his consultant, Dr Madeleine Humbert, replied to Jacques Postel’s enquiries about Fanon’s early career: ‘I have no memory of Fanon deigning to note down any observations. He left the most unpleasant memory possible of his stay, and treated the nurses . . . like a colonialist. It has to be said that, at the time, he was the only intern for five hundred patients.’91 The claim that Fanon acted ‘like a colonialist’ is clearly grounded in a retrospective vision filtered though a negative perception of Fanon as theorist of colonization, but Humbert’s memory is faulty. The final section of Peau noire, masques blancs shows quite definitely that Fanon did note down observations at Saint-Ylié, and that he made good use of them.
The case he discusses was brought to Fanon’s notice by the doctor in charge of the female ward – presumably Humbert herself – and involved a nineteen-year-old who was suffering from obesity as well as a variety of tics and other nervous problems. The symptoms had first appeared when she was ten and had worsened at puberty. Now that she was living and working away from home, she was also suffering from depression and experiencing panic attacks. During an interview with the consultant psychiatrist, it emerged that she was experiencing hallucinations, and she described them in a waking-dream state: ‘Deep, concentric circles that expand and contract to the rhythm of a negro tom-tom. This tom-tom brings to mind the danger of losing her parents, and especially her mother.’92 When she glanced towards the drum, it was surrounded by half-naked men and women performing a terrifying dance. Told not to be afraid of joining the dance, she does join in. The appearance of the dancers changes immediately; they are now guests at a splendid party. Further sessions revealed more hallucinations of a group of negroes dancing around a cooking pot, and preparing to burn a white man in his fifties.
Having read his colleague’s case notes and having held ‘many conversations’ with the patient, Fanon concluded that the young woman’s fear of negroes dated from the age of ten and was associated with a memory of her father, who had served in the colonial army, listening to radio broadcasts of ‘negro music’. As she lay in bed, the house throbbed to the sound of a tom-tom. She could see negroes dancing and hid from them under the blankets. Circles would then appear and ‘scotomize’ the negroes or make them disappear; they were a defence against the hallucinations. At a later stage, the circles appeared without the negroes; the defence mechanism was now coming into play in the absence of its determinant, and the circles alone were enough to trigger the facial tics. Fanon argues in conclusion that her condition was the result of a fear of negroes and that its emergence had been triggered by ‘determinate circumstances’.
The Saint-Ylié case was of obvious interest to someone working on the psychology of negrophobia: ‘It shows that, in extreme cases, the myth of the negro, the idea of the negro, can determine an authentic alienation.’93 But it also provides an insight into the clinical methods and techniques with which Fanon had become familiar in Lyon. He is clearly more interested in the effects of the ‘myth of the negro’ than in how a neurosis originates in the individual unconscious of the patient, and does not trace it back to unconscious sexual fantasies. He explicitly refuses to elaborate on ‘the infrastructure of this psycho-neurosis’, but it is surely of more significance that he devotes so little of his discussion to the figure of the patient’s father – not something that any Freudian psychoanalyst would overlook. He refers to the use of the ‘waking dream’ technique without comment or question, indicating that it was something with which he was so familiar as to find it unremarkable. The technique was originally developed in the 1920s in connection with research into mental imagery, but Robert Desoille’s Le Rêve éveillé dirigé (1945), which was presumably the source of Fanon’s knowledge, gave it wider currency. Although the technique has something in common with Freud’s free association technique – the patient lies on a couch and describes the ‘affects’, or emotions, associated with the images that come into his or her head – it is more closely related to Pavlov’s research into the higher nervous system than to psychoanalysis. The material thrown up during the daydream allows the therapist to provoke new situations so as to observe the subject’s affective reactions and gradually to reduce the level of anxiety by releasing tension at both the psychological and physiological level. There is no attempt to establish transference, or the relationship that allows the patient to actualize unconscious wishes by projecting them on to the figure of the analyst. Infantile prototypes and memories re-emerge and are experienced with a very powerful sense of immediacy.94
Fanon has no criticisms to make of waking dream therapy. Yet one word indicates that he was also interested in going beyond the parameters of the psychotherapy in which he had been trained. He writes: ‘Then increasingly small circles appear and scotomize the negroes.’95 Scotomiser is a very rare word, and it has a very peculiar history in French psychoanalysis.96 It derives from the Latin scotoma, and originally meant an obscuration of part of the field of vision due to a lesion on the retina. Tentatively introduced into psychoanalysis by René Laforgue to describe a process of psychic depreciation by means of which the individual attempts to deny everything which conflicts with his ego, it was rejected by Freud. It was then used by Lacan in his 1938 article on the family to describe the mechanism that triggers a psychosis (Lacan later ceases to use the term and replaces it with ‘foreclosure’).97 The discussion of the Saint-Ylié case indicates that there was already a tension between the tradition in which Fanon had been trained and a Freudian-Lacanian discourse which he knew only from his personal reading. The same tension structures his medical dissertation of 1951. Although Fanon’s dissertation is often referred to as his ‘thesis’, it was part of a first degree and not a submission for a postgraduate qualification. Its purpose was to demonstrate his competence within his field and not to make any original contribution to it.
Fanon remarks that he had intended to submit Peau noire, masques blancs as the dissertation he was required to write in order to qualify as a doctor of medicine, and then adds somewhat mysteriously ‘And then the dialectic forced me to take a much firmer stance’.98 His failure to submit it had in fact nothing to do with any ‘dialectic’, and it is wounded pride that prevents him from admitting that the planned thesis was angrily rejected before he was able to submit it by an outraged Professor Dechaume on the predictable grounds that it defied all known academic and scientific conventions. A medical thesis is not the place for such an experimental exploration of the author’s subjectivity or for such lengthy quotations from Aimé Césaire. Fanon had to begin again with a more conventional topic, and rapidly produced a seventy-five-page typescript (typed by an unknown hand) with the cumbersome descriptive title of ‘Altérations mentales, modifications caractérielles, troubles psychiques et déficit intellectuel dans l’hérédo-dégénération spino-cérébelleuse. Un cas de maladie de Friedrich avec délire de possession’ (‘Mental disturbances, changes in character, psychic disturbances and intellectual deficiency in spinal-cerebral degeneracy. A case of Friedrich’s disease with delusions of possession’). Defended before a board of examiners on 29 November 1951, it deals mainly with the mental symptoms associated with a case of Friedrich’s ataxia, which is a recessive hereditary disease of the central nervous system. As is the convention with a thesis, the first section summarizes the literature on the condition whilst the second summarizes Fanon’s observations of the female patient in question. In the concluding section, Fanon moves into a discussion of the respective roles and nature of neurology and psychiatry.99
Fanon never again mentioned his thesis, and made no attempt to publish it. He was, on the other hand, sufficiently proud of it to dedicate a copy to his brother Félix with a rather wordy inscription:
To my brother Félix,
I offer this work.
The greatness of a man is to be found not in his acts but in his style. Existence does not resemble a steadily rising curve, but a slow, and sometimes sad, series of ups and downs.
I have a horror of weaknesses – I understand them, but I do not like them.
I do not agree with those who think it possible to live life at an easy pace. I don’t want this. I don’t think you do either.100
Although Fanon did follow the academic conventions this time, even to the extent of citing Dechaume (of whom he had a very poor private opinion), the dissertation still reflects