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“Art brut”, which originated in psychiatric asylums, is not only a creation ignorant of codes, as J. Dubuffet suggests, or as the alienists of the nineteenth century thought, a creation of madness; it also forms a mode of response to the totalitarian influence defined by E. Goffman. Nor is it possible to reduce these works to a form of secondary adaptation utilized by the patient to resist institutional prescriptions. These creations of solitude and of the secret represent one of the forms of the “work of culture” operating a reduction of “misinscription” (exclusion from the common social fabric), through the paradoxical restoration of a symbolic order thanks to singular artistic creations. The institutional evolutions that followed the end of the Second World War led to the gradual disappearance of this type of creation in favour of the appearance of therapeutic mediations. The presence of a third party and of a clinical setting establishing the possibilities of a transference relationship restores to the creative process its dimension of address and symbolization, extricating subjects from their condition of “sign disabled” to which they had been relegated by asylum institutions.