On 20th July 2025, Frantz Fanon would have turned 100 years old. Despite having died at only 36 years of age, the Martiniquan psychiatrist is still today perceived as a great anti-colonial thinker and revolutionary whose works are still widely received. Additionally, his psychiatric works have been rediscovered as a reference, also in the field of medicine and critical global health.[1] Horton even locates his work “at the origins of global health”.[2] What makes the revolutionary psychiatrist a global health prophet? Reading his writings beyond the widely known books in the context of his psychiatric work and revolutionary engagement delivers answers.
Fanon and his medical staff in Blida 1953-1956 (Wikimedia Commons)
A lifelong quest for disalienation
In this first book, the famous Black Skin, White Masks (BSWM, 1952), Fanon works his personal experiences as an Antillean in racist French society into a psychopathological study of the effects of racism. For Fanon, that racist society creates a potentially pathological alienation of racialized and colonized people that cannot be reduced to the individual level. This specific alienation (the term aliéné also means mentally ill in French) and its reversal, “The Disalienation of the Black Man” (the working title of BSWM), would be Fanon’s lifelong “quest”.[3]
As a psychiatrist in Blida, he applied François Tosquelles’ “institutional therapy” approach to the French Algerian context, distancing himself from then dominant ideas of ethnopsychiatry that saw mental illness, aggression and criminality as an inherent part of North African culture. Coined by the French psychiatrist Antoine Porot and his so-called Algiers School, pseudo-scientific ideas of the North African as a primitive being with a pathological penchant for crime had become dominant in French Algeria and even adopted on the whole of Africa by WHO doctor J.C. Carothers.[4] In the 1955 text “Ethnopsychiatric Considerations”, Fanon dismantles the ethnopsychiatric arguments, all the while not denying the frequent violence in Algeria.[5] But for Fanon, the breathtakingly oppressive living conditions under violent colonial rule were the most significant determinant for Algerian criminality. The decline of criminality during the liberation war was the best empirical argument that the Algerian is in fact not a born criminal. As he writes in The Wretched of the Earth (1961), “the criminality of the Algerian, his impulsiveness, the savagery of his murders are not, therefore, the consequence of how his nervous system is organized or specific character traits, but the direct result of the colonial situation”.[6]
Medicine and illness in the colonial situation
Fanon observes how the colonial situation affects the colonized’s relation to medicine. In chapter four of his second book A Dying Colonialism (1959) entitled “Medicine and Colonialism”, he observes a deep mistrust of the colonized vis-à-vis Western medical science, institutions, practices and staff stemming from the fact that “in the colonies, the doctor is an integral part of colonization, of domination, of exploitation”. In colonial Algeria, the doctor is first and foremost a landowner, a settler. Due to this position and his high standard of living, he is “economically interested in the maintenance of colonial oppression” and therefore often fulfils the role of “leaders of colonialist movements” or militia chief or organizer or ‘anti-terrorist raids’”. As if that were not enough, Fanon documents European doctors actively taking part in the torture of Algerian freedom fighters. He writes: “The doctor sometimes reveals himself as the most sanguinary of colonizers. His identity as a doctor no longer matters. Just as he was a doctor in addition to being a property owner, so he becomes the torturer who happens to be a doctor”.[7]
Having been subjected to racism himself, he was sympathetic with the colonized patients. He thus restructured the clinic integrating what he learned during regular visits in rural communities. He looked for sociocultural, i.e. external and institutional influences on the mental condition of his patients, assuming that mental illnesses always have relational and social dimensions related to alienation.[8] In this practice, Fanon’s universal aspiration of disalienation met with sensitivity towards particular contexts: “If [the patients] were to be disalienated as men, they had to be disalienated as the ‘concrete’ individuals they were: Muslim Algerians with traditions of their own”.[9] Fanon was convinced that “the veritable social-therapeutic milieu is and remains concrete society itself”.[10] So, in order to professionally heal his patients without completely separating them from their social context – according to Fanon the place with the most potential for the creativity and rupture that disalienation demands – in May 1958, he opened Africa’s first psychiatric day clinic, the Neuropsychiatric Day Centre of Tunis.[11] His critique of the psychiatric institution aimed at liberating both the patient and the doctor from their confined relation to one another, thereby expanding his disalienation approach from the patient to his own kind, the doctor.[12]
Medicine and illness in times of war and revolution
While Fanon is deeply sympathetic with the Algerian patients that mistrust colonial medicine, and he blatantly exposes the complicity of doctors and medicine with the colonial system of violent oppression, he remains faithful to the ideal of objective medical truth. Jean Khalfa states that according to Fanon, “Europe has to learn from [Algerian attitudes on mental illnesses] if it is to develop better systems of mental care, but this in no way implies […] that one ought to abandon a scientific perspective in psychiatry”.[13] The colonial situation merely obscures, but does not wither away the fact that medicine heals people, an issue Fanon experiences as “tragic”. He contends: “The truth objectively expressed is constantly vitiated by the lie of the colonial situation”.[14] Therefore, it is not Western biomedicine as such that is violent and colonial, but the colonial system that perverts medicine.
