a sectored psychiatric

165
service and how the role of institutions could be renewed, rather than just aban-
doned.
This seems to have been detrimental for creating an operational base for the ini-
tial organisation of out-patient treatment. Likewise, it seems to have had conse-
quences for the gradual development of new diagnostic tools based on a social-
psychiatry, as it has de-focused the possibilities of cross-sectoriality and thus the
development of cross-professional competencies. Very probable explanations
close at hand for this apparent lack of interest have already been given, but the
general trends of the seventies and eighties should also be considered.

The rhetoric of the sector in the beginning of the eighties sweeps away and de-
legitimises old routines and pretends instead through very broad and general
terms to push the development through to the concrete actions of each of the
professions involved. This trend can already be seen in the reports from the
conference in 1977 where cross-professional and cross-sectored efforts were
viewed as a narrow structural organisational issue. The focus was the co-
ordination of efforts between the hospital and the social services in the primary
sector. This whole issue thus was not considered according to its implications
for paradigmatic struggles.

Rather the trend protruding into the eighties is that politicians and their experts
create the ‘right’ visions according to vague trends of de-centralisation and mod-
ernisation under the slogans ‘better’ and ‘cheaper’. In this game, the health- and
social services- professions become the scapegoats, who are easily exposed to
criticism when services fail. The broad vision sustained by the trend is based on
the fantasy of the network in the local community, which can contain the former
patient. When the counties during the eighties are accused for not having devel-
oped enough Out-patient Treatment resources, professions are blamed for not
being able to fill in ‘the gap’ between hospital and local community.

As mentioned this gap, which should be filled in by a new independent system,

is difficult to match as the staff of different systems have not had time enough
to develop the competencies necessary for the operations of a new sectored- or

166
social-psychiatry. This includes as mentioned above completely new theories and
methods to counter, on one hand the tendencies of psychiatrification and on the
other failure to deliver proper service and care.

The sudden destratification accomplished by normalising forces creates tenden-

cies of rigidified and immobile strata. To be more specific, the innovation proc-
ess is slowed down as it is forced into an administratively and politically prede-
fined space of an imaginary collaborating sectored psychiatry. This negative
process however is made possible through the complex interplay of different
tendencies of psychiatry and anti-psychiatry as already mentioned.

In this context, the debate on ‘the sector’ from the late eighties and start nineties
can be seen as an important nexus for these early experiences, which extend as
far back as the beginning of the seventies (perspective-plans 1 and 2) and the
prospects for the nineties.
The examples from abroad are used in an active way to expose and accentuate
how these experiences can link up with the Danish conditions and prospects.

The liberal spirit from the eighties is reflected in the opinion of the Minister of
Health, were de-institutionalisation gets a humanistic and liberal image. It goes
well with the opinion of The Mad Movement as far as these people want less
psychiatry and less systems-rule and more autonomy and social tolerance. How-
ever the end eighties produce an important step away from anti-psychiatry with
psychiatrist becoming more active in debating the potential of the sectored psy-
chiatry.

This tendency is renewed by the end of the eighties with psychiatrists arguing
for the different technological innovations, which have produced new insight
into the biological causes of mental illness. Again a very stereotyped projection
of anti-psychiatry as a romantic fantasy is applied to stress the argument about
the brain as a chemical machine in comparison to the developmental and envi-
ronmental factors emphasised in humanistic camps.

167
Also the cross-sectored collaboration was under a fierce attack from psychia-
trists calling it a multi-headed monster of over-professionalism, without the pos-
sibility of creating near relations to the concrete cases.

One of the reasons for this impression could stem from the fact that until now
the material quality of treatment and care, including a discussion of the target
groups had not been discussed across the sectors.

This changed with the theme-planning process in the end eighties including pro-
fessionals on al levels to participate with their experience. The process thus in-
tended to suspend traditional modes of planning focusing on figures and how
the process could be a way to develop quality of a cross-sectored psychiatry.

As also mentioned by The Movement of Madness, the planning process re-

flected a systemic approach, rather than a focus on the differentiated needs of
the mad-citizen e.g. illustrated by a lot of talk that concerned concepts like tar-
get-groups. Target-groups are often seen as part of the operational base for the
systematic planning. However it could be argued, that social-psychiatry should
have a more pragmatic base to accommodate the shifting needs of clients. This
should certainly be the case in a phase of systemic transition, where experiments
can create a new base for adjusting to these needs. This should also be the con-
sequence of the observation, that the mere availability of specific facilities e.g.
hospitals create a corresponding match of professional and public attitude to-
wards their utilisation. This stresses the importance of developing new theories
and methods to improve quality of treatment in an incremental process rather
than through structural planning and redistribution of resources.

However this period marks a clear break away from the general resource and
structural thinking of the eighties. In this sense, the period around 1990 marked
a turn towards more humanistic-, de-professionalised-, qualitative-, concrete-,
and processual ways of thinking. It is e.g. when referring to the case-manager
model that treatment has not been active enough etc.

168
As part of this trend, you see a more moderate patient organisation entering the
scene (SIND) with concrete demands to the quality of the cross-sectored treat-
ment. Likewise, the Mad Movement seemed to show a more moderate attitude
asking for rights to ‘proper’ treatment rather than ‘no’ treatment, however still
being very suspicious towards ‘the conservative psychiatric system’.

Another theme is prevention, which has as a precondition, that people with the
right training apply concrete working models. This again stages that psychiatry
has a role to play in an active prevention of fatal cases, a role which it is men-
tioned has been neglected caused by the general negative attitude towards the
discipline. In this way the more concrete focus helps to include professions in
the work towards new models, which serves to professionalise the sector. The
other tendency of de-professionalisation stages another issue namely the right of
the patient to his own private sphere, which is to become the bigger issue later
in the nineties.

Madness has reached a growing degree of monopolisation through psychiatry,

thus reducing the abnormal to scientific facts. This monopolisation means that a
pragmatics of mad resistance has become a project of creating a mad voice from
within the one of the patient. The extensive de-institutionalisation process cre-
ates a danger of cutting off mad existence as patient, and thus establishing an
uncovered exposure to the forces of normalisation. Instead of focusing on the
potential of the asylum in the process of ‘becoming citizen’, the asylum is unilat-
erally negated. Citizen is the designation applied by the sectorisation-discourse,
but which could be rephrased as ‘a becoming citizen as mad’ (creating assem-
blages of becoming citizen as mad).

Thus the overall picture of the development of psychiatry from the mid-
seventies to the start eighties is the lack of participation of psychiatrists in the
discourse on de-centralisation. The discipline seems to suffer as it is been given a
bad name making it easier to cut down on resources and to stop investing in re-
search, education and new physical facilities. The main humanistic argument as-
sociated with decentralisation is the reduction of the application force and of

169
creating the possibilities for the mentally ill person to live a life as close to the
normal as possible. The psychiatrists and other professional officers see here the
risk of increasing the gap between professionals and the patient in favour of the
application of abstract measures (rules) in the handling of cases. This creates a
loss of continuity of treatment in general and a loss of commitment in particular
of the single professional involved in the course of treatment.

The focus on cutting down spending in the public health sector initiated in the
start seventies with the two general plans (Perspektivplan 1 & 2) is sustained by
the general tendency of anti-psychiatry. In this way, the voices, which are scepti-
cal about the de-centralisation are easily silenced. It can thus be seen that decen-
tralisation as a structural reform is not backed by resources aimed at research
and education. Even when the systems are urged322 to seek out new ways of col-
laboration through the local concrete cases rather than through abstract general-
ised procedures, it is a project destined to failure as the cross-professional readi-
ness is absent.

In this way, the aim has not been to qualify the personnel for the new tasks as-
sociated with decentralisation. Neither has it been the attempt to base the re-
form on research bridging the different branches of modern psychiatry. Rather
the model has been fragmented building on the one hand on traditional hospital
based psychiatry and on the other an imaginary of social integration through dif-
ferent measures detached from the profession of psychiatry. Neither on the op-
erational level nor the level of theory has there been anything to drive psychiatry
into an active role in the creation of a future decentralised psychiatry or collabo-
rating psychiatry.

The Diagrammatic Component

In the end eighties, it is finally concluded that radical anti-psychiatric or non-
psychiatric experiments have failed. Rather local facilities have to be established
on a larger scale through the joint effort of counties and municipalities.

322 Socialstyrelsens Informations- og konsulentvirksomhed. 1988.

170
Out-patient Treatment thus becomes a legitimate model be it more and more as
an active model of treatment.
In this way, the abstract and general way of relating to the citizen from the be-
ginning of the eighties is slowly replaced by an attitude of service and sensitivity
to the needs of the citizen. The focus on the concrete and the single case fore-
grounds the concrete inter-professional exchange of knowledge and ideas. This
is a new trend for professions that have been used to doing their job by relating
to the abstract and general sphere of the imaginary collaborating psychiatry. Ac-
cordingly, during the seventies and eighties, each worker has made an interpreta-
tion of this imaginary according to the schemes of his profession rather than by
developing new ones in a process of inter-professional learning. However, the
active intervention of professions into a formulation of the problems associated
with the sectored psychiatry is a step towards a more operational basis.

This potential base is also sustained by the active collaboration of patient

organisations like SIND. In opposition to The Mad Movement, SIND seems to
be able to establish a liaison with the psychiatric system maintaining a critical
voice.
What seems to obstruct this humanistic project is the fact that the de-
institutionalisation discourse and Anti-Psychiatry together have produced a-
historic approach, which seems to be difficult to put to work in a practical field
of the becoming mad of the patient. This is the case, as this project must embed
a respect of the traces of the past. The bourgeois intentions seem in this regard
to betray psychiatry its true humanistic companion, through the years and hands
over the patient to a non existent care of a local community, which cannot be
compensated by out-patient facilities.

Madmen can only act through the potential generated by themselves, which is
most likely not to be generated in situations where they remain denied their his-

171
tory as patients or are produced as clients in a manageralistic bourgeois sys-
tem323. This is the aspect of the abstract machine of normalisation.

This block or vacuum did not make way for a new independent system, a third
thing in between government and the dogmatic professionalism of the clinic.

It takes more than a production of self-propelling arguments as those of Anti-

Psychiatry based on a stereotyped exposure of psychiatry, as it takes more than
creating structures and reallocating resources in the public system. In the first
case such a project is driven by the imaginary of a mad originality, which can be
uncovered and retrieved. In the second case it is driven by an imaginary of col-
laboration across professional psychiatric systems, which can contain and culti-
vate not ‘madness’, but the citizen who is not mad (the resurrection of good old
bourgeois ideals of education). This perspective misses the point, that real mad
becoming should carry the traces of psychiatry in its strife towards action.

However, historical studies, which treat difference or madness applying a more

generalised social perspective, are rare. One study treats the development of the
public attitude towards madness in the general population between year 1700
and 1900 that is the transformation of the village fool into psychiatric patient324.
It is here seen how the interplay of more subtle socio-economic developments
shapes attitudes, which transforms madness into illness. Psychiatry is just one
part of this transformation when it comes to the emancipation of the mad as pa-
tients all kinds of socio-economic conditions must be considered equally. This is
where the real challenge lies.

In this regard the radical experiences from Italy are interesting as they seem to
allow for effective becoming mad assemblages if we mean by that the acting out
in the local community – in ‘real’ society.

323 The Danish Minister of Domestic Affairs Britta Schall Hollberg stated in the beginning of the eighties, that all which

was needed to make Out-patient Treatment a success was that people in the local community make an effort to show
compassion with these patients.
324 See Morten Lundby Jensen: Fra Landsbytosse til Psykiatrisk Patient-Holdningsændringer overfor Galskaben og Be-

handlingen af Gale i Danmark 1700-1900, in: Den Jydske Historiker. Tema: De andre – udskillelse og Anderledeshed. Nr
41, 1987.

172
The more practical rather than idealistic approach of the out-patient treatment
was not reached until the second half of the eighties. However at this point the
structural developments of the institutions had already been transformed creat-
ing a gap of competency between professions and an even bigger gap between
professions and administrators and politicians. What was worse the gap between
the expectations of the public at large and the actual performance of the psychi-
atric system was huge. The building of myth towards the psychiatric system en
block was one thing while another more serious was the general hostility to-
wards mentally ill living in the streets without proper care. The latter aspect cre-
ated an even more marginal situation for the mentally ill.

The big question is how a counter discourse could be invigorated to include

these people. The Mad Movement has as mentioned during the seventies and
eighties been preoccupied with securing basic human rights of autonomy, rather
than the concrete material rights to proper treatment and care faced with the re-
ality of the sectored psychiatry. These rights were not to be included until later
in the nineties.

Also internationally, the Mad Movement seems even today to focus on the is-
sues of power, violence and alienation, which are all well-known categories in
the public mind325. The core issue is the control issued from the profession of
psychiatry and its institutions (forced medication and incarceration), which in a
sense can be viewed as an anachronism faced with the situation of sectorisation.
From the US, it is reported how mad-people ‘choose’ to stay in the hospital, be-
cause of the difficult conditions on the outside where a poor housing situation
creates homelessness and further alienation326.

It is further mentioned that tools as force and violence, which should only be
used against law offenders are used by psychiatry as treatment. The paradox is
that the use of force or violence towards people with a psychiatric history is
likely to increase the moment psychiatry gives up the creation of objects of men-

325 Vicki Fox Wieselthier, founder of MadNation in: Dendron 41. 1998.
326 Ibid.

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tal illness. Abnormal behaviour in the local community might be dealt with
forcefully through police intervention rather than through a more gentle han-
dling by experienced professionals.

Again madness will not ‘act’ from the bare fact of not being ‘treated’ that is e.g.
by excluding psychiatrists. Rather it should be discussed how the use of a direct
force as a reflex could be challenged in praxis by stating that the real force con-
fronting madness is the over-coding associated with the forces of normalisation.
This obscure force (abstract machine), which clasps action only leaving behind
stunned existence. This force could equally well be realised by giving up direct
force or intervention e.g. in cases where a person with a history as a psychiatric
patient is abandoned without any attention to his special needs.

Consequently, direct application of force and regulation is just the concrete

manifestation of the governing efforts of society. The ‘virtual real’ forces inside
these manifestations are the normalising forces, which abstract the concrete case
by recourse to an alienating abstract modus operandi. These are more likely to
create unauthorised force in cases where reflex actions are applied, rather than
concrete ‘ethical’ estimates.

Another stunned existence could be the home-visiting nurse finding himself

trapped in a new task-environment without the proper preparation and rela-
tional back up. Still, another could be the dynamic, innovative and dedicated
psychiatrist who only faces prejudice and reluctance due to his academic back-
ground.

Likewise, the needs of the patient might in certain situations include the in-
volvement of family and relatives or an active medical or therapeutic interven-
tion. However the more psychiatry is sectored the more these situations become
an issue, which is dealt with by people who have no or little experience with
people with a psychiatric history. These facts create together a scenario where
abandoned patients are likely to loose basic rights of treatment and care and at

174
the same time are being exposed to an untrained (and thus less moderate) use of
force.

The alienation of the patient of the sectored psychiatry was an issue dealt with in
the end eighties. The focus was supposed to be the “total situation of the pa-
tient” and the local cases, rather than that generalised solutions were supposed
to generate a new cross-sectoral collaboration. The responsibility was still with
the professions, who are left to find new ways to deal with the single cases.
Psychiatry as a medical profession has traditionally been tied up with diagnostic
instruments and structures allowing a positivist and empiricist approach to the
patient. This tradition could be challenged by de-institutionalisation, where a
new ‘mad voice’ and thus a new concept of illness based on actions of patients
in a societal context could replace illness as pure medical facts.

Traditionally, the medical profession has in its function an a-historical way of

dealing with illness and does not situate it in a socio-political context. Mad exis-
tence is totally dependent on the categories – the signifying chains established by
the medical gaze. As such it can be argued that within this medical logic madness
cannot act and as such cannot participate in social-life. So when Guattari327 some
years ago argued for a de-psychiatrification of madness, he meant the possibility
of transforming psychiatry and the hospital by allowing for a new function. In
this regard ‘sectorisation’ could function as an impetus, however as will be
elaborated on in the following section 8 this potential new function has been
blocked. Rather psychiatry can be said to have had the function as a scapegoat –
a negative sign legitimating the creation of new (empty) signifiers.

Actually, this turning away from psychiatry and its obscure past does not seem
to have produced less repression of madness, rather other repressive technolo-
gies take over when the specific psychiatric or psychotherapeutic technologies
are outdone by the open space of the sector. In this way the extension of de-
psychiatrification as creative project is blocked in the sense, that it does not ex-
tend itself beyond the hospital and the sectorisation of psychiatry.

327 See Genosko, 1996 in the introduction to The Guattari Reader.

175
If de-psychiatrification means to make ‘madness’ speak for itself we must deal
more specifically with what I in general terms choose to phrase as ’the becoming
mad of the patient’. In other words, the conditions of everyday life, which face
an individual with a psychiatric history, where the talk is not of a specific indi-
vidual history, but the signifying potential or mixed semiotics in the transforma-
tion of institutional psychiatry into sectorisation or a collaborating psychiatry.
To have madness act rather than being clasped by the objectifying technologies
is for sure a becoming mad of the patient or to have the medical function being
transformed in correspondence with the socio-political conditions of the be-
coming mad of patients.

However de-psychiatrification is practised in a negative sense where psychiatry is

stereotyped, and thus not acknowledging the history of psychiatry and not the
least what has been referred to as the three Ps pay, prestige and power328. This
has been the trend in sectorisation efforts during especially the eighties. Rather
de-psychiatrification as a change of treatment culture takes another positive an-
gle allowing psychiatry to find its new functions, without abandoning the poten-
tial of the tradition.

328 Richard F. Mollica: From Gramsci to Basaglia, in: International Journal of Mental Health, vol. No. 1-2. 1985.

176
 Section 8 - The Becoming Mad of The Citi-
zen
The Nineties and Beyond

If out-patient treatment was the headline of the sectored psychiatry of the eight-
ies, for sure Social-Psychiatry is the focus of the nineties.

The concept of ‘Social-Psychiatry has undergone a development from referring

to demographic studies329 in the nineteen sixties and seventies to denoting cross-
professional collaboration between sectors and professions and measures with
reference to certain socio-legal acts to benefit patients who are not hospitalised.
On top of this you find the concept social psychiatry applied to all kinds of local
experiments with alternative housings and activities financed by central funding
of The Ministry of Social Affairs.

As can be imagined you can discover a lot of frustration concerning different

concepts related to Social-Psychiatry i.e. psychiatrists pretend that they represent
some pure form of psychiatry, whereas different social services are labelled So-
cial-Psychiatry. Out-patient treatment is a label used by doctors and administra-
tors to refer to the community-based, but hospital governed psychiatric service.
These different distinctions serve the abstract demands of rules and regulations
as well as the reproduction of professional identities. However it seems more
operational to use Social-Psychiatry as a pragmatic term, as an open space to be
explored.

