MED-DG01 — Institutional Psychotherapy, La Borde and Guattari

Course Code: MED-DG01
School: School of Medical Sciences
Field: Critical Perspectives on Mental Health
Level: Intermediate
Estimated duration: 16–20 learning hours
Access: Paid — one-time purchase

Course purpose

This course offers a historical, philosophical, and institutional examination of institutional psychotherapy, the Clinique de La Borde, and Félix Guattari’s contribution to thinking about collective life, subjectivity, hierarchy, care environments, and micropolitics. It asks how an institution may become part of the conditions through which care is enabled or obstructed, while maintaining a clear distinction between studying a historical-intellectual tradition and providing contemporary clinical instruction.

MED-DG01 is an independent non-degree humanities and medical-sciences course. It does not train learners to diagnose or treat mental illness, does not replace accredited clinical education or supervision, and does not provide individualized medical or psychological advice. Historical practices and theoretical concepts are examined critically rather than presented as universally validated standards of care.

Historical and intellectual orientation

Institutional psychotherapy developed in twentieth-century France through efforts associated with Saint-Alban and later La Borde. The tradition questioned whether an institution could be treated as a neutral container for individual therapy. Its participants argued that routines, spaces, roles, speech, labour, hierarchy, and collective organization affect the experience of patients and staff. Jean Oury established La Borde in 1953, and Félix Guattari became deeply involved in its institutional life. Their collaboration contributed to experiments involving clubs, collective activities, rotating responsibilities, meetings, and analysis of institutional relations.

The course carefully distinguishes institutional psychotherapy from the broad category of antipsychiatry. Historical scholarship records important differences in their assumptions, methods, and relationship to psychiatric practice. Learners are therefore expected to compare sources and avoid treating every critique of the asylum or psychiatric hierarchy as a single movement.

Learning outcomes

By completing the course, learners will be able to:

• Situate La Borde within the history of postwar French psychiatry and institutional psychotherapy.
• Explain why institutional arrangements became objects of clinical, political, and philosophical inquiry.
• Describe the roles associated with Jean Oury and Félix Guattari without collapsing their distinct intellectual trajectories.
• Define transversality and distinguish it from ordinary horizontal communication.
• Compare subject groups and subjugated groups as analytical categories.
• Analyze how everyday routines, spatial arrangements, roles, and decision processes distribute voice and power.
• Distinguish historical description, theoretical interpretation, empirical evidence, and normative judgment.
• Evaluate institutional cases without diagnosing individuals or prescribing clinical treatment.
• Identify ethical risks in transferring concepts across historical, cultural, and professional contexts.
• Produce a source-aware institutional analysis with explicit limitations and safeguarding boundaries.

Course structure

Module 1 — Postwar Psychiatry and La Borde introduces the historical setting and examines attempts to construct a clinic that differed from the custodial asylum. Module 2 — Institutional Psychotherapy investigates the proposition that an institution’s organization must itself become an object of continuing analysis.

Module 3 — Guattari and Lacan examines the relationship between psychoanalytic concepts, collective processes, and institutional questions without treating theoretical affiliation as clinical proof. Module 4 — Transversality studies communication and agency across formal hierarchies and professional divisions.

Module 5 — Subject Groups and Subjugated Groups considers how groups may reproduce fixed roles or develop capacities for collective enunciation and self-questioning. Module 6 — Clinic and Micropolitics analyzes everyday care as a field structured by power, routine, language, space, and organizational decisions.

Module 7 — Institutional Ethics addresses dignity, participation, responsibility, coercion, boundaries, consent, accountability, and historical context. Module 8 — Critical Case Reflection integrates the course through a non-diagnostic analysis of an institutional case.

Learning method

Each module uses historical orientation, conceptual clarification, guided comparison, a worked example, critical questions, and an applied task. Learners maintain an institutional-analysis notebook that separates four layers: documented historical information, an author’s theoretical claim, the learner’s interpretation, and questions requiring further verification. This separation reduces the risk that compelling concepts will be mistaken for established empirical findings.

Activities focus on documents, organizational arrangements, fictionalized scenarios, and publicly available historical material. Learners must not submit identifiable clinical information or confidential accounts of patients, clients, colleagues, or institutions. Where professional experience informs reflection, details must be removed or transformed so that individuals and organizations cannot be identified.

Assessment

The assessment portfolio includes a historical timeline, an institutional map, a concept comparison, a transversality analysis, a group-process reflection, a micropolitical observation framework, an ethics checklist, and a final critical case analysis. Rubrics emphasize accuracy, source traceability, conceptual precision, recognition of alternative interpretations, ethical awareness, and the ability to state limitations.

The final evaluation will assess whether learners can connect institutional form to questions of subjectivity and power while preserving boundaries between historical study, philosophical analysis, and clinical decision-making. Course completion recognizes academic engagement only; it does not certify therapeutic competence.

Responsible use of theory and AI

Theory should illuminate a problem rather than rename it. Learners must identify the scope, assumptions, and limits of each concept and consider what it may obscure. AI tools may support organization or language revision when permitted, but generated claims and citations must be verified. No confidential health information may be entered into public AI services. Material AI assistance must be disclosed when it affects submitted work.

Source and safety note

The course draws on published scholarship concerning Jean Oury, Félix Guattari, La Borde, institutional psychotherapy, transversality, and collective institutional life. Sources include historical and scholarly treatments available through established academic publishers and journals. Learners should consult original texts and qualified historical scholarship where possible, recognizing that interpretations of this tradition remain contested.

This course provides general educational content. It does not offer diagnosis, therapy, crisis intervention, medical advice, clinical supervision, professional licensing, or authorization to implement historical practices. Anyone needing mental-health assistance should contact an appropriately qualified local professional or emergency service.

Completion standard

Completion requires engagement with all eight modules, submission of the required portfolio, respect for privacy and source-integrity requirements, and successful completion of the final assessment when available. A successful learner should be able to explain the tradition accurately, analyze institutions critically, and recognize the point at which academic interpretation must yield to contemporary evidence, professional standards, law, safeguarding, and accountable clinical judgment.

Selected scholarly orientation

• Published scholarship on Jean Oury and the history of the Clinique de La Borde.
• Historical work on institutional psychotherapy and its relation to Saint-Alban.
• Studies of Guattari’s concepts of transversality, group subjectivity, and micropolitics.
• Critical scholarship distinguishing institutional psychotherapy from antipsychiatry.