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，同时很有可能发展为严重的精神疾病。它代表着一个有限的空间，或者，正如我们所说的，它是病理与健康、疾病与非疾病之间的“灰色地带”。本项目旨在分析这一灰色地带的结构和功能，作为一种在正常和病理之间划清界限的方式。这一相当新的精神病学类别的构成是基于一系列心理测试程序、流行病学方法和风险分析，结合筛查和预防措施。这个集合如何部署自己，以及它如何反映当代生物医学过程是这个项目的主要问题，在这个项目中，我们追溯了过去50年来早期精神病的出现和发展。调查将有助于了解这种集合的后果，无论是精神实践还是有关个人面临的情况超出正常范围而没有机会达到新的正常状态。虽然它们今天的普遍存在与风险、预防、治疗和慢性病概念的当代发展有关，但我们认为，这些充满实践和生存不确定性的灰色地带构成了构成的第三空间，为当代社会实践、文化习惯等中的二分法带来了稳定性。尽管在其他非精神病学医疗实践领域已经对这种灰色地带进行了分析，但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来分析当代社会精神病学实践和类别不断变化的边界。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，以了解精神病学知识和实践建设中局部和全球过程之间的相互作用；以及4)促进精神病学社会研究中正在进行的辩论。为了实现这些目标，该项目依赖于比较方法，并将由历史学家、社会学家、心理学家和人类学家组成的跨学科团队进行。它分为两部分：A部分将依靠分析精神科医院和研究机构的患者住院记录和其他档案来源，以及精神病学期刊的评论和口述历史。它的目的是探索自第二次世界大战以来关于早期精神病的思想的发展及其对临床实践的影响。B部分将探讨如何在专门咨询的日常实践中使早期精神病变得生动起来，以及这对这些咨询的主角意味着什么。它将依赖于在巴黎和柏林诊所进行的民族志研究，包括对咨询和工作人员的观察以及对专业人员、患者和家属的采访。

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.