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Starting from the adage of Hermann Simon according to which it would be better to treat the institution before seeking to treat the “patients”, this article draws on a fundamental distinction made by institutional psychotherapy between the establishment and the institution. In the wake of this distinction, a number of major operators proposed by François Tosquelles, Félix Guattari and Jean Oury are recalled in order to underline their function for thinking through clinical work within a treatment structure, and thus to support their vitality in the contemporary space. The article thereby discusses the effects that result from superimposing the landscapes of the institution (a place of treatment and movement) and of the establishment (material reality irrigated by and administrative-logistical logic. Finally, some thoughts are outlined concerning the free circulation… of the clinician. It is because the institution is mobilised by the subjects who live there, invite themselves, or suddenly appear – upsetting what is established, comfortable and organised – that it is able to treat… the establishment.