Retrieving alternatives. Pluralism in practice in European psychiatry, 1950-1980 – Alter-Psy

This transnational project lays the foundations for the history of psychiatric practices at the time of the rise of modern psychopharmacology. Focusing on the diversity of Continental Europe's post-war psychiatry will challenge both the biological-Kraepelinian paradigm (with its drug-related diagnostic and therapeutic corollaries) and its side-lined "alternatives" in diagnosis, therapy, and physician-patient relationships. Using enhanced quantitative and qualitative methodologies, this study will reconstruct the clinical activities in five psychiatric settings in the cultural heart of Europe, representative of the broad spectrum of the "spaces of alternatives" composing the psychiatric panorama of the time: (1) the psychoanalytic approaches which blossomed in post-WW2 France with the Strasbourg case; (2) the concept of therapeutic community implemented by Franco Basaglia in Gorizia (Italy); (3) the socio-psychiatric care system of the Paris "secteurisation"; (4) the hermeneutical-anthropological conceptions from Heidelberg; (5) Karl Leonhard's "nosological gardening" combining fine-grained neuropathology with individual therapy at the Charité in East-Berlin. These five spaces exemplify the plurality of options in European post-war psychiatry. Three cases represent the capitals or centers of the rising discipline in the late 19th and early 20th century (Paris, Berlin, Heidelberg); two were - literally speaking - liminal entities placed at the border (Strasbourg, East-Berlin); one represented the subversion of the status quo (Gorizia); and each stood for a "progressive" approach in the decades the study will consider (1950-1980). Combining analysis of patient files, institutional records, and specialist discourses will lead to a finer-textured picture of the variety of psychiatric practices comprising interaction techniques, diagnostic and therapeutic strategies, and institutional routines. The research strategy is threefold. First, it is crucial to explore the multiplicity of European therapeutic and conceptual approaches superseded by modern psychopharmacology and US-American diagnostic schemes. Second, the project investigates this diversity as both an entangled history and a history of therapeutic practices. Whereas the theoretical aspects of these approaches have been widely explored by historians of medicine and science, the corresponding sets of everyday institutional and therapeutic practices have been largely ignored, much less compared. Third, the concept of "alternative" will provide an opportunity to critically engage with the appropriation of the past as a means of shaping the future. In this sense, reconstructing the pluralism will help reinforce the reflexivity of contemporary psychiatric practices and mental health professionals in continental Europe. In consequence, re-examining the diversity in European psychiatry will also give insight into what we may call the European exercise of pluralism.