Accordingly, in the following I will refer to ‘Social-Psychiatry’ as the broad

frame within, which the old function of psychiatry ‘as a whole’ can be innovated
based on an active sectored or community based effort. In this community-
based effort, hospital, out-patient treatment centres and social-services play a

329 Earlier the concept had as mentioned been covering descriptive epidemiological inquiries of distribution of mental ill-

ness in the population. See Brandt, P: Socialpsykiatri - psykiatri på et humanistisk grundlag p. 9ff. DAFOLO. 1995.

177
role. In this way, it becomes a rejection of the polarised debates of the seventies
and eighties still blocking a lot of creation potential. As it will be shown in the
following, a lot of tendencies survive in new and more legitimate disguises. In
this way, it is important to consider the background for the creation of this open
space. It must be considered how past struggles permeate it manifested in the
cross-sectored and cross-professional debate of integration.

In this sense it becomes an open space that contains logics, concepts and argu-
ments, of becoming citizen of the patient and later becoming mad of the citizen.
These logics, concepts and arguments have both references to law, economy,
administration and politics as well as to psychiatry, psychology and sociology.

Looking from above at this space you can discern a variety of ways that adminis-
trators, politicians and their associated experts view the possibilities of future
psychiatry. So far it has produced a frame, which can be formulated like this on
the level of the system:
New social norms for the public sector have, in conjunction with the develop-
ment of medical psychiatry and experiments with out-patient treatment, created
a demand for radical new ways of organising psychiatry. This observation has
created the formulation of the problem of co-ordinating and integrating profes-
sions and sectors to create a unity. This unity I will refer to as ‘the imaginary col-
laborating psychiatry’.

The Social-Psychiatric trend of the nineties meant that a lot of concrete projects
of innovation and dynamics were initiated. The new trend indicated that the
work being done in the community was an important part of the treatment
rather than a bare supplement, but that this development should not be at the
expense of the hospital-based psychiatry.

In the beginning of the nineties, the label Social-Psychiatry covered still new
fields as many diverse projects were established through pool-money under the
jurisdiction of the Ministry of Social-Affairs. The challenge of channelling the
results of these inquiries into a practical Social-Psychiatry is still in its infancy as

178
theories and methods are still in the making. The following will be a mapping
out of these Social-Psychiatric tendencies, which make up this raw material of
future psychiatry.

Social-Psychiatric Experiments
Politically there was an increasing focus on the problems accompanying the de-
velopment of Out-patient Psychiatry. The growing pressure urged the politicians
to reflect on the critical cases, which were frequently presented by the media:

“On the seventh of March 1991 the parliament unanimously passed an agenda (D8), which
aimed at improving the conditions for mentally ill. The agenda also meant the increase of bulk-
funds available for municipalities and counties…… In December 1992 the Ministry of Social
Affairs established a new central pool of funds amounting to 50 million Danish kroner each
year starting 1991” 330.

The experiment- and development pool labelled ”The City-pool” aimed at sup-
porting especially the persons who were ostracised including persons with men-
tal illness and problems of substance abuse. These people who had earlier been
determined by their status as clients or patients, but now presented a new mix of
symptoms caused by their marginalised social-situation. The psychiatric patient
now also had the imprint of substance abuse, crime, poverty, malnutrition and
several somatic diseases creating even more marginalisation. In this sense, it can
be said that the sectored psychiatry has accelerated the need for a social-
psychiatric expertise, as it has created a new type of clients, who cannot be con-
tained within the existing theories and methods of psychiatry or other therapeu-
tic tools available. In this sense the sector can be said to feature a self-sustaining
discourse, which has its own consistency.

The funds of the city-pool have primarily been allocated to the establishment of
basic occupational facilities, special housing facilities, support and contact-
facilities provided by Social-Workers. At about the same time, the Ministry of

330 Seemann, Janne: Når Organisationer Skal Samarbejde. Distriktspsykiatri på tværs af professioner, sektorer og politiske

niveauer. Munksgaard, København, 1996 p. 21

179
Social-Affairs established a support-group representing a vast selection of pro-
fessions. The aim was to strengthen the support of non-hospitalised psychiatric
patients. The parliament agenda signalled in a fundamental way that social-
service efforts were considered a critical factor for the renewal of psychiatric
treatment in general. It is stressed that treatment is not only a task of the medical
profession but something, which should be handled through a flexible cross-
professional effort.

A further improvement of the efforts toward the mentally ill has later been at-
tempted by establishing a Commission of Advance in 1993 (‘Fremrykningsud-
valget’). Added to this, the general legislation on social welfare was improved
with an amendment coming into effect from April first 1995331. This initiative
was established after the central government had filed its status report covering
the whole service directed towards the mentally ill. The elaboration of this re-
port was the direct result of one of the decisions contained in the agenda passed
by the parliament in 1991 (D8 march seventh 1991).

From the status-report it appeared that the plans, which had already been elabo-
rated could not be fulfilled before January the first 1994 as presupposed in The
Agenda D8.
The Commission of Advance established a line of work-groups filing their re-
sults in an important document from 1993332. Considering procedures of hospi-
tal-discharge and the collaboration between hospitals and municipalities a work-
group was established with the aim to make:

“Proposals for procedures for the discharge of psychiatric patients”.

The work-group, which focused their work on procedures of discharge referred

to the report from The Commission of Correlation (‘Samordningsudvalget’)
from 1985 and the follow up in the review “The citizen between municipality
and hospital” see also above in section 7.

331 See e.g. Janne Seemann, p. 22-23

332 See “Fremrykning af indsatsen for sindslidende”. Sundhedsministeriet og Socialministeriet, 1993.

180
It is important to stress that the focus of the report is the patients, who have not
benefited from the reorganisation of psychiatry. It is emphasised that special
housing and occupational facilities are needed for this group of patients. As
mentioned above this fact should be considered a consequence of the produc-
tion of new social-clients with a psychiatric history.

The talk is of the change of philosophy of treatment, which has entailed that the
current situation is that it is only patients suffering from severe psychoses, who
are hospitalised. While an increasing number of patients are treated in Out-
patient Treatment facilities in their local environment.

The conclusion was that special emphasis should be put on:

- Procedures, which include the whole collaboration in relation to hospitalisation and the dis-
charge process.

- That a follow up on treatment is conducted by a general practitioner or in an Out-patient

Treatment unit.

- That the housing facilities of the patient - and where it is relevant – social support facilities
are included, so the patient is not discharged and sent in the street.

- That medical and social information between hospital, institution and local authority concern-
ing hospitalisation and discharge from the hospital has to be improved.

From these statements you can observe a shift toward what you could refer to as
integration thinking, where continuity of treatment is in the foreground. The
municipal treatment facilities are in the foreground and are not merely viewed as
a small supplement, but rather as an important part of the treatment. As men-
tioned above this should not be seen as a bare product of change of philosophy
of treatment as it is indicated. The case is rather that the sectorisation of psy-
chiatry has produced a situation where a new type of social clients is calling for

181
new functional structures in the shape of new theories and methods. Further-
more, it is interesting that legal questions are introduced in connection with the
sharing of information between authorities. These questions are of special inter-
est, when the exchange of information between county and municipality is con-
sidered.

Here it is mentioned that the main rule in The General Act of Administration
that the client/patient should give his consent to, is this sharing of information.
A problem for obvious reasons arises the moment the patient is too ill to give
this consent. In these cases, there is a risk that exchange of information does not
take place, which could be vital for the continuity of treatment.

The conclusion of the work-group on this issue is that the rules are not more re-
strictive than necessary, and as such should not damage the collaboration be-
tween authorities.
The standard procedure is based on the consent of the patient. However in
cases where the patient due to his mental condition is not able to make a deci-
sion, the sharing of information will be legal according to the rule of exchange
of value in The General Act of Administration, section 28 subsection 2, no.3,
(that is without consent).

The fact that this theme is considered at all can be seen as an expression of a
making concrete of the general ideas linked to a cross-sectored/cross-
professional collaborating psychiatry. This is a new development in comparison
to the preceding reports where the topic was treated in more general terms. The
work-group presented the following conclusion on the development of the
cross-sectored collaboration:

- The development of the collaboration between the sectors must be the focus in the future.

In The Danish Psychiatric Society, the report and its conclusions was seen as
too unilateral in its focus on the social part of the sectored psychiatry. The

182
chairman of The Society Povl Munk Jørgensen333, who also during the eighties
was a frequent commentator on the sectored psychiatry, (see above) wondered
how the report could be a result of a joint collaboration between the Ministry of
Health and The Ministry of Social-Affairs. He saw the focus in the report on the
sectored psychiatry and the community services as an indicator of the total plan-
ning of psychiatry moving away from the hospital and the medical field.

The argument in an earlier comment334 from 1993 was as follows:

“The sectored psychiatry is used as a hostage and every time we doctors complain about the de-
crease of quality in the hospital service the answer is we don’t want the big institutions back.
The point of view illustrates how psychiatrists see their field degraded and misunderstood in the
course of the new developments as the sectored psychiatry and new social services are seen as real
alternatives to the hospital”.

The narrow focus on the sectored psychiatry had gradually marginalised the im-
provement of conditions in the hospitals, which everybody agreed was a neces-
sity in the beginning of the 1990ties (including politicians and administrators).

The report with its focus on the operational parts of the decentralised psychiatry
in this sense can be seen as accelerating and making concrete the ideas of the
sector. In this sense the document marks a further legitimation of The Sector as
it does not specifically mention how the hospital should improve its services for
the patients in need of hospitalisation.

However the lack of attention to client opinions was to be accommodated re-

flected by new trend of client evaluations of service functions established
through the nineties335. This gives the picture that the clients are now the agenda
setters, an issue, which has been stressed a lot of times in official documents.
The pools of money being established under the governance of The Ministry of
Social-Affairs establish a trend, which can be phrased as a humanistic bottom up

333 Povl Munk Jørgensen: Sindslidende svigtes, in: Politiken. November 8th 1993.
334 Povl Munk Jørgensen, The strait-jacket of Psychiatry. (Psykiatriens Spændetrøje), in: Politiken April 7th 1993.
335 See e.g. Hanne Kathrine Krogstrup and Else Stenbak: Socialpsykiatri mellem System og Bruger. Socialministeriet,

1994.
Merete Nordentoft et alt.: Brugerevaluering af Psykiatrisk Dagcenter. Ugeskrift for Læger 156/45. 7. November, 1994.
Peter La Cour et alt.: Brugernes syn på hospitalspsykiatrien. In: Agrippa årg. 14. nr.3/4. 1993.

183
project encouraging diverse local projects and experiments. Attempts seem to be
made to use experiments and knowledge as a strategic resource for designing fu-
ture psychiatry. In the eighties the trend was rather to negate the past using it to
generate pictures of ‘an imaginary collaborating psychiatry’.

In contrast the nineties, to simplify a bit, can be said to feature a psychiatric

planning based on a more pragmatic/experimental and less idealistic (polarised)
model.

Another striking difference compared to the eighties is how patient-rights are

treated in a more integrative sense. In the seventies and eighties patient-rights
were about freedom and getting rid of institutional power. In the nineties it is
about having a patient-voice in the middle of the creation of a new psychiatry.
Patient-rights become an issue of having the right treatment in the local com-
munity by the system as well as by the population in general. This is what social
integration of mental illness is about in the nineties as it was put by The Minister
of Social-Affairs in 1996336: “ We shall all make an effort to create a better life for the
mentally ill. They should feel welcomed and they should be provided with public services. If the
mentally ill are met with hostility they will never find their way in society”.

The following year, SIND (the moderate patient and relative organisation)
launched a campaign with advertisements in papers and in the street with the in-
tention of killing the myth of mental illness. The Ministry of Social Affairs sup-
ported the campaign by ½ million kroner. Rather than just assuming like the
case was in the eighties, that tolerance of mental illness should come through
practice, an active strategy towards the public is chosen. Integration is not
merely an issue, which calls for efforts of the established health system, it be-
comes an issue of humanity, compassion and social solidarity. This statement
also represents the de-professionalisation trend, which is also part of the ex-
periments of the nineties.

336 Karen Jespersen: The Mentally Ill Have Horrible Conditions. (De Psykiatriske Patienter Har Forfærdelige Betingelser)

In: SIND no. 3, Maj 1996

184
The trend can also be seen in the experiments with ‘support and contact per-
sonnel’337 under the jurisdiction of the local communities. This personnel has as
a task to visit mentally ill in their home and help them take care of their basic
needs. These teams consisted first of all of people with a strong commitment
rather than of people with a specific professional training. This experiment has
since 1998, after a very successful trial period of two years from 1993-95, been
an official part of the services of the local authorities.

In 1995 a catalogue of ideas concerning the development of psychiatry was

made by an expert group under the jurisdiction of The Government of
Health338. This expert group included representatives from the health sector.

In this regard it is remarkable that the cross-sectored collaboration is mentioned

as a necessary part of treatment, a phrasing traditionally preserved only to the
medical profession. This seems even more remarkable when it is considered that
the committee consisted exclusively of people from the health (hospital) sector.

In the introduction of the report it is mentioned how the general development

trend is that the public health service globally, nationally and locally must be oc-
cupied with well-defined goals, as it must be competing on the development of
quality. This phrasing also seems to mark a new opening toward a softening
trend, where the more reductionist de-centralisation trends are supplemented
with more value-oriented/bottom-up agendas. This observation is even more
sustained when you consider how the Out-Patient Treatment-Social Psychiatry
liaison is described:

“It poses huge demands for collaboratory efforts and continuity in the treatment service and
that is why it is now very important to specify what society can demand from these services”.

Støtte- og kontaktperson-ordningen. see Socialpsykiatri. March, 1999. Videnscenter for Socialpsykiatri.

337
338See ”Objectives for The Quality Adult-psychiatry”. The Danish Government of Health, 1995. (“Målsætninger for
kvalitet i voksenpsykiatrien”. Sundhedsstyrelsen, 1995).

185
In conjunction with this statement, it is mentioned how the Government of
Health has decided to have this group of experts to look into the extensive activ-
ity of experimenting with Social-Psychiatric services:

”... It is important to stress the necessary consistency in the psychiatric treatment service and
opportunities for development, which is posed by the new knowledge”.339

In a very straight-forward way it is mentioned how Social-Psychiatry can intro-

duce new knowledge to traditional medical psychiatry by considering Social-
Psychiatry (that is social-services) as part of treatment.

In general it can be argued that the report introduces a new kind of integration
thinking, which urges the professional in the different units to self-reflection
demanding a development of quality in cross-professional/cross-sectored col-
laboration. Rather than having a negation of something, which assumes to have
existed in the past, the challenge seems to be the making of the future through
the fragmented experience with the sector.

It seems to be a definitive blow to the integration thinking of the seventies

where psychiatry was seen as a medical profession and an integration of somat-
ics and psychiatry was the aim of integration efforts. The focus in the nineties is
more as mentioned above how knowledge from the sector can be used strategi-
cally to improve quality. It seems to assume the existence of more conscious
demands of the users as it is mentioned: “What society can demand from the services”.
Rather than having mentally ill persons spoken of as clients they seem to be re-
ferred to as part of those, who directly or indirectly can act and thus demand.

This feature is also reflected in the reform process of The General Legislation
on The Psychiatric Service (‘Psykiatriloven’). In 1992, an inquiry was initiated to
make a status of the period from 1989 when the last amendment was effectu-
ated. Also the aim was to come up with a proposal as to how patient rights
could be extended to the right to proper treatment including sectored or social

339 Op.cit. s.14-15.

186
services. In this sense, the inquiry was extended beyond the old theme of patient
rights in relation to the application of force to integrate a specification of the
right to quality treatment.

One of the critics of the old legislation was Chief psychiatrist Sten Borberg340.
He reflected, in conjunction with the amendment process, on the balance be-
tween active treatment and the violation of rights to freedom. His overall argu-
ment was that the new law should balance the obligation of the systems to pro-
vide proper care: “..[A]s the necessity of force stems from the consequences of freedom”. His
argument was that the existing legislation on psychiatry was much too abstract
and difficult to administer. The legislative measures aimed at preventing unnec-
essary application of force entails paperwork and bureaucracy, which defocuses
the patient. Further the legislation is too much concerned with the freedom right
of the patient, rather than the obligation to apply force when necessary.

The abstract spirit of the law also accounts for the misfit between the intentions
of the law and the psychiatric reality. It is too easy for everybody to deny re-
sponsibility for the application of force. Even if it might be reasonable, that doc-
tors are the ones who have the final decision on the application of force, it
makes it too easy to argue the case of freedom rights rather than to acknowledge
the difficult estimates, which are involved in the application of force. As it is ar-
gued the complaint and legal system in this sense seems too abstract and remote
in its approach and the law contributed to this “twisted” situation.

These critical remarks must be considered valuable. As stated by the author,

psychiatrists can also blame themselves for their marginalised situation concern-
ing these issues: Psychiatrists are too reluctant when it comes to an open debate
of their actual clinical practices including a discussion of their balancing of ethi-
cal and professional principles.

340 Sten Borberg. Ord som Forvrider: in: Ugeskrift for Læger. 155/21. May 24th. 1993.

187
Originally the law was to be submitted to the parliament for amendment in
1994-95, which was stipulated in the 1989 law. However this was postponed to
1996-97 in order to have the inquiry made with the aim of having a more com-
prehensive reform of the law.

The report341 was finally filed in August 1996 analysing a lot of cases of com-
plaints filed to the Patient Commissions (a new authority established by the 1989
law) concerning first of all unauthorised application of force, including forced
medication and forced detention.

The overall conclusion of the report was that many complaints have been filed
caused by the psychotic condition of the plaintiffs, rather than incidences of
unauthorised application of force. Furthermore it is mentioned that many
hospitals do not comply with the standards described by The Kallehauge
Commission342 (see above), which stipulated that some minimum facilities
should be available including patients’ access to fresh air, single rooms etc.
Another general point was that the law in its entirety is difficult to administer
and far from the concrete decisions, which have to be taken everyday involving
very difficult estimates.
The final proposal for the new law was presented for the parliament in autumn
1997. As already indicated the proposal contained a further concretisation of the
rules concerning the application of force as it attempted to specify some stan-
dards and deadlines for the cross-sectored collaboration. This included the es-
tablishment of discharge agreements between hospital and municipality, the es-
tablishment of treatment plans, co-determination and access to patient-advisors
in the process.

It should be expected that this attempt to accommodate some of the criticism,

which had been posed against psychiatry for several years, would be appreciated
by The Mad Movement. However in this period, The Mad Movement was, to
judge from the contents of their journal, still very much concerned with the

341 Per Maegaard Poulsen with a contribution by Peter Kramp. Psykiatrilovsundersøgelsen. Ministry of Justice. August,

1996.
342 The commission was established before the amendment of the law in 1989.

