Architectural Stumbling Blocks

In the lecture, Lacan posits “the ego (is), a function of miscognition,” rather than a “function of the real.” He lays down the “toron,” the hole, and what is played out on the “edge,” as if he wanted to make visible and to capture in a sensory yet also mathematical way what is played out between the subject, desire, the unconscious, reality, neurosis, in other words, what is played out as psychoanalysis and as knowledge. Holes, impasses, aporias, stumbling points (points de butée) (this last concept being constructed by Lacan based on that of perspective, which is indispensable to painting and architecture) are defined here as the very materiality of knowledge. We could then embrace this and open it towards that of “stumbling places” (lieux-de-butée) or “stumbling areas” (espaces-de-butée), in order to be able to mentally construct what is lacking, what escapes synthesis (precisely this reality). Yet, we must nevertheless grasp it and attempt to make this reality inhabitable, even though it will never be conclusively so. Therefore, in order to posit architecture as a thought that progresses from the stumbling places (of these places in which forms, devices, built structures, houses, hospitals, or derelict sites will take shape or not), it is in these places where vulnerability acts as leverage because it leads to a deadlock, and in these places where vulnerability is a stumbling point, specifically allowing a thinking of care that doesn’t show off (as Lacan could have put it) to emerge.
We therefore needed to look for these “toron places” (lieux-tores), these “hole places” (lieux-trous)—in other words, for stumbling points on the surface of the planet. There was also this other inspiration drawing to some extent from the UN system. Falsely pragmatic, yet nevertheless efficient, it consists in placing biodiversity hotspots on the surface of the planet (which are supposed to act as regulators sustaining universal ecosystem services). Here too, the step to the side was a simple and fairly intuitive one—establishing a map of vulnerability hotspots was definitely possible; it wouldn’t be as thorough as the one drawn up by the United Nations, yet it could give us a way of conceiving, seeing, and “architecting” a different world than the one that is offered to us and that most us consider exceedingly unequal and “depriving.” By establishing this map of vulnerability hotspots, it may be possible to devise smarter models accounting for greater complexity and sensitivity to the singularity of situations, which would help generate formulas for habitability—ways of inhabiting the world that rest on the insights uncovered at the edges of these stumbling places. By taking care of these places, by understanding what is at play there as a deficiency, as a deficit, as a neurosis of the world, it could perhaps be possible to upgrade global governance and make it smarter and more efficient, where it had previously demonstrated a consummate competence for falling short of its objective. Was there even an intention to achieve anything else? There emerges a possibility of beating the system at its own game: to use its own tools and to make them more poetic, yet nevertheless operational. If we were to start tracing this map, there would surely be the various circles of Fukushima, given how much they teach us about the intersectionality of industrialism and climate deregulation—if it isn’t simply one and the same thing. It is a prime example of an Anthropocenic place, that could deliver a great many messages and protocols to the future in order to get us out of this now irreversible deadlock. There could also be a rare earth mine, which forms an exemplary stumbling area to compel architectural science in its diversity to generate livable spaces. Within a more Western-centric history and in greater resonance with the topic that we are discussing here, stumbling places where an institutional approach to care was constructed could also be included. Places of psychiatric care have put a rather great emphasis on this requirement of a “place-based” approach to clinical care (clinique du lieu).

Before outlining these various, rather symptomatic places of the transformations of the vision of health—and mental health in particular—let us also look back on this primal “envelope,” (the more primary enclosure which is that of the body) and the psychic envelope. It would be inconceivable to question the dialectic between architecture and care without commenting on the questions raised around the concepts and functions of “capacity” (contenance),[2] “containment,” and “envelope,” as well as space in the thymic sense,[3] “skin-ego” (moi-peau),[4] and the “institutional envelope.”[5] Just as Didier Houzel, it is possible to consider a “place,” and in particular a place of care, as a “process of stabilization of pulsional and emotional motions that allows the creation of psychic forms endowed with structural stability”?[6]

