Psychiatric fringes. An historical and sociological investigation of early psychosis and related phenomena in post-war French and German societies

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Early psychosis is used today as a label for a condition of being mentally healthy and at the same time having a strong probability of developing a severe mental illness. It represents a space of liminality or, as we call it, a “grey zone” between pathology and health, illness and non illness. This project aims at analyzing the construction and function of this grey zone as a way of negotiating the boundaries between the normal and the pathological.The constitution of this rather new psychiatric category is based on an assemblage of psychological test procedures, epidemiological methods, and risk analysis, combined with screening and prevention measures. How this assemblage deploys itself and how it reflects contemporary biomedicalization processes are the leading questions of this project, in which we trace the emergence and development of early psychosis over the last fifty years. The investigation will help in understanding the consequences of this assemblage both psychiatric practice and for the individuals concerned confronted to conditions outside the realm of the normal without having a chance to reach a new normal. While their pervasiveness today is related to the contemporary development of notions of risk, prevention, treatment, and chronicity, we hold that these grey zones, which are fraught with practical and existential uncertainties, form constitutive third spaces which bring stability to dichotomies in contemporary social practices, cultural habits, etc. Although such grey zones have been analyzed in other fields of non psychiatric medical practice, the example of psychiatry has never been addressed. Early psychosis thus offers an opportunity to develop an analysis of the shifting boundaries of psychiatric practice and categories in contemporary societies. The project sets as its goals the following: 1) to explain current changes in psychiatry’s theoretical perspectives concerning the nature of its objects; 2) to analyze psychiatry’sits relationships to transformations in contemporary biomedicine; 3) to outline an analytical framework for understanding the interplay between local and global processes in the construction of psychiatric knowledge and practice; and 4) to contribute to ongoing debates in the social studies of psychiatry. To reach these goals the project relies on a comparative methodology and will be undertaken by an interdisciplinary team of historians, sociologists, psychologists and anthropologists. It is divided into two parts: Part A will rely on analyzing patient hospital records and other archival sources in psychiatric hospitals and research institutions, on reviews of psychiatric journals as well as on oral history. It aims at exploring both the development of ideas about early psychosis and their implication for clinical practice from World War II on. Part B will explore how early psychosis is brought to life in the daily practice of specialized consultations and what it means for the protagonists of these consultations. It will rely on ethnographies to be conducted in Paris and Berlin clinics, consisting of observations of consultations and staff as well as interviews with professionals, patients and families.