188
broad paradigmatic questions and principles, rather than more concrete issues of
the planning and organisation of the psychiatric service. Issues like the applica-
tion of force343, the pseudo-scientific image of psychiatry, the biologic over-
emphasis of psychiatry vs. holism and spirituality344 were all issues treated in
their publication.

This could be interpreted as an acknowledgement of the development in pro-

gress, though one publication in 1994 featured a series of articles concerning
homelessness, the visible symptom of the failed psychiatric reform.

It seems as if the very critical voices against the psychiatric system gradually are
silenced or wrapped in. However, when representatives from The Mad Move-
ment345 are asked about the development and especially the legislative efforts to
secure the rights of the patients, they refer to a reply given in 1985 concerning
the amendment of the general legislation on psychiatry.

This reply346 marks in a very fundamental way the position of the movement,
how it is still dissatisfied with the established system. This is even the case after
the amendment of The General legislation on Psychiatry in 1998 establishing
minimum demands on the quality of hospital facilities, integrating the cross-
sectored collaboration in a more concrete way than earlier and most importantly
reserving resources for the implementation of these goals (which was not the
case when the law was amended in 1989). This comment on the proposal of
1985 was maintained concerning the later amendment in 1998. The comment in
this sense can be seen to contain some basic and general demands to the psychi-
atric system represented by The Mad Movement.

In an article347 from 1997, a group of former patients (or psychiatry victims as

they call themselves) maintained this attitude towards what they termed ‘an insane
legislation’, which violates basic human rights. The extended access to the applica-

343 Amalie Galebevægelsens Blad. Årg. 15, nr. 6. December 1993.

344 Amalie Galebevægelsens Blad. Årg. 15, nr.2 April 1993.
345 From a personal conversation with Caia Carupi a leading member of The Mad Movement. September 2000.
346 Sindssygelov – Nej Tak! Galebevægelsens høringssvar på betænkning om tvang i psykiatrien. July, 1986.
347 Amalie – Galebevægelsens Blad. Vol.: 19. no.: 5-6 December, 1997.

189
tion of force and forced retention (and what is referred to as ‘the mouse trap
clause’) is mentioned in conjunction with the new proposal concerning dis-
charged agreements and the extended access for authorities to distribute infor-
mation about the patient. Another strong point is the old theme of the abuse of
medication and the lack of qualifications of doctors.

The new law like the preceding, it is argued, violates the autonomy of the indi-
vidual etc.
This is a strong contrast to the arguments of professions and the broader critics
from the eighties, concerning the cross-sectored collaboration where distribution
of information and the lack of active treatment in the hospital is often seen as
leading to failure and social dysfunction.

The Ethics Commission, an independent cross-professional organ under the ju-

ridiction of the parliament, the same year filed a document348 containing some
proposals for guidelines concerning the amendment of the law. At the same
time the document discussed in detail how the practical handling of people with
a mental illness is a subject of practical skill and concrete estimate. The law can
only give a broad frame for a practice, which must be an issue of constant reflec-
tion. However, it is mentioned that the law can have an important impact on the
general attitude towards mental illness in society as well as inside the treatment
system349.

The commission also considered the issue of giving material rights to the quality
of treatment and of how the patient could have a voice concerning his own
treatment. This was an issue, which was crucial to the Mad Movement, who like
The Ethical Commission considered the opportunity to write a psychiatric will
stipulating the kind of treatment preferred in case of admission in psychiatric
care.

348 Det Etiske Råd: Psykiatriske Patienters Vilkår - en redegørelse. Det Etiske Råd, 1997.
349 Op.Cit. p. 98.

190
A very important point made by the Ethical Commission was the fact that psy-
chiatry must be considered a practice where no blue-prints are given. Rather a
common cross-professional ethical-reflection must be integrated into the every-
day routines of the different systems. Indirectly it is said, that this is the only way
to secure the right treatment while respecting the autonomy of the patient350.
This reflection, it is indicated, is a question of resources as it is a question of
change of attitude in the process of treatment.

In this period another important subject was the issue of clinics where treatment
was undertaken without the use of medication. The parliament allowed that ex-
periments were established. The arguments about the detrimental effects of
medication and the natural reactions of the psyche being doped had reached a
point where the time for experiments with drug-free mental clinics was consid-
ered right. The decision was made it seemed not at least influenced by the pa-
tient-organisations.

The decision however was not made without protest. One of the traditionalists
Chief Psychiatrist, Tom Bolwig, referred to this decision as an illegitimate
interference from the parliament, an anachronism and a distortion which was
both unrealistic and untimely351.

A psychologist352 defended these experiments, which he saw as a genuine oppor-

tunity to get rid of the dominance of medical psychiatry and its inability to un-
derstand social and cultural phenomena. Psychiatry it was claimed is far from
understanding the psycho-social situation of clients, which can better be done
through psychotherapy.

The future of psychiatry joins integration and development. An example is the

motto of the newly (1996) established Foundation of Psychiatry: ‘Danish Psychia-
try 2000 – Development and Integration’ indicated that development and creation of
something new should emerge out of experience rather than be designed top-

350 Op.Cit. p. 96.

351 Tom G. Bolwig, Professor: in: Politiken February 23th. 1998.
352 Kurt Dauer Keller, in: Politiken Feruary 2nd , March 5th1998.

191
down through a narrow dogmatic means-ends calculation. In a collection of arti-
cles353 under ‘the motto’ title the foundation presented a selection of contribu-
tions stressing the multi-paradigmatic future of Danish Psychiatry.

Likewise it was mentioned how the new paradigmatic trend within Social-
Psychiatry is to have the planning of treatment as a negotiated process between
patient, relatives and cross-professional and cross-sectored teams. Another point
was that an extended involvement of society in general for instance through rela-
tion to the media, should be attempted in order to accomplish a change of atti-
tude among the general population354.

However one important question was still: How to transform this generalised
thinking into concrete action in this emerging collaborating field of multi-
paradigmatics.
The search for a new language in this open space should still not in absence of
points of reference be tempted to fall back on old known categories and modes
of operation.

One Doctor, Niels Reisby, who earlier in the eighties had commented on the
‘political’ role or just the reform role of psychiatrists (see above), referred to the
crisis of defining the role of future psychiatry referring to several monkeys sit-
ting on the back of psychiatrists355.

The point of departure was the postulated identity crisis of the psychiatrist faced
with the complex demands of clinical, humanistic, legal, economic, organisa-
tional, scientific and social origin. The diagnosis as the specific medical classifi-
cation rule is challenged even though new fine-tuned diagnostic tools are avail-
able (ICD-10) (developed by WHO) to further the diagnostic process and to
improve the comparison between results of treatment. However Reisby saw a
tendency of doctors retiring into an abstract anachronistic clinical shell, which

353 Psykiatrifonden Jes Gerlach ed.. Dansk Psykiatri 2000. Udvikling og Integration. Kbh. 1997.
354 Leif Gjørtz Christensen: Udviklingstendenser indenfor socialpsykiatrien. In: Agrippa. Vol. 17, no:3-4, 1996.
355 Niels Reisby: Om Psykiaternes Identitet. A speech held at the Symposium on The General Legislation on Psychiatry

(Psykiatriloven) in Ebeltoft May 9th, 1996. In: Agrippa vol.: 18. no. 1-2. 1997.

192
thus comes to function as a refuge when the other demands exceed the immedi-
ate competency of the single doctor.

These multiple demands, which are not reflected in the education of the doctor,
create a basic misfit between expectation and the actual performance. This fact
however it seems is often difficult for doctors to admit, who instead cover their
uncertainty with an arrogant attitude towards other professions and patients.
The development of pragmatic eclecticism faced with colluding ideologies was
seen as necessity for a renewal of a new cross-paradigmatic psychiatry. A task re-
flected by the complex reality of changing conditions, which would take courage,
perseverance, humbleness and strength.

Reisby it seems is one of the few commentators, who through the eighties and
nineties stress the developmental role of psychiatrists. He has since his inquiry
into the participatory efforts of doctors in the eighties shown an interest in the
ways in which doctors can renew themselves by being an active part in creating a
new practical and ecclectic discipline in correspondence with the trends of de-
institutionalisation and the sector.

This point of view was supported by another psychiatrist356, who mentioned the
myth of reductionism associated with psychiatry, which is merely sustained by
unscientific discourses on mental illness. He considered it very important that
psychiatrists participate in the public debate in order to kill these misunderstand-
ings. Psychiatry he mentioned is a discipline based on science and a differenti-
ated humanistic view.

This open and reflective attitude from one of the grand old men of Danish psy-
chiatry can be compared to a comment given by one of The Mad Movement’s
old activists, Karl Bach Jensen, who labels himself a surviving victim of psychia-
try. He commented357 on what he saw as built in conservatism in the psychiatric
profession. The argument was that the reform of psychiatry to include other

356 Psychiatrist Raben Rosenberg, in: SIND-Bladet. No: 1, vol. 25 1996. p. 8.

357 Karl Bach Jensen: På Vej Mod et Paradigmeskift. In: Amalie-Galebevægelsens Blad. Årg. 20. nr. 3 July, 1998.

193
more psychological and sociological theories and methods is a mere phantom.
Rather the focus on natural scientific methods and theories emphasise the basic
misunderstanding of mental illness as a systemic lack.

New technological and medical ‘progress’ was seen as having cemented this de-
lusion thus blocking a more integrative development. Further he repeated the
old argument about considering mental illness as a natural reaction and a misun-
derstood potential as he was referring to the social role of the shaman in differ-
ent indigenous tribes throughout the world.

The comment is a clear manifestation of The Mad Movements idealistic point of

departure. The Movement thus must be regarded as an alternative to the estab-
lished system in some cases probably giving people hope, who find themselves
lost in the established system. The focus on spirituality etc. might benefit people,
who find themselves without any value in society, because of their fundamental
dissidence and misfit. However, as The Mad Movement is more idealistic than
pragmatic, it pays the price of not being able to address the actual future of psy-
chiatry. It might very well be that psychiatry inherently is conservative caught in
a web of narrow interests. However, the real change of practice can only happen
if the task is viewed as a joint project even by those, who embrace the ideal of
non-psychiatry. This comment also stresses the importance that mad existence
cannot benefit from fantasies produced by narrow ideals. This narrow mission
might preserve normalising forces rather than promoting mad-becoming.

The issue of identity can be said to be an issue of linking the future with the
past, without repeating the past and without succumbing to fantasy. This goes
for the professional identities in question as for the former patients, who want
to become mad-citizens (that is: autonomy and social integration). The question
is how to find a new language in the concrete actions of a cross-professional col-
laborating psychiatry without having the structural and procedural demands of
systems (legal-, administrative-, clinical-, diagnostic-, economic- etc.) of abstrac-
tion dominating and carrying all efforts away.

194
This task was the specific focus of still more actors in the last part of the nine-
ties. Psychiatrists claimed:

”We shouldn´t psychiatrify social problems”358.

“We should consider the role of the psychiatrist, when he uninvited intervenes in a persons life
outside the hospital”359.

“Social psychiatry can only be a supplement to medical treatment in hospitals or in the Out-
patient Treatment centres, as social workers have not got the proper insight in treatment”360.

“We should develop a method and a theory of social psychiatry to understand and handle the
relationship between individuals. That is social psychiatry has to be engaged in the mentally ill
as a social individual towards “the others” and see the individual and be engaged in the indi-
vidual as an autonomous irreplaceable being”.
This method and theory should be founded on humanity” 361.

Brandt, one of the leading Danish Social-Psychiatrists, has later commented on

the normalisation trend in general and the role of the psychiatrist as social-
psychiatrist:
”You should not just treat these people as untreatable and hopeless because they cause prob-
lems. ….. Change can happen, however only at a slow pace, and most likely inanother direc-
tion, than traditions prescribe. A good life is not tantamount to a normal life within the estab-
lished society”.
”It is necessary with a certain will to understand the person, on his or her own conditions, com-
bined with the ability to see the limit of the possible”362.

Brandt actually took the radical step of his ideas to establish himself as an inde-
pendent social-psychiatrist based on the idea that people who are lost by the sys-
tem cannot be expected to seek help by themselves. Consequently, he estab-

358Preben Brandt (Social-Psychiatrist)from an interview November 1996.

359Preben Brandt from an interview November 1996.
360 Per Vendsborg (psychiatrist) quoted from a speech made in March 1997.
361 Brandt, Preben: Socialpsykiatri - psykiatri på et humanistisk grundlag. Dafolo Kbh. 1995.
362 Brandt, Preben: Unpublished manuscript on the future of psychiatry. 1997.

195
lished his project ‘Outside’363, an active support of people living in the street.
This is a step towards adjusting psychiatry to the ‘new’ types of clients carrying
the traces of a life in the social margin outside the protection of the institution.
This attempt to meet the client on his own condition, in his own environment is
the radical consequence of the bottom up focus in the nineties.

An example of how the initiative towards mentally ill persons is sliding into the
jurisdiction of the social-sector is the new social-legislation coming into effect in
1998. The complex includes three separate acts stipulating the rights and obliga-
tions attached to the access to social-services. One of the acts, the act on activa-
tion, extends the obligation of a given municipality to activate people who are
without a job.

This also concerns people who have been hospitalised for a mental illness.
Cases364 have shown that patients have been involved in activation efforts by the
local authorities with relapse and re-hospitalisation as a result. In this process,
doctors have not been consulted to give their opinion, as the case has exclusively
been under the jurisdiction of professionals in the social- and employment sec-
tion of the municipality.

Furthermore, another of the three acts, The Law on Social Services, abandons
the concept of the institution in the sense that the aim is that people should be
considered as having their own home no matter how the actual housing is organ-
ised. Officially, the reason for this is the intention of equalling people, who are in
need of special services vs. citizens in general.

As a consequence the Act on Social Services only contains 2 sections especially

dealing with people with a mental illness. This attempt of equality should create
new possibilities for people to define themselves as they want without institu-
tions declaring patients incapable of managing their own affairs365. Likewise it
should produce the possibility to abandon standard solutions in favour of tailor
363 Project ’Udenfor’ was established in 1997 funded by bulk funds form The Ministry of Social Affairs. The Danish
word ’Udenfor’ has a double meaning: 1) an outsider and 2) to be out-doors.
364 A case reported in 1999 by a psychiatrist from The Hospital of Bispebjerg.
365 Anne Brams, The Ministry of Social Affairs in: Socialpsykiatri, 4. September 1998.

196
made solutions, in this sense the act is considered a natural part of the de-
institutionalisation process366.

The de-institutionalisation process had been on its way for years and in the nine-
ties, it had reached the point that institutions were considered old-fashioned.
The aim in itself has been to cut down hospitalisation and re-hospitalisation.
However, this quality goal in it self does not produce any valuable information
about the availability of the proper services of treatment. It is as if de-
institutionalisation has become a goal in itself, with the only caveat that the pro-
fessions have to adjust. Actually, a low rate of re-hospitalisation can represent a
lack of ability to diagnose and fulfil the patients’ need for hospitalisation. This
can very will be suspected to be the case as lack of methods and theories entails
the lack of diagnostic devices, which influences what kind of persons can be
considered in need of care.

The fact that many hospitals have reduced their capacity because lack of re-
sources often cause situations of overload entailing refusal of patients or a pre-
mature discharge. The overemphasis on out-patient treatment has neglected the
development of quality inside the hospitals. Cases have shown that some coun-
ties still do not apply with the standards stipulated by The General Act on Psy-
chiatry367.

A parallel can be found in the way homeless-people are treated:

Under the jurisdiction of the local authorities of Copenhagen, a process was ini-
tiated to close down a big homeless institution (Sundholm) in accordance with
the intentions of the new social-service acts. In this process very little recogni-
tion was given to the way in which this institution had situated itself in Danish
society, developing highly specialised competencies for the very special type of
clients368 (cf. above) produced in the course of de-institutionalisation. In this
sense, it can be argued that the proper treatment of certain clients' needs re-

366 Stine Bøgebjerg Hansen, The Danish County Association. in: Socialpsykiatri, 4. Videncenter for Socialpsykiatri. Sep-

tember 1998.
367 See Sune Bové: Ansatte Kritiserer Lokal-Psykiatri: in Jyllandsposten January 28th, 2000.
368 This included special health facilities, which integrated treatment of substance abuse, somatic deseases and mental problems.

These integrated facilities were one of a kind developed by dedicated and highly skilled personnel. The closing down of these fa-
cilities was a catastrophe for these clients as they would have no alternatives.

197
quires the idea of the asylum (like professions need it to contain highly special-
ised knowledge), when these very vulnerable clients are concerned.

Consequently, it could be argued that the asylum as an environment outside the

pressure of normality should survive however in a more contemporary version.
This line of thought has been defended by e.g. Niels Christie, a Norwegian
criminologist in his book369 about villages for unusual people, a line of thought,
which was actually followed to a certain degree at Sundholm. The aim of tailor
making services to the needs of the single individual is a very sympathetic idea,
however the question is to what degree this can be accomplished, without insti-
tutions of some kind.

The de-institutionalisation process is about to cut away the mad person’s history
as patient from one day to the other. This is the case as the members of the
treatment community in the hospital, including the patient, have been inter-
locked creating and sustaining each other’s identity. The shared past should cre-
ate the possibility to make joint efforts finding the future, even if it is going to
be separate futures. Without this relational network, the mad-person finds him-
self, naked and exposed to the over-coding forces of normalisation (activation
and alienation).

In this way, the madman without a past is unable to create himself a position in
communication with the normal.

As mentioned throughout this and the preceding section, this is a process of a

mutual constituency of the body of Social-Psychiatry defined by active and reac-
tive forces.
Consequently the development of new theories and methods of Social-
Psychiatry in itself is interesting. An attempt in this regard comes from Sweden,
the neighbour country of Denmark having experienced a similar de-
institutionalisation process like the Danish.

369 Christie, Nils: Til Forsvar for Ghettoen. Om Landsbyer for Usædvanlige Mennesker. Munksgaard, Kbh. 1990.

198
Lars Christer Hydén concludes in his text-book on Social-Psychiatry aimed at
personnel within the new emerging Social-Psychiatry:
“How to explain the illnesses within the new reality established by the non-hospital related psy-
chiatry? How do we make sense by using our common conceptions of mental illness and the
causes of mental disturbance? This must be discussed from the experience to be had from So-
cial-Psychiatric work, the place where you meet the patients in their own life-situation and envi-
ronment. The slide of tasks from hospital to the social-sector means that the personnel, who
lack a fundamental socialisation into the traditions of medical science, must develop new defini-
tions and a new praxis replacing what was formerly barely considered as illness”370.