Work on stabilization, on stabilizing a world made unlivable due to instability, is a theme that we also recall from earlier voices from the 1970s—the period that formed a “moment,”[7] of care and, jointly, and even severally, of architecture. The voices of Kenneth Frampton[8] in the United States, Henri Lefebvre[9] in France, and later David Harvey,[10] all displaced the Marxist arsenal to make visible the mechanisms of space as “production.” They taught us that the spaces of capitalism progress and persist by destabilizing anything they run into, by erasing any edge or relief in order to leave the way open for the “circulation” of flows,[11] the unhindered flow of liquidity. This results in a space that is made homogenous, neutralized, and inhabitable and has reduced us to dimensionless points spurring on to perpetual, grueling, and painful movement as “we coincidentally crawl about.”[12] In 1965, Alexander Mitscherlich, an alert observer and pioneer of the relations between “psychoanalysis and urbanism,”[13] rightly warned us against the disastrous effects of the anonymizing homogeneity of cities on both the health of individuals and that of the “social body.” Previously, architect Claude Parent and philosopher Paul Virilio[14] had swept away that orthonormality and traced a world made of slopes, made livable through “weight,” and “potential,” as well as “exhaustion”—a world that is reshaped in “the measure of man”—although, in this case, contemporary man is exhausted.
Frampton (whose approach consists in efficiently bringing together Karl Marx and Martin Heidegger)[15] also believes that we should resist, and do so by endlessly rebordering the edges by erecting dikes even when they are soon submerged, by setting limits in the Greek and Heideggerian sense (the limit as peras, i.e., the permission to “start” something, a treatment or therapy for instance); to border as we plow the first furrow, as we in-augurate the city.[16] And, for Lefebvre, by doing so, the aim is also to engage a female, “uterine,” quality of space. We then return to the bodily envelope, this time in the form of the mother, of the enclosure. At this stage, there are two approaches. The first, where we consider the surrealists—André Breton, Tristan Tzara, or Roberto Matta Echaurren, whose contributions to the question of psychiatry are well known (especially after Paul Éluard’s time in Saint-Alban),[17] and who were also the first ones to feel the havoc wreaked by modernism, which was described in the magazine Le Minotaure as early as 1933 as the “negation of the image of the dwelling.”[18] They too preferred primal architecture—that of “mothers”—and are partial to the womb over the tomb—the architecture of the belly, the place for rest that is finally possible, the “perfect cavity”[19] that Gaston Bachelard also viewed as a deep, unconscious image that architecture would then merely reproduce, repeat, in the mythological sense of the word. The second approach has more to do with the important and astounding readings of Nicole Loraux,[20] who revealed the almost demonic precision with which the conception of a “feminine” and “motherly” architecture was achieved at the cost of a death sentence for the woman, for the female citizen. In order to be convincing, the metaphor had to make us forget its initial model, which it replaces and buries (literally, in the foundations of the construction). Loraux’s contribution here, and more generally that of feminist interpretive lenses, are crucial, as it is in the contemporary consideration of care. In our case let us say that, if architecture provides care, if it is so, just like, and because, mothers do, then why not make the most of the collation, by stating that that care should be “good enough,”[21] that architecture should know how to border when required, and that it also knows when to let go, to let off, just as Bachelard’s house is held in vertical balance between its cellar (which is primal and deep-rooted) and its attic (which is both “foliage”[22] and a launch pad)?

In fact, we hit upon the well-known paradox that is inherent to all care, the one that stretches out its threads between “vulnerability” and “autonomy,”[23] and we notice that this paradox, of course, has architectural consequences or equivalents. Over the course of history, innumerable places of care are hesitant or turn back when faced with choosing between distancing (always for the good, but the good of whom?) and repatriation, between openness towards the city (at the risk of a counterproductive normalization) and the re-edification of edges, which we yearn for once they fall. The places of the institutions of care are most concerned here. Within these very same 1970s, which saw modernism crumble, one of the most formalist opponents of “abstract” and “mechanized” architecture, Bertrand Goldberg, specifically chose the hospital as his place to respond.[24] Spaces made of “shells” (seashells, eggs, or, again, wombs) and “focal points,” brooding bedridden patients, defy the world that is devoid of any center or edge located beneath it—the world of care as a purely technical act—through style. By seeing this vertical entanglement of an ambulatory flatland and clusters of beds nested high, and by referring to reading lenses that are archaic (yet that have never been denied), we can first believe in a repetition of the founding dialectic of human inhabitation, as it is handled by timeless deities for instance—between the “fixity” of the hearth (the navel of the goddess Hestia) and the “infinitely mobile” traveler, Hermes.[25] Even more so, it should be observed that it is the first of these modalities that benefits from a preferential treatment this time, and there was probably a need for the hindsight we have today—in order to be able to appreciate the true significance of the gesture performed by the American architect—in Chicago and elsewhere—after twenty years of an “ambulatory shift” that has already largely changed the way the hospital operates and its architectural forms. It is now disturbing to come across the productions of a time that gave the largest and finest place to its patients undergoing remission and to its convalescents. The architect then raises another question, which is both difficult and essential for us—whether there exists “new” architectures of care of which we can (intuitively) foresee the qualities (the human scale, light, air, vistas…)—qualities that are present, in particular, in the Maggie’s Centers, which started being built in the 1990s and became quite successful—will these architectures stand up to the test of a necessary scaling up (at the scale of the institution, of the city), and how so? Goldberg himself believed in this possibility of an “industrialized” humanism…

These elements can fairly easily resonate, if we return to considerations that are specific to the psychic question, with the various functions of reassurance, or support structures,[26] “holding” and “handling,”[27] “imaginative elaboration,” or “alpha function”[28]—in other words, these possible interplays between the phoric, semaphoric, and metaphoric functions.[29] These possible interactions between the exterior envelope and the psychic envelope are extremely well defined by the various schools of thought of institutional psychotherapy (François Tosquelles, Jean Oury, Félix Guattari),[30] as well as the works on eco-phenomenology,[31] which takes up the traditional notion of ambiance/atmosphere.[32] No one can dispute that architectural choices generate an “atmosphere,” which results in an asepsis, which in itself is protective of a certain well-being of the actors of the place. A “place” can take on the vectorial function of the transferential object, or the more containing aspect of the object, [33] even as it goes beyond the notion of an object. However, a place produces “edges,” allowing for a dialectic between a “place-based” approach to clinical care (clinique du lieu) and an “edge-based” approach (clinique du bord).[34] What is an institution that takes care? How can it be empowering for the subject, especially when vulnerable, and operate like a symbolizing function?[35]