Moreover, when the Algerian war of liberation had erupted in November 1954 and Fanon had become more and more involved in the struggle with the Front de la Libération Nationale (FLN), he bears witness to how the Algerian liberation fighters appropriate Western medicine for their purposes: “The Revolution and medicine manifested their place simultaneously. […] The war of liberation introduced medical technique and the native technician into the life of innumerable regions of Algeria”. [15] Not only his observations on medicine changed with the advent of the war. Adam Shatz observes that in his earlier writings on Algerian attitudes about mental illness, “Fanon never used the word ‘superstition’”.[16] Indeed, Fanon’s early ethnographic text “Daily Life in the Douars” first speaks of the alleged “backwardness” of Algerian rural communities before rejecting the evolutionist model in favor of scientific cultural relativism: “’Primitive’ is only a value judgement that scarcely helps us progress in our knowledge of the Algerian Muslim man. […] In Algeria, it is normal to believe in genies”. Interestingly, Fanon then predicts the imminent advent of technological progress for rural Algeria, whereas he claims that popular beliefs will “remain very deeply rooted in individual and collective consciousness, perhaps lagging behind the vital, economic and technological conditions of existence”.[17] Having written these words around or shortly before the beginning of the war in 1954, at least the first part of his predictions came true. Five years into the war,observing how Algerians appropriate technological progress in medicine for revolutionary purposes, the term “superstition” reappears:
“Old superstitions began to crumble. Witchcraft, maraboutism (already considerably discredited as a result of the propaganda carried on by the intellectuals), belief in the djinn, all these things that seemed to be part of the very being of the Algerian, were swept away by the action and practice initiated by the Revolution. Even instructions difficult for highly technological societies to accept were assimilated by the Algerian.[18]
The pre-war, cultural relativist ethnographer-psychiatrist view seems to have transformed into revolutionary evolutionism. Never would the outsider, the ethnographer, the doctor Fanon have judged the ways of the native Algerians as inherently backward. But in time, the emotionality of revolution takes over ratio, and the only way that counts is forward.
Revolution and disalienation
Fanon’s engagement for Algerian liberation and the war’s deep impact on his psychiatric work is no coincidence. Already in the beginning of Black Skin, White Masks, which is a “psychoanalytical interpretation of the black problem”, he clarifies that the alienation the black man experiences in a racist society is determined by their material conditions: “If there is an inferiority complex, it is the outcome of a double process: -primarily, economic; -subsequently, the internalization – or, better, the epidermalization – of this inferiority”. Consequently, the ultimate goal he formulates – disalienation – requires first a “recognition of social and economic realities” and then their complete transformation: “There will be an authentic disalienation only to the degree to which things, in the most materialistic meaning of the word, will have been restored to their proper places”.[19] After impressive elaborations about the mentioned inferiority complex, the lived experience of being black and the psychological effects of racism on the mental condition of racialized persons, this psychological study’s conclusion is essentially a call for global revolution: “I, the man of color, want only this: That the tool never possess the man. That the enslavement of man by man cease forever. That is, of one by another. That it be possible for me to discover and to love man, wherever he may be”.[20]
If you want, it is possible to interpret this ending as an early prequel to Fanon’s most revolutionary work, The Wretched of the Earth (1961), which he wrote after seven years of deep involvement in the anti-colonial armed struggle of the Algerian people, just before his death. Despite their obvious differences in context and content, the continuity of these two works represents the close link between psychiatry and revolution in Fanon’s life and work: While the alleged psychiatric study (BSWM) ends with a call for revolution, his alleged revolutionary manifesto includes a whole chapter of psychiatric studies.[21] In it, he classifies mental disorders emerging after torture, and the psychosomatic disorders of Algerians caused by colonialism and the war. He identifies one of those as specific to the Algerian war: systemic muscular contraction and muscle stiffness.[22] The statement from the famous first chapter “On Violence” that “the muscles of the colonized are always tensed” is thus no metaphor. Under colonialism, muscular tensions and aggressions regularly erupt into fights between the colonized, muscular spams or ritual dances.[23]
Since colonialism inscribes itself into the body and mind of the colonized, for Fanon, decolonization is a process in which the colonized’s bodily expression is the tool for collective liberation. Maxaulane interprets that in Fanon’s work, “criminality and madness in the colonial context are forms of struggle which register the political demands of the colonized subject”.[24] But in order to embark on a process of decolonization, this registration of political demands has to become conscious. The racialized subject must overcome the unconscious psychopathology of racism, collectively organize and channel the muscular tension and aggression that the colonial situation produces and direct them against the colonial master. Only then, real disalienation, the ultimate liberation – “truly the creation of new men”, is possible.[25] The anti-colonial revolution is therefore the “ultimate expression”[26] of his work as a doctor in the sense that psychiatry can help disalienating individuals by making them conscious of their pathologies – but since alienation really stems from the oppressive material conditions, true disalienation can only be realized through global revolution.
What to make of this?
