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

今天，早期精神病被用作精神健康状况的标签，同时有很大的可能发展为严重的精神疾病。它代表了一个界限的空间，或者，正如我们所说的，病理和健康，疾病和非疾病之间的“灰色地带”。本项目旨在分析这一灰色地带的结构和功能，作为正常和病理之间的边界谈判的一种方式。这一相当新的精神病类别的构成是基于心理测试程序、流行病学方法和风险分析的组合，并结合筛查和预防措施。这个组合如何部署自己，以及它如何反映当代生物医学化过程是这个项目的主要问题，我们在这个项目中追踪了过去50年来早期精神病的出现和发展。调查将有助于理解这种组合的后果，无论是精神病学实践还是面对正常范围之外的条件而没有机会达到新的正常的个人。虽然它们今天的普遍性与风险，预防，治疗和慢性病概念的当代发展有关，但我们认为这些灰色地带充满了实际和存在的不确定性，形成了构成性的第三空间，为当代社会实践，文化习惯等的二分法带来了稳定性。精神病学的例子从未被提及。因此，早期精神病提供了一个机会，发展分析的精神病学实践和类别在当代社会的变化边界。该项目的目标如下：1）解释当前精神病学关于其对象性质的理论观点的变化; 2）分析精神病学与当代生物医学变革的关系; 3）概述一个分析框架，以理解在精神病学知识和实践的构建中局部和全球过程之间的相互作用; 4）为精神病学社会研究中正在进行的辩论做出贡献。为了实现这些目标，该项目依靠比较方法，将由一个由历史学家、社会学家、心理学家和人类学家组成的跨学科小组进行。它分为两个部分：A部分将依赖于分析病人的医院记录和其他档案来源，在精神病医院和研究机构，对精神病杂志的评论以及口述历史。它的目的是探索两个发展的想法，早期精神病和他们的影响，从第二次世界大战的临床practices. Part B将探讨如何早期精神病带来生活在日常实践中的专业咨询和它意味着什么，这些咨询的主角。它将依靠在巴黎和柏林诊所进行的人种志，包括对咨询和工作人员的观察以及对专业人员、病人和家属的采访。

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.