One of the more curious encounters in the history of Modern art took place in September 1945 at a psychiatric hospital in southern France. A pall of ash still hung over Europe when Jean Dubuffet, a prosperous wine merchant-turned-painter, showed up at the hilltop village of Saint-Alban-sur-Limagnole and met the asylum’s unconventional Catalan director, Francesc Tosquelles.

Their private conversations rate only a passing mention in the American Folk Art Museum’s tangled and sporadically illuminating show about Tosquelles and the intersection of psychiatry and art. Even so, you get a glimpse of two highly original minds squaring off before coming to a momentous understanding.

Dubuffet had come on a shopping expedition; he wanted to collect the works of a talented inmate, Auguste Forestier, which had recently cropped up in Paris salons. He craved the sculptures — boats, houses and soldiers that Forestier assembled out of wood, foil, string, wires and bones — precisely because of their maker’s status as a mental health patient.

To Dubuffet, works of such crude vigour and sublime naiveté could form the kernel of a collection of “art brut” — the kind that was raw, untainted by sophistication, uncorrupted by training. He valued the radical individuality of people who created purely because they must. He saw them as masters of “the pure artistic operation, unrefined, thoroughly reinvented, in all its aspects, by the maker, who acts entirely on his own impulses.”

A sculpture of a house with two carved heads beside the door
An untitled work made from wood, metal, glass and coloured pencil by Auguste Forestier © Cécile Dubart

Tosquelles received Dubuffet with suspicion. The doctor saw the interloper as a sophisticate eager to aestheticise suffering. He rejected the effort to sunder artmaking from its therapeutic role and turn it instead into a connoisseur’s commodity.

There was a touch of hypocrisy to that position: Forestier’s work was already selling nicely to local buyers and medical staff from displays in the hospital’s courtyard. In a 1947 photograph, Tosquelles stands on the roof of the asylum, looking more like a patient than a doctor, in a baggy T-shirt and bare feet, holding a wooden ship of Forestier’s aloft like a trophy. The sculpture was part of the brand.

And yet the show suggests, without quite explaining how, that the two men found enough overlap in their agendas to jointly promote Saint-Alban as an artistic incubator and a beacon shining from the margins of postwar society. The same artworks could be used to overhaul two drastically different institutional structures: psychiatry and visual culture.

Saint-Alban was an anomalous place, run by Communists who sheltered Jews and intellectuals under the Nazis’ noses. After the war, it became a place of pilgrimage and refuge for free thinkers, poets, and cultural tourists. Frantz Fanon spent a year there as a doctor before going off to Algeria to help wage the war against colonialism.

A textile, made with colourful embroidery, featuring two people in a boat on a lake in front of a mountain range. People, including a man with a bow and arrow, are on the shore and there is a range of animals including polar bears, stags and deer
‘Landscape with Boats, Hunters and Animals’ by Marguerite Sirvins

It was also home to artists whose very existence was a reproach to the narrow provincialism of the Parisian establishment. Among Dubuffet’s discoveries was Marguerite Sirvins, who spent the last 25 years of her life, from 1932 to 1957, at Saint-Alban, embroidering elaborate tableaux. Her “Landscape with Boats, Hunters, and Animals” is a fantastical mash-up of pastorale, mountainous panorama, hunt, and vignettes of inexplicable chaos. One man in a rowboat has just pulled a knife on another. On the far bank of a river, where pink-horned stags graze peaceably, two people sprint into the distance, spooked by who knows what. Assorted other humans and beasts seem rapt in their separate worlds.

The exhibition meanders in many directions, following connections so loose that they are practically free-associative. Partly that’s a testament to Tosquelles’ influence on other hospitals and other countries. But the transition to the US is an especially disorienting digression, from the history of hellish asylums to an oddly blithe description of the disastrous deinstitutionalisation movement of the 1960s, which left many mentally ill patients with nowhere to turn. Among the artefacts on display is a suitcase owned by Lawrence Mocha, a janitor, window-washer and, eventually, gravedigger at the Willard Psychiatric Center in New York. If there’s a thread here, it becomes increasingly difficult to follow.