The following will feature some of the practical dilemmas and challenges, which
illustrates how the network of patients and professionals mentioned above are
interdependent.

The nineties feature a more refined and also complicated challenge of The Sec-
tored Psychiatry as the development is distributed to a more local level in the
sense that it is expected that integration is going to emerge out of concrete local
experiences.
In this regard, part of the material for the present project stems from an ac-
tion/intervention project, which has been accomplished with the collaboration
of The Danish Ministry of Health and The Danish Ministry of Social Affairs.
This project371 was conducted with the participation of professions and patients
of two hospitals and six municipalities with the aim of producing some concrete
proposals for new ways of collaboration.

This material illustrates in a concrete way, how efforts of intervention in this

frame of emerging or developing psychiatry, make conditions emerge and un-
fold. In this sense, the material will show how the introduction of different is-

370Lars Christer Hydén: Psykiatri – Samfund – Patient. Kbh. Munksgaard. 1997.

371 The reference to specific dialogues with professions and patients in this section and the following sections refer to
dialogues with professions and patients from two psychiatric hospitals: The Psychiatric Hospital of Dianalund and The
Psychiatric Hospital of Brønderslev. The material includes dialogues with professions from municipalities having col-
laboration with the two hospitals. These municipalities were: Haslev, Ringsted, Sæby, Frederikshavn, Skagen and Læsø.
The dialogues were focused on issues related to collaboration inside and outside the hospital, and the experience of pa-
tients being discharged and admitted to the hospital. The project was funded for a period of three years starting 1996.

199
sues concerning collaboration and integration of services makes the field emerge
in still new ways.

The Collaborating Psychiatry in The Nineties

As mentioned above one of the proposals in the new general legislation on psy-
chiatry, which was passed by the parliament in 1998 concerned the cross-
sectored collaboration. One of the proposals concerned discharge agreements
between hospital and the social authorities. In conjunction with these agree-
ments the authorities should be allowed to share important information even
without the patients prior consent, in cases where the patient refused to partici-
pate. This was a point, which the Mad Movement objected to seeing it as a viola-
tion of the patient's autonomy.

However, even before the legislation was passed, the General Legislation on
Administration stipulated that information in certain cases could be shared. The
main rule in the Danish General Legislation on Administration is that all distri-
bution of information of specific character concerning a client between authori-
ties presupposes the consent of the client involved, or when other legislations
justify distribution of information.

However one problem arises, when the client is a mentally ill person, who mo-
mentarily could be without ability to judge, what actions should be undertaken
for the clients own benefit. For this reason, the legislation has a special rule
named “the shift of value rule” (‘værdispringsreglen’), which stipulates distribu-
tion of information to another authority, when it can be justified according to an
overall estimation of the circumstances. In this regard, it must be either for the
benefit of the citizen patient or other relevant persons.
In May 1996, a conference was arranged by The County of Copenhagen, with
the participation of a vast array of representatives from different parts of the
psychiatric field. The aim was to throw light on some of the problems concern-
ing the collaboration between the systems especially in conjunction with the dis-
charge of the patient from the hospital. One of the big issues was the sharing of
information necessary for ‘continuity of treatment’.

200
In this connection, the striking fact was that the “shift of value rule” seemed
never to be used in praxis and few professionals knew that it existed. This is
contrasted by the fact, that the Ministry of Social-Affairs and the Health Minis-
try in a report from 1993 explicitly had specified how the rules of confidentiality
should be applied in the field of psychiatry. In opposition, the General Legisla-
tion on Administration could be used as a legitimate foundation for non-
collaboration. One argument was among other things: “How can I share this very
confidential information, when I do not know what it is going to be used for”? The problem
of course is that the rule takes an estimate of interests and considerations, which
however presupposes some kind of cross-professional fit or understanding. In §
3, section 3 in the proposal for the new General Act on Psychiatry, it is stipu-
lated that information can be shared, when it is necessary for the effectuation of
a discharge agreement, which is a step towards making it more concrete how the
rule should be applied. However as already mentioned and as stressed by the
Ethical Commission, a better quality of treatment cannot be legislated into ef-
fect.

In the commentaries accompanying the new legislation, it is said that the dis-
charge agreement should apply to the group of patients, which are in need of
special facilities after their discharge from the hospital:

“However from this specific group of patients, there might be cases, where the patient does not
want to participate in the process of an agreement, or the patient does not want to give his con-
sent to the distribution of information between authorities. Information, which is necessary for
the preparation and later implementation of the discharge agreement”.

It therefore seems necessary, that the proposal or the legislation creates a clear
base of jurisdiction, that authorities and health-service persons get the ability –
without consent – from the person, whom the information concerns to discuss
issues in relation to certain patients as part of establishing and implementing dis-
charge agreements”.

201
Exchange of information in relation to monitoring and establishing an agreement should not
damage the patient relations of the relevant professionals. Therefore, the proposal only includes
the distribution of information by authorities, health-service professionals etc. It is not the inten-
tion that these persons should be obliged to distribute information. These measures modify §31
of The General Legislation of Administration stipulating that an authority, who is justified to
distribute information, is obliged to do so, when a query for information by another authority is
based upon? this authority’s treatment of a case in progress.

A member of the patient-organisation SIND commented on a report filed by

another patient-organisation (‘Foreningen af Pårørende til Sindslidende’) con-
cerning the application of the rule of confidentiality. His conclusion was:

” That the rule involves all kinds of professionals of the established system in both the social-
sector and the health-sector. However the actual praxis, the interpretation, has been experienced
by relatives of patients as completely random and dependent on the personnel involved. Even
praxis differs between departments within the same hospital”.

The proposal mentioned above is a step toward narrowing the gap between the
systems through the elaboration of concrete agreements. The autonomy of the
different systems should be sustained by the stipulation of the possibility for the
distribution of information, rather than the obligation to do so.

This seems to be a clear precondition to sustain a good patient-relation not least

in relation to the very confidential relations sustained by the non-professionals
of the special local occupational units outside the hospitals. These non-
professionals often sustain confident relationships with the patients, a relation-
ship which should be preserved, but which should also be used actively for the
recovery of the patient. This could imply the distribution of information in spe-
cial cases.

In one of the case-hospitals involved in the present inquiry (The Psychiatric

Hospital of Dianalund) it was obvious that the different professionals were very

202
concerned what kind of information could be distributed to whom and in what
situations.

It can be concluded that each professional group holds on to the ethical guide-
lines given by their respective associations disregarding the fact that the rules of
the general legislation of administration do not apply to cross-professional col-
laboration within the same authority e.g. the same hospital. The consideration of
each profession is first of all the course of treatment/case in progress headed by
a certain profession.

An estimate of interests concerning the patient also involves the cli-

ent/professional relation, which must be judged against the total treatment situa-
tion involving other professions and systems. In this sense, the concrete esti-
mate becomes even more difficult and reintroduces the social-psychiatric di-
lemmas already mentioned:

The sectored psychiatry is a political and legislative fact, however not in

tune with the client/profession level.

The professions have not developed an operational basis, which can fill the in-
tentions of the law and the expectations of the patients and their organisations.

An example:
A home-visiting nurse described her dilemma in the following way:
“What can you do, when you are dealing with a family, which is exposed to both mental and
physical illness and your opinion is that the kids are the ones supporting the family. Should you
contact the local Out-patient Treatment team and the social authorities in the municipality, to
do something for the kids, to give them the opportunities of creating their own life outside the
family? Or would that be a violation of the trust-relations built through a period of time, and
would that at the same time be a violation of the rule of confidentiality, when you cannot judge
the actions of the parents as direct neglect of the kids?”

203
This is a case of a difficult estimate, which cannot be handled by the single pro-
fessional. Often the decision is made unilaterally as the dialogue with other
professions and with the patient is seldom initiated. The reflex action is to give
up a concrete estimate, rather than discussing cases in general with colleagues
and supervisors. Consequently, the rule of confidentiality does not get the
intended effect as pointed out above.

A complaint in a case concerning the rule of confidentiality was filed to Patient-

tribunal of Health-Services 1990. In this case the decision was in favour of the
patient, who had complained about unauthorised sharing of information372.

In the psychiatric hospital of Dianalund, the decision is referred to as emphasis-

ing that the rule of confidentiality gives a problem in the daily work not at least
in relation to patients’ relatives. Having a closer look at the case it can be told
that the Patient-tribunal stressed that the patient was not insane (psychotic) and
explicitly had refused to give her consent to doctors contacting her relatives.
Consequently, the plaintiff argued for a violation of the rule of confidentiality cf.
The General Legislation on Medical Care section 9, stipulating ‘a shift of value
rule’ like in The General Legislation on Administration. However the involved
doctors took the case to the national court (Landsretten) in 1993, which deliv-
ered its judgement in 1996 (see U.1996.1261). This judgement acquits the in-
volved doctors, who are considered having made a medical estimate, which does
not violate the rules of confidentiality, as it is said:

“In deciding whether the consideration for peoples’ needs can justify a violation of the rule of
confidentiality one has to make an estimate. Making this estimate it must be considered justi-
fied to consider, that suicide can be a violent experience for the relatives.

Considering this, the court does not find that the doctors have gone over their limit in their es-
timate by informing the father, with whom the patient was going to stay. Consequently the doc-

372 From the inquiry into the general legislation on psychiatry (psychiatrilovundersøgelsen) it can be learnt that there is a

broad dissatisfaction with the decisions of the patient-tribunals. The decisions are accused of being flawed by lack of
professional psychiatric insight. More confidence is showed towards the national courts, because they often prepare a
case by involving the medical officer of health. See Maegaard Poulsen, Per: Psykiatrilovsundersøgelsen med bidrag af Pe-
ter Kramp. Retspsykiatrisk Klinik, Kbh. august 1996

204
tors can be considered as having acted in consideration of others needs cf. The General Legisla-
tion on Medical Care section 9 (lægelovens § 9)”

It is interesting that the judgement of the national court has not made an im-
pression on the different professional systems. On the contrary you only see ref-
erences to the original decision made by The Patient-Tribunal. It shows that it is
difficult to make an estimate with only one profession involved (the doctors had
actually tried to work out the legal situation with the local police officer in
charge prior to the decision about giving information).

When the issue is Social-Psychiatry, the number of potential involved parties in-
creases and with that the number of variables, which as a consequence of the
multi-paradigmatic nature must be considered while making an estimate. Conse-
quently, considering the immaturity of the field, the growing load of work and as
documented lack of training of personnel, it is no mystery that the professionals
cover themselves behind the rule of confidentiality.

However, as mentioned above it is important to stress, that from the commen-

taries following the new General Act on Psychiatry it can be read that the rights
of the patient also include the actual concrete estimate on a qualified basis, with-
out the patients’ consent.

An Experience from County X373

An action-research project had as the specific focus: how new models of col-
laboration could be developed to improve the quality of the sectored psychiatry.
The following is an example from the initiation efforts concerning this project.

The research team saw the possibility of putting to work their expertise of doing
organisational development studies built on the idea of collaboration and in-
volvement. The research team had experience working with a psychiatric hospi-
tal to improve learning and cross-professionalism. The experience was that psy-

373 The following case story is based on the personal experience of the author.

205
chiatry as a profession was very conservative and not mature for major devel-
opment and challenge of tradition.
Still the general attitude of having psychiatry as a priority in both the Ministry of
Health and the Ministry of Social-Affairs, urged the team to design a develop-
ment/action research project using two counties as cases. The primary goal
should be a focus on bottom-up, process, dialogue and the design of new work-
modes. With this point of departure, the group filed an application for funding
in two ministries.

In one letter accompanying a grant from the Ministry of Health it was said:
”It is the clear impression that this project could qualify the efforts, which are
necessary for the future of psychiatry”.

Being given this legitimising stamp, the group started negotiating with Dr. X a
chief psychiatrist in his sixties in charge of a department in one of the hospitals
in one of the most criticised counties. The doctor saw the project as:
“ A way of mapping out bad routines and ways of communication. In this regard the project
could help to suggest better ways of doing things”.

As it could be imagined, the doctor and the county as such needed stories of
success. The Out-patient Treatment of the county had been under pressure
since three cases within a short time had documented loss of contact with pa-
tients, with fatal results of violent police intervention.

Moreover June 1996 produced what could be referred to as firm documentation,

that collaboration between the different systems of the county was in poor con-
dition. The county had asked a consultant firm to inquire into the psychiatric
service of the county coming up with suggestion for improvement.

Of the many suggestions374 given one was to try to work towards a more bal-
anced professional culture challenging the domination of the medical profession.
Other proposals included reallocation of resources between the county’s hospi-

374 See Lisberg Management. Hovedrapport – Undersøgelse af Sygehuspsykiatrien i Københavns Amt. June, 1996.

206
tals backed up by a new management structure featuring “unity management”.
From this background, the county administration started working on an action-
plan, to be passed by the county council by the end of the year 1996.

In May 1996, as mentioned, the county had been the host of a conference made
on the initiative of a group of hospital occupational therapists. The theme of the
conference 'The discharge and social integration of the patient' was anchored in
the discourse on cross-sectors and cross professionalism and was featuring many
experts as well as relevant professions, patients and relatives.

The conference included parallel sessions where different professionals had the
opportunity to discuss problems related to the conference theme. The prelimi-
nary result was a fairly detailed document, which was decided to be the point of
departure for a work-group, which had to reflect on the results and how they
could be used.

The research team from the university was invited as chairpersons in the group,
now having to work for a formal mandate in collaboration with the county ad-
ministration.

However the workgroup had only two meetings then it was denied a full man-
date of its own. It appeared as if the action-plan, which was to be decided by the
county council based on the report was attracting so much attention, that other
initiatives were given lower priority. This was the case even if the plan could
have benefited from the valuable information gathered during the conference
and its parallel sessions.

Now the research team had to work out the final plan with Dr. X and his de-
partment. That is working-partners should be contacted how many dialogue ses-
sions were necessary and so on. At the meeting the research team was aston-
ished by the reluctance of Dr. X, he was very doubtfull and was backed by a
spokesperson from the staff of the department.

207
Dr. X:” Now, we need a load-plan before we can decide further, this is a lot of resources I
guess that we have to put into this?!”.

The researcher: “Yes, but that we already had talked about this and that you really can
benefit from this, that was my impression from the answers in your letter”.

Dr. X: “But, we still need this load-plan before we can decide further”.

The research team was very astonished when presented with this message. What
had been seen as a formality meeting now had resulted in a critical situation con-
cerning the whole collaboration with the county.

The team then decided that a higher ranking administrative officer in the county
who had been a good back up before had to be contacted, to deliver a certain
pressure on Dr. X.

At the same time a letter was compiled by the research team in order to accom-
modate the needs for results and to shift focus on the long-term process inten-
tions. However when Dr. X learned about the group having a meeting with this
administrative office, he sent a letter announcing the suspension of the contact
with the research team.

The meeting in the county administration was held in a good atmosphere where
also Dr. X was present and the former plans were repeated and the team agreed
to produce a load plan.

Before the team could full-fill this agreement they received a letter from Dr. X:”
I have discussed the issue with my colleagues and I have decided that we have to back out. I
think the whole thing has taken a turn, we cannot participate in a project, which has these
broad intentions and doubting the paradigm of the medical profession. Another problem is that
we can not control the result and there is even a chance of deteriorating our relations with our
network of collaboration”.

208
The research-team could only see this as the final deathblow to the collaboration
with the county. The researcher remarked to his colleague: “ How can you ever
imagine that this field will change without a de-psychiatrification. These doctors just have too
much power, they set out to control everything, which they see as a threat of their profession. The
only solution must be politicians and administrators that have guts to bring this field more into
level”. “I think the only way to this is make a strong coalition with the administration and
politicians in both county and national level”.

So the team set out to find a friendlier environment for their project, they real-
ised that the field apparently was much too turbulent and fragile for their broad
intentions of dialogue and involvement. What instead was needed was a case
county, which did not have too much at stake.

The case can be seen to reflect how the research project is considered a threat
and as a questioning of the psychiatric paradigm. The reaction exposes in an ex-
treme way the ideals of the medical science, the need for evidence, hard data and
clearness of perspectives. At the same time, it is evidence of the hierarchical
character of the medical field, where the chief psychiatrist has to be considered
the key person. Dr. X has later in a book published in spring 2000 praised the
accomplishments of modern medical psychiatry emphasising psychiatry as a
medical discipline. Furthermore he is full of admiration of the new accomplish-
ments of the research into anti-psychotic drugs and describes this development
as a revolution.

A clear clash can be seen between “the humanistic ideals” of the research team,
which misjudges the power of the traditions and logic of the psychiatric field
and the potential of influencing and controlling the administrative system. It also
documents the distance between the administrative and political level and the ac-
tual operations of the treatment systems. The plan375, which was later passed by
the county board based on the management report did not include more con-
crete outlines as to how to improve the work processes in and between the dif-

375 Københavns Amt – Sygehusdirektoratet. Undersøgelse af Sygehuspsykiatrien i Københavns Amt. Forslag til hand-

lingsplan. Copenhagen, August 27, 1996.

209
ferent parts of the treatment systems. Rather the solutions were merely struc-
tural and general recommendations.

The Generative Component

The de-territorialisation of medical psychiatry in the nineties is reflected by a
more humanistic trend, as a structural and resource-oriented unity-thinking fea-
tured in the eighties is gradually replaced.

The state now produces rhetoric, which is more oriented towards the concrete
processes of the different part of the treatment systems. The de-
professionalisation trend also goes hand in hand with the move away from sys-
tems thinking. Bottom up and dialogue is the buzzword in the Ministries and
expert organs. However the structural thinking of the eighties survived in the ac-
tual operations of the systems, where new modes of operation are attempted
through structural reallocations (see e.g. County X). In this sense, it could be
said that especially in the start nineties the sectored psychiatry features two
statements or order-word machines: the one of unity and management and the
one of co-determination ethics and dialogue. Not until the late nineties you find
broader initiatives (e.g. The Knowledge Centre of Social-Psychiatry 1998 and &
The Psychiatric Foundation of 1996), which include a more thorough approach
to the development of a qualified multi-paradigmatic base of future psychiatry.

Likewise psychiatrists start to participate and reflect on their new role in a way,
which is more integrative. Anti-psychiatry is not produced merely as a counter-
picture to sustain a preservative attitude, but is interpreted in a more differenti-
ated way. More willingness is shown to debate the practical implication of the
sectored psychiatry as well as the issue of developing Social-Psychiatry theories
and methods as a precondition for a collaborating psychiatry is acknowledged.
However and this is a crucial point: by the bare fact that de-institutionalisation
and non-medicalisation become an accepted solution, psychiatry as a diagnostic
system is challenged in its foundation, namely the clinic and its hierarchy. How-
ever, ‘the diagnosis’ is practiced everyday outside the clinic, but without the par-
ticipation of doctors. It might be that doctors according to the law have to par-

210
ticipate in conjunction with the application of force. The actual transformation
of patient as citizen entails that the patient is defined as a ‘social client’ most ap-
parent with the new social laws of 1998. Treatment accordingly will often be a
product of a social diagnosis rather than a medical. This establishes a new basis
for conservatism within the medical system, retaining the autonomy of the clinic
as a last stronghold for a medical identity. Likewise, the social diagnosis will
sometimes be fragmented without the participation of medical expertise.