Medical ethics and philosophy teach us that the birth of the clinic is inseparable from another conception of architecture and its openness, its possibility of moving with the bodies, of being “holding places” (lieux-tenant) and not merely enclosing containers (contenants-enfermants). The advent of care and the recognition of the right to health, in its holistic approach, were part and parcel of another way of conceiving the city and places of care, of not reducing them to devices for confinement and marginalization, to the extent that confinement cannot precisely produce decent clinical care. Thereafter, a city builds up and develops as a welfare city, through the very implementation of a certain philosophy of the architecture of institutional places of care—though it first developed as a “technical device,” scientific rationality being the tool of choice of the first industrialization and emergence of the social issue, it later became structured around openness, destigmatization, social inclusion, and humanizing organizational relationships and places. Depending on the historical time period, the architecture of places of care has more or less allowed bodies to “become seen,” to be made either visible or invisible, depending on whether they expressed what was historically posed as being the “norm” or “pathology.”[36]

As we’ve already seen, the 1970s were critical in this philosophy of care (or clinical philosophy), proposing a transformation of the psychiatric clinic that is inseparable from architectural transformation. “Places” holding the subjects were then built, and were profoundly exemplary of this phenomenological, psychodynamic, and sociotherapeutic approach, derived from the desalienist psychiatric discourse.[37] The model of the “healing machine”[38] became that of the “person in need of healing,” or healing-focused healthcare teams, or the “shared nursing function”[39] that must be taken into account in its plurality and its plasticity—Saint-Alban with Tosquelles, La Borde (Cour-Cheverny) with Oury and Guattari, Le Vinatier (Lyon), La Chesnaie (Clinique de Chailles). Today, a high number of places are the heirs, whether declared or not, of these movements that were intent on humanizing psychiatrics and destigmatizing mental health. In addition, these are places that experiment with architectural devices driven by the belief that the concern for the spatial dimension of care is irreducible.Consider, for example, L’Adamant hospital barge (in Paris), Soteria (in Berlin), Ballerup (in Denmark), Sou Fujimoto’s light structures in Hokkaido (Japan), Clinique Caradoc (in Bayonne, France), the Brain and Mind Research Institute in Sydney (Australia), or, in a somewhat different register, Alzheimer’s Village (in Dax, France). From village-hospitals (extra muros) to the return of urban hospitals (intra muros), which can rehabilitate old industrial buildings or serve as third places with certain of their facilities, the architectural trend of these past years has been to hybridize devices, to summon the ethics of care—from the most psychopathological (Donald Winnicott)[39] to the more politicized (Joan Tronto)[41]—to incorporate the drive and methodologies of makerspaces and fab labs, while taking into account the contribution of the geography of healthcare,[42] with the notion of “therapeutic landscapes,” and indicators related to the place of natural elements (light, sun, silence, air quality, access to gardens, to biodiversity sites, either ordinary or remarkable, and so on) in health resilience. Architectes Giovanna Borasi and Mirko Zardini[43] thus defined nature as a “skin of vegetation” that is supposed to wrap exterior spaces as well as buildings in an envelope.