Reading Fanon’s works in the context of his short life as revolutionary psychiatrist thus reveals vital lessons for the field of global health: His work permits a necessary change of perspective from supposed academic or medical neutrality to relating to the patient’s position in a politico-economic frame that is shaped by highly unequal, in Fanon’s case blatantly violent power dynamics. It is the intimate entanglement of the particular illness of one person with social revolution, the creation of a new humanity, that makes Fanon’s conceptions of health global. But since his considerations on illness and medicine are so closely tied to his personal, temporal and spatial context, Fanonian interpretations of today’s global health issues require precision. Several works have commenced to apply his considerations on the Palestinian question, which is probably the context that most resembles Fanon’s Algeria in the contemporary world.[27] An application on the Palestinian or other particular contexts would imply precisely correlating Fanon’s French Algerian context with the contemporary world in which colonial conditions are still active but have fundamentally changed.
Until then, Fanon urges us to consider how striving for genuine health for all people requires the abolition of all oppressive structures of the material world, way beyond medical institutions. Consequently, I will side with Todd Cronan’s assessment that “far too much commentary on Fanon ignores the highly unstable historical and political situation under which his work was written, looking instead to extract a portable theory of colonialism or race from his pages. Fanon explicitly rejected the pursuit of theory outside of a specific context of action”.[28] Accordingly, being true to Fanon and his work would mean “withdrawing Fanon from the theory shelf and placing him back into the world of organizational praxis” – what exactly this may mean remains to be defined by struggle, praxis and self-critique.
[1] Ali, S. Harris/Rose, Jarrett Robert (2022): The post-colonialist condition, suspicion, and social resistance during the West African Ebola epidemic: The importance of Frantz Fanon for global health. Social science & medicine (1982) 305; Gibson, Nigel C./Beneduce, Roberto (2017): Frantz Fanon, Psychiatry and Politics: Rowman and Littlefield International; Hirsch, Lioba A. (2019): In the wake: Interpreting care and global health through Black geographies. Area 52.2, 314–321.
[2] Horton, Richard. 2018. Offline: Frantz Fanon and the origins of global health. Lancet (London, England) 392(10149):720.
[3] Shatz, Adam (2024): The Rebel’s Clinic. The revolutionary lives of Frantz Fanon: BLOOMSBURY PUBLISHING PLC: 85; Fanon, Frantz (2008)[1952]: Black skin, white masks. Get political. London: Pluto Press: 174.
[4] Khalfa, Jean (2018): Fanon, revolutionary psychiatrist. In Khalfa, Jean/Young, Robert J. C. (2018) (eds.): Alienation and freedom. London, Oxford, New York, New Delhi, Sydney: Bloomsbury Academic: 167–202: 192-94.
[5] Fanon, Frantz (2018)[1955]: Ethnopsychiatric considerations. In Khalfa, Jean/Young, Robert J. C. (2018) (eds.): Alienation and freedom. London, Oxford, New York, New Delhi, Sydney: Bloomsbury Academic: 405–408.
[6] Fanon, Frantz (2004)[1961]: The wretched of the earth. New York: Grove Press: 233.
[7] Fanon, Frantz (1965)[1959]: A dying colonialism. New York: Grove Press:134-135.
[8] Khalfa 2018: 175-76.
[9] Shatz 2024: 133.
[10] Fanon, Frantz/Geronimi, Charles (2018)[1959]: Day hospitalization in psychiatry: Value and limits. Part Two: doctrinal considerations. In Khalfa, Jean/Young, Robert J. C. (2018) (eds..): Alienation and freedom. London, Oxford, New York, New Delhi, Sydney: Bloomsbury Academic: 495–509: 500.
[11] Shatz 2024: 202.
[12] Shatz 2024: 205.
[13] Khalfa 2018: 198.
[14] Fanon 1965: 121, 128.
[15] Fanon 1965: 142.
[16] Shatz 2024: 135.
[17] Fanon, Frantz/Azoulay, Jacques (2018)[1954]: Social therapy in a ward of Muslim men: Methodological difficulties. In Khalfa, Jean/Young, Robert J. C. (2018) (eds.): Alienation and freedom. London, Oxford, New York, New Delhi, Sydney: Bloomsbury Academic: 353–371: 383-384.
[18] Fanon 1965: 143.
[19] Fanon 2008: 3-5.
[20] Fanon 2008: 180.
[21] Fanon 2004: 181–234.
[22] Fanon 2004: 217-18.
[23] Fanon 2004: 16-20.
[24] Maxaulane 2022: 92-93.
[25] Fanon 2004: 2.
[26] Shatz 2024: 205.
[27] Sheehi, Stephen/Sheehi, Lara (2020): The settlers‘ town is a strongly built town: Fanon in Palestine. International Journal of Applied Psychoanalytic Studies 17.2, 183–192; Jabr, Samah/Berger, Elizabeth (2021): Fanon and Palestine. The Struggle for Justice as the Core of Mental Health. In Gibson, Nigel C. (2021) (eds.): Fanon today. Reason and revolt of the wretched of the Earth. Cantley, Québec: Daraja Press: 127–154.
[28] Cronan, Todd (2021): Fanon Can’t Save You Now | Los Angeles Review of Books. https://lareviewofbooks.org/article/fanon-cant-save-you-now/ (23.08.2024).