This development is also reflected in the development of the concept of psy-

chiatry. Originally it had marginal importance for practical psychiatry merely
designating demographic studies. Later however it came to include as a term, the
special facilities provided by the local authorities stipulated in the general law on
social welfare (‘Bistandsloven’). Latest it has been established as a term, reterri-
torialising the whole discipline of psychiatry by including social-indications and
the social-part of treatment. This development is still in progress integrating
many approaches in different mixtures. This for sure has created a lot of possi-
bilities for the development of the quality of treatment through experiments and
the inclusion of patients as active partners in this process.

In the beginning of the nineties, Social-Psychiatry is taken up by different signi-

fying regimes creating different versions according to the group or profession
applying it.
Still a lot of management logic from the end eighties spills over into the nineties.
In the early nineties Social-Psychiatry is seen as a buzzword spanning paradig-
matic fields, but having a more legitimate ring of inclusion and co-determination
of users. The pool money from the Ministry of Social-Affairs sustained this
trend, as a lot of experiments were initiated in the local community.

It can be argued that the de-centralisation of the seventies and eighties had cre-
ated a new type of clients, that is people with a psychiatric history now carrying
the imprints of a life in isolation often without proper treatment and care.

211
In this sense the rhetoric on the psychiatrification of social-problems, which is
often produced against social psychiatry by the end eighties, can be reframed.
An experimentally founded and explorative Social-Psychiatry logically can not be
satisfied with fixed categories, finalities and truisms.

Social-Psychiatry must work with a dynamic concept of treatment, which is sen-

sitive towards the change of the (social)-conditions of clients as well as the pos-
sibilities posed by the application of still new professional competencies.

The new trend of the nineties is to pay attention to the marginalised patients and
to attempt an experimental bottom up approach. This is especially reflected in
the report from 1993, which produced proposals according to the agenda of the
parliament of March 7th 1991.

The following quotes reflect this development from the seventies to the nineties
and are examples to show the development in argumentation of the central ad-
ministration:

1976: “The counties were to become self supplying with psychiatry and had to plan the psychi-
atric hospital service based district psychiatric principles”376.

1988:” There is no need for formal agreements of co-operation between the system,s the goals
have to be achieved through common goals and co-ordination. Administrative agreements
should be diffused in the systems by management and politicians. Barriers should be solved
through local dialogues on action plans for the treatment course of the patient”377.

1988: “It is the general impression of reports and plans on psychiatry, which have been elabo-
rated by the counties in the last couple of years, that it is the problem of co-ordination between
the hospital sector and the social sector and relationship with general practitioners, which have
to be clarified”378.

376 The Danish Ministry of Health, 1988.

377 The Danish Government of Social Affairs, 1988.
378 The Danish Ministry of Health, 1988.

212
1995: “…It is important to point at the continuity of the psychiatric treatment course and at
the opportunities given by the new knowledge (social psychiatric experiments)”379.

“The numbers in the received reports do not say anything about the quality of the service offered
and the satisfaction of the users - in this regard a series of other conditions have to be considered
including the effort of including the perspective of the users and their relatives”380.

1995: “In all counties fora of dialogue and co-operation on the efforts towards mentally ill per-
sons have to be established. These fora have to be put together on a broad base with representa-
tives from both sectors including users and their relatives”.
“Politicians and administrators must to a greater extent seek for the involvement of users in the
arrangement of the service and have to create opportunities for the personnel to develop the ser-
vice”381

In comparison to the eighties, the nineties feature a post-signifying regime of

participation, process and experiments. These trends de-territorialise the medical
part of the sectored psychiatry, by staging the social as the primary concern.

This approach aims at considering the total situation of the patient and his social
needs, and reflects an attitude where the problems of the patient are emphasised
as social because he is not in the hospital. However because of the bare fact that
the patient is not in contact with a hospital or out-patient treatment facilities,
does not mean to say that he could not benefit from the expertise of medical
psychiatry. The trend thus produces the picture of a new monopolisation of
mental illness under the logic of multi-professionalism and centralised funding.

The focus is on processes and the quality of the operations of the different sys-
tems. All focus and most resources are channelled into the sector, whereas psy-
chiatrists and the hospital are faced with a more marginal role. This tendency
survives all the way through the nineties.

379 The Danish Government of Health, 1995.

380 The Danish Minister of Health and The Danish Minister of Social Affairs in: The Danish Government of Health,
1995.
381 The Danish Ministry of Health and The Danish Ministry of Social Affairs, 1995.

213
Campaigns towards having mentally ill accepted in the near environment also re-
flect the normalising intentions of both the patient organisation SIND and the
Ministry of Social-Affairs. The rhetoric on quality and user involvement and
evaluation further accelerated the movement towards the creation of a legitimate
foundation for the sectored psychiatry.

The revision of the general legislation on psychiatry exposes in a fundamental

way what is the primary problem of psychiatry, namely the arrogance of a disci-
pline, which has not been able to participate in the game of the sectored psychia-
try. Consequently, a lot of myths have been created especially concerning the
application of force and experiments with treatment. This fact can be traced to
the lack of openness concerning the estimates applied by psychiatrists in differ-
ent situations associated with the application force. In this sense psychiatrists
have not been able to show how the application of force is part of the responsi-
bility of the psychiatrist and a precondition for providing proper care. The new
patient council, which was established with the effectuation of the old act from
1989, was a step towards a focus on patient-rights. The council produced the
possibility of having complaints evaluated by an independent institution. This in
itself was a possibility to have cases being exposed to the public eye, and accord-
ingly, the possibility for getting rid of myths concerning the application of ille-
gitimate force. The act of 1989 also contained rules concerning special measures
to be applied in situations, where the application of force was considered neces-
sary. These measures however were criticised of causing too much bureaucracy
and unnecessary work. Moreover, the new regulation seemed to be focused on
the easy claim of freedom rights rather than the more complicated: "That the ap-
plication of force is the price for freedom". The rules are considered to be too abstract
in comparison to the everyday tasks in the clinic. Psychiatrist can use the rules to
document the application of the right measures. At the same time the rules can
give the patient a false sense of security as rules could have the effect of alien-
ation, rather than the presence of professionalism.

This alienation has been documented in the collaboration between the different
treatment systems. The rule of confidentiality seems to have replaced concrete

214
(cross) professional commitment with logic of safety and of using the rule to le-
gitimate refraining from concrete actions.

The lack of openness concerning the ‘necessity’ or maybe rather the concrete
conditions for the application of force might account for the difficulties of find-
ing new modes of applying force or rather finding other modes of legitimate ac-
tion to replace physical force outside the hospital. The application of force has
been monopolised by the psychiatric profession for decades and formally it still
is. However, when faced with ‘the fact’ of the sector, the issue of the application
of force becomes dependent on more actors in the professional field.

The application of force is a difficult issue and is closely associated with the
'doubtfull character' of the psychiatric profession. This in itself makes the aban-
don of force an aim in itself when the establishment of the sector is considered
in opposition to the hospital. In the hospital, force has been established as part
of an integrated treatment. There is probably no doubt that historically patients
have been exposed to excessive application of force, but also this has changed in
modern clinical practice. In the hospital, the application of force has changed
with the discovery of new medical treatment. The application of physical force
has gone down in favour of a more active medical treatment. The application of
force in the clinic has become even more closely connected to clinical psychiat-
ric practice. This accounts for the difficulty of applying force in ‘the right way’
outside the clinic as the patient/citizen is created as a new object through the
gaze of different professions at the same time as imprints and conditions of so-
ciety have altered the everyday life in the local community.

The patient of the sector contains the imprints of a life of social-marginalization

as he in many cases has been forced to face the social reality sometimes prema-
turely in relation to his treatment. This force could be manifested in the lack of
application of force in the sense of active treatment. This is the abstract force of
the sector where the pressure to discharge patients as fast as possible and the
devaluation of the treatment of the clinic has created a state where the profes-
sional presence and commitment is replaced by an alienating force. This is the

215
real force, which faces professions and patient as well as the relatives of the pa-
tient. This fundamental problem cannot be touched by the comments by the
Mad-movement focusing solely on issues like the mouse-trap clause382.

The issue of force is thus taken up by a regime of subjectification issuing a nega-

tive line of flight, where the indication of negative blockage is the alienation to-
wards finding a cross-professional operational basis. Force is produced as a
negative reference rather than as the point of departure for the incremental
elaboration of new practices within 'the sectored-psychiatry' (absolute positive
deterritorialisation).

The work of the ethical commission can be seen as a step towards focusing on
the importance of concrete action and reflection on the actual conditions for the
development of the quality of treatment. Co-determination of the patient is
mentioned as a crucial issue and how the law could help moving the general atti-
tude. It was also considered how psychiatry should be considered a discipline
where standardised solutions are not given. The experiments with clinics without
medication can be seen as a step towards challenging psychiatrists to see beyond
their received professional values. At the same time it is a learning experiment
for other professions to dig into the possibilities of clinical practice. However
one should show precaution due to the fact that these experiments come to
produce new ‘fundamentalisms’.

At this point I have to quote Guattari’s comment on Basaglia and his work on
renewing the psychiatric institution: At a certain point the Italian experiment had
reached a point where the avantgarde from the early experiments in Gorizia had
disappeared, in some sense they felt betrayed by the state and its lack of support
in renewing the institution. What was left was a desperate negation of the
institution, which was, in Basaglia’s opinion, about to betray itself:

“But does not the agreement around the negation of the institution, which has meaning only if
it is taken up by a real avantgarde and securely anchored in a social reality, risk serving as a

382 You can admit yourself in the clinic voluntarily, but once admitted it might be decided to hold you back by force.

216
springboard for a new form of social repression, this time at the level of global society and aim-
ing at the very status of madness?”383

What seems to be the point is that abstract global forces will force themselves
on madness and its status in absence of a liaison with dedicated therapists, who
try to renew their tradition from within rather than jumping onto ideologies de-
tached from a social reality.

Accordingly, medication in itself should not be considered bad rather its applica-
tion should be considered. Basaglia commented upon the relation of the psy-
chiatrist with the medication that he administers: “ The doctors calm down their anxi-
ety in the face of the patient, with whom he does not know how to enter into contact nor find a
common language”. And Guattari adds: “ An ambiguous and perhaps demagogic expres-
sion: psychopharmachology is not, in itself, a reactionary science! It is the context of its use that
must be called into question”384.

The crisis of the psychiatrist faced with the sector and its opportunities produces
a lot of challenges, which cannot be faced easily. The sectorisation is in relation
to medical psychiatry manifested in a relative deterritorialisation in the seventies
and early eighties, where the culmination of the different approaches is the clinic
and its integration into the local hospital. By the beginning of the eighties until
the end eighties you discover regimes of subjectification, where the sector is tak-
ing shape and is presented as an undisputed model from the end eighties. How-
ever the line of flight is still negative and blocked the lines of subjectification
start out from the negation of the institution replacing the signifying chain of the
institutional psychiatry. The new priest is created replacing the monopoly of
treatment in the institution. This new priest is the model of out-patient treat-
ment.

383 The quote stems from Guattari’s review of Franco Basaglia’s L’Institution en Negation. Editions du Seuil, 1970. in: Guattari,

Felix: Psychoanalyse et Transversalité. Maspero. Paris, 1972. pp. 261-64. printed in Genosko, Gary: The Guattari Reader. Black-
well. Oxford, 1996. p. 44.
384 Ibid.

217
However the sector poses other problems than just practising psychiatry in the
community, it takes the positive task of creating a new eclectic pragmatic psy-
chiatry. This positive task is not to be formulated until the end nineties, in this
way the new milllenium features an absolute positive deterritorialisation of psy-
chiatry. It accomplishes at the same time a possible shift of plane in the sense of
creating a new ‘psychiatry’ or just of having accomplished a globalisation of
madness, a machinism, which can be both liberatory and threatening. The end
nineties, in opposition to the beginning of the nineties, features not only the ne-
gation of the institution, but the abandon of the whole concept of the institution
most clearly illustrated by the effectuation of the new social legislation in 1998.

An example of an avantgardist in Danish psychiatry is the late Niels Reisby, who

all the way from the end seventies through the nineties argued for a pragmatic
eclecticist psychiatry open to still new challenges from the world outside the
clinic.

This eclecticism can be seen in a higher degree in the last part of the nineties.
Psychiatrists seem more open to discuss the possibilities of mixed paradigmatic
approaches also outside their own journals and publications. These authors also
seem willing to discuss some of the delicate issues e.g. the problem of arrogance
associated with professional insecurity.

Also the practically oriented psychiatrists like for instance Brandt argue for new
theories and methods based on ‘the fact of the sector’. The search for a new
paradigm has not explicitly got the medical psychiatry as a reference rather it
seems from around 1995 to be legitimate that doctors talk about the social ef-
forts under the jurisdiction of the local authorities as treatment. This is also
manifested by the report of the government of health, which traditionally has
been dominated by the medical profession. In this report about the development
of the quality of the psychiatric service, the social services are mentioned as part
of treatment.

218
The radical experiment of establishing 'an outsider-psychiatry' without any for-
mal institutional liaison can be seen as an attempt to approach a new social-
psychiatric paradigm relying exclusively on a relation with the mad-citizen living
in the streets.

This is a strong contrast to the fundamentalism of the mad-movement, which

can be documented now and again. Also the documentation from county X in-
dicates how vulnerable institutional psychiatry is when development issues are
introduced. The idealistic trend of using an open process approach to develop-
ing a new mode of interaction between professions shows to be unproductive
and blocked forming a negative line of flight.

Likewise the data concerning the rule of confidentiality suggest that abstraction
and systemic tradition and self-containment to a large extent account for the
fundamental lack of experimental spirit. This is another indication of the domi-
nation of regime of subjectification during most of the nineties. The tendency of
a too sudden destratification of the strata binding institutional psychiatry ac-
complishes a rigidification, which most clearly is manifested by the continued
structural thinking penetrating the sector in an attempt to remedy the experi-
enced failures. In this sense, the sectored psychiatry embeds a destructive force,
which in a way can be said to be self-generated.

The Transformational Component

The status of the nineties it can be said is the establishment of the sector as an
unchallenged model, where the madman is cut out of from his patient past and
inserted with surgical precision into a predefined imaginary designed by first of
all bureaucrats and legislators. In this process there seems to have been marginal
‘real’ participation of professions and patients with their experiences. This is the
result of the rigidification of institutional psychiatry described above. It is justi-
fied to say that psychiatry is split in two, starting around 1995 and eventually
codified in 1998 with the new social legislation. The new priests of the sector are
empowered over the old priest of medical psychiatry. However the new priest of

219
the sector does not speak with one tongue. The sectored psychiatry gradually is
both under the jurisdiction of the counties and the municipalities.

This means that planning and budget is split in two. This sudden shift or deterri-
torialisation from a centralised to a decentralised structure accounts for the lack
of coherence and thus continuity of treatment of the patient. Hospital psychiatry
seems even more detached from the development manifested in the channelling
of resources into the sectored psychiatry. In this way, the end nineties features
the final abandon of asylums, with the arguments of the creation of more hu-
mane services. This tendency becomes one of self-reference, detached from the
negation of the institution.

In this new predefined space, the madman can be exposed to new technologies
of normalisation, which has been demonstrated above. Rather than being able to
act as a patient becoming citizen, the madman is dispossessed of his history as a
patient. In this way he has his right to treatment and care taken away as he is ex-
posed to the merciless demands of normality.

As demonstrated there is a danger that de-centralisation legitimated by buzz-

words like ‘humanity’ and ‘co-determination’ can be efficient ways to take away
the rights to proper and active treatment and care. However one should not for-
get that one of the original reasons for diminishing the importance of hospitals
was the possibility for a reduction of public spending385. A qualified selection of
sectored services including housing and occupation facilities is most likely to be
more expensive than the institutions. This is at least the experience from abroad.

The sectored psychiatry is a long process, which cannot be sustained by a pure

adjustment of professional efforts, which is argued by administrators and politi-
cians.
If it is the intention to include patients and professions in the development of a
new psychiatry, a focused training and dialogue must be undertaken across the
splits between professions and patients. As already mentioned, psychiatry should

385 See e.g. Kr. List. Den Psykiatriske Service og Planlægning til Debat. In: Danmarks Amtsråd. Vol. 8. no.21. 1977.

220
be based on involvement, reflection and tailor-made services, rather than top-
down governance rules and standard solutions.

The core issue is not to ontologise madness, on the contrary we must abolish
our romantic projections issued from normalisation. Otherwise we will exclude
the mad or the very special, because we conceive of it as a genuine idealised
voice without the traces and imprints of the past. These people’s real situation
can neither be understood by considering them as psychological facts, that is
products of a certain individual lived past, nor by referring to a generalised idea
of a societal development creating traceable causations. Both perspectives work
by subsuming either under law or means-ends logic, thus programming and cut-
ting of future possibilities.

Rather these special people should be seen as inserted in a flow of signs, which
give them the imprints and potential, which can protrude into the future. These
signs are the tendencies and relational possibilities given to them by their actual
immediate existence in a relational network: as social-clients, patients, analy-
sands, parents, daughters, consumers, voters, pedestrians, plaintiffs etc. This
flow of signs is only relational, and consequently a very productive material, as it
cannot be submitted to law and causations. As such it is very volatile, and thus
not suitable for grand theories and the production of blue-prints, rather the
signs must be considered as strict pragmatic tools.

The sectored psychiatry can be said to be part of the reactive and active forces
defining the social-psychiatric body. When the patient-organisation SIND386 ar-
gues that the focus on target group is a dangerous regression of systems thinking
it is a reference to one of these reactive forces. The active forces are related to
the production of clients with mental problems, which can be linked to different
interactions with society e.g.: (incest, family-trouble, stress, burn-out, work-
climate, general life-crises etc.). This is the material to enter the continuous fold-
ing through new social-psychiatric theories and practices. This folding should
abandon the exclusionary ideas of target-groups. Decentralisation of the public

386 Peter Storm: Bøtten Skal Vendes. In SIND. No: 1 February, 1990.

221
administration, contact with the citizen, rationalisation and efficiency are terms,
which go hand in hand establishing a kind of code.

This was more or less the starting-signal for a new way of debating the organisa-
tion of psychiatry, which now could not anymore be exclusively related to the
medical profession. From now on psychiatry could not so to say be contained
within the protecting shield of the hospital walls, but has become a question of
the social individual or the meeting between ‘normality’ and ‘madness’. Psychia-
try becomes a concept, which is floating carried by administrative-, political-,
economic- and socio-cultural streams.