The apprehension of therapeutic landscapes and the natural elements as being the primary care was decisive in the history of healthcare, especially that of infectious and respiratory diseases. Alvar Aalto’s Paimio Sanatorium was an archetypal figure of that trend. This is consonant with the comments made by Le Corbusier and Charlotte Perriand, who considered architecture as being “biological,” feeding primarily on sunlight, vistas, emptiness, and silence—in other words, an architecture that immediately deems itself a healthy “living environment” at the service of human health, an empowering milieu. Today, a great many third places and commons (the notion can indeed be extended to that of “care commons”) are attempting to renovate this alternative culture of the milieu, in the sense that it becomes emancipated from institutional normalizations. At the core of this approach are the work of Anne Lacaton and Jean-Philippe Vassal, as much as those hinging on the active involvement of its residents in the architectural choices than are made, as well as those of Patrick Bouchain, with “the power of seven” (la Preuve par 7), in reference to the seven territorial scales (village, small town, city, suburban municipality, regional metropolis, disused public building, and overseas territory) that can be called upon on the experimental grounds that were legitimized by Article 88 of the French Law of 7 July 2016 on the Freedom of Creation, Architecture, and Heritage.
The boom in such practices shows that establishing links between architecture and care implies substantive, long-term work on the roles and methodologies of architects. And it isn’t surprising to observe that it is in post-Fukushima Japan that the profession, led in particular by Toyō Itō, has wanted to lay the foundations of an “architecture of the day after.”[44] The penance of an entire discipline, given that architecture as it was practiced in the 2000s to the tune of evanescence and transparence had clearly missed the mark, failed, by neglecting its primary, prosthetic, enveloping, mural function—remain standing, and holding with it those occupying the premises. The time has therefore come to add some more thickness, to restencil the walls, to recreate shelters, to descend from the “imaginary heights of abstract reason”[45] in order to re-engage in architecture “in this world of ours,” not in the cosa mentale of the architect, but in the one that we’re treading on—where that is still possible, at least. Indeed, there are whole parts of this world, Fukushima for instance, that are now uninhabitable and will remain so for a very long time. Yet it is also on these brutalized lands that new forms of habitability will be invented—we must, following Achille Mbembe, believe in the “power in reserve”/the “reserve of power” contained in traumatized geographies.[46] 
The moment of the 1970s contained, once again, some of the seeds of what is currently becoming widespread. In 1969, Bernard Rudofsky’s acclaimed and ever-popular Architecture Without Architects[47] was published—behind the praise given to vernacular architecture and local expertise. The entire field of architecture was implicitly under attack because it had forgotten about its inhabitants. The figure of the “anti-architect” emerged in response. Building, but doing so in “a profoundly antiarchitectural gesture, a nonconstructive gesture, one that, on the contrary, undermines and destroys everything whose existence depends on edifying pretensions,”[48] was also the literary (or antiliterary) project of Georges Bataille, the vocal critic of “the architectural chain gang,” as well as the risks of a culture of the monuments, reducing the human species to a “middle stage between ape and great edifices.”[49] And the legacy of another “moment” in the relationship between architecture and care, two centuries prior, can be recalled. In the years following the fire of the Hôtel-Dieu in Paris, in 1772, one must remember, alongside the consecration of the technical and ungrounded model of the “hospital as machine,” a decisive and joint evolution that took place on the terrain of methods, processes, and “acting”—extended on this occasion to experts, committees, consultants,[50] all voices with conflicting interests now involved in architectural design. It is to that field that we must also return, following Ito, as well as Tronto, in order to, in turn, talk about project extensions fanning out in other directions. Care—for architecture among other things, if we want to consider it as a caregiver—has less to do with sensibility (which would be too simple) and more to do with responsibility. Responsibilities towards the materials that the architects are moving around, towards the craftspeople and construction workers who will build the project, towards individuals and groups that will live in it, towards a site, its history, and the life forms occupying it. A point to remember in that respect is that the trauma of the Great Lisbon earthquake of 1755 had portended a shift in the history of the arts, from an anthropocentric tradition towards a slow process of “decentering” in the representation of the world and its components;[51] in like manner, the disasters of the present day are enjoining us to, at long last, rally behind a “non-human turn”[52] that is already well underway by many in the social sciences. Exploring the possible forms of an architecture of which the foundations would be revised following an approach based on relationalities remains, largely, yet to be explored.
Nowadays, the research being carried out at the confines of architecture and care ethics is becoming more cross-disciplinary and open to more complex and intersectional issues. Elsa Dorlin[53] and Helen Zahavi’s[54] work on “dirty care” is also relevant to run counter to the ethics of care that do not sufficiently deconstruct the patriarchal structures and gender violence that are at play in these ethics. By shifting these critical approaches into the architectural field, it becomes necessary to show how architecture thinks too little about the biases of domination that underlie architectural assumptions, how it inadequately calls into question the behavior patterns of avoidance of care as a praxis of resistance generating another form of care (that of emancipation) or how, for Frantz Fanon,[55] the decolonization of the being, the true objective of care, finds itself trapped by the colonial medical institution. In other words, the aim is to avoid the following two pitfalls: Is heeding to dominants still a form of care? And how can one undergo healing within a structure of domination? By addressing these issues, the challenge is also to restore, or even to rebuild, trust in care institutions by demonstrating that they do not exclusively play into the hands of the powerful. How can a space that isn’t bound to the “architectonics of power,” but rather to the architectonics of care, be created, considering that purity of either form is never achieved, with the two dynamics simply more or less balancing out?
What can these architectonics of care be in the case of psychiatric pathologies? Oury also spoke of atmosphere (ambiance) in the psychotherapeutic process, of the importance of “defining the atmosphere, what I called the ‘entours.’”[56] Again, defining the entours, the envelopes, the edges, as if this time it was necessary for architecture to deliberately try to stumble in some places, to create stumbling areas, and for the individual to brush against them, to hang on to them, or even to fuse into them. That is what the wander lines (or lines of drift—lignes d’erre) reveal, tracing the trajectories of the patients that Fernand Deligny followed over the course of ten years in rural Cévennes in order to capture the invisible—these practices of space—that unfold as if tangentially, but that also reveal themselves as being organized around “coincidences or ‘binding joists’ (chevêtres) (wander lines that intersected at a precise point, indicating that markers, and a commons, had developed).”[57] We also know that in Deligny’s speechless (mutique) patients, the quest for a spatial stumbling block (butée spatiale) has to do with a sort of language that has also stumbled, stumbled on the forming of words, on generating a sound destined to another person.[58] For these speechless individuals, other methods of subjectivation must be activated (“the-human-that-we-are is not there,” observe Deligny and Guattari in other pictures drawn by the patients themselves; the subject isn’t there). What can the space do here? The “milieu” has a role to play, of course, Deligny argued, and in fact it is this milieu that must be “educated” rather than the child. And we are led to believe, in this context, that it is architecture itself that finds itself, at the same time, stricken in its own relationship to language, in its traditional semantic or semiological function, in its role as a symbolic prosthesis conditioning and increasing the capacity for symbolization specific to each of us.

