Madness & Civilization analysis

 Defending the Different Representations of Madness as Articulated by Michel Foucault

In 1965, the English edition of Michel Foucault’s book Madness & Civilization was released and would forever change the philosophical landscape. The book, most simply put, outlines a general theory of the history which led to how madness is understood today. Put less simply, the book employs Foucault’s conception of archaeological analysis to understand how the contemporary episteme of ‘madness’ was formed, thus ‘unfolding’ our presuppositions and demythologizing the origins of the knowledge of psychiatry. This is not to say that Foucault is directly engaging with the specifics of psychiatry (as in, “mental illness is X” or “insanity should be thought of as Y”), rather, as he puts in his preface “to explore [the history of madness] we must renounce the convenience of terminal truths, and never let ourselves be guided by what we may know of madness.”(ix) Foucault’s analysis in Madness & Civilization may be easily misread as, for example, taking a ‘progressive’ stance of sorts to promote an ethical treatment of mentally ill people. While doubtless this may be a better alternative to some cruel confinement, this essay seeks to explain how Foucault uncovers the foundations, what he uncovers, and all doing so, most importantly, “without assuming a victory, or a right to a victory”(x).

There are three main conceptions of madness which Foucault makes clear: madness in the middle ages and early Renaissance with its ‘mirror’ of reason, madness in the classical age with the ‘great confinement,’ and finally madness in the modern era and its psychiatric model. These three conceptions historically grew out of one another, not arbitrarily, but where each was made possible by the prior. To begin, in the first chapter, titled Stultifera Navis, or ‘Ship of Fools’ in English, Foucault looks at madness as it was understood in the late middle ages to mid-Renaissance. To do so, he does not simply look at the leading theories of insanity or whatever studies the scholars of the time had taken part of, rather Foucault looks at the art in the time periods and how madness was depicted in the ‘social consciousness.’ For example, in Hieronymus Bosch’s painting (1490-1500) of the same name, we see the ship itself: its crew comprised of both the colloquially insane, such as a sickly man vomiting off the ship’s right side, a jester, nude beggars, presumably drunk people, and, most interestingly, a nun and a theologian. This grouping together implies an important universalizing characteristic of the boat’s crew: their access to a special wisdom or knowledge which serves as both their liberation and their grounds for future confinement in the Common era. Foucault argues that Bosch’s painting demonstrates that while the madman’s speech was ‘nonsensical’ or separate from the common discourse, it did contain a hidden truth; in the madman’s words was a rationality beyond reason. The mad contained a certain type of wisdom in their folly which was not ‘normally’ accessible, and thus, gave them a ‘magical’ status. Foucault explains that Bosch’s portrayal of madness “Fascinates men… By a strange paradox, what was born from the strangest delirium was already hidden, like a secret, like an inaccessible truth, in the bowels of the Earth.”(23) 

This all is brought about with what we could understand to be the ‘seed’ which would sprout into the confinement of madness. That being specifically, in 1226, when Louis VIII established the lazar-house law, we see the start of the confinement of people with leprosy. This caused the normalization of confining people with illnesses which, after the seventeenth century and after leprosy had practically disappeared, would take place– the precedent was set for the future of both a). Confinement and b). The eventual doctor/patient dichotomy (although this occurs most prominently much later in the Modern age). Furthermore, precisely because the mad would come to be confined within the same hospitals and under the same aesthetic as those sent to lazar-houses, the insane would be subject to the same specific socio-religious subjugation as lepers; as Foucault writes on page 72, “madness borrowed its face from the mask of the beast.” Specifically, he means madness’s connection to animality, although this ‘animality’ was marked by both the insane’s ability to endure, like animals, extreme and harsh conditions, but also from their ‘othering’ and exile. This also came out of the late middle ages where leprosy was both a manifestation of God’s anger and grace. Regarding the latter, the exclusion of leprosy was itself  “another form of communion.”(7) (For both the person who exiles and the exiled-leper, that is.) The leper was subject to God’s anger– it was punishment for his sin, yet simultaneously was the gateway for the leper to confess, repent, and find salvation. The religious side of this confinement would, unknowingly or not, influence the future of the confinement of the mad. The former, God’s anger, leprosy as punishment, would go on to link madness and insanity to the devil (and hence the ‘beastial’ equivocation), opening the cultural consciousness’ possibility for antipathy contra mental illness in the Neo Classical age.

But what exactly did madness become in the Classical age, and how was it adapted out of the view of the middle age? Foucault explores the turn of the cultural consciousness in the 15th century; he writes that “in the domain of literary and philosophical expression, the experience of madness… takes the form of moral satire.”(27) Further, madness is no longer an antithesis to reason (in that it exists outside of accessible knowledge for most people), but instead it is fundamentally tied to ‘man.’ “Madness deals not so much with truth and the world, as with man and whatever truth himself he is able to perceive.”(27) This phenomenological understanding of madness, on the eve of the enlightenment and its submission to reason and truth as concrete and totalizing, was the groundwork which would lead the way for madness to be ‘pathologized’ or to be clinically understood. But this was coincided by the ‘great confinement,’ which was the specific move to include, within madness and its confinement, vagabonds, beggars, and general idleness. This was done during ‘crises’ of unemployment for the “reabsorption of the idle and social protection against agitation and uprisings.” During more stable periods, the confined could be put to work as “cheap manpower in the periods of full employment and high salaries.” (51) 

Yet within the Classical age, there was also a proto-version of what we would come to understand medically as mental illness. The key difference being that “[i]n the Classical period, it [was] futile to distinguish physical therapeutics from psychological medications for the simple reason that psychology did not exist.” The two means of ‘remedy’ were understood as the same thing. This is evident with the Classical age’s actualized confinement; it was mentioned earlier that the insane were confined partially as a politico-economic move, but the actual institutionalization was, put bluntly, literally inhumane. This is not to say that the conditions of confinement were ‘not up to par’ or that their wardens were ignorant to the abuses the insane faced, but on the contrary: the animalization of the insane was intentional because of the Classical episteme. Treating the insane like animals was only expected if the insane could be understood as ‘animalistic’ since their madness placed them outside of reason and (like animals) impossible to talk to. The responsibility, then, was not specifically left to a ‘moral correction’ on the inane person’s part, nor yet to a matter of ‘diagnosis,’ but rather the insane were put in the hands of doctors who, by the end of the 17th and beginning of the 18th century, would come to acquaint themselves with psychological analysis.

