Therapeutic Fascism

Ana Antić’s book makes innovative use of psychiatric case records as a lens to view popular attitudes to the German-imposed order in the dismembered and occupied Yugoslavia during the Second World War. The primary, and wholly laudable, aim is to examine the construction of mentalities under the severe stress of occupation. At the same time this is a study which is comparative in terms of sporadic references to other contexts. A link is discerned between Yugoslav psychiatry and Red Vienna, although the ‘Staeckel’ referred to on page 18 is surely Walter Stekel. The reference point for evaluating psychiatric case files of state hospital patients in occupied Yugoslavia is not that of Nazi Germany or Austria (particularly studies dealing in depth with patient files), but anachronistically that of James Glass on Maryland, as well as to colonial contexts. Antić thus adopts an approach involving a close reading of files but screens out of the wider socio-political and ideological context of the German occupying power, even though it is that context which is being addressed. In terms of framing the issues, no attempt is made to locate inter-war psychiatry within the international movement for mental hygiene, or eugenics, although a WHO evaluation of the 1950s is criticised. While the study contains numerous comparisons with other international contexts, what is under-represented are wider issues of Nazi policies towards psychiatry in vassal states. While a horrific picture is emerging of psychiatric institutions in occupied Poland and of the former Soviet territories where there were mass shootings and mobile gas vans, Antić leaves the reader largely in the dark regarding German occupation policies towards psychiatry in Serbia, and German views on policies in Croatia. Antić overlooks that, from the annexed Slovenian territory of ‘Untersteiermark’, 357 patients were killed on 9 June 1941 at the ‘T4’ gas chambers of Hartheim, representing 89 per cent of the patients at Novo Celje: one therefore wonders how Serbian institutions fared? Despite a stray reference to wider killings of Jews in Serbia, Antić’s study is eerily silent regarding Jewish patients, and indeed persecution of Jewish psychiatrists. Were the patients discussed by Antić left after German combing through of inmates, or indeed admitted only later? Despite a commendably wide range of references to contextual secondary literature, none of the in-depth studies of psychiatric files in Nazi Germany and post-Anschluss Austria are referred to. Mention is made of Goeschel’s work on suicide (although a quotation left unreferenced raises questions about the publisher’s editorial scrutiny), but this somehow contrives to be a study of ‘the Nazi new order’ without engaging with the interlinked issues of psychiatry and the Holocaust. That said, there is an abundance of brutality which traumatised patients. Even the Germans distrusted the brutal Croatian Ustasha. Patients certainly feared being put to death, and the communists were implausibly blamed for killing patients. Throughout, one sees how patients and political delinquents were caught between opposing ideological forces of collaborators (whether Ustasha or Serb), and the ferocity of communist partisans. The rallying call on the side of collaborationists was the fight against communists, although the patients had conflicted allegiances. Antić teases out the politics in the files of the contrasting Croatia and Serbia. Pleasingly, individuals are named, as Antić analyses narratives of victimisation, making them both victims of the Germans and collaborationists. She does not consider whether such a ‘dilemma intolerance’ was itself a cause of mental breakdown, although post-war psychiatric theory would suggest the possibility. Special education policies are examined as an alternative to brutal imprisonment, and a model of ‘therapeutic fascism’ is constructed. Policies in post-war Yugoslavia are compared to former fascist re-education. The study concludes with some bold conclusions on traumatisation, psychiatric theory and practice

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