It is then hard not to see that the moment of the 1970s (again, one last time) was, also and precisely, one of a crisis of architecture as a “signifier” (Charles Jencks, Umberto Eco, Joseph Rykwert…),[59] a crisis of the model of the metaphor that had become too overwhelming and too heavy a burden, or had become obsolete in a world not wanting to subject the individual to predetermined spatial significations anymore. As to the other moment mentioned, that of the 1770s and its profusion of architectural machines imagined to replace the Hôtel-Dieu, it had already been the occasion of a similar disruption. Architecture, which is a “knowledge of a largely linguistic nature” was suddenly impelled to reconsider its methodology based on “questionnaires, population tables, and mortality rates.”[60] The quest for efficiency, especially within the architecture of hospitals, and, more broadly, in healthcare architecture, is obviously legitimate, and even non-negotiable. But that must happen without decreasing the capacity of space to produce signs—in other words, “marks” (repères) and “commons” (commun) in Deligny’s lexicon. In his latest book,[61] Ludger Schwarte follows on these discussions and advocates another idea—that architecture actually “precedes” languages, coming just before it, and is “at the limits of language”[62] (an archaeological architecture… of a Foucauldian nature?); the signifying moment—Lacan’s Jaw—slides, partially at least, from architecture towards dwelling, from the inhabited object towards the inhabiting subject. Just as a care practice precedes, prepares, and prepares itself to let go (even if that means allow for return, whether it’s shortly after, or even chronically).
Another major question has long been carried down through architecture—what place should be assigned to the traumatic trace within buildings? Where must it be included? How can it be reflected in order to avoid a denegation of individual and collective trauma? What must be made of it so that the place becomes a resilient third place? This question is not extraneous to any form of therapeutic work that attempts to define the right distance to and recognition of trauma. After all, how can one refer to the registration of time, of history, of memory, of the imprescriptible sometimes, of a point of no return in the sense that a mourning was played out, in space? How can we spatially understand and move beyond what cannot simply be said, what would like to forget oneself, but cannot, either due to pathological reasons or due to duties and responsibilities? How, precisely through the inclusion in a building, a stretch of land, can we embark on the adventure of the non-repetition of the tragic event? In the context of the post-trauma reconstruction of Germany’s cities, Mitscherlich rightly suspected the consequences of an architecture that was proceeding “as if no catastrophe had taken place,” which would then shut off the “psychic healing” of society. For the city as well as for the individual, we know that there is the same impossibility of psychically going back, we know that there is an “irreversibility,”[63] and that architectured spaces must accumulate, archive, and withstand. We are therefore called upon to talk once again about one of the constituent functions of architecture—that being an art of memory,[64] a “great orthopedic device,”[65] and therefore also mnemonic. It appears, now, that we might be able to discuss the topic in new terms. There indeed exists, since the advent of care studies (with Joan Tronto, Martha Nussbaum,[66] etc.) as well as before (with Günther Anders[67] for instance), a rather largely shared premise: to make caring a foundation of organizations involves prior acceptance of a “vulnerability,” both irreducible and shared, though always differentiated, to each individual. Thus, “the obsolescence of man” shouldn’t overwhelm him with “shame” (Anders), and, though there will always be an “unease,” this unease, which is ultimately something  specific to everything that is perishable, should also be recognized as a “singularity” that nothing will be able to compete with, and especially not the ever-failing power of supposedly immortal artifacts. Yet, architecture is one, if not the very first, of these means that are sought by humans in order to make up for their existential “lag,” to transcend its vulnerability in order to build the “cheery denial”[68] of the city. Must that part of history be revisited so that architecture can continue playing its role as an archive crucial to the resilience of the human project, but in a way that this archive may finally and truly become inhabitable? Beyond aesthetics, it is an issue that touches upon what produces history—how do we each take part, collectively and individually, in producing civilization, in a way that fits into a mental landscape that will come to endorse one possible future or another. Ludger Schwarte defines the challenge of architecture as being capable of designing “a world that is ahead of us,”[69] and doing with forms, with buildings, what others can achieve with language.

What is this world that is ahead of us? Everyone is familiar with the Vitruvian Triad of solidity (that which holds and supports), utility (that which serves and enables), and beauty (that which inspires and nourishes). It remains unsurpassable, even though the new horizons ahead invite reinterpretation and the re-establishing of architectural principles. Architecture faces a daunting challenge (and probably the most sensitive and the most immediately open to experimentation)—that of shaping the world, to enable us to “land,” in the words of Bruno Latour.[70] To land, to settle, to dwell, without nevertheless losing all one’s drive, and accurately perceiving through the horizontality of matter the immanent verticality, which is sometimes material, and invariably intelligible.


