[Source: Reproduction from The Journal of the British Society for Phenomenology, Vol. 18 No. I, January 1987, pp. 3-5. http://www.siue.edu/BSP/journal.htm]
By JEAN-PAUL SARTRE
17 April, 1972
I read your book with the greatest interest. In it I found not only the sole possible radicalization of anti-psychiatry, but a coherent practice which aims at replacing the so-called "cures" of mental illness. To put things generally, what Marx called alienation-a general fact in capitalist society - you have given the name illness. It seems to me that you are right. In 1845, Engels wrote in Situation ofthe Working Class: "[industrialization has created a world in which] a race can only exist once it has been dehumanized, degraded, rendered physically morbid and lowered to a bestial level both intellectually and morally". As atomizing forces applied themselves to systematically degrading a class of men into sub-men, from the exterior as well as the interior, one can understand how the ensemble of persons of whom Engels spoke has been affected by the "illness"; it can be grasped at one and the same time as an injury that wage-earners are made to suffer, and as a revolt of life against this injury which tends to reduce them to the condition of object. Since 1845 things have changed profoundly, but alienation remains and will remain as long as there is a capitalist system; since it is, as you say, the "condition and result" of economic production.
Illness, you say, is the only form of life possible in capitalism. The psychiatrist is at once a wage-earner and a sick person like everyone else. The ruling class has simply given him the power to "cure" or intern. Obviously, the cure cannot, in our regime, be the suppression of the illness: it is the capacity to continue producing all the while remaining ill. Thus in our society there are the sane and the cured (two categories of ill persons who are unaware of themselves, and who observe the norms of production) and, on the other hand, the identified "ill persons"-- those whose disturbed revolt places them outside the conditions of production and against the wage given the psychiatrist. This policeman begins by outlawing them, in so far as he refuses them their most elementary rights. He is a natural accessory to atomizing forces: he considers individual cases in isolation, as if psychoneurotic disturbances were the characteristic detects of certain subjectivities, their particular destinies. Thus bringing together ill persons who seem to look alike as singular beings, he studies diverse behaviours-which are only effects-and the connection between them, thereby constituting nosological entities that he treats as illnesses and then submits to a classification. The ill person is thus atomized in so far as he is thrown into a particular category (schizophrenic, paranoic, etc.), in which are found other ill persons with whom he cannot relate socially, since they are all considered as identical exemplars of the same psychoneurosis.
You, however, despite the variety of its effects, have attempted to come to terms with the fundamental and collective fact: that mental illness is indissoluble connected to the capitalist system that transforms labour force into commodities and, consequently, wage-earners into things (Verdinglichung). According to you, the isolation of ill persons can only follow upon the atomization begun at the level of relations of production; and, to the extent that the patients, in their revolt, obscurely claim an other society, it is appropriate that they be together, and that they act upon one another and through one another- in short, that they constitute a socialist collective. And since the psychiatrist himself is an ill person, you refuse to consider the ill person and the doctor as two organically separated individuals: this distinction, in fact, has always resulted in making the psychiatrist the sole signifier, and the isolated ill person, outlawed, the sole signified - thus a pure object. You, on the contrary, consider the patient-doctor relation a dialectical one that is found in everyone; a relation which, depending on the conjunction created as the ill persons are reunited, will manifest especially one or the other of these two terms: the patients will either lay greater stress on the reactionary elements of the illness, or they will become more conscious of their revolt and their real needs, denied and disfigured by society. Because the illness, beyond its various effects, is a shared contradiction, and because each individual is a signifier-signified, it becomes necessary to place ill persons together in order that through one another, they disentangle the reactionary elements of the illness (e.g. bourgeois ideology) and the progressive elements (requiring an other society in which the supreme end is man and no longer profit). It is obvious that these collectives do not aim at curing, since the illness is produced in each man by capitalism, and since the psychiatric "cure" is nothing but a reintegration of the ill person into our society; these collectives tend to push the illness toward its fuller development, that is, toward the moment when it will become, by the common prise de conscience, a revolutionary form.
What seems to me to be striking about the SPK is that those patients without individual doctors - that is, without an individuated pole of signification's - establish human relations and help one another to become conscious of their situation by looking one another in the eye, that is, in so far as they are signifying-signified subjects; whereas in the modern form of psychiatry, psychoanalysis, the ill person looks at no one and the doctor is placed behind him to record his words and arrange them as he sees fit. This spatial determination of the patient-doctor relation puts the former in the situation of a pure object, and makes the latter the absolute signifier, deciphering the discourse of the illness by a hermeneutic of which he alone claims to have the secret.
I am happy to have understood the real progress made by the SPK. In appreciating your work, I also understand that it exposes you to the worst repression of capitalist society, and that it will unleash against you the fury of the representatives of "culture", the politicians and the police.
You must struggle with all means, since the leaders of our society seek to prevent you from pursuing your practical work, gratuitously accusing you of conspiracy. It is not the imbecilic imprisonment on which you shall be judged, but the results which you have achieved.