The confined were weaponized for capital by the state to control them as a social body (preventing uprisings or revolution and mechanized for labor production). To sum up, the key takeaway of confinement in the 17th century was that it was “the moment when madness was perceived on the social horizon of poverty, of incapacity to work, of inability to integrate with the group[.]” From this moment forward, madness no longer would hold any ‘mysticism’ or hidden knowledge. It would instead let madness become a ‘sickness,’ a new object of study for doctors to cure, something apart from rationality and normality, and be vilified to serve purely as an object of domination to be controlled, subjugated, and placed within reason during the Modern age. 

The 18th century marks the beginning of the Modern age and the introduction of Doctors and Patients, specifically with the start of the discourse of madness. For Foucault, this time period was peculiar as it does something unique not seen in the other epochs: explicitly, it understands madness as both an object of study and, less explicitly (but all the more prevalent and powerful), a matter of language. On page 198, Foucault writes that “Freud went back to madness at the level of its language, reconstituting one of the essential elements of an experience reduced to silence by positivism… the possibility of a dialogue with unreason.” After Freud, madness had become ‘reconstructed’ so that the eventual birth of the asylum was possible. The mother of that birth was nothing else than the 18th century desire to “determine the place madness was to occupy within [humanity]... to situate [it] in a social sphere that was being constructed.”(240) And so, we now have the asylum, the mark of the Common age, “when madness was finally recognized and treated according to a truth.”(241) Not only can madness no longer evade the grips of reason, rather it is welcomed with open arms. The asylum was granted permission by the state to “judge immediately… without appeal.”(266) With their diagnosis, the insane would be punished, but unlike the Classical age’s punishments to be physical, such as a “heavy blow of a rod across the fingers,”(75) the asylum seeked to diffuse the discipline from, for example, a guard who would strike the inmates fingers, into a series of punishments focused on the mind; so that the punishment or “correction” would “continue indefinitely in the inmate’s unconscious.”(267) With the Common age, it’s asylums, psychiatry and doctors, power became not ‘hidden’ per-se, but incorporated into the subject of that power-enforcement.

Foucault’s aim is not to invoke nostalgia or to glorify the Renaissance’s conception of madness. His point is not to embrace some type of ‘return’ to the madness of Stultifera Navis. In fact, not only is such a goal impossible (and also missing the point of Foucault’s archaeology of the present), but Foucault is fundamentally analyzing the way power moves within the cultural evolution of madness. The institutions, the state, the ´cultural consciousness´ all hold a power which excludes the insane. This exclusion is only possible, as the alternative, unreason, cannot be reasonably talked about except for when it exists in this psychiatric framework, for instance, where the exclusion leads to a total domination via ‘inclusion.’ That is to say that ‘unreason’ cannot engage in discourse, and the language of psychiatry only arose out of “the basis of such a silence.”(xi) Reason was tasked with filling the gaps of unreason, and, despite the nominally ‘better’ conditions which madness is treated contemporarily, a total domination of the insane has taken place, more cruel than ever, where the madman is subject not to a society, king, institution nor doctor, but himself. To conclude, Foucault is thus introducing the reader to this possible analysis of history which shows us how, beneath the absolute and concrete understanding of (in this case) madness, there is a city, one constructed out of the abuses and total domination of the insane, that haunts our own as the fog on our glasses. One where the responsibility for sanity is on us and the enforcement of that responsibility is inherent within reason.

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This was a (first draft of a) paper I had to write for school. Honestly, I've been struggling with philosophy for a while now, and I've kinda procrastinated writing this until the last minute (like a week ago(?) when its due tomorrow. I think the essay is fine. Originally I was going to write about hoe he understands representation (and particularly representation as representation) in the classical age, but that book is pretty difficult. It's also kind of hard to argue for him when I'm nose deep in derridian semiology right now so with everything Foucault says I kind of have a negative gut-reaction, or at least I feel like its missing the point ((?)ironically) to what it's saying which is weird to thin about but I guess that's derrida and foucault for you. What I think I got right in this essay was that Foucault's analysis is based on two things: one, the understanding of the present via the past (which isn't understanding the past as the present (nostalgia) nor understanding the present as a stacking (nor arbitrary) which 'concludes' all prior knowledge, but rather as an explanation of the present because of the past which is caused by, and also is my second point of fundamental foucault, power and its diffusion. That's the big P which moves sovereign societies into disciplinary societies into societies of control (only if you're a deleuzian, otherwise its still just foucault) and also this is why Baudrillard is the greatest foucaultian because foucault is doing in M&C what he is critiqueing (and also in all of his books I guess) because foucault fills the silence of power(also what derrida says nietzsche (and by extention hiedegger (BUT (and this is the best part) derrida didnt do(!))) did to metaphysics) since he was "able to write about [it] so good" or whatever that quote is.