Colonial Madness: Psychiatry in French North Africa. Richard C. Keller. Chicago: University of Chicago Press, 2007. 294 pp.

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In July 2008, the French President Nicolas Sarkozy implemented the next stage in his pet project to build a geopolitical Mediterranean Union linking Europe, North Africa, and the Middle East. Maghrebian critics were quick to voice their suspicions at this EU-endorsed plan which revived bitter memories of French colonialism, especially given Sarkozy’s grandiose allusions to ancient unity under the Roman Empire. Libya, in particular, objected to the project with Moammar Qaddafi highlighting the cultural differences between Europe and the Maghreb:

Do we share a culture with Europe? Absolutely not. We each have our own culture. In Scandinavia, people walk around naked. Can you walk around naked in Tunisia, Algeria, Egypt, or Libya? They would stone you and throw you into a mental hospital. But in Scandinavia, it is common to see people walk around naked. That’s their culture. Is it conceivable for a union to be formed between somebody naked and somebody who considers this to be crazy? This is an example of the differences between our cultures. We don’t even share the same religion (The Middle East Media Research Institute, July 15 2008).

This passage neatly encapsulates an inversion that has taken place in Franco-Maghrebian relations, for in his contrast between Maghrebian sanity and European insanity Qaddafi utilized the same cultural logic that characterized French colonial-era thinking about the Arab Other. This is therefore a propitious time to be examining the traumatic relationship between France and North Africa. In his thoroughly researched and intellectually ambitious study, Colonial Madness: Psychiatry in French North Africa, Richard C. Keller does precisely this by showing how the political relations between metropolitan France and its North African colonies were to a large extent mediated through the field of psychiatric medicine.

Building on the work of Jean-Michel Bégué and Robert Berthelier in the history of North African psychiatry, Keller traces the idea of the Maghreb as an exoticized space of insanity and irrational violence. Situating his subject in a wider historical field, Keller demonstrates how, from the late-nineteenth century until the decolonization of North Africa, psychiatry maintained the cultural and racial rift between colonizer and colonized. Citing the legacy of the great reformer Philippe Pinel, French psychiatrists represented themselves as humanitarians seeking to modernize the barbaric conditions that the mentally ill endured in the Maghreb. Yet this ideology of emancipation disguised the implementation of an asylum-based model of confinement that worked in tandem with colonial exploitation – expressed through the concept of mise en valeur – and discourses of scientific racism.

The North African context was further complicated by religious sectarianism: as both Arab and Muslim, the North African male was labeled by French psychiatrists as innately irrational and incapable of adapting to French civilization. This undermined official assimilationist policies and further distanced the populations of the Maghreb from French metropolitan identity. As the discipline of ethnopsychiatry developed from the 1920s, the ‘primitivism’ of the Algerian mind was frequently used to justify French authoritarianism, heralding an independence struggle in which psychiatry featured on the frontlines.

Focusing primarily, but not exclusively, on the Algiers School of French North African psychiatry, Keller draws on the stories and day-to-day realities of psychiatrists and their patients to frame his analysis of a complex social field involving the mental state of colonial settlers, North Africans, and Europeans. At the centre of Keller’s narrative lies the Hôpital Psychiatrique de Blida-Joinville, an asylum southwest of Algiers that began admitting patients in the late 1930s. Run by the Lyon-trained neuropsychiatrist Antoine Porot, Blida represented a turning point in the ‘biopolitics’ of colonial and metropolitan psychiatric care. Rejecting easy dismissals of the Blida hospital as a coercive element of colonial authority, Keller highlights the progressivism and latent utopianism of a project that sought to place Algeria at the forefront of psychiatric innovation. “With its emphasis on reform and professional reorganization, the progressivist rhetoric that surrounded colonial psychiatry testified to the ways in which colonialism was about science, modernization, development, and process as much as it was about exploitation” (p.80). In this revisionist vein Keller brings in the work of Michel Foucault and Bruno Latour to support his thesis that French psychiatry was a discipline in crisis which used North Africa as a space for medical experimentation and professional renewal.

The use of mental stereotyping as a weapon in the colonial mission is familiar to many, but Keller complicates the matter by arguing that in French North Africa psychiatry could also act “as a tool for the emancipation of the colonized, an innovative branch of social and medical science, an uncomprehending therapeutic system, a discipline in crisis, and a mechanism for negotiating the meaning of difference for republican citizenship” (p.4). This approach places Keller in dialogue with the powerful critique of Frantz Fanon, who in The Wretched of the Earth (1961), attacked colonial psychiatry, and the attitudes of Porot in particular, as nothing less than medical racism. Fanon, it is crucial to note, resigned from his position as Head of Psychiatry at Blida in 1956 to devote himself to the struggle for Algerian independence. Perhaps the principal achievement of Colonial Madness is Keller’s contextualization of the Fanonian critique, for by placing Maghrebian anticolonialism within a broader history of psychiatric theories, institutions, and practices, he complicates any simple reading of the role of psychiatry during the Algerian war. In later chapters Keller branches out from case histories and psychiatric treatises and uncovers in Maghrebian autobiographies, fiction, and cultural memory “the development of an intellectual culture of resistance that took medicine and psychiatry as its object” (p.162).

If Keller’s narrative is sometimes difficult to work through, this is chiefly due to the complexity of issues and wealth of detail offered. Colonial Madness would therefore be best appreciated by the advanced student. In demonstrating the extent to which mental health issues regulated the colonial and postcolonial relationship between France and North Africa, Keller has fashioned an important work that is as much a history of ideas as it is a social history or history of psychiatry. The cultural logic deployed by Qaddafi, it is shown, has a fascinating context.

Shane McCorristine
Humanities Institute of Ireland
University College Dublin