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Foucault says what constitutes insanity is a label determined by society. Whether someone is sane or insane is not a clear, objective fact. I do not disagree. He says this labelling can be dangerous.

At first glance, this all seems evident but somewhat trivial: of course it is bad to have people committed for some evil purpose, if they are merely a bit quirky but can take care of themselves well enough. Likewise, it is bad if doctors are too quick in judging someone insane. We all know this.

But what did Foucault want with this? What situation was he thinking of in which his perspective could be an eye-opener, what practical use? I am probably missing some point.

If you have something to add about the practical application of post-modernist sociology in general, i.e. not specifically about insanity, that would be interesting as well.

  • Great question. Could you provide a source for the primary claim? – Joseph Weissman Jun 11 '11 at 3:07
  • @Joe: Hmm, the problem is that I have only ever read parts of books of his that do not deal with madness. I have browsed both books you mention a little bit on Google Books, but I didn't find his making any clear-cut assertion on the matter, at least not without reading the whole book. My question was triggered by secondary literature and conversations with friends; but I can't remember any specific sources or details. Am I misinterpreting Foucault entirely? – Cerberus Jun 11 '11 at 3:36
  • @Cerberus, I don't think this is a complete misrepresentation, but I will try to see if I can isolate a straightforward statement of his position on the matter. The other text I can think of that might be helpful would be The Birth of the Clinic. I will try to provide my sense of his position in an answer, but for now I might point you to his Wikipedia entry which actually does a fairly decent job discussing the motivations and scope of his investigations into madness. – Joseph Weissman Jun 11 '11 at 3:43
  • Have found some secondary sources summarizing his major works on this and placed in an answer for now (too long for a comment.) – Joseph Weissman Jun 11 '11 at 3:49
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    I like this question - although I am not sure that 'postmodern sociology' would consider itself amenable to pragmatic assesment, I do believe it is a fair and important question to ask of it. – Chuck Jun 11 '11 at 21:53
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With regard to Foucault himself, you are unquestionably missing the point. Foucault repeatedly insisted that he was a historian, not a philosopher. He wasn't interested in solving the world's problems, he was interested in investigating them and writing a genealogy. In fact, it has been problematic for many people that he seems to propose no realistic alternative to biopower. Instead, he says that such relations of power are everywhere and unavoidable.

So if biopower is truly inevitable, what are we supposed to do? Foucault is largely silent on that point. He seems to disregard the possibility of alternatives altogether.

The best you get is found in the collection of lectures entitled Society Must Be Defended, where he specifically advocates the use of a genealogical analysis of history to confront systems of power. In other places, he haphazardly seems to advocate "resistance", but that's never particularly well-defined The idea is that the only possible alternative to disciplinary forms of power is to recognize the problem and where it's coming from: the end goal of his theories seems to be mere recognition. He praises criticism itself  (i.e., "critical discourse") as being of extreme importance, and as a valuable end in and of itself.

But how, specifically, do we resist biopolitical control? And how do we avoid the dangers that he himself cites of our resistance being co-opted by the institutions of power already present in society? In fact, he warns specifically that in setting up a new system (a post-alternative world) is particularly dangerous, because it allows the current system (the current structures of power) to assimilate the movement, blocking off any real chance of reform. He'd probably say that we can't, but many people find that answer quite unsatisfying.

There are lots of possibilities proposed by post-Foucauldian scholars, but that would take another entire answer to even brush the surface. The dangers of "labeling" is a fundamental topic throughout critical theory, taken up by an absolutely dizzying array of people, all with their own unique brand of Foucault-inspired resistance. But if you're particularly interested in applying Foucauldian thought to psychiatry, I strongly recommend investigating the works of Thomas Szasz.

