Richard C. Keller, Colonial Madness: psychiatry in French North Africa. Chicago IL: The University of Chicago Press (hb $70.00 – 978 0 2264 2972 4; pb $25.00 – 978 0 2264 2973 1). 2007, 320 pp.
This book traces ideas, institutions and practices dealing with madness in French North Africa (Algeria, Tunisia and Morocco) from the beginnings of colonial rule to the present. As such, it offers the first comprehensive account of the genesis and development of psychiatry in the Maghreb, presented, furthermore, within a lucid, critically engaging framework. Some might criticize Keller for not tackling local social perspectives more thoroughly and for being rather ‘top-down’ in his analysis, but to do so would be to miss the point of this study and do a disservice to Keller's truly nuanced presentation of a discipline's development. This is above all a history of ideas – principally the multifarious ways in which North African madness was constructed and perpetuated during the colonial period, and how these constructions were resisted and revised in the post-colonial one. The book's strength lies in its critical exploration of the tensions inherent within, and between, various colonial discourses. Psychiatry was not only a powerful agency through which to categorize otherness and socially regulate the populations of remote colonial locations, but – more subtly and no less manipulatively – it was also a means of presenting the French colonizers as philanthropic, forward-thinking humanitarians actively engaged with a rhetoric of cultural sensitivity. What's more, unlike many colonial African locations (where psychiatric theories and practices notably lagged behind those of the home countries), French North Africa is actually presented as a ‘crucible for innovation’ (p. 62), where some new ethno-psychiatric theories, once tested and developed in the colonial locale, were exported back into mainstream French psychiatry. This analysis helps enrich historical understanding of the development of Western medicine, challenging ideas of a unidirectional flow of ideas from centre to colonial periphery and revealing some colonies as important seedbeds for medical and psychiatric innovation.
Despite the title, Algeria, Morocco and Tunisia are not uniformly assessed together. Although there were evident similarities between the three countries, the different emphases and directions within the psychiatric histories of each place are drawn out and explored. Interestingly, too, psychiatric developments are not only presented as a result of the political and social imperatives created by the colonial situation, but also as a way in which the discipline of psychiatry itself could extend its professional appeal and socio-medical utility. In short, through its successes in the colonies, the future and credibility of French psychiatry was secured within the Western home context.
This thorough analysis extends conventional Foucauldian interpretations of social bio-control through institutions of madness and the work of Frantz Fanon on the savage exploitation of the North African insane. While accepting both these viewpoints, Keller additionally posits that they tell only part of a more complicated story. He resurrects, for example, the reputation of Antoine Porot, the principal architect in the development of French psychiatric institutions in North Africa, posthumously largely remembered through Fanon as a symbol of the repressive regime. While not denying his racist policies, Keller nevertheless gently reminds his readers to assess Porot in context and to pay heed to his huge contributions in terms of the innovative psychiatric infrastructures he personally instituted in colonial North Africa. Similarly Keller revisits Fanon's presentation of colonial medicine as an institution wholeheartedly resisted and rejected by local people. Keller argues instead that local people actively used the colonial medical bureaucracy as a means of removing dangerous and disruptive individuals from their families and maintaining an element of social control.
These emphases may seem to suggest that Keller has written an apologist's account of colonialism, but he offers no such thing. He examines in depth the hegemony of the colonial psychiatric encounter and the way theories and practices fundamentally supported the imperialist agenda. He actively explores the cruelties and racial inequalities inherent in the provision of colonial psychiatric care, the way psychiatric rhetoric could be complicit in systemic violence and suffering, and the way local people differently conceived the causes of, and treatments for, insanity. Particularly interesting is his analysis of post-colonial writers Frantz Fanon and Kateb Yacine, as members of the paradoxical social group of évolués – indigenous colonial subjects and powerful critics of colonialism, yet nevertheless educated by the very system they came to resist. Rather bravely, however, Keller has re-inserted into the colonial story the suggestion that the colonizers themselves were also constrained by wider broader social and cultural pressures, that the eventual demise of colonial psychiatric models of understanding was as much about changes within the profession of psychiatry itself as about popular disenchantment with fundamentally hegemonic and racist theories.
This is a thorough and fascinating book, written with flair and lucidity. It deserves to be on every colonial history reading list.