You can characterise this space by a mixture of de-institutionalisation/anti-

psychiatry and managerialism. The development through the eighties has created
a space for the challenge of institutional psychiatry where experiments with out-
patient treatment centres have paved the road away from the medical profession
and the hospital as the revolving-point towards out-patient treatment and spe-
cially designed social-psychiatric experiments.

This discourse is dominated by expressions like: “To seek for a holistic view on mental
illness treatment and care”, “An integrated effort toward the mentally ill”, “To seek dialogue
and a co-ordinated effort” etc. Contained in these expressions is a belief in the self-
government of the different systems in accordance with the intentions of the
political and administrative systems.

The last seven or eight years (2001) have created a growing expectation of pa-
tients becoming citizens as the traditional professional-client relationship has
been changed for more emphasis on the former patients’ self-governance. So-
cial-Psychiatry had as the primary the life-world and as such ‘the original’ envi-
ronment of the patient as its focus. All efforts towards the mentally ill should
take place as a negotiation and involvement of the patient, in collaboration with
the totality of the professional environment. This transformation could be seen
as an ideal transformation, established through joint efforts of development of

222
skills and knowledge in a gradual process of coming to mutual understanding
and respect of traditions.

In 1995, the government stated the necessary knowledge had been developed, but was in a state
of fragmentation caused by efforts, which could be labelled as traditional social-work and more
traditionally medically based outpatient treatment. Moreover the government emphasised the
lack of patient involvement.

Taking just a very superficial glance at this development you can find many par-
allels to the experience from the Italian reforms. The Danish reform law pre-
dates the Italian by two years and seems to have had less radical intentions and
expectations attached to it. One clear parallel however is the aim towards inte-
grating psychiatry into general hospitals and to emphasise the development of
out-patient treatment and cutting down permanent treatment in hospitals. Today
this development has accomplished that the psychiatric field presents itself as a
heterogeneous unity with discourses penetrating and transgressing fields, which
historically have been confined to territories or segments determined by differ-
ent paradigms.

The reform has often been criticised for the lack of continuity of treatment and
lately for not giving priority to the hospital facilities, which are left behind as all
resources are pooled into Out-patient Treatment. This criticism has staged ‘The
Collaborating Psychiatry’, which however seems to have been a phantom dating
long time back to the initial planning effort so of the counties in 1977, being an
imaginary attached to the reform of the sector. This can be seen as ‘collabora-
tion and co-ordination’ have been regarded as the panacea for ‘the integration’
of professional paradigms: in this way a multi-paradigmatic issue with all its his-
torical traces including anti-psychiatry has been transformed into a managerial
and organisational development issue in the narrow sense. In this regard you can
refer to a trend of sectorisation on a large scale, which blinds out the possibility
for the development of a new treatment culture from within professions them-
selves.

223
To simplify, collaboration has been an unquestioned issue reduced to an organi-
sation development issue in the narrow sense, prior to the concern of what to
collaborate about (the active forces of an emerging Social-Psychiatry).

This fact produces the risk that professions become bare functionaries of consent, rather than
active co-players with the ability of (self)-transformation. Failing to link psychopathological
problems to their relations with the conditions of everyday life (work, home, in the community,
in the education system) psychiatry will be locked in a cage and finally produce itself as an ana-
chronism. This issue has been commented by at least one Chief-psychiatrist Niels Reisby in
leading psychiatric journals in both the eighties and nineties. However the same doctor showed
that especially during the late seventies and eighties psychiatrists have been very reluctant to de-
bate the actual conditions of the sectored psychiatry. In this way, it is obvious that sectorisation
and the adjoining managerialism do not produce and distribute innocent tools within a limited
and visible space, rather they function as a programmer of the future in the making blocking a
lot of creative energy.

The Diagrammatic Component

The fact is that the agenda setters, that is politicians and administrators, are a
step ‘ahead’ defining subjects as they design how different development settings
should be ordered in terms of means, ends and methods. Thus the voice that
madness can extract will always be a voice, which reactively is dependent on de-
cisions made and agendas set. No continuation comes into existence between
past, present and future. The madman is so to say taken from the past and
transposed into a ready-made future where he is destined to take over his 'ready-
made' existential identity as ’a citizen’. You can discover traces in diverse fields
where normalisation and humanism has been accomplished by an emphasis on
restraint from intervention enforced by the globalised forces of normalisation.

The de-institutionalisation sweeps running through Denmark and other western

countries is only one such indicator. Doctors give up hospitalising very ill psy-
chiatric patients and are not involved when the patient’s application for a social-
pension is treated: homeless people in homeless-institutions are treated accord-

224
ing to normalising standards, implying an over-focus on the permanent ‘private’
residence as the ultimate goal for these people.

I will now attempt to demonstrate the above argumentation through some criti-
cal cases of recent developments within Social-Psychiatry, showing how what I
will later refer to as an abstract machine of humanism (normalisation) is distrib-
uting symbols endowing individuals with stereotyped identities. These identities
are facilitated by different change and development technologies. You see a
transformation of the patient into citizen under the legitimating label of emanci-
pation and liberation from incarceration in hospitals. This liberation however is
unilaterally defined by the concepts of higher societal needs, not recognising the
whole continuity of becoming patient. Humanism becomes the label that can
justify that all kind of rights associated with being patient are taken away: which
among other things include treatment, pension without the pressure of a normal
job etc.

The normalising technologies thus can be seen not to respect a whole tradition
of psychiatry and the identity construction associated with the being of a patient.
Rather the symptomatology associated with the medical profession is handed
over to community workers as the patient discharged from the hospital now as a
citizen living in ‘the normalising humanistic’ setting of the local community. This
implies that the whole framework for establishing an identity as a patient with all
its securing functions is taken away more or less overnight leaving behind a gap
to be filled by different missions, which in an arbitrary way are sheltered by the
legitimating labels of ’humanism’.

Hence embracing ‘The Other’ (liberating the madman) can be seen as an elabo-
rate managerialistic project however under a legitimating humanistic label. It cre-
ates the madman as an object in the picture of the fixed historical context la-
belled ‘liberalism’ or just ’humanism’. This objectification is accomplished out-
doing a whole tradition associated with becoming a patient, including legal and
political rights and the association of institutions and the medical tradition.
Rather than being defined and exposed to the visible technologies of psychiatry,

225
the former patient is left with self-surveillance, within a more subtle frame of the
normalising discourse of the open space of The Sector. Normalising technolo-
gies become just as much oppression for the one who cannot answer back,
which you cannot, if the crevasses, the counter-signifying potential from where
you can launch yourself, are closed by subjectifying forces.

Normalisation becomes a very efficient technology when it actually absorbs and

assimilates the abnormal. What is abnormal will always be relative to the context
in question, however the becoming of what can at any time be judged as abnor-
mal should be able to find its escape route within normalisation, rather than be-
ing silenced by the rhetoric of ‘liberalism’ and ‘humanism’. Thus what promotes
itself under the label of liberalism and humanism becomes the support of prac-
tices, which threaten multiplicity, if it is successful in blocking counter-signifying
(the vertical war-machinic movements creating disruption of subjectifying re-
gimes).

The practices of psychiatry created a discursive landscape where becoming a pa-

tient, was as much relying on counter discourses of anti-psychiatry, the discourse
of normalisation repels all counter-signification, in its continuous creation of
points of subjectification.

The de-institutionalisation process in Denmark seems, like in other countries, to

create a state of de-territorialisation in the sense that old categories, which were
formerly undisputed reference-points, are dissolved. It becomes a positive line
of flight or an absolute de-territorialisation – from where the game can go any-
where. Society does not code it takes flight387.

The de-territorialising sweep of thinking collaboratory Social-Psychiatry as a

unity, creates an empty concept blocking the potential for concrete action.
However the imaginary installs an expectation or a longing for the concrete, a
longing for embracing and empowering a concrete ‘Otherness’. The logic associ-
387 Deleuze, Gilles: Desire and Pleasure. In: Foucault and His Interlocutors. Arnold I. Davidson, ed. Unive. Chic. Press.

Chic. & London, 1997. In conclusion.

226
ated with de-psychiatrification entails that the concrete is constantly swept away
abstracted by the rhetoric of the sector and managerialism and its desire for
categorisation and abstract rules (e.g. the rule of confidentiality). The collective
and the concrete are annihilated in a black hole. The installation of the imaginary
is accomplished by an abstract order-word machine (unity and humanism),
which works together in a network with an orderword-machine of managerial-
ism. These machines create a double articulation, which over-code and block out
the counter-signifying forces of particular singularities. These singularities, which
are dependent on retaining sign-potential, become absorbed by the technologies
of unity. The potential contained in the creation of different assemblages are
blocked or annihilated in a black hole dependent on the negative sign (relative
deterritorialisation).

The abstract machine of unity is programmed through rules (and normalisation),

stereotypes and uniformity, it is a state-machine defined by rigid segmentarity,
even if it is surrounded by a gloss of ‘humanism’. When Ronald D. Laing in a
famous quote once stated, “Who helps us against our helpers, who protect us against our
protectors”, he touched upon the situation where resistance is impossible due to
the loss of sign potential. Resistance can only emerge by slowing down de-
stratification, by creating assemblages (concrete and machinic) connecting with
‘the real’ sign potential within stratifying and de-stratifying movements. This
rather than sustaining anti-psychiatric tendencies of remaining within an imagi-
nary established in relation to and dependent on a stereotyped psychiatric-
repressive signifier.

227
Section 9 - The Stratification of ’Madness’388

”[W]hen I act my scream has ceased to turn upon itself, but that it awakens its double from
sources in the walls of the tunnel.
And this double is more than an echo, it is the memory, of a language whose secret the theatre
has lost”.

(Antonin Artaud, For The Theatre and Its Double).

Now let us reintroduce the theme of mad resistance as a pragmatic, rather than
as an idealistic project. Let us abandon the idea of madness as a pure suppressed
voice as it is produced in some romantic versions. And let us rather consider the
possibility of mad-becoming, within the immediate everyday relations of human
interaction, in the sense of a mad reterritorialisation. It is a programmatic crea-
tion, a conjugation of the cutting edges of deterritorialisation, an instantaneous
apprehension of a multiplicity. At this point the sector and its lines of flight are
blocked and synthesised. It is a capture, an articulation, a complex refrain, which
opens towards new articulations and assemblages of becoming mad, becoming
psychiatrist etc. This becoming mad of madness or stratification of madness is
transference becoming vehicular. It is the role of patient or client being trans-
formed into a new mode or resingularisation, a performative subjectivity. It is
the face of the signifier being challenged, by a schizoid-war-machinic program.
Like D&G mention389:
“Dismantling the face is no mean affair. Madness is a definite danger: is it by chance that
schizos lose their sense of the face, their own and others’, their sense of the landscape, and the
sense of language and its dominant significations all at the time? The organisation of the face is

388 This section is partially based on material gathered in the period 1996-2000: conversations made with professionals,

patients and their relatives. The program or composition will only as an exception include concrete references as the
program first of all features singularities and events. Consequently the material has been informed by the tracings and
mappings produced in the two preceding sections. The material includes interviews and dialogues with professions pa-
tients and their relatives from two psychiatric hospitals: The Psychiatric Hospital of Dianalund and The Psychiatric Hos-
pital of Brønderslev. The material includes dialogues with professions from municipalities having collaboration with the
two hospitals. These municipalities were: Haslev, Ringsted, Sæby, Frederikshavn, Skagen and Læsø. The dialogues and
interviews were centered around issues related to collaboration inside and outside the hospital, and the experience of pa-
tients being discharged and admitted to the hospital.
389 Deleuze, G & Felix Guattari: A Thousand Plateaus. Athlone. London, 1988, p. 188.

228
a strong one. We could say that the face holds within its rectangle or circle a whole set of traits,
which it subsumes and places at the service of signifiance and subjectification”.

The enterprise of articulating madness is thus one of dismantling and assembling

faciality traits - traits of landscapes and language. Dismantling the face and retai-
ning faciality traits has been the main activity of the preceding sections. At this
point we find the sectored psychiatry decomposed into tracing experiments of
signifying regimes. We have seen how transformation potential is generated
through lines of subjectification and the interaction of tracing experiments, and
how abstract order-word machines of normalisation are always there present in
all concrete assemblages. We have to loose the referential function of the signi-
fier and the face, to be able to open up to meta-morphosis or a self-
transformation, which should be accomplished by twisting and turning the lines
of subjectivation, producing a real becoming minor within the major.

Consequently, we have realised the sector is not merely a structure outlined by a

political administrative legal discourse, framed by professional identities. It is a
social-field or a body with co-extensive machines, which is both threatening and
potentially liberatory. We can now include the last analytic component – the
nomadic component, which launches itself in conjunction with the other three
analytical components. We now take the final self-transformational step of laby-
rinthian man, he who forever seeks his Ariadne. In this sense, it should be kept
in mind, that the text is inconclusive in the sense that it forms a program, which
is folding while making analytic, artistic and revolutionary cogs work together:
The real intervening potential lies in the effects of the prolongation of the text.

Thus within this frame we must view mad-becoming as fundamentally machinic

and experimental, thus linked equally to the becomings of psychiatrist, politi-
cians, citizens analysts etc. It is a machinic program containing all the tendencies
or sign-potential from where war-machines can insert themselves as a blockage
of the infinite speeds of normalising forces.

We could see this program as a war-machine in itself, but it would be more

229
correct to see it just as a machinic program creating new possibilities for resingu-
lariation and war-machinic assemblages. In this way, the text is folding as a
concrete assemblage inserting itself potentially blocking or fundamentally inter-
fering with the flight of society390.

The desert is in-between pure particles and forms and substances, it is in this
machinic-phylum, transformational complex and thresholds of machinic nodes
that the following is created.

’Society of control’
The general trend of abandoning institutions in favour of more indirect govern-
ance measures is an example of what Deleuze with reference to Foucault refers
to as the shift from a society of discipline to a society of control391. Deleuze re-
fers, besides Foucault, to Virilio and Burroughs, and the latter's term: ‘The New
Monster of Control’.

Discipline was related to the explicit framing by institutions and the disciplining
function on individuals. Control refers to abstract invisible forces, Deleuze re-
fers in this regard to the impact on psychiatry: "With the breakdown of the hospital as
a site of confinement, for instance, community psychiatry, day hospitals, and home care initially
presented new freedoms, while at the same time contributing to mechanisms of control as rigor-
ous as the harshest confinement. It's not a question of worrying or of hoping for the best, but of
finding new weapons".

This observation is very precise and is supported by the evidence presented

above concerning the Danish development. Further it sums up how mad-
becoming must entail a proactive search for 'new weapons' inside the new con-
ditions. One such search has been carried out in Italy since the reform was initi-
ated in 1978 and it still going on. Looking at the outcome of the Italian experi-
ments today you find in Trieste a psychiatry, which has abandoned the large in-
stitutions, but still have some protected facilities, with intensive professional
390 ”Society does not code it takes flight” in: Deleuze, Gilles: Desire and Pleasure. In: Foucault and His Interlocutors. Arnold I.

Davidson, ed. Unive. Chic. Press. Chic. & London, 1997.

391 Deleuze Gilles: Negotiations. Columbia Univ. Press. 1990.p. 178.

230
support. Medication is used, sometimes in high doses and violence towards
‘guests’ (former patients) has not been abandoned totally. What however is im-
pressive, is how professionals, families, local community, local government have
adjusted to new ways of interacting around the former patient. One very impres-
sive achievement seems to be the establishment of co-operatives running differ-
ent businesses and thus actually contributing in a considerable amount to the
general economy of the region392. The gradual involvement of the former patient
in activities like this is a contrast to the abstract, pacifying or even a-historical
functioning of reforms and regulations within the Danish field.

Trieste is by year 2000 the Mecca of Democratic Psychiatry where people from
all over the world come to study the outcome of thirty years of experiments.
Like in the mid-eighties there is still disagreement how to interpret the results.
Some of the opinions seem to be rooted in a basic misunderstanding of the con-
text and aims of Psichiatria Democratica. Some records conclude that it is peo-
ple who are romantic about everything Italian, who consider the reforms in Italy
a success. Moreover it is emphasised that Italian institutional psychiatry was in
such a bad condition, that any radical attempt of reforming it would be guaran-
teed a success393.

By mapping out the different statements connected to the Italian experience,

you get a mixed picture of the problems connected to the becoming politics of
psychiatry and the problems connected with resisting this development. Again, a
development experience seems at the end of the day to be inconclusive and sub-
ject to shifting agendas, rationalisations and negotiated orderings. This however
is the very condition of organising and the challenge is to create still new assem-
blages from the potential generated – to lance still new arrows.

In the following, I will conclude by giving voice to new assemblages within the
Danish sectored psychiatry, this will be done segment by segment: the segment
of the institution, the profession, the clientship, the law and the political envi-
392 Some of these co-operatives have reached a production worth 5 million £ per year. See Tim Kendall: Trieste. The Current

Situation. A Plenary address to The Third International Conference on ’Psychosis – Integrating The Inner and Outer Worlds.
University of Essex, Colchester, England. September. 1996. http://www.human-nature.com/hraj/trieste.html.
393Jones & Poletti in: The British Journal of Psychiatry, 1985. p. 346.

231
ronment. Control society cannot be framed by mapping out governance rela-
tions and causalities, but rather as segmented relations. Control society must ac-
cordingly be approached through the flow of tendencies that it forms.

Actually as psychiatry has been loosing its institutions, which becomes most ap-
parent when the concept of the institution directly is banned in 1998 in the new
social-legislation394, it also looses its definition as a medical profession. From
that point on, the institution is not the revolving-point, rather the services and
thus the resources are from now on supposed to be centred around the client’s
home. As mentioned above a positive version of de-psychiatrification should
embed the idea of de-institutionalisation as institutions to a certain degree have
contained the medical profession in a state of self-sufficiency.

The tendency of objectifying patients dealing with them as facts and program-
ming their illness by referring to it as a chronic disturbance is what should be
challenged. With the new concepts of Social-Psychiatry and the new legislation
psychiatry is established merely as a matter of governance (The Apollonian),
rather than as a matter of self-transformation (The Seeking for Ariadne, see also
section. 6 on Nietzsche) developing new functions outside and inside the hospi-
tal. Actually social-psychiatry has been a practice for some time as de-
institutionalisation and the focus on sectorisation in itself has transformed pa-
tients into social-cases. However a stable functional structure has not been cre-
ated to establish a coherent social-psychiatric theory and practice. To repeat col-
laboration and integration has been staged as a governance issue even before
what to collaborate about has been established.

