This talk will explore the attempts of the radical psychiatrist and political revolutionary Frantz Fanon to develop an etiology of exhaustion under conditions of colonial alienation. Bridging the writings that would eventually anchor his legacy, Fanon spent most of his career as a doctor in a small town in colonial Algeria. Building on Fanon’s influences with and against institutional psychotherapy—Tosquelles, Guattari, Lacan—and the Algier’s School colonial psychiatry of Antoine Porot, this paper argues for the political theoretical importance of Fanon’s clinical writings, which respond to the symptoms of the colonial situation, including exhaustion and refusal, with experiments in world-making within the bounds of his clinic, while making critically visible the eventual dissolution of this possibility and the turn of his therapeutic imagination towards questions of anticolonial revolution.