Event refers to an occurrence or experience in the lifeworld of human beings which is an exception or rupture that opens new horizons in life. It derives from Being and Event, the key work of philosopher Alain Badiou which updates and replaces subjective phenomenology, the dominant philosophy of the 20th century that was introduced into psychiatry a century ago through the seminal work of Karl Jaspers. Phenomenological psychiatry became the exemplary model for clinical psychiatry for much of the last century, with many elaborations and refinements by figures as diverse as Eugène Minkowski, Ludwig Binswanger and Ronald Laing. Badiou’s evental thought outlines a new objective phenomenology for philosophy and the human sciences, including psychiatry. Ever since its foundation by Edmund Husserl, phenomenology has had pioneering psychiatrists apply its philosophy to clinical practice. Husserl inspired Jaspers’ phenomenological psychiatry, while his successor Martin Heidegger’s Being and Time inspired Binswanger’s existential analysis. Sartre’s reading of Heidegger in Being and Nothingness inspired the social phenomenology of Ronald Laing. Our generation now has the inspiration of Badiou’s objective phenomenology in Being and Event to revision psychiatry today. The author recently conducted philosophical investigations supervised by Badiou for his doctoral dissertation entitled Trauma and Event which re-examined trauma by contrasting it to the Event. Working closely with Badiou, the author proposes that the pivotal notion of the Event offers psychiatry and all forms of psychotherapy (from psychoanalysis to family therapy to cognitive therapy) a theory of change (evental being), a new definition of the subject (evental self), and therapeutic practices (evental therapy) that flow from that. Badiou affirms that the author’s proposal for an evental psychiatry opens a broad new horizon for philosophy and for psychiatry. The presentation will outline three possible model Events for psychiatry and for psychotherapy with clinical illustrations. As well as describing the phenomena of psychiatry in a new, objective way and offering a new theory of change, evental psychiatry also accounts for a new definition of the subject of psychiatry and psychotherapy, the evental self. The self that emerges from the Event will be outlined and linked to contemporary issues in clinical psychiatry.

1. Thinking the Event, Thinking Change:
A new theory of change
for psychiatry and
psychotherapy
Vincenzo Di Nicola

2. Éloge à la complexité
49e
Congrès annuel de l’AMPQ
• Le Château Frontenac, Québec
• Samedi le 30 mai 2015
• 17h00 à 17h30

3. Thinking the Event,
Thinking Change
Vincenzo Di Nicola, MPhil, MD, PhD
• Psychologue, psychiatre, philosophe
• Professeur titulaire,
Université de Montréal

4. Thinking the Event,
Thinking Change
Vincenzo Di Nicola, MPhil, MD, PhD
Conflicts of interest? Many!
• As a psychologist, a psychiatrist and a
philosopher –
these are domains of inquiry and practice
that are by definition critical and sceptical
about truth claims and in conflict with each
other!
• Not faith-based

5. Thème : Des neurosciences à l’inconscient (2009)
Philosophy and Psychiatry:
Reflections of Mind
Vincenzo Di Nicola

6. Thème : À la recherche du sens (2014)
Philosopher en clinique :
Aider le patient à naviguer
entre sens et signification
Vincenzo Di Nicola

7. Thème : Éloge à la complexité (2015)
Thinking the Event, Thinking Change:
Capturing Complexity
Vincenzo Di Nicola

8. 1. Introduce and define the notion of the Event based
on the philosophy of Alain Badiou into psychiatric
theory and practice.
1. Outliine evental being, a new theory of change for
psychiatry and psychotherapy based on the Event.
1. Demonstrate how evental being, a new theory of
change, creates a new objective
phenomenology for psychiatry and a new definition
of the subject with the notion of the evental self.
Pedagogical Objectives

9. Epigraph
• What will philosophy say to us? It will say:
“We must think the event.” We must think the
exception. We must know what we have to
say about that which is not ordinary. We must
think change in life.
—Alain Badiou
Ref: Alain Badiou, Polemics, trans. and with an
introduction by Steve Corcoran (2006), p. 8.

10. Alain Badiou
(Né Rabat, 1937)

11. “Geopoliticus child watching the birth
of the new man”
- Dali, 1943

12. Epigraph
• The philosopher’s treatment of a question
is like the treatment of an illness.
—Ludwig Wittgenstein
Le traitement du philosophe d’une question
c’est comme le traitement d’une maladie.
Ref: Ludwig Wittgenstein, Philosophical Investigations
(1953) §255, p. 91.