In the book « Soutenir. Ville architecture et soin » published by the Pavillon de l'Arsenal in 2022.

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Cynthia Fleury
Philosopher and psychanalyst Cynthia Fleury is also Professor and Chair in Humanities and Health at the CNAM, attached to GHU Paris Psychiatrie & Neurosciences. For several years now, she has made care one of the main focuses of her research and thinking. Her approach is that of a philosopher, and also psychoanalysis practitioner, who examines society based on the disorders she encounters in a clinical setting.

Éric de Thoisy
Architect, PhD in architecture, research director at the architects collective SCAU, and associate researcher at the Chair of Philosophy at the Hospital, in charge of the “Architecture and Care” seminar, Éric de Thoisy recently published La maison du cyborg [The House of the Cyborg] (Paris: L'Harmattan, 2020).

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* The French word butée is generally translated as "stumbling block" in Lacan's works, but its meaning is closer to the notion of a "stopping point," while also carrying a secondary meaning unrelated to that of an obstacle bringing an object (or thought) to a halt. It is then a "holding point," a buttress, or an abutment, restraining the thrust of a structure and thereby preventing its collapse.


1. Jacques Lacan, “The Object of Pyschoanalysis” (1965–1966), lecture V: 5 January 1966. Available online in French at https://ecole-lacanienne.net/wp-content/uploads/2016/04/1966.01.05.pdf, and in English at http://www.lacaninireland.com/web/wp-content/uploads/2010/06/13-The-Object-of-Psychoanalysis1.pdf
2. René Kaës, ed., Crise, rupture et dépassement [Crisis, Rupture, and Overcoming], with texts by André Missenard, Raymond Kaspi, Didier Anzieu, Jean Guillaumin, José Bleger, Elliott Jacques (Paris: Dunod, 1979).
3. See Ludwig Binswanger, “Das Raumproblem in der Psychopathologie” [The Problem of Space in Psychopathology], Zeitschrift für der gesamte Neurologie und Psychiatrie 145 (1933), chap. 2 “[Thymic Space].”
4. See Didier Anzieu, Thought: From the Skin-Ego to the Thinking Ego (London: Jessica Kingsley Publishers: 1996), originally published in 1993, and Didier Anzieu, The Skin-Ego (New Haven: Yale University Press, 1989), originally published in 1985.
5. See Didier Houzel, “Enveloppe familiale et fonction contenante” [Family Envelope and Containment Function], in Émergences et troubles de la pensée [Emergences of Thought and Thought Disorders], ed. Didier Anzieu (Paris: Dunod, 1994), 27–40.
6. Ibid., 31.
7. See Frédéric Worms, Le Moment du soin. À quoi tenons-nous ? [The Moment of Care. To What Do We Tend?] (Paris: PUF, 2010).
8. Kenneth Frampton, “Towards a Critical Regionalism. Six Points for an Architecture of Resistance,” in The Anti-Aesthetic. Essays on Postmodern Culture, ed. Hal Foster (Port Townsend, WA: Bay Press, 1983).
9. Henri Lefebvre, The Production of Space (Oxford: Basil Blackwell, 1991). Originally published in 1974.
10. David Harvey, Spaces of Capital. Towards a Critical Geography (London: Routledge, 2001).
11. Ibid.
12. Edmund Husserl, “Enracinement or The Earth, the Originary Ark, Does Not Move,” in Philosophical Essays in Memory of Edmund Husserl, ed. Marvin Farber (Cambridge, MA: Harvard University Press, 2014). Originally written in 1934.
13. Alexander Mitscherlich, Psychanalyse et urbanisme. Réponse aux planificateurs [Psychoanalysis and Urbanism: Response to Planners] (Paris: Gallimard, 1965).
14. "Architecture Principe (Claude Parent, Paul Virilio) — La fonction oblique, 1965-1967” [The Function of the Oblique]. Available online at https://www.frac-centre.fr/_en/art-and-architecture-collection/architecture-principe/la-fonction-oblique-317.html?authID=10&ensembleID=30.
15. Kenneth Frampton, “On Reading Heidegger,” Oppositions, no. 4 (1974).
16. See Ivan Illich, H₂O and the Waters of Forgetfulness (Dallas: Dallas Institute of Humanities and Culture, 1985).
17. See in particular Paul Éluard, Souvenirs de la maison des fous [Memories of the Madhouse (Paris: Gallimard, 1945).
18. Tristan Tzara, “D’un certain automatisme du goût ” [On a Certain Automatism of Taste], Le Minotaure, no. 3–4 (1933).
19. Gaston Bachelard, Earth and Reveries of Repose: An Essay on the Images of Interiority (Dallas: Dallas Institute Publications, 2011). Originally published in 1948.