  • Deleuze and Guattari's Anti-Oedipus might not be a bad place to go either; Foucault writes an introduction where he calls the book something like a handbook for non-fascist life. Deleuze himself also writes a wonderful book on the event of F.'s death, appropriately entitled Foucault. – Joseph Weissman Jun 11 '11 at 14:07
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    @Joe: Yes, indeed. But D&G is hardly what I'd recommend for someone as an introduction to Foucauldian thought. Their writing is exceptionally dense, and there are phrases that even someone as experienced with critical literature as I am still struggles to wrap my mind completely around. Also, be careful that when D&G talk about "schizophrenia", they don't mean it in the traditional psychological sense--they're talking about capitalism, and the way that it enforces neurosis as an attempt to maintain normality. They're loosely consistent with Foucault, but also quite distinct. – Cody Gray Jun 12 '11 at 4:00
  • Good answer. When I failed to see the practical implications of Foucault's views on madness, that was because it wasn't really his objective to offer any. – Cerberus Jun 13 '11 at 0:01
  • @Gray: Why the bio in biopower? Is this specifically a foucaldian term or a Deleuzian term? – Mozibur Ullah Jun 25 '12 at 18:29
  • @MoziburUllah a Foucauldian term; cf. en.wikipedia.org/wiki/Biopower – Joseph Weissman Jun 25 '12 at 19:51
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The Stanford Encyclopedia of Philosophy has this to say about Foucault's History of Madness:

A study of the emergence of the modern concept of “mental illness” in Europe, The History of Madness is formed from both Foucault's extensive archival work and his intense anger at what he saw as the moral hypocrisy of modern psychiatry. Standard histories saw the nineteenth-century medical treatment of madness (developed from the reforms of Pinel in France and the Tuke brothers in England) as an enlightened liberation of the mad from the ignorance and brutality of preceding ages. But, according to Foucault, the new idea that the mad were merely sick (“mentally” ill) and in need of medical treatment was not at all a clear improvement on earlier conceptions (e.g., the Renaissance idea that the mad were in contact with the mysterious forces of cosmic tragedy or the 17th-18th-century view of madness as a renouncing of reason). Moreover, he argued that the alleged scientific neutrality of modern medical treatments of insanity are in fact covers for controlling challenges to a conventional bourgeois morality. In short, Foucault argued that what was presented as an objective, incontrovertible scientific discovery (that madness is mental illness) was in fact the product of eminently questionable social and ethical commitments.

The Wikipedia entry on Foucault describes Madness and Civilization, a notable translation of an abridged version of the same work, in the following way:

Foucault begins his history in the Middle Ages, noting the social and physical exclusion of lepers.[29] He argues that with the gradual disappearance of leprosy, madness came to occupy this excluded position. The ship of fools in the 15th century is a literary version of one such exclusionary practice, namely that of sending mad people away in ships. In 17th century Europe, in a movement Foucault famously calls the "Great Confinement," "unreasonable" members of the population were institutionalised.[30] In the 18th century, madness came to be seen as the reverse of Reason, and, finally, in the 19th century as mental illness. Foucault also argues that madness was silenced by Reason, losing its power to signify the limits of social order and to point to the truth. He examines the rise of scientific and "humanitarian" treatments of the insane, notably at the hands of Philippe Pinel and Samuel Tuke who he suggests started the conceptualization of madness as 'mental illness'. He claims that these new treatments were in fact no less controlling than previous methods. Pinel's treatment of the mad amounted to an extended aversion therapy, including such treatments as freezing showers and use of a straitjacket. In Foucault's view, this treatment amounted to repeated brutality until the pattern of judgment and punishment was internalized by the patient.

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    Thank you for these relevant quotes. This more or less fits my impression of Foucault's work: he offers an analysis, but not much of a practical solution to the various problems of our treatment of the insane. – Cerberus Jun 12 '11 at 23:55
  • @Cerberus it is worth noting that Foucault was politically active, and helped form several groups which advocated on behalf of prisoners' rights – Joseph Weissman Jun 22 '11 at 2:52
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    Madness and Civilization is not "a different work, his first major book"-- it's just a translation of an abridged version of his History of Madness. – Michael Dorfman Nov 24 '11 at 17:51
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    @Michael thanks for the correction! I will try to repair soon – Joseph Weissman Nov 26 '11 at 1:34
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Foucault does not say insanity is merely a label applied by society. Below is an extended response written to address the question "Does madness have an essence, which is expressed in individuals regardless of their culture and historical period? Answer with reference to Foucault’s work on the history of madness." It is from a paper I wrote for a unit on Foucault last year. I'm not sure of people's views on posting things like this, but it contains the most comprehensive explanation I can give of why madness was not merely a label to Foucault. References are to the abridged version translated by R. Howard.