13. Ludwig Wittgenstein
(1889-1951)

14. Épigraphe
• Pour guérir quelle blessure, pour ôter
quelle écharde dans la chair de l’existence
suis-je devenu c’est qu’on appelle un
philosophe?
—Alain Badiou
Réf : Alain Badiou, « Préface », Quentin Meillassoux,
Après la finitude (2006), p. 9.

15. Epigraph
• What wound was I seeking to heal, what
thorn was I seeking to draw from the flesh of
existence when I became what is called “a
philosopher”?
—Alain Badiou
Ref: “Preface,” Quentin Meillassoux’s After Finitude,
trans. by Ray Brassier (2008), p. vi.

16. Qu’est-ce que la philosophie?
Deux types de philosophies
• Philosophies et anti-philosophies
– Alain Badiou
• Philosophies systématiques et
édifiantes – Richard Rorty

17. What is philosophy?
Two types of philosophy
• Philosophies and anti-philosophies
– Alain Badiou
• Systemic and edifying philosophies
– Richard Rorty

18. Qu’est-ce que la philosophie?
Philosophie/
Systématique
Rechercher de la vérité
Fondement, clarification,
consolation
• Plato, Aristotle
• Aquinas, Augustine
• Husserl, Heidegger
• Wm James
• Badiou
Anti-philosophie/
Édifiante
Intérroger des vérités
Déconstruction,
problématisation
• Héraclite
• Nietzsche, Marx
• Wittgenstein
• Freud, Lacan
• Derrida, Foucault, Rorty

19. L’Événement
The Event
Event refers to an occurrence or
experience in the lifeworld of
human beings which is an
exception or rupture that opens
new horizons in life

20. L’Événement
The Event
This notion of Event derives from
Being and Event –
the key work of French
philosopher Alain Badiou

21. L’Événement
The Event
Being and Event updates and
replaces subjective
phenomenology, the dominant
philosophy of the 20th century
that was introduced into
psychiatry a century ago through
the seminal work of Karl Jaspers

22. L’Événement
The Event
Phenomenological psychiatry became
the exemplary model for clinical
psychiatry for much of the last
century, with many elaborations and
refinements by figures as diverse as
Eugène Minkowski (France), Ludwig
Binswanger (Switzerland) and Ronald
Laing (Britain)

23. L’Événement
The Event
Phenomenological psychiatry was an
attempt to capture the complexity of
human experience and relations in
clinical psychiatry –
not to simply, reduce or tame them

24. Objective
phenomenology
Badiou’s evental thought outlines a
new objective phenomenology for
philosophy and the human
sciences, including psychiatry

25. Foundations of
phenomenology
• Phenomenology was founded by
Edmund Husserl (1859-1938)
in Germany
• Further elaborated by his student Martin
Heidegger (1889-1976) to become one
of the dominant schools of philosophical
thought of the 20th century

26. Phenomenology in
psychiatry
• Phenomenology has now had
several generations of pioneering
psychiatrists apply philosophical
method to clinical practice

27. Phenomenology in
psychiatry
• Edmund Husserl inspired Karl Jaspers’
phenomenological psychiatry (1913)
• Martin Heidegger’s Being and Time (1927) inspired
Ludwig Binswanger’s existential analysis exposed
in his famous case of Ellen West (1943-1944)
• Jean-Paul Sartre’s reading of Heidegger in Being
and Nothingness (1943) inspired the social
phenomenology of Ronald Laing in The Divided
Self (1960) and Self and Others (1961)

28. • Karl Jaspers
(1883-1959)
• Phenomenological
Psychiatrist
• Professor of
Philosophy
• General Psychopathology
Phenomenology and existential
psychiatry

29. Phénoménologie et psychiatrie
existentielle
• Ludwig Binswanger
(1881-1966)
• « Daseinanalyse »
• « Der Fall Ellen West »
avec multiples lecteurs
(Foucault, R.D. Laing)

30. Phenomonology and existential
psychiatry
• Ludwig Binswanger
(1881-1966)
• Existential analysis
• « Der Fall Ellen West »
with many readings
(Foucault, R.D. Laing)

31. Phénoménologie et psychiatrie
existentielle
• R.D. Laing
(1927-1989)
• Psychiatre et
psychanalyste
• Philosophie et
psychiatrie existentielle
• Psychiatrie critique

32. Phenomenology and existential
psychiatry
• R.D. Laing
(1927-1989)
• Psychiatrist and
psychoanalyst
• Social phenomenology
• Critical psychiatry

33. Phenomenology in
psychiatry
• Our generation now has the inspiration of
Alain Badiou’s objective phenomenology
outlined in Being and Event
to revision psychiatry today