20 Nicole Loraux, The Children of Athena: Athenian Ideas about Citizenship and the Division between the Sexes (Princeton, NJ: Princeton University Press, 1994). Originally published in 1981.
21. As with Donald Winnicott’s “good-enough mother,” in Donald Winniccott, “Transitional Objects and Transitional Phenomena. A Study of the First Not-Me Possession,” International Journal of Psychoanalytics, 34, no. 2 (1953).
22. Gaston Bachelard, Earth and Reveries of Will (Dallas: Dallas Institute of Humanities and Culture, 2002). First published in 1947.
23. See Paul Ricœur, “Autonomy and Vulnerability,” in Reflections on the Just (Chicago: The University of Chicago Press, 2007). Originally published in 1997.
24. These are Goldberg’s words, as reported in Michel Ragon, Goldberg. Dans la ville / On the City (Paris: Paris Art Center, 1985).
25. Jean-Pierre Vernant, “Hestia–Hermes: The Religious Expression of Space and Movement in Ancient Greece,” in Myth and Thought Among the Greeks (London: Routledge & Kegan, 1983). Originally published in French: “Hestia-Hermès. Sur l’expression religieuse de l’espace et du mouvement chez les Grecs,” L’Homme 3, no. 3 (1963).
26. Hermann Broch, Massenwahntheorie [Theory of Mass Hysteria] (1955). Translated in French by P. Rusch and D. Renault as Théorie de la folie des masses (Paris: Éditions de l’éclat, 2008).
27. See Donald Winnicott, The Child and the Family (London: Tavistock, 1957).
28. Wilfred R. Bion, Learning From Experience (London: William Heinemann, 1962).
29. See Pierre Delion, Fonction phorique, holding et institution [Phoric Function, Holding, and Institution] (Toulouse: Érès, 2018); and Pierre Delion, ed., La Pratique du packing avec les enfants autistes et psychotiques en pédopsychiatrie [The Practice of Packing with Autistic and Psychotic Children in Pedopsychiatrics] (Toulouse: Érès, 2007).
30. On this topic, see for instance Jean Oury and Patrick Faugeras, Préalables à toute clinique des psychoses [Primer to Any Clinic of Psychoses] (Toulouse: Érès, 2013).
31. Bruce Bégout, Le Concept d’ambiance [The Concept of Ambiance] (Paris: Seuil, 2020).
32. This work is largely based on that of the German psychiatrist Hermann Simon, with his
“Active Therapy in the Lunatic Facility,” in From Madness to Mental Health. Psychiatric Disorder and Its Treatment in Western Civilization, ed. Greg Eghigian (New Brunswick, NJ: Rutgers University Press, 2010). This text was originally published in 1929 and translated in French at the Saint-Alban Hospital.
33. See Esther Bick, “The Experience of the Skin in Early Object Relations,” The International Journal of Psychoanalysis, 49, no. 2–3 (1968): 484–486.
34. Howard Buten, Burt (New York: Holt, Rinehart and Winston, 1981). Also later published under the title When I Was Five I Killed Myself.
35. See René Roussillon, “La fonction symbolisante de l’objet” [The Symbolizing Function of the Object], Revue française de psychanalyse, 61, no. 2 (1997).
36. Georges Canguilhem, The Normal and the Pathological (Dordrecht: Springer Netherlands, 1978). Originally published in 1966.
37. See Lucien Bonnafé, Désaliéner ? Folie(s) et société(s) [Disaleniate? Madness and Society] (Toulouse: Presses universitaires du Mirail, 1992).
38. Michel Foucault, Blandine Barret-Kriegel, Anne Thalamy, et al., ed., Les Machines à guérir : aux origines de l’hôpital moderne [Healing Machines: The Origins of the Modern Hospital] (Brussels, Liège: Pierre Mardaga, 1979).
39. The phrase was coined by Jean Oury, a psychiatrist and founder of the La Borde Clinic; see, in particular, his 2009 lecture entitled “L’analyse institutionnelle” [Institutional Analysis], given in Tours during a seminar of the Aprec (Association des psychologues de la région Centre). Available online in French at https://bibliothequeopa.blogspot.com/2009/07/jean-oury-lanalyse-institutionnelle.html
40. See Donald Winnicott, “Cure: A Talk to Doctors,” lecture given on 18 October 1970.
41. Joan Tronto, Moral Boundaries: A Political Argument for an Ethic of Care (New York: Routledge, 1993).
42. Robin A. Kearns and Wilbert M. Gesler, ed., Putting Health Into Place. Landscape, Identity and Well-Being (Syracuse, NY: Syracuse University Press, 1998) .
43. Giovanna Borasi and Mirko Zardini, ed., En imparfaite santé : la médicalisation de l’architecture [In Imperfect Health: the Medicalization of Architecture] (Montréal: Centre canadien d’architecture/Baden: Lars Müller Publishers, 2012).