This imaginary of a paradigmatic unity has primarily been sustained by bureau-

cratic and legal reforms through the eighties and nineties. This space is often
presented as allowing different subjects to question themselves and their profes-
sion, doctors should legitimately talk about the social-indications of mental ill-

394 Three new acts on Social-Services were put into effect on the first of July 1998. One The Act on Services (Service-

loven) stipulates that the institution as concept should be abandoned rather the focus should be to provide the service of
citizens in the local community.

232
nesses as social-workers should discuss diagnoses and how their work can com-
plement the medical professions.

New Assemblages of Mad-Reterritorialisation

The following will be addressing these issues through the creation of new as-
semblages of mad reterritorialisation. These assemblages are composed segment
by segment as monologues and connected as virtual dialogues. The way the no-
madic component launches itself entails, that the virtuality of these dialogues is
created combining the tendencies out-lined in section 7 and 8 and real time dia-
logues. These dialogues thus present them selves as virtual-real and nomadic,
rather than actual-real, which was the case with the citations in the sections 7
and 8 referring to real persons. In this sense the following dialogical monologues
are fictitious refrains of mad-becomings emerging from inside a dominant reality
of the actual-real (see also section 1).

Dr. X. is a psychiatrist in his sixties, who is the same person who was involved
with the development project in county X mentioned in section 8:

Dr. X: “I think it was not until 1989, that much attention was paid to the real problems fac-
ing the whole idea about sectorisation. 'The theme planning process, had psychiatry as its spe-
cific focus. They actually invited people from all parts of the system to participate in this two
days conference to discuss the principles as well as the specific problems of outpatient treatment.
I think in fact this was the first concrete attempt to create involvement through what they
termed co-ordination of efforts”.

"Also I think it was a first attempt not to focus on structures and resources. I mean it was a
real attempt openly to discuss the opportunities for the sectored psychiatry. Still as far as I see it
in spite of these attempts it is most problematic that there has been lack of participation and
discussion, between the professions and the ones making the final decisions. In the eighties we as
doctors, representatives of the hospital psychiatry, have been almost silent. A few progressive
doctors have been debating these issues, but they have some way or the other been critical to-
wards institutions on beforehand and have not had any close association with a hospital. Now
we as hospital practitioners do not feel responsible for the historical decisions of reform made for

233
the simple reason that we haven´t been part of it. I see this now as the primary reason why we
as doctors react in a defensive way, when the talk is about reform. It is as if too many reflexes
are the result when the whole machine of media and rhetoric is running, where grounded scien-
tific knowledge is not considered at all”.

“I mean what has happened here in the nineties is that treatment should be integrated and that
is not the same as the intentions of the eighties were co-ordination was supposed to mean auton-
omy of treatment ideology. I think that this whole integration and multi-professionalism debate
is a monster like one of my good colleagues Mr. Lunn once called it. I think that it is a prod-
uct of romantic and utopian fantasy. Now after Social-Psychiatry has become the new buzz-
word, the talk is about having these local experiments accepted as treatment on the same level
as medically founded psychiatry. I mean this is again a development, which is not natural it has
been forced on us by politicians promoted by different interest groups".

"It still has to be acknowledged that psychiatry as a medical discipline is also developing, take
for instance the concept of ICD-10 diagnostics, which inscribes a whole new scheme of descrip-
tion of behaviour rather than a narrow telos of diagnostics. We try to circumscribe the inertia
inherent in our systems not by breaking down the systems in a visible and explicit way, but by
renewal from within. This development was actually initiated when the parliament univocally
passed the agenda of 7 March 1991 signalling the priority of the social part of mental disease
giving a lot of money to both counties and municipalities. The following years have produced a
lot of initiatives aided by the extensive funding of The Ministry of Social Affairs”. “This has
provoked a lot of reactions and I think that psychiatry can be debated more openly, where also
we as medical persons can be given a voice, e.g. The New Foundation of Psychiatry (Psykiatri-
fonden) is a good example”
.
"Still however I see a tendency toward unreflected opposition to medical psychiatry, which is not
going to produce any good”. We must still reserve a space for a scientific culture of medical psy-
chiatry. In this context we are dependent on sufficient resources for the hospitals to have long-
term treatment. The situation for the time being is that we have a strong pressure on the few fa-
cilities that we have in the hospital. This means that we are often forced to discharge a patient,
who could benefit from a longer stay. Likewise patients are not hospitalised when they are
really in need”.

234
Dr. C is another psychiatric practitioner who has been reflecting on the new role
of the psychiatrist in creating a new collaborating psychiatry. He has for some
years been working as a chief psychiatrist and is also supervising an out-patient
treatment facility. He is man in his late forties, who regards himself as a tradi-
tionalist. However he acknowledges the necessity of giving high priority to the
cross-professional approach inside the hospital as well as outside it. The ideol-
ogy of the hospital employing him is obeying Christian principles and his work
thus to a large extent is guided by charity and compassion.

Doctor C: “You should always signal your interest in other professions points of view. I don't
see this however as a big issue in our hospital, the problems arise first of all when we are de-
pendent on the relations outside the hospital. There we really have to work for the establishment
of close collaboration in dealing with these partners. However I think it is still important to re-
alise that we as doctors are the ones who have the overview and should be able to coordinate the
efforts as we are also the ones who are in charge of diagnosing. The psychiatric professionality is
first of all anchored in the field of medicalization.

"I therefore see the primary problem of cross sectoriality and cross professionality as originating
in the lack of ability of having a clinical approach in observing. What we get instead is state-
ments in diverse languages that we have to interpret, what we loose here is conclusiveness, and
what we get is too much polyvocality.

"You will not get any qualified cross-professionality unless you can really agree on what you see
and that takes a lot of education and training to do this. First of all however it is important,
that we acknowledge that the psychopatological dictionary should be our common point of refer-
ence. In this way we can train people to represent what they see without all kinds of superfluous
narratives about this and that”.

“The problems increase when we get outside the hospital. First of all it is the issue of educating
our partners, to make them have the right expectations, when it comes to what kind of patients
we deal with, that is who is in our target group. The outpatient treatment is of course a new es-
tablishment, that has an ideal of close collaboration with the hospital and the surrounding soci-

235
ety and the institutions and authorities occupied, with what is now called Social-Psychiatric ac-
tivities”.

“Here we have again the problem of having decided a new structure for the psychiatric service,
having a delay of elaborating the processes which have to work on the inside”. “How can you
expect us to have a collaboration with people who haven´t got the most basic knowledge about
psychiatric diseases”. “ I mean the problem is not the extreme cases of deep psychosis, it is more
the borderline cases: social-crises, life-crises or existential crises, there we have a problem we
have some expectations of partners' efforts above all the municipalities, and they have some ex-
pectations of our efforts. Here we have the experience of pushing the problem back and forth,
here we really experience that we think differently”.

“I mean if we really want to develop a Social-Psychiatry it is important, that we really adjust

our structures so that when we have collaboration, then it is not by coincidence!!!!. Moreover the
development of Social-Psychiatry and the special facilities necessary in the near environment of
patients, should be designed, in dialogue with us as the primary expertise and not solely based
on the knowledge that they think they have inside the municipal system”.

Now, taken the values of this doctor and his professionalism, how does it com-
bine with the supposed local values of the hospital. How does the discourse on
cross professionalism, find its place in these basic values of embracing “the
Other”, and what about the patient as a partner? How could the patient be em-
powered, in the sense of having treatment and care as support rather than the
one determining factor? Could it be that cross-professionality could be used as a
medium between the inside and the outside of the hospital?

One profession, which works 'transversally' inside and outside the hospital is the
nurse.

Nurse Jane has been a motivated and dedicated professional working in the
hospital for more than 25 years. She is a chief nurse and was first employed in
the old institution of the nerve sanatorium of the hospital and later found her

236
way to the open psychiatric department and is now running this department
with Dr C.

Nurse Jane: “I think that this whole development within the field of psychiatry and how it af-
fects me and my profession is very exciting to participate in. I mean both what is happening
outside the hospital, when it comes to experiments with new institutions and the development
here inside the hospital with new medication and approaches to treatment. I know that we still
as a hospital have a strong tradition of the medically founded treatment methods including elec-
tro therapy.

"However we and the other professionals I think make a good job at preparing the patients for
a life outside the hospital. This of course takes more than medical treatment, we train social
skills and different everyday practices. We have two occupation therapists who make a good job
here though I think we should improve, when it comes to record their observations systematically
so we have some guidance as to the occupational interests of the patient. This insight could be
very valuable, when the patient is discharged and other professionals take over.

"So we really try to follow the new trends of development. I mean we as nurses see ourselves as
the ones who really have the holistic approach to the patient, when he is in the hospital. We are
the ones who always know what is going on and cover the patients needs socially, psychologically
and physically. We see ourselves as that professional group that creates the relations, creates the
climate of trust that is necessary for the patient’s well-being and is the precondition for the pa-
tient to go through a development.

"I think what is important these years is that we as nurses within psychiatry find our own pro-
fessional identity and insist to have our own courses and supervision and make sure what is our
core-competency. I think that this is a precondition for having the influence and cross-
professional development of the psychiatric department.

"Here I think it is important to have cross-professional conferences. The code-word I think here
is respect to listen to other opinions than ones own, which however often can be difficult because
of the heavy job-pressure that we experience. Another problem is that we are the ones who are
there all the time while the other professions are in and out of the department. That is why we

237
have developed our own way of dealing with things, because we are simply the only ones there to
do it”.

"As we are often the only ones there for the patient they see us as the ones who can make mira-
cles. If we can do this, we can also do that, they often get disappointed when we have to inform
them, that their social problems and economic affairs are not our jurisdiction, but the task of
their social-worker in the municipality. Being a patient often involves being unrealistic about
ones own situation, including the fact of being ill. This often installs huge problems when you
want to plan with other professionals outside the hospital because you get no collaboration from
the patient. At the same time it is difficult to imagine how you should work with the patient,
when you have no idea how the patient has been living before the out-break of his disease".

"This is often the fact because, the relations with relatives is broken of for one or the other rea-
son. A fact is that it can be difficult for relatives to contain a mentally ill person, the result of-
ten being that the patient pushes away the maybe closest resource. Another situation is when
the patient doesn´t want relatives to be informed by his admission to the hospital, because it is
still seen as shame-full to be involved with a psychiatric institution”. “ I think the only way out
is to focus more on the education of relatives, before the contact is broken off, the problem of
course is that this has already happened when we see the patient the first time”.

“When the patient is discharged the only resources we have is the municipality and here we have
good back up from the different professionals, but at the same time we often have the impression
that they do not have the facilities to cope with the problems”. “I think we have a shadow
hanging over us everyday, which is that we have been given a task, which has been fostered in
the imagination of politicians and administrators. However we can also blame ourselves for not
having participated enough, when the decisions were made back in the seventies and eighties”.

A profession, which seems to have the opportunity to be a medium for cross-

professionalism, is the social worker. The social worker is the person building
the bridge between hospital and the local community. The social worker is sup-
posed to establish contact with the local authorities, when a patient is admitted
or discharged. Consequently, this profession could be part of an empowerment
tool for patients finding their way in and out of the treatment system.

238
Social worker A: “I think that our strength as a professional group is our training, which is
very broad and has a holistic approach in the sense that we can both contain issues of treatment
as well as issues which are more pragmatic, that is things that have to do with legal aspects”. “
I see us very much as having very good professional dispositions to make contact with the part-
ners outside the hospitals, not at least because we have the regulations, that we can use as a
common point of reference. That makes it possible to get through with other issues around the
patient, that is those containing aspects, which are not strictly related to social counselling in a
narrow sense".

"I really also see our primary resource as the conversation, that we always insist on listening
carefully to the client above all, but also the professions and their wishes before we come up with
suggestions”.

“I think in this hospital it is very much the internal decision of each professional group if they
want to have a voice, about the treatment of patients. There I think first of all it is important
to accept the fact that each group has to find a professional identity otherwise it will be impossi-
ble to have any idea of how you can connect your own professionalism to the totality of profes-
sions in and outside the hospital”.

“I think the primary forum for this kind of cross professional development is the hospital con-
ference, and I really think that it is important that as many professional groups as possible
participate here. I think the code-word here is trust, that you really dare to doubt your own ca-
pabilities and in this way invite other professions to participate in solving a certain problem,
but to me it seems, that this kind of trust is difficult to establish”.

It seems that the social worker profession has embedded a way of thinking
about other professions in and out of the hospital. It is a profession that actively
invites other professions to participate. An important point seems to be that
professions should find an identity in relation to the profession of psychiatry,
which has earlier been monopolised by the medical profession. This hierarchy
still exists and should to a certain extent be respected, but at the same time chal-
lenged.

239
In this regard the social worker has a constructive approach as she is very con-
scious how her professional training as socio-legal consultants can create a pos-
sibility for a proactive thinking in the development of a cross-professional ap-
proach to the patient. The social worker stress the fact that legal regulations em-
bedding the rights of the patient, when it comes to social service and support,
create a natural connection to the professions outside the hospital.

A crucial point however is how the totality of professions inside the hospital is
viewed from outside the hospital.

Mrs. Selina is the head the social services of the local authority hosting the hos-
pital of nurse Jane and Dr. C. She has been employed in the department for
three years, she has an education as a social worker and has prior to her current
position been employed in a big psychiatric hospital in the neighbouring county.

Mrs. Selina: “ I see very much that we are bound up in old and outdated ways of thinking. I
see very much that we have all the possibilities to have a good cross-professional co-operation,
but what is lacking is a more general progressive attitude, yes it is simply a question of develop-
ing a new culture, a new attitude”.

“Take an example we haven´t really established any formal collaboration with the health-
department here in the municipality. You know the health department is responsible for the
home-visiting nurses and I know that they feel a huge distance from the very practical problems
that they are facing in the homes of the citizens and the way the staff from my department
works, you know they take care of all the paperwork social-legal affairs and that kind of stuff.
I mean basically this should have happened long time ago in our department we have been ask-
ing for this kind of collaboration, but its only a short while ago that I realized that things were
moving a bit".

"I regret, that the issue of cross-professionalism is tied up with the expectatio, that the initia-
tives come from the outside. I think, that it is more the responsibility of the single employee. I
think it is strange that there is not more informal communication between the employees, it is

240
like there is the expectation that everything has to be formal. When it comes to psychiatry of
course the problem is that the client moves from one department to the other according to what
aspect of his case is treated, that calls for coordination.

"Some municipalities have solved that problem, they think, by employing a what they call psy-
chiatry co-ordinator. I think here there is a big danger of betting everything on one number, it
could create even more neglect of the responsibility of every employee for creating continuity in the
flow of the cases between department and in and out of the house”.

“I think it is more a question of creating a broad professional base where our staff get used to
treating this kind of clients, that is that they get some basic knowledge about this group of cli-
ents. Here I think that it is important to stress that this is not one homogenous group that we
can put under one hat, rather the talk is of a group, which it takes a lot of expertise to read,
which will mean that you discover the multiplicity and the potential these people contain".

"Education can help us some part of the way, but close collaboration with the out-patient
treatment centre is a must, we need close supervision in a great part of the cases”. “In this re-
gard we haven´t had any tradition for supervision, but I have to say that you need a minimum
of knowledge before you can start asking the right questions and as a consequence get the rele-
vant answers”. “In this regard I have to say to be fair, that our communication with the hospi-
tal has improved a lot after Dr. C has taken over, he seems to be a person who is open-minded
and wants to listen to our wishes. I have great hopes in this regard, but it takes also a lot of
work inside my own organization”.

"I think institutionally we are doing pretty well, we have established this new non-treatment
centre, that is a place were you can just be yourself as a mentally ill citizen, without being
turned into a case. In practice however it has shown itself that this border between treatment
and non-treatment is very difficult to uphold, when you first have established an institution.
The involvement of the institution is quickly developed and takes over more and more of the
citizen's life in that way the borderline between simple care and respect of autonomy and treat-
ment becomes blurred. It is a very vulnerable group of people, that unattended might be exposed
to a lot of suffering, I see it as our task to prevent this and at the same respect the autonomy of
the patient. Still I see my personnel have a lot of trouble drawing that line and I don´t blame

241
them, this is really a job where there is no standard blueprint. Still our wish however is to have
more flexible living facilities, I think that we have to face the fact, that these people do not bene-
fit from an isolated way of living, many of them are just sitting in their own apartments. I
think that we have to think in more flexible solutions with small-protected communes with staff
attached for all kinds of support. Again however it is a question of respecting the space of the
citizen”.

The problem is stated now and again how to join professional forces without
violating the freedom of the individual. As mentioned earlier the problem can be
seen as one of making concrete judgements, when you only have an abstract lo-
gic of multi-professionalism to apply.

To approach this problem I will now turn to the case of Antotnin Artaud.
Antonin Artaud sent a letter in 1925 to the doctors of the mental asylum where
he was admitted several times in his life-time over a large span of years. His
point was that he wanted to state his right to choose his own self-hood his own
individuality. This individuality as he stated will always be considered anti-social
and thus mad. However Artaud and his works have a doubleness, which can
serve as model of mad becoming, thus being crucial for understanding the pos-
sibility of mad-reterritorialisation of psychiatry. He can be the personification of
the schizoid model, at the same time inside and outside psychiatry. Even psy-
chiatry in the twenties was still in its infancy and treatment had minimum ef-
fects, even electro-therapy had not yet been discovered, Artaud for decades so-
mehow was dependent on the asylum. In this sense it can be argued, that it so-
mehow was a precondition, for lancing his provocative and subversive arrows.

On one hand Artaud himself as a mad-person, an ultimate victim of social re-

pression, on the other as a mad person and the bearer of subversive wisdom.
Artaud associates himself with the most underprivileged and illiterate part of so-
ciety, but at the same he sees himself in company with the famous 'mentally dis-
turbed' geniuses of history e.g. Nietzsche, van Gogh etc.

In the letter to the doctors he stated: "We will not allow the inhibition of freedom to de-

242
velop through delirium, which is as legitimate and logic as all other human ideas and actions.
The repression of anti-social reactions is in principle as chimerical as it is unacceptable"395.

The same year he ended a letter to his doctor like this: "…And now, Doctor, that
you are fully aware of the part of me that can be reached (and cured by drugs), of the litigious
point of my life, I hope that you will be able to give me a sufficient quantity of subtle liquids,
specious agents, mental morphine to raise my sinking, to balance what falls, to reunite what is
separated, to rebuild what is destroyed.
My thought salutes you"396.

Psychiatry and its institutions had the possibility of creating long time sustain-
able relations with the patient. The psychiatrist had the opportunity to relate in a
concrete way to the patient, if he chose to. He could store his clinical gaze and
create a relation beyond the established client-patient relationship. No doubt
Antonin Artaud has benefited a lot from this: How would he have reacted faced
with an abstract system of multi-professionalism like in the current sectored
psychiatry?