Even when the curators stick closer to Tosquelles’ stamping grounds in France, they get easily distracted by tangents. Take, for instance, three splendid neo-medieval reliefs in cork by another Catalan, Joaquim Vicens Gironella. He was born into a family of cork makers, emigrated to Toulouse and taught himself to carve the pliant bark. Dubuffet (who, as a wine seller, needed a regular supply of stoppers) saw Gironella’s work in a cork manufacturer’s Paris office and was instantly charmed by the marriage of folk and corporate art. What makes the pieces an awkward fit for this show, though, is that Gironella had nothing to do with the hospital, the doctor or mental illness. (Nor was his art especially brut.)

A watercolour-and-ink collage of pictures including a train, cars, people in military uniform and small print
‘The Symbol of My Story, or Filiation of the Locomotive’ (1927-33) by Eugene Bedeaux

You can understand why the curators conscripted Tosquelles as their protagonist: he was a crusader, a soldier against fascism, an advocate of patients’ rights, a medical celebrity and a pragmatic visionary. A veteran of the Spanish civil war, he wound up in France in 1939, running a psychiatric unit at the Septfonds concentration camp. Treatment often involved prodding prisoners to escape.

By 1940, he was ensconced at Saint-Alban, which was sufficiently small and isolated for him to put his Marxist ideas into practice there, even as totalitarianism loomed. Mental illness, he believed, was a form of oppression, rather like military occupation, and resisting both required similar techniques. That meant liberating the institution, tearing down hierarchy, eliminating authoritarian approaches (and white coats) and mobilising the village’s lawyers, patients, priests and nuns to work alongside the hospital staff in pursuit of a harmonious, egalitarian community. Everyone pitched in to clean, cook, run the hospital’s farm and publish its internal newspaper.

And so, when the Germans occupied France in their utterly non-metaphorical way, and tens of thousands of mentally ill people all over Europe died of starvation and neglect, Saint-Alban managed to keep (most of) its occupants alive. Patients roamed surrounding villages, begging and bartering. One psychiatrist wrote up fake diagnoses for Jews who snuck into the asylum, seeking sanctuary from an insane world. His colleague, Lucien Bonnafé, a communist and resistance fighter, not only managed to hold on to his job, but turned the hospital into a hub where patients mingled with partisans in hiding and avant-garde artists on the run.

A black-and-white photo of a woman, child and man standing together, holding hands
Cécile Éluard, the fiancé of surrealist painter Gérard Vulliamy, with Danièle Souquières, the niece of Dr Lucien Bonnafé, and Mr Alexandre, a patient at Saint-Alban
A pencil drawing of a man with a long beard and a hat
Gérard Vulliamy’s drawing ‘Mr Alexandre’ (1945), a patient and gardener at Saint-Alban psychiatric hospital © Artists Rights Society/ADAGP

The last group included the surrealist poet Paul Éluard, who arrived in 1943, with his wife Nusch, his daughter Cécile and her fiancé, the surrealist painter Gérard Vulliamy. The latter took advantage of his sojourn to make a series of 13 portraits (later published as illustrations to Éluard’s book Memories of the Madhouse). His pencil drawings, reminiscent of Géricault’s studies from Paris’s Salpêtrière, are a catalogue of unfocused gazes and drooping lips, suggesting that the artist’s generosity of spirit had stalled. These people were his subjects, not his peers. (One exception is “M Alexandre”, a sympathetic portrait of a man with warm eyes and a flowing white beard.)

Such distinctions — between patient and visitor, the cooked and the raw, art and therapy, fascist and democrat, culture and impulse — animate an exhibition that is ostensibly about the effort to elide them. The desire for ambiguity collides with the urge to classify.

Perhaps that’s to cover the uncomfortable truth that making art is a deeply, often painfully irrational activity. “The artist and the madman are voyagers in the same strange landscape of the mind,” wrote John MacGregor in The Discovery of the Art of the Insane in 1989. “The world of the unconscious, into which the madman falls and the artist descends, is one world.”

To August 18, folkartmuseum.org

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