44. Toyō Itō, L’Architecture du jour d’après [Architecture of the Day After] (Brussels: Les Impressions nouvelles, 2014).
45. Tim Ingold, “Walking with Dragons: An Anthropological Excursion on the Wild Side,” in  Animals as Religious Subjects : Transdisciplinary Perspectives, ed. C. Deane-Drummond, D. Clough, & R. Artinian-Kaiser (London: Bloomsbury, 2013)
46. Achille Mbembe, Brutalisme [Brutalism] (Paris: La Découverte, 2020).
47. Bernard Rudofsky, Architecture Without Architects : A Short Introduction to Non-Pedigreed Architecture (New York: Doubleday & Company, 1964).
48. Denis Hollier, Against Architecture. The Writings of Georges Bataille (Cambridge, MA: MIT Press, 1990). Originally published in French as La Prise de la Concorde (Paris: Gallimard, 1974).
49. Georges Bataille, “Architecture,” Documents, no. 2 (May 1929). Reprinted in Denis Holier, Against Architecture. The Writings of Georges Bataille (Cambridge, MA: MIT Press, 1990), where “une étape intermédiaire entre les singes et les grands édifices” is plainly translated as “an intermediate stage between monkeys and great edifices.”
50. See Blandine Barret-Kriegel, “L’hôpital comme équipement” [The Hospital as Equipment], in Les Machines à guérir : aux origines de l’hôpital moderne [Healing Machines: The Origins of the Modern Hospital], ed. Michel Foucault (Brussels, Liège: Pierre Mardaga, 1979).
51. See Thomas Schlesser, L’Univers sans l’homme [The Humanless Universe] (Paris: Hazan, 2016).
52. Richard Grusin, The Non-Human Turn (Minneapolis: University of Minnesota Press, 2015).
53. Elsa Dorlin, Self-Defence. A Philosophy of Violence (New York/London: Verso Books, 2022). Forthcoming. Originally published in 2017.
54. Helen Zahavi, Dirty Weekend (Macmillan: London, 1991).
55. See Alice Cherki, Frantz Fanon, portrait [Frantz Fanon, Portrait] (Paris: Seuil, 2000).
56. Jean Oury, “Transfert, multiréférentialité et vie quotidienne dans l’approche thérapeutique de la psychose” [Transfer, Multireferentiality, and Daily Life in the Therapeutic Approach of Psychosis], Cahiers de psychologie clinique, 2003/2, no. 21. (2003).
57. Gisèle Durand and Jacques Lin, ed., Cartes et lignes d’erre / Maps and Wander Lines. Traces du réseau de Fernand Deligny, 1969-1979 [Maps and Wander Lines. Traces of Fernand Deligny’s Network, 1969–1975] (Paris: L’Arachnéen, 2013).
58. See Nicolas Brémaud, “Autisme : de bords à corps” [Autism: From Border to Body], L’Information psychiatrique, 87, no. 8 (2011).
59. These include: George Baird, Charles Jencks, Meaning in Architecture (London: Barrie & Rockliff, The Cresset Press, 1969); Joseph Rykwert, “Meaning and Building ,” in Zodiac no. 6 (1960); Umberto Eco, “Function and Sign: the Semiotics of Architecture” in Structures Implicit and Explicit, ed. James Bryan, Rolf Sauer (Philadelphia: University of Pennsylvania, 1973).
60. Bruno Fortier, “Le camp et la forteresse inversée” [The Camp and the Inverted Fortress] , in Les Machines à guérir : aux origines de l’hôpital moderne [Healing Machines: The Origins of the Modern Hospital], ed. Michel Foucault (Brussels, Liège: Pierre Mardaga, 1979).
61. Ludger Schwarte, Philosophie de l’architecture [Philosophy of Architecture] (La Découverte: Paris, 2019).
62. Michel Foucault, The Archaeology of Knowledge (New York: Pantheon Books, 1972). Originally published in 1969.
63. See Catherine Malabou, The New Wounded (New York: Fordham University Press, 2012). Originally published in 2007.
64. Frances A. Yates, The Art of Memory (London: Routledge and Kegan Paul, 1966).
65. José Ortega y Gasset, in Darmstadt, in 1951, during a conference that mostly remained famous due to Heidegger’s intervention; see José Ortega y Gasset, “Der Mythos des Menschen hinter der Technik," in Mensch und Raum, ed. Otto Bartning (Darmstadt: Neue Darmstädter Verlagsanastalt, 1952).
66. Martha Nussbaum, The Fragility of Goodness (New York: Cambridge University Press, 1986).
67. Günther Anders, Die Antiquiertheit des Menschen [The Obsolescence of Man] (C.H. Beck: Munich, 1956).
68. Layla Raïd, “Care et politique chez Joan Tronto” [Care and Politics in Joan Tronto], in
What Is Care?, ed. Pascale Molinier, Sandra Laugier, and Patricia Paperman (Payot: Paris, 2009).
69. Ludger Schwarte, Philosophie de l’architecture [Philosophy of Architecture] (La Découverte: Paris, 2019).
70. Bruno Latour, Down to Earth: Politics in the New Climatic Regime (Cambridge: Polity Press, 2018). Originally published in 2017.