Antonin Artaud no doubt has been dependent on finding concrete manifesta-

tions, like in the medical psychiatry, in order to lance his arrows. Subversive ac-
tion for sure is a creative act inside a dominant reality, where the balance must
be maintained between over-coding and abstraction.

For ’Organising and Its Double’

The voice of madness is as much dependent on the voice of psychiatry, the
voice of art, spirituality, law and economy etc. In all these voices of de-
institutionalisation you find one dominating: the normalising, the over-coding
established according to the arbitrariness of negotiated ordering. Social life is
sustained through normalising forces. Obsessed with unity and coherence it in-
cludes ‘the multiple’ through a mode of normalisation.

395 Artaud, Antonin: Letter to the doctors of the lunatic asylums. 1925. in: Laugesen, Peter: Udvalg af Artaud tekster. Arena.

København, 1973.
396 Artaud, Antonin: Selected Writings. Susan Sontag ed. Univ. California Press. Los Angeles, 1988. p. 61.

243
As mentioned once by Antonin Artaud in his letter to the doctors of the mad-
institution where he was hospitalised: “All individual actions are anti-social. Mad-men
are the individual victims par excellence of social-dictatorships”.

As indicated in section 6 the challenge of mad-resistance (and for organising) is

to use de-territorialisations and reterritorialisations of signs. This installs the
body or rather the body without organs as the immanent force.

Consequently, organising could be reframed as a ceremony, which appreciates

bodily intelligence. Like Artaud proposed the Balinese double of western theatre
as the way to get rid of social enslavement, in favour of bodily intelligence.
Western theatre has been enslaved by spoken language and aesthetics, which has
blocked reconciliation with the universe397.

Theatre should not get the function as entertainment, rather it should restore its
original function as it expresses impulses larger than life: “ Theatre serves an inhu-
man individuality, an inhuman freedom .. the very opposite of the liberal sociable idea of free-
dom”398.

In this sense the theatre stages a possibility of self-transformation or meta-

morphosis as Nietzsche would phrase it. It is not merely a challenge of the ego
(the double is not an echo), which can be reflected on. Rather the theatre re-
leases a speed vector and comes to function as a dubbing, a playfulness, which
points towards the body without organs - the post-human (or inhuman in Ar-
taud’s phrasing).

Here art and the revolutionary come together. Art is not to be confused with
aesthetics (entertainment) as organisation science should not be secluded in a
shell of self-sufficiency versus other critical strands of social-science. Rather or-
ganisation science has a huge potential as a subversive force inside the dominant
397 In: For The Theatre and Its Double, Artaud, Antonin: Selected Writings. Susan Sontag ed. Univ. California Press. Los Angeles,

1988. p.268.
398 Susan Sontag quoting Artaud from ’For The Theater and Its Double’. Artaud, Antonin: Selected Writings. Susan Son-

tag ed. Univ. California Press. Los Angeles, 1988 p. xlviii.

244
reality of ‘organised society’. This is the case as organisers are a legitimate part of
everyday (work) life. Consequently a nomadic organising could have a radical in-
novating potential inside the very power structure of society.

Attempts to question this essence by disturbing the surface of ‘the organon’

consequently have implied that current mainstream (and male-stream) organisa-
tion and management theory is in ‘deep shit’399.

What has been called a retro-organisation science diving into the pre-modern
has been dealing with this question at length, viewing Enlightenment:
“ As being a source of misgivings and worry, rather than the beginning of civilisation as we
know it” 400

This seems a very fruitful endeavour, exposing how the autonomy of organisa-
tion science (and thus its potential) is a fantasy. Rather ‘the organon’ is associ-
ated with the mono-lithic state, where all legitimacy is gained from a ‘logic of the
one’ rather from the nomadic co-extensive with the state, (the Apollonian rather
than Dionysian etc).
We could use it as a warning and take off for going beyond invited by the chal-
lenge from ‘the body without organs’, the plane of consistency where only forces
and desire flow.

However, these particles are condensed or stratified, this is where we can talk of
human action (and ‘the double of the organon’), we have the molar as we have
the molecular, discourse and forces, knowledge and power. It is in between
these aspects, in the desert, that real resistance is possible in casu - where the or-
ganising organises. This is where we benefit from the thoughts of D&G, Berg-
son and Nietzsche: we find the folding of material, the articulation of expression
and content, stratification, kinetics, movement in itself, l’Élan vital, a life neutral
beyond good and evil etc.

399 As it is stated by Gibson Burrell: “What is sought here is a way of invigorating my discipline and I will make a history bend and

groan if necessary in attempting to carry out this task”: Pandemonium. Towards a Retro-Organization Theory. SAGE. 1997.
400 Ibid.

245
This for sure addresses the silence or the blind spots of organisation science and
how it could link up with other singularities of ‘social theory’ and ‘cultural stu-
dies’. Consequently it could be said for organisational researchers, that they
should maintain ‘the organon’ as a tradition, however reintroducing it as an issue
of critical resistance from inside the very core from where it gains it legitimacy.
For organisational practitioners it should be considered how the different flows
of management tools are more than innocent development devices and see them
as part of strategies and ever shifting circles of persuasion. These circles serve to
preserve and reduce to the known, but also generate the living potential of the
future. This fact seems the more important to stress, when the issue is multipli-
city, innovation and creativity inside the organised world.

Empirically we have studied these aspects of emerging multipliciy through

mixed semiotics and machinic assemblages. That is organising has featured as
pure transformation, rather than as reduction and reification.

Consequently it has embedded: knots of transformations, and the possible and

effective emerging abstract machines, which can be actualised by individuals as
war-machines, a pure resistance, a stopping of infinite speeds, inconclusive and
neutral.

‘An Organising of Organising’

The challenge for a redefinition of organising and organisation intervention is
not to abandon it all together, but to work at the margins of the logic of ‘the or-
ganon’. It is to take the immediate discourse of organisation and management
thinking with its dynamic and ethical intentions literally and turn them against
themselves, in order to see how they work social life from within creating their
own circles of persuasion. It is to use a familiar expression a ‘reterritorialisation’
of organising applying a subversive mode.

The aim of this text has been not only to show how ‘the organon’ in its essence
endows our everyday life with an instrumental thinking, which is inherent in a
more or less blurred human condition of western society. Rather, more specifi-

246
cally, it has attempted to indicate the difficulty of escaping normalising tenden-
cies, because of the flares and legitimating glosses issued from this essence. In
other words, the forces of normalisation make resistance a difficult task, as it
must insert itself in the middle of these lines of flight, rather than from the signi-
fiers blurring the very essence of ‘the organon’ or even making it redundant.

Basically, this approach to resistance gains it radicalisation, in comparison to OD

discourses in general (reverse discrimination, co-determination and dialogue
etc.), by working inside the stratification of language inside these signifiers.

These circles of signifiers create circles of persuasion or normalising forces,

which become the more difficult to block. Failing to challenge them creation of
existence can only be one of receiving what is already there ready to be consu-
med rather than touched401 as you are stuck in a regime of ’being’402.

Concluding Interventionist Remarks

If we consider the last 25 years of development within Danish psychiatry, we are
left with different basic logics penetrating the field, whether we consider decen-
tralisation/new public management or the broader more value oriented Social-
Psychiatry. It seems from the preliminary investigation of the mixed semiotics
that we have three sections dominated by a tendency or an assemblage of gov-
ernance (1976, 1982, 1989) and two dominated by ‘welfare/humanity machine’
(1992, 1995-).

As such there seem to be a change around 1992, however the two machines can
be seen working the same sections, but with the welfare/humanity machine pro-
gressively becoming the more visible.

The abandon of the permanent hospital-facilities and the development of decen-

tralised treatment can be seen as a way of coping with the increasing financial

401 See Bauman as cited by Burrell 1997 p. 5ff.

402 See also Guattari in: Chaosmosis

247
problems which were facing The Welfare State through the eighties, through ar-
guments of integrating the mentally ill persons in society.

As illustrated the basic way of coping with these issues has been through struc-
tural reforms and reallocation of resources. Through the eighties this tendency
can be said to have been outdoing very vital societal questions, which have been
reduced to economic language and narrow goals. From the documents referred
to in the above section it can be seen that a preoccupation with co-ordination
and correlation of tasks through structural adaptations.

The lack of a common language, which is mentioned now and again as the stum-
bling block in the development is supposedly caused by the historical dominance
of the medical profession. The hospitals have traditionally been responsible for
the psychiatric treatment. This tradition is still dominant in the majority of the
Danish counties, manifested in the hospitals governing the Out-patient
Treatment systems.

In the eighties you could spot a tendency of campaigns against the medical pro-
fession in the name of innovation and development. The rhetoric was domi-
nated by claims of being to stereotyped approaches and lacking the ability to re-
prioritising work-tasks403.

This can explain that the medical profession in periods of the eighties seems ab-
sent in discussions on the future of the medical profession in the co-laboratory
psychiatry.
The exposure accomplished by a debate on these issues has been avoided, be-
cause of the experienced lack of back-up from politicians and administrators.

As collaboration is de-centralised to different treatment units in hospitals, out-

patient treatment centres and different experimental projects in the municipali-
ties, radical new conditions are created. These structural reallocations of re-
sources become an efficient silencer and a producer of functionaries of consent.

403 See Vallgårda, Signild: Sygehuse og sygehuspolitik i Danmark. s. 228ff. DJØF. 1992.

248
In this way development becomes framed by the historical programming of dif-
ferent professional cultures. Development becomes bracketed by history as the
systems become unable to expand their own boundaries and be co-producers of
a future in the making.

Professions get caught in historical games instead of creating fix-points of inno-

vation.
Development is trapped in a narrow professional rhetoric, because a proactive
communicative readiness between the operating professional systems is non-
existent.

Likewise there has not been made a centralised planning of the distribution of
tasks and resources between the local authorities and the counties. The act of
resignation of professions and the lack of centralised initiative seem to explain
the entrenchment, which characterise the relation between the sectors. This
shows that transformation and innovation cannot be controlled or activated by
administrators and politicians, but take a communication between equal partners
- politicians and administrators must be listening to clients and professions.

As an exception a few counties have chosen to organise Out-patient Treatment

under the jurisdiction of the authorities of social-affairs404, in this structuring it is
conveyed that the collaboration with the social-sector is considered a crucial
point. However the fact that most of the organising of Out-patient Treatment is
under the jurisdiction of the administration of health and based in the hospitals,
it is signalled that psychiatry is still first and foremost a question of treatment of
a disease405.

However the argumentation has gradually changed and in this connection the
theme-plan process around 1990 was a crucial step away from narrow resource

404Viborg Amt og Nordjyllands Amt

405Seemann, Janne: Når Organisationer Skal Samarbejde. Distriktspsykiatri på tværs af professioner, sektorer og politiske
niveauer. Munksgaard, København, 1996.

249
focused-thinking, as it was stressed how the counties qualitatively should make
their means and ends visible. As indicated these changes in governance rhetoric
do not suggest co-responding radical changes in the practical work-relations of
the psychiatric field. The development shows an absence of a real (decentralised)
cross-professional/-sectored communication as too much initiative has been
given to politicians and bureaucrats.

By using and spreading out the concept of quality in the important document
”Goals for The Development of Quality in Adult-Psychiatry” published by The
Government of Health it is stressed that responsibility for these qualifying ef-
forts are decentralised to institution management, administration management
and the political level. However this can also be seen as a very refined form of
control and governance where responsibility for malfunctions is put on the insti-
tutions and professions.

Rather than seeing the failure of the structural developments as a common re-
sponsibility where different histories must meet and create something new, the
repair work is loaded on professions and institutions. This implies a totally dif-
ferent focus on the level of operations rather than general frames and declara-
tions of intention, which until this period had characterised the planning of psy-
chiatry. This has resulted in a struggle on resources between professions, instead
of invigorating a necessary liaison built on trust and mutual respect. This focus
can only reproduce old conflicts and trap possibilities in a dogmatic treatment.
The professions thus come to suffer under ‘the malfunction repair logic' of
management thinking as the possibility of an experimental spirit is sacrificed in
favour of a narrow focus, placing responsibility and blaming single actors.

The Government of Health participates in this trend by defining a space where

professions on all levels can define their different tasks. This urge has resulted in
an emphasis on developing and discussing new theories and methods embed-
ding the problems posed by the developing psychiatry. In this connection the
subject of Social-Psychiatry has become a nexus for this new front, where ex-

250
periments have contributed to the development of theories and methods in pro-
gress. This marks the positive trend of the nineties.

This new orientation should be ascribed to the increasing involvement of the

social-sector, when it comes to psychiatric subjects. This was marked by the es-
tablishment of financial pools under the jurisdiction of The Ministry of Social-
Affairs. This is a contrast in comparison to the lack of debate on management
and collaboration in the eighties.

The emerging discourse on ‘Social-Psychiatry’ marks a willingness to discuss the

special professional issues inherent in psychiatry in transition. Social-Psychiatry
in this way seems to close a gap as it serves to anchor cross-sectored collabora-
tion in a new client driven direction.

Social-Psychiatry promotes a holistic view of the citizen and a focus a way from
the client making and patient making objectifying gaze of traditional psychiatry
and the bureaucracy of the social-welfare systems. Social-Psychiatry now marks
the positive trend of experimentation based on ideas of developing the local ser-
vice for users of the psychiatric system.

This trend seems as something new also to be embraced by people with a tradi-
tional medical background. In a publication406 from the newly established foun-
dation of psychiatry a tendency by the different authors mainly with a medical
background are interested in finding new ways of combining different paradigms
in the development of future psychiatry. Likewise the new Knowledge Centre on
Social-psychiatry407 has the empty space (closing the gap) as a nexus, rather than
the existing systems.

A remarkable shift is that the talk is of direct integration between biological psy-
chiatry, psychology and Social-Psychiatry, whereas the phrasing from the eighties

406 Danish Psychiatry – Integration and Development, 1996.

407 Videnscenter for Socialpsykiatri established in 1998.

251
was co-ordination and correlation indicating more a separation between para-
digms.

These overall efforts show a willingness to pave new roads the integration of
paradigms, still new theories and methods must be developed:

Can a doctor intervene in the lives of people, who have decided to live in the
street, or is his job primarily to be a doctor (a narrow diagnostic function) or
does it imply ethical considerations?408

The problem becomes very pertinent, when the question of forced hospitalisa-
tion is actualised. The law demands a medical indication and not ‘only’ a social
indication etc., which indicates that the medical profession still has a lock-in with
preserving structures.
This example demonstrates in a very concrete way, that traditional patterns and
institutional frames, which embed the different paradigmatic approaches, are
important to consider when the overall efforts of paradigmatic integration must
be transferred to concrete models of collaboration.

Another caveat is that integration should not lead to more surveillance and ob-
jectification, or becoming a multi-headed monster as one commentator Villars
Lund has phrased it. Social-psychiatry should be balanced in favour of the em-
powerment of the client.

A preserving factor is the huge economic interests, which are at stake in relation
to a slide of tasks from the health sector to the social sector. Powerful medical
corporations have already demonstrated their position by challenging the use of
alternative curing methods, where the status of their products has been ques-
tioned409.

408 See e.g. Brandt, Preben: “Proposal for social psychiatry based on experiences from a programme for the homeless

mentally ill”. Nordic Journal of Psychiatry suppl.37/1996.

409 Jvf. Lektor Esben Hougaard, Århus Universitet i weekendavisen d.3.1 1997.

252
However it cannot be concluded right away from the failure of out-patient treat-
ment that institutions should be the solution. Rather the asylum as an idea
should be considered, however as a positive opportunity - as a shield against the
pressure of normalisation.

When you study the tendencies of the emerging sectored psychiatry and its
fragmentation you discover how a new treatment culture should emerge incre-
mentally through a willingness to experiment. This is actualised when you talk to
professions and patients, who during the years haven't been able to participate
with their voice. New communities of cross-professionalism should be estab-
lished and given the opportunity to find new ways serving as models and inspira-
tion for other projects.

It can be argued that the management thinking of sectorisation produces elabo-

rate technologies of exclusion. As mentioned in some cases you can see subjects,
groups of citizens (former patients), disappearing in discourse as the technolo-
gies of change and humanistic ideals contain them410.

These technologies as such produce points of subjectification or points of dis-

appearance - no more space for interpretation. It can be said that sectorisation
creates a relative de-territorialisation of the signifier psychiatry in the seventies
and early eighties towards an absolute de-territorialisation in the late eighties and
early nineties and we approach a shift of plane or a re-territorialisation in year
2000 (with a folding into sedimentary rock of social-psychiatry and practice).

In the nineties accordingly you can see a reterritorialisation of biologic psychiatry

acknowledging some of the progress, which has been done concerning medical
treatment. This trend has supported the sectorisation trend and has as men-
tioned by Shorter411 created normal patients to be accepted like other (somatic)

410 E.g when patients disappear when they get the tag of being citizen instead of patient loosing basic needs associated

with their identity as a patient. In this way a persons identity is changed by a discursive technology defining and regulat-
ing in a linear way. Another example is when the mentally ill has additional needs caused by a somatic disease and a drug
abuse, which can only be contained within a special treatment unit. When there seems to be no argument to stop the
closing down of a special treatment unit, without compensating measures, this special target group of people actually dis-
appear in discourse.
411 Shorter, Edward: A History of Psychiatry: From the Era of The Asylum to The Age of Prozac. Wiley & Sons. New York, 1996.

253
patients. However this conclusion seems to be a little too optimistic and prema-
ture.

In the seventies and early nineties the reference of sectorisation is still reference
to the signifier of medical psychiatry it is a negative line of flight. In the eighties
sectorisation follows a positive line of flight producing itself around managerial-
ist unity thinking. It is in this translation of sectorisation into a post-signifying
regime, that a new treatment culture is blocked. This is also where the potential
of the becoming citizen of the patient is blocked412.

This can be seen to reflect a split between politics/administration on one side

and more or less self-contained professions of treatment on the other. The fact
alone that the politico-legal system have a strategic/legal power of decision and
in this way sets the agenda for the desired time/space relations create an asym-
metry where professions become the produced rather than the producers. But
bottom up evaluation projects, which features in the nineties create a possibility
for professions and clients to have a voice on the political agenda.

However it must be considered that professions get exposed to a certain self-

surveillance, which gets transferred to the patient: he seems to get all the
normalisation tools that he can wish for, free from psychiatric force and the
bonds of institutions, as he enters the normalising environment as ’a citizen’.
It is thus a joint destiny of self-surveillance, which face the actors of future
Social-Psychiatry, a so to say trap of the everyday language given by their
shared past. It can be argued that these more invisible or subtle measures of
regulation of becoming citizen rather than patient have a bigger governing
potential as they close the private space for self-transformation.

412 See also D&G ATP, p.133.

254
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