South African Psychiatry - November 2018

REPORT
The psychoanalytical approach to the memorial
ceremony and conference invited attendees to
embark on the momentous psychic journey to
salvage psychic life from the devastating debris of
the decanting. The red thread of psychoanalysis
wove itself through the LE team’s initial interviews with
the affected families; the preparation, presentation,
and cross examination of the LE team’s expert
testimony report during the ADR (a ground-breaking
forensic application for psychoanalysis in South
Africa); and the culminating memorial ceremony
and conference. Where persistent and repeated
legal questioning of conscious motives and
knowledge was unable to provide clarity, the 2017
psychoanalytical testimony at the ADR and this
year’s dialogue at the Deadly Medicine Conference
offered tentative explanations for the emergence of
this tragedy. By engaging with deeper, unconscious
motives and driving forces within individuals and
society, aspects of the LE decanting have started to
be metabolised and rendered less ineffable and at
least partially comprehensible.
The keynote address at the conference was delivered
by Professor Leslie Swartz, who initiated a critical
dialogue around the disenfranchised locus of the
disabled and of mental healthcare users in our
society, and the fraught politics of identity in relation
to our psychoanalytic work. He also highlighted how,
as in the LE Decanting, death makes neglect visible,
but that “the Esidimeni tragedy is … not unique in its
betrayal and neglect of disabled people”. 6 Swartz’s
emphasis on LE not being an isolated event was
reiterated throughout the conference: abundant
examples were named of the abject disintegration
or absence of physical resources and of systemic
deficits to tolerate and symbolise unbearable
horror. The LE disaster is, unnervingly, simply one
instantiation of a far more pervasive and insidious
disregard for human life and dignity; simply one of
many – admittedly less public – concrete expressions
of the organisational and societal dysfunction within
the Gauteng Health Department and broader state
and societal structures.
THE PANEL PRESENTATIONS AND PAPERS
WHICH FOLLOWED SWARTZ’S KEYNOTE
ADDRESS EXTENDED DISCUSSION OF THE
ESSENTIAL PROCESS OF CONTAINING
AND SYMBOLISING SUFFERING; THE
ROLE OF COUNTERTRANSFERENCE
IN RELATION TO TRAUMA; AND THE
DECONSTRUCTION OF THE PERVERSE,
PSYCHOTIC, AND ANARCHIC STATE OF
MENTAL HEALTH SERVICES IN GAUTENG
AND SOUTH AFRICA AS A WHOLE.
Van der Walt’s paper, which critically examined and
contrasted the Truth and Reconciliation Commission’s
(TRC) approach to achieving reparation and redress
with that of the ADR, also serendipitously provided an
additional perspective on Primo Levi’s suicide. Whilst
the TRC’s unofficial preoccupation appeared to be
omnipotent healing and forgiveness – possibly at
the cost of acknowledging the unbearable truth
of boundless and unbound suffering and rage –
the ADR process seemed to be less susceptible to
the compelling urge to retreat from “the raw and
destabilizing power of trauma”. 7 As a result, the ADR
could introduce into an official record a “metabolized
version of trauma narrative” 7 , a potential starting
point for confronting the emotional – and not
simply cognitive – truth of unthinkable human
suffering. This then in turn introduces the hope of
safeguarding the psychic life of individuals and
social structures in the aftermath of trauma – unlike
for Primo Levi whose conscious ‘reason’ afforded
others a rich understanding of the Holocaust, but
whose unbound residues of horror never achieved
representation and expression, thus ultimately killing
him.
In 1958, Primo Levi initially wrote that “if there is
one thing sure in this world, it is certainly this: that
it will not happen to us a second time”. This may
well be the desired rhetoric in the aftermath of the
LE tragedy (and perhaps may have also been the
Upon request of the families of the victims of the Marathon Project, memorial ceremony attendees dressed in black and affixed differently coloured flowers to their
clothing. Family members of the deceased wore red flowers; family members of the survivors, white flowers; and other attendees, yellow flowers. From left to right:
memorial ceremony attendee Bokang Mpeta; poet and conference presenter Makhosazana Xaba; and member of the LE clinical team and conference presenter
Zamakhanya Makhanya. (Photographer for “Flowers for Memorial”: Louise Gubb; Photographer for “Flowers”: Michael Benn)
32 * SOUTH AFRICAN PSYCHIATRY ISSUE 17 2018