Europäische Zeitgeschichte

Life paths of alcoholic patients in a Brussels psychiatric institution in the 1960's

This contribution aims to better understand the evolution of the relationship between psychiatry and addiction through the study of the experience of alcoholic patients in a mental institution. Alcoholism plays a central role in the emergence of the scientific approach to the pathological dimension of addiction.
Although the medicalization of alcoholism dates to the second half of the 19th century, its integration into the field of psychiatry remains complex. Drunkenness, which later
was referred to as alcohol dependence, has only been partially psychiatrized until today. To better understand the forms of integration of alcoholism in the field of psychiatry, this communication questions the modalities of care of 15 people who were interned in the Institut de psychiatrie de l’hôpital Brugmann in Brussels for alcoholism in 1963. Thanks to a meticulous examination of their medical files, various observations on the care of alcoholics in psychiatric institutions could be revealed. Firstly, an inequality of treatment between patients automatically excluded from psychiatric care and others admitted to the Institute could be observed. Secondly, for those alcoholic patients
who can integrate into the institution, the length of stay is often much longer than for other patients at the Institute. Thirdly, the transfer of these patients from the Institute to provincial psychiatric hospitals is not always mobilized as a last resort when attempts of reintegration have failed, but rather at the very beginning or in the middle of their psychiatric career and then abandoned afterward. Fourthly, these inter-institutional migrations are as much the product of contingencies external to the
patient's situation (existence of networks, interpersonal relations between doctors, available places, etc.) as they are the result of therapeutic concerns. Fifthly, the affirmation of the role of the institute's social nurses in the care of alcoholics from the early 1960s onwards favored discharge from the institution and outpatient treatments. Sixthly, the types of care for these alcoholic patients brought
to the establishment of forms of partial hospitalization before they were legalized by law. Through the examination of original archives that support the upper observations, the attempt is to answer the following question: in what manner did the transformation of institutional psychiatry in the field of addiction treatment and particularly of alcohol disorders, impact the lives of individuals in the 1960’s?

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