What the hell am I doing here?

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On July 16, 2013, I arrived with my suitcase at the Clinique de la Borde, in the Loir-et-Cher. This private psychiatric institution approved by the Social Security, founded in 1953 by the neuropsychiatrist Jean Oury — who is still its current director — was born of the institutional psychotherapy movement. This place is known to the general public thanks to the film « La moindre des choses » by Nicolas Philibert. What about this place today, how do we live there, what encounters do we have, how do we get around? What is this particular atmosphere, between lightness, benevolence but also suffering?

In Blois, I take the « Chauffe », a shuttle between the station and the château de la Borde. The labordians like to name in their own way the very specific uses of the place. The next day, my friendly driver will be the « pilot fish » who will take me around the institution. I introduce myself to everyone I meet, I am the new intern. I accompany him in the various places articulated around the castle in which we live and between which we circulate. My guide shows me his room, goes to the infirmary and asks for a Xanax. Only then do I realize that my driver fish is a resident. It is only through clues that I come to know who is « caregiver » and who is « cared for ». The caregivers are called « monitors » and the cared-for « residents », but we call a spade a spade and « madness » and « crazy » are not obliterated words, thus recovering their letters of nobility(1). This confusion allows me to enter the meeting by putting aside my preconceptions. Indeed, one can suffer from a major depression or schizophrenia and still be able to drive a car and take responsibility for the group.

A certain number of residents have had a trade and still have a know-how, even a talent in a specific field. I learn from everyone and there is no shortage of conversation and energy. I wonder about the moment when everything changed for them … It is during these encounters that one realizes that there is no clear line between the normal and the pathological. La Borde is « the least we can do », i.e. a space where « we leave them alone » and where it is above all a question of « avoiding the worst », which is already not so bad.

No white coats here, no compartmentalized hierarchy and no antagonistic separation of roles. At La Borde, everyone has a status but does not identify himself totally with it. A resident or cook may have a more important therapeutic function than a caregiver for another resident. « Every encounter with another person causes memories to resurface. » This aphorism by François Tosquelles also reminds us that transference occurs where we do not always expect it. It is the unexpected, the chance encounter that rules life at the Château de la Borde. And yet, the collective is structured, organized, has its laws, but without bureaucratic rigidity. We try to find a solution for each one while articulating it to the group. This is discussed during the daily and weekly meetings, during which the action can be thought out.

« It’s human » says Patrick(2), a long time resident who tells me in confidence that he is in love with this castle and that this castle is his. I think: a place where everyone is at home? A place of care in the sense of taking care of the other? The healing that would come on top of that? Better living with the disease rather than a cure? A castle for fools? I have this image of Jean Oury, a young psychiatrist, dissatisfied with the administration of the institution where he was practicing at the time, setting out on the road with thirty or so patients, staying for two weeks in hotel after hotel. Passing one day on his motorcycle in front of a magnificent cedar tree, he discovers the castle and its outbuildings, which the owner will sell him for a pittance…

No fences, no walls, no locked doors (except for the infirmaries), no isolation rooms, but a castle and multiple paths leading from one place to another, a diversity of places of different sizes and styles, but always on a human scale, spread out in the very large domain: the vegetable garden, the chapel which has become a library, the club’s secretariat, the trestles for the theater, the henhouse (and its horses), the rotunda, the medical coordination office, the daycare center for the staff’s children(3)There are three sectors: the Wood, the Pilotis, the Park and the Extension, with a total of about one hundred residents.

The heterogeneity of places goes hand in hand with the heterogeneity of the people who live or work there. The monitors are nursing assistants, nurses, psychologists by training but also without any training in the field of care. As for the residents, they are between 20 and 90 years old, some are there for a short stay, others spend their lives there, some former residents attend La Borde during the day (day hospital). But what would these places be, sometimes open, sometimes intimate, without free circulation? Everyone comes and goes, many know where to go, others get picked up by a sidekick at the bend in the road. The « Day Sheet » is there to remind us of the day’s activities or the « R.A.I.L. » meeting for the afternoon’s activities, we also welcome newcomers. And chairs, everywhere chairs, occupied, empty, dot the place. The areas do not always have the elegance of the castle and are sometimes dark and dirty. But what is even more striking is that after a few days spent in La Borde I don’t see the same reality anymore, the human being having taken the place of the material. The housekeeping carried out by residents and monitors is done with a focus on the relationship that is formed. Thus, the broom has allowed me, better than a diploma, to bond (befriend? I can’t say) with Antoine who can’t leave his bed. Taking care of Claire’s paperwork has a calming effect on this little lady who has been struggling with moments of anxiety. Helping Yolande to wash herself at her request creates a bond that may make her show me her photographs a few days later. I discover there the Borde of thirty years ago, identical. Nothing seems to have changed, except maybe a dishwasher, a computer, a fire escape… Nothing has changed at La Borde, but the psychic, social and institutional movement is in perpetual motion.

