1st Edition

Outsider Art and Psychoanalytic Psychiatry The “Nativity of Fools” at the Cogoleto Psychiatric Hospital

By Cosimo Schinaia Copyright 2024
    166 Pages 39 Color Illustrations
    by Routledge

    166 Pages 39 Color Illustrations
    by Routledge

    Outsider Art and Psychoanalytic Psychiatry is a study of psychiatric institutes and psychiatric violence as seen through art created by the inhabitants of a psychiatric hospital.

    Cosimo Schinaia explores the history of the Cogoleto Psychiatric Hospital, now abandoned, and how its architecture and ideology influenced treatment of the patients who lived there. At the book’s core is an in-depth historical, anthropological, and psychoanalytical study of the “Nativity of Fools,” a large art installation constructed from 1980 to 1984 by patients, nurses, and psychiatrists, representing their everyday lives in the asylum. Schinaia’s understanding of the scenes considers questions of nostalgia, isolation, privacy, and freedom and reflects on the risks of institutionalised segregation. The book proposes original psychoanalytic reflections on the subject of the obsolescence of psychiatric hospitals and treating mental suffering without institutionalising people.

    This book will be of great interest to psychoanalysts in practice and in training, psychiatrists, psychologists, social workers, and nurses as well as readers interested in outsider art, Arte Povera, and the history of psychiatric institutions and contemporary psychiatry.

    Series Editor's Foreword by Silvia Flechner


    Introduction to the English edition

    Foreword by Fausto Petrella

    Introduction to the Italian edition

    1 Cogoleto Psychiatric Hospital

    2 Thinking Beyond the Asylum

    3 Projects and Materials for a Nativity Scene in the Asylum

    4 The Nativity

    5 Segregation

    6 The Square

    7 The Doctors’ Office

    8 Electroshock

    9 The Children’s Ward

    10 Work

    11 Death

    12 Between Past and Future


    Cosimo Schinaia is a training and supervising psychoanalyst of SPI (Italian Psychoanalytic Society) and a full member of IPA (International Psychoanalytical Association), working in private practice in Genoa. He was formerly the director of the Cogoleto Psychiatric Hospital (Genoa) and of the Mental Health Centre of Central Genoa. He has published many scientific papers on psychoanalysis and psychiatry in Italian and international journals and edited books. His books include On Paedophilia (Routledge, 2010), also published in Italian, French, Spanish, Portuguese, Polish, German, Russian and Greek, Psychoanalysis and Architecture: The Inside and the Outside (Routledge, 2016), also published in Italian, Spanish and French, and Psychoanalysis and Ecology: The Unconscious and the Environment (Routledge, 2022), also published in Italian, French, Spanish, Russian, Greek and Portuguese.

    ‘This book by Cosimo Schinaia is an important testimony of the passion and creativity of many Italian health-care workers and culturally minded people who fought to go beyond the ideal of the asylum. In it, he describes a season of great participation in which psychiatric hospitals became places of creative, emotional, and relational inventions before being dismantled and transformed into regional facilities near patients and their families. The Nativity Scene of Cogoleto is testament to a new start for the cure and care of mental disease. It highlights institutional psychoanalysis’ crucial contribution to a revolution aiming at restoring dignity to health-care workers and patients alike.’

    Franco De Masi, Italian Psychoanalytic Society


    ‘The construction and form of a hospital’s Nativity crèche is the leitmotif through which Cosimo Schinaia brilliantly informs us of the history of Italian psychiatry as well as its representations in architecture. Unpacking the spirit and materials of this Nativity scene allows Schinaia to deepen our appreciation of the historical and personal forces that have led us to keep our physical and emotional distance from those so different. Nazi camps are never far from his mind while he also creates a space for a work-based treatment that at long last allows for dignity and self-respect. Readers of this work will be more deeply informed about the interface between mind, spirit, and our surroundings.’

    Harvey Schwartz, American Psychoanalytic Association


    ‘This book on the under-represented area of outsider art is a gift to psychoanalysts, psychiatrists, and art historians. Cosimo Schinaia does an in-depth, scholarly analysis of the figures in a nativity scene created by staff and patients in a now-closed psychiatric hospital. These figures represent the pathos of the lives and suffering of the inmates. For Schinaia, architecture can facilitate or impede healing. He addresses this subject at length with respect to this hospital. He is a clear, outspoken critic of the violence to be found in psychiatric hospitals in Italy, where he works.’

    Janice S. Lieberman, Institute for Psychoanalytic Training and Research


    ‘A unique and edifying book, Outsider Art and Psychoanalytic Psychiatry, serves up an intriguing and comprehensive discussion of the history, architecture, functions, and violence of psychiatric institutions. Cosimo Schinaia uses the Cogoleto nativity scene to examine the intricacies of institutional psychiatry. Patients, nurses, and doctors collectively transform their mental anguish and frustration into a symbolic scene that tells the story of their lived experiences, reflecting human, Christ-like, suffering as well as the irony of redemption. What makes this book particularly important for mental health care practitioners is how it clarifies the function of external aspects of treatment spaces in the healing process. One leaves it, and the project it is inspired by, with the conviction that serious mental illness requires a transitional space` that encourages relationship and creativity.’

    Danielle Knafo, PhD, author, Dancing with the Unconscious: The Art of Psychoanalysis and the Psychoanalysis of Art