It is the thesis of this paper that Madness and Civilisation does not show that there is an essence of madness which exists a-historically and a-culturally. Instead the book shows how different ways of engaging with madness have, as their most significant commonality, functioned to transform it into a silent phenomenon. This commonality persists through time relationally in dynamic and historically localised networks of meaning, conditioned by the relation of reason to madness. The history conducted by Foucault unveils the process by which madness was forced first into a liminal social position, then to an exteriority; the movement of confining the mad and positioning madness as an Other in relation to reason. The truth of particular images of madness recounted from the classical age are neither affirmed nor discredited, and archival records are instead taken to be instantiations of the socio-historic context from which they emerge. Foucault named his project the archaeology of silence because it is a thesis of the book that madness endures in excess of the coordinates of reason.

Madness persisted through time inside a complex of historically dynamic meanings masking it in concise formulations from the order of reason. After the time madness passed from a liminal experience to a pure exteriority, Foucault says it became “the Déjà là of death” (1961, p.13). Madness became a dimension of death already-present inside life. It was dissolved into the ether of non-identity through the opposition to meaning engendered by its exteriorisation from and objectification by reason; made into an ‘already-present-death-in-life’, a negativity or an “absence”. The important point to retain in seeing the various forms through which madness passed is that “madness, if it is nothing, can manifest itself only by departing from itself, by assuming an appearance in the order of reason and thus becoming the contrary of itself” (Foucault 1961:101). Each of the elaborate visions of madness in the classical age, despite their differences, functioned to silence madness by situating it inside a discourse whose positivity created, sustained and masked its relation to this absence. Foucault’s ultimate formulation of madness is an answer to the difficulty of conveying the relation of a culture to the entity whose exclusion determined the possibility of its own truths.

Franz Fannon wrote of the decolonisation of Algeria that “being colonized by a language has large implications for one’s consciousness. …It means, above all, to assume a culture, to support the weight of a civilization” (1963: 91). In a similar vein Foucault writes that the phenomenon of madness is woven inside a “tyrannical synthesis” (1961, p.139) of myriad forces including morality, economics, religion, science and the ascendance of reason. Foucault shows how the mind and body of the madmen, as well as the abstract categories of madness during the classical age, became sites upon which dispersed and changing lines of discursive power were operated, forcing the mad to assume the weight of the culture through which the categories of madness endured. Foucault shows that in classical age the locus for constructing the meaning of madness was not the mad, as would be the case in empiricism. Instead a networked and dynamic set of historically particular meanings as diverse as ethical responsibility, the relation between the mind body and soul, and human physiology, all came to inform protocols for engaging with madness.

The question of Madness and Civilisation concerns not only the permutations through which madness endured in time. The image of madness which comes to dominate the book has its foundational analogue in the practices of confinement which begin with the 18th century. According to Foucault the historical demarcation between madness and reason mirrors the material means through which madmen and women were exorcised from the social body, and forced to exist either exterior in isolation, or as a hideous spectacle. Foucault says that the truth of classical age madness can be found in the practices of confinement which came to surround it. The enforced disengagement of the mad with society contains inseparable parallels with the abstract contrast between reason and madness described in the book. In each case both madness and the mad are driven out of their origin. Unreason was circumscribed from reason just as the mad were removed from society, and the subjugated element in both cases became forced into a relation with its other which was coercive and silencing.

Madness however was more than just a tabula rasa onto which the discourse of reason was transposed. In the concluding chapter Foucault