A place full of history, where Félix Guattari (co-director of la Borde), Jean Renoir (who wanted to make a film on la Borde around 1960), Fernand Deligny (who was invited there), Min Tanaka (who danced butô in front of the castle) have passed by for a while… The people who have passed through and the events that punctuate the year, such as the August 15 festival, or more occasional events such as film shoots, constitute a common history. But it is the everyday that is elevated to the highest rank: « God lies in the details »(4). One task is not a priori more important than another, the spiritual and the material are mixed, as well as the singular and the collective. During the « Bar-à-tea », Patrick, who already refused to eat at the evening meal because he said he didn’t deserve it, is withdrawn, retreating. I insist on offering him some cakes, he finally accepts, tastes and his face lights up: « I have never eaten anything so good! He then joins us in various games. Here we are talking about attention to the atmosphere, Oury also uses the term connivance.

The place where one is hospitalized is above all a place of existence, a place where the singular and the collective are articulated, a micro-society with its conflicts too, where one tries to live together on a daily basis. Whereas what characterizes psychosis is precisely this link that has broken with the other. In this regard, I reread my notes (from the seminar on Szondi organized at La Borde by the psychoanalyst Marc Ledoux.): « Life begins with contact: touching and being touched: are we capable of being touched? Are we capable of creating an alternative society, where we would touch the other with the greatest possible benevolence and caution, this other who has been mistreated by existence? Institutional psychotherapy is not an « ideal society » but above all a tool for thinking.

Oury says he is influenced by Kierkegaard, Gide, Lacan, Marx. But also and above all by his friend, the Catalan psychiatrist François Tosquelles, founder of the critical paradigm of psychiatry that is institutional psychotherapy, intrinsically linked to his experience in the concentration camps. Thus, Oury distinguishes two types of alienation: psychotic alienation and social alienation. I remember his anecdote on this subject: as a child, he locked frogs in a jar and the next day, instead of their having proliferated, their number had decreased because they had eaten each other. This jar, we will open it, seek to care for the establishment permanently. And to set up a structure allowing a quasi self-management(5) by the residents themselves, with a real voice and decision making. A structure that can be used as a reference, that can be used as a reference, but that can also be questioned.

Thus in La Borde, one is struck by the large number of meetings: first floor, medical, staff, Club, reception, Peachum, etc. The list goes on and on, with each workshop and sector having its own meeting. Where we go, where we don’t go, where we pass, where we stay… This joint management of daily life is not without therapeutic effect, as the patients see their psychological activity shifted to other problems than their pain of living. Patrick confides to me: « I try to have ballast in my thoughts ». I note, I also try…

To go further:
Oury J. & Faugeras P., 2012, Préalables à toute clinique des psychoses, Erès.
Foucault M., 1972, History of the madness to the classic age, Tel Gallimard.
Oury J. & Depussé M., A quelle heure passe le train, Calmann-Lévy.
Tosquelles F., 1995, De la personne au groupe, Erès.
Norgeu A.-M., 2006, La Borde : le château des chercheurs de sens, Erès.

Also the sites:
http://www.revue-institutions.com
http://www.collectifpsychiatrie.fr
http://www.croixmarine.com
http://www.euro-psy.org

 

Notes et références
  1. Ici, on est plus proche de la pensée du fou du Moyen-Âge et de la Renaissance où la folie fait partie de l’homme que de l’âge classique. Ce 17e siècle cessera de considérer la “déraison” comme l’expérience de toute existence humaine. Ce changement de perception crée alors l’internement et ainsi l’opposition normal-pathologique. On y rejette toutes les formes d’inutilité sociale et donc toute une catégorie de la population. Comme unique thérapeutique: le châtiment. La déraison devient la dénomination permettant de mettre sous  clôture tout ce qui dépasse, trouble la morale: malades vénériens, débauchés, blasphémateurs, alchimistes, suicidés, etc. On voit à quel point il s’agit de la sensibilité d’une époque donnée. L’oeuvre de Michel Foucault traitera de ces thématiques hétérotopiques
  2. Les prénoms cités dans cet article sont des prénoms d’emprunts
  3. La garderie ressemble à une cabane élaborée avec vue sur un étang, Où tout semble construit à taille d’enfant,  comme un décor d’Alice. On m’a dit qu’elle a été construite grâce à Françoise Dolto avec les droits d’auteur d’un de ses livres..
  4. Phrase d’un pensionnaire et titre du livre de Marie Depussé paru aux éditions P.O.L, écrivaine fréquentant La Borde depuis près de soixante ans
  5. Deux entités sont créées pour permettre la prise de décision des pensionnaires eux-mêmes: le club et le comité
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