Trieste as Symbol and Place: Reflections on the 'In and Out of the Asylum' Workshop

By Cristian Montenegro.

What does it mean to rethink psychiatric reform from a borderland? This was the question that stayed with me throughout In and Out of the Asylum: Psychiatric Critiques and Reforms in Historical Perspective, a two-day workshop held at the University of Trieste this February. Set in a city shaped by migration, imperial legacies, and radical experimentation in mental health, the event brought together researchers exploring the entangled histories of psychiatry, politics, and social transformation in the Alps–Adriatic region.

The workshop marked the launch of a new project led by Francesco Toncich, which seeks to revisit the experience of Basaglia and the reforms in Gorizia and Trieste by placing them within a deeper regional and historical context—one shaped by war, linguistic and cultural diversity, shifting borders, and layered institutional legacies. I’m especially grateful to Francesco for the invitation, and to Tullia Catalan, Marianna Ginocchietti, and all the generous colleagues at the University of Trieste’s Department of Humanities for their kindness and hospitality throughout.

Many of the presentations explored the history of psychiatric practice during the two world wars and in their aftermath—tracing how partisan allegiances, suspicion, expulsion, occupation and conflict translated into institutional settings. They examined how psychiatry absorbed and mediated long-term, intergenerational violence and disruption through its languages and therapeutic practices. This regional specificity is essential to understanding how the radical experiences of Gorizia and Trieste became possible. One key insight in this regard: Trieste must be understood within a history of overlapping conflicts and shifting borders that long predates fascism. The region has been shaped by empire, war, partition, and postwar occupation—from the Austro-Hungarian era through both World Wars and the Cold War reordering of Europe. Rather than a peaceful mosaic, its cultural and linguistic diversity is the outcome of displacement, redrawing of borders, and the sedimentation of multiple, often contested identities. This layered and unsettled terrain formed the backdrop against which Basaglia’s ideas took shape. While his personal experience of fascism deeply marked his critique of locked institutions, his work in Trieste unfolded in a city already defined by crossings, tensions, and the challenge of co-existence.

Basaglia was not alone in being a psychiatrist shaped by political violence or committed to resisting it. To grasp this it’s helpful to think of the region less as “Italy” and more as a space of central Europe, whose borders repeatedly shifted through conflic. The Gorizia psychiatric hospital—where Basaglia began his democratic experiment—was literally on the border between the Slovenian and Italian sides of the city, with patients from both nationalities and linguistic backgrounds. 

Again, Basaglia was not unique in this context, with other pscyhatrists before him also reacting to the violence of war through new practices and a renewed appreciation of the effect of context upon patients lives. The crucial difference is that he survived (many others were killed), and that he was able to give form to his convictions in a politically and socially favourable setting—particularly in Trieste, where multiple forces converged in support of transforming the hospital. He had the backing of political parties, religious communities, artists, intellectuals—a kind of transformative magnetism that everyone wanted to be part of and contribute to. Symbols like Marco Cavallo and enduring phrases like “Freedom is therapeutic” emerged from this collective work.

In our final conversations, two themes emerged that I’ll continue reflecting on through the Transitions project.

First is the political economy of deinstitutionalisation, a topic raised by Chantal Marazia and others. It’s important because, as we know, a key promise of deinstitutionalisation was that in the medium and long term it would be more cost-effective than maintaining large psychiatric hospitals. Yet this economic calculus remains largely unexplored empirically: Who paid? How much did it cost? Who funded what? Without detailed, grounded examples, the promise of deinstitutionalisation—while ethically compelling—risks being caught in the divide described by David Rothman in the US: between conscience (what we feel we must do) and convenience (what can be done, given material and legal constraints).

This links to a second, double-edged theme: the transformation of Trieste into a symbol. I see this taking two, apparently contradictory, forms.

On the one hand, there is a kind of fixation on the Trieste process: its innovation, courage, political vision… its uniqueness. The experience sometimes feels frozen in the past, in all its brilliance and clarity, as a permanent contrast with the messiness of the present. I saw this quite clearly during our visit to Parco San Giovanni and the excellent presentation at the Centro di Documentazione “Oltre il Giardino”. As we moved through the history—from the hospital’s closure to the building of community-based services—something was clearly gained (after all, that was the aim: to replace the asylum with alternatives), but something was also lost: the political clarity and collective energy around the act of closing the institution. There is, undeniably, a certain nostalgia at play.

The second form of symbolisation is different but connected: Trieste became a model—particularly through its entanglement with the WHO. A model, by definition, is a simplification. It sacrifices complexity for scalability. What happened behind the scenes, usually the crucial conditions for reforms to succeed, was sacrificed. Today, it sometimes feels like we know more about “the Trieste model” as a blueprint than about the dense web of human, material, and cultural forces that once made it possible. What would it mean to reverse that tendency—and to place those forces back at the centre of our understanding?

It’s encouraging to know that Transitions is joining with other researchers and groups committed to restoring depth and texture to the description and analysis of this process via tracing its connections with other experiences, particularly in South America.