34. Being and Event:
Ontology
• Badiou’s work is based not on a
critique or rejection of fundamentals
• Critical theory – Frankfurt School
• Anti-foundational – Richard Rorty
• Badiou returns to fundamentals, to
ontology – the science of being

35. Trauma and Event:
A Philosophical Archaeology
• I recently conducted philosophical
investigations supervised by Badiou
for my doctoral dissertation, Trauma
and Event (2012)
• We re-examined trauma by
contrasting it to the Event

36. With Alain Badiou in Saas-Fe
European Graduate School, Saas-Fe, Switzerland – 2008-12
PhD, European Graduate School - 2012

37. Trauma and Event:
A Philosophical Archaeology
• We were struck by the parallels between
Event, as Badiou defined it, and
trauma, the subject of my work
• In his definition of Event, I seized the key idea of
rupture
• For Badiou, Event heralds novation – bringing into the
world something new
• Trauma, too, is a rupture

38. Trauma and Event:
A Philosophical Archaeology
• Rupture – abîme, breach, break, caesura, chasm,
interruption, hiatus –
is the link between these two notions
• Whereas Event opens a breach that leads to novation
– the emergency of novelty and change
• Trauma occurs when the breach shuts down the
capacity for novelty and change, leading to repetition
and stagnation

39. Trauma and Event:
A Philosophical Archaeology
• Event opens up – expands outward –
to a world of new possibilities and change
• Trauma closes down – withdraws inward –
foreclosing adaptation and change

40. Trauma and Event:
A Philosophical Archaeology
Open closed open. Before we are born everything is open
in the universe without us. For as long as we live, everything is closed
within us. And when we die, everything is open again.
Open closed open. That’s all we are.
—Yehuda Amichai, Open Closed Open

41. Trauma and Event:
A Philosophical Archaeology
• Event opens up – expands outward –
to a world of new possibilities and change
• Trauma closes down – withdraws inward –
foreclosing adaptation and change
• A consequence of these investigations led me to
reflect on the problems of psychiatry with change
• Whether in clinical psychiatry (i.e., psychopathology)
or interventions (e.g., psychotherapies)
we have no theory of change!

42. Trauma and Event:
A Philosophical Archaeology
Whether in clinical psychiatry (i.e., psychopathology)
or interventions (e.g., psychotherapies)
we have no theory of change!
• Description is not explanation
– cf. Thomas Insel’s critique of DSM5
– e.g., describing processes, procedures, steps
is not the same as explaining them
– cf. behavioural slogan: Insight does not
equal behaviour change

43. Trauma and Event:
A Philosophical Archaeology
Whether in clinical psychiatry (i.e., psychopathology)
or interventions (e.g., psychotherapies)
we have no theory of change!
• Procedural knowledge or wisdom is not theory
– cf. empiricism
– e.g., methods and procedures neither explain
(insight) nor instruct (theorize)
– e.g., Why Lacan and not Klein?
Why DBT or CBT?
Why flooding instead of SD?
(The answer is edifying vs. systematic philosophy)

44. Trauma and Event:
A Philosophical Archaeology
Whether in clinical psychiatry (i.e., psychopathology)
or interventions (e.g., psychotherapies)
we have no theory of change!
Conclusion:
• Currently, we cannot adequately
explain (gain insight) or instruct (theorize)
change in psychiatry and psychotherapy

45. Trauma and Event:
A Philosophical Archaeology
Event is a pivotal notion that offers
psychiatry and psychotherapy –
from psychoanalysis to family therapy to
cognitive therapy –
• a theory of change (evental being)
• a new definition of the subject (evental self)
• therapeutic practices (evental therapy)

46. Evental Psychiatry
La psychiatrie événementielle
The name that Badiou proposes for this bold
project is:
« La psychiatrie événementielle »
Evental Psychiatry
Badiou affirmed that the author’s proposal opens
a broad new horizon for philosophy and for
psychiatry

47. Emergence of the
Evental Self
• Event requires three things:
– it must occur/be experienced
– it must be named (acknowledgement – which is
why “testimony/witness” is so important)
– it must be integrated into our lives – we must be
faithful to it
• Fidelity to the Event makes us subjects,
what Badiou calls a “subject to truth”

48. Emergence of the
Evental Self
• An evental psychiatry will be a science
of “subjectivizable bodies”
• Badiou describes this as the “pivotal
concept” of his philosophy

49. Emergence of the
Evental Self
• Badiou describes 3 types of subjects
each with key processes and
emblematic situations:
1. The faithful subject
2. The reactive subject
3. The obscure subject

50. Emergence of the
Evental Self
• These types of subject fundamentally define
the “attitudes” or possibilities of responding to
the situation (Badiou’s description in Being
and Event, BE I), the world (his description in
Logics of World, BE II) or the predicament in
my psychiatric formulation
• Badiou calls these attitudes subjectivations
that “prescribe” the 3 type of subjects

51. Emergence of the
Evental Self
1. Incorporation within the body
- the subject responds with enthusiasm for what is new,
with active fidelity to the event,
which is “a perturbation of the world’s order”
- this is the hallmark of the faithful subject
2. Indifference to the event
- this reactive, conservative position typifies the reactive subject
3. Hostility to all that is new or “modern”
- this intense response to “the new body as a malevolent foreign
irruption that must be destroyed”
- the obscure subject wants to maintain tradition at all costs

52. Emergence of the
Evental Self
The faithful subject is marked by porosity (cf. Benjamin),
open to radical change and witnessing (e.g., Paul of
Tarsus, Primo Levi, Agamben) of desire through
processes of absorption/incorporation.

53. Emergence of the
Evental Self
Two responses occur when porosity becomes a threat:
dissipation or mimesis.
These responses are described through these pairs:
centrifugal vs. centripetal, dispersal vs. containment and
evacuation vs. encapsulation.
The reactive subject, who is marked by dissipation,
experiences rupture as trauma through a process of
dispersal/evacuation.
The obscure subject is marked by mimesis, whose
emblematic experience is paranoia, triggered by failed
attempts at containment/encapsulation.

54. Evental Therapy
• Evental therapy means entering people’s
predicaments to see if it could be an evental site for
them
• Accompany them in the Event
• How to prepare for it, how to recognize it when it
happens, what to call it, and how to prepare for and to
live new lives in the face of the Event

55. Evental Therapy
• I call this process Evental therapy
• The experience is Evental being out of which an
Evental self emerges
• The quality that is required for living through an Event
is fidelity

56. Model Events
1. Enhance uncertainty
2. Introduce novelty
3. Encourage diversity

57. Evental Analysis
• Evental analysis:
• The event has occurred
• novelty has been introduced …
• new and different ways of living are encouraged
• what Badiou calls fidelity to the event

58. Evental Analysis
• This is often missing in many therapies
• It means following people over time or studying what happens
after an Event occurs in their lives
(follow-through, rather than follow-up)
• Not encouraged by the current models of brief interventions,
“episode de soins” and operational end-points
• Isolated and professionalized practices and the retreat of the
helping professions into the institution
(retreat from the community mental health movement)
• It is possible in community practices or practices which decrease
the boundaries and barriers between people and providers of
health services

59. Evental Therapy
Clinical practice
• E.g., Richard Mollica
Director, Harvard Program in Refugee Trauma
• Follows a group of Cambodian refugees in his
Massachusetts community for decades
• Mollica doesn’t close their cases and he doesn’t make
diagnoses
• Imagine – a mainstream psychiatrist at one of the
world’s premier medical faculties who doesn’t use
diagnoses or medications, an expert in trauma who
doesn’t diagnose PTSD!

60. Evental Therapy
Clinical case
• “The Memory Clinic vs. the Forgetting Clinic”
• Female adolescent refugee from Iraq, 14 years
Sx: oppositional, rebellious, Dx: PTSD
• What do you want?
I want to forget!
• Intervention:
This is the memory clinic! - “Je me souviens”
• Reply:
I’m in the wrong place. I want the forgetting clinic.

61. Evental Therapy
• “The Memory Clinic vs. the Forgetting Clinic”
• Prescription:
View film, “Eternal Sunshine of the Spotless Mind”
• Formulation:
Complex – war, displacement, migration, cut-offs –
behavioural manifestations
No evidence of PTSD or traumatic impacts
• Recommendation:
Witness, destigmatize, remove PTSD dx, capture complexity

62. Evental Psychiatry
Conclusions
• Re: Change
• If we can capture complexity and normalize it, people
don’t need to change as much as they – or others –
think they do
• Change is based on the Event, predicated on rupture
which may be experienced as a traumatic closing
down or an evental opening out to novelty through
adaptation and new constructions of the self

63. Evental Psychiatry
Conclusions
• Evental Psychiatry offers:
• A theory of being (ontology) based on the Event
• A theory of change – Evental being
• A new definition of the subject – Evental self
• Therapeutic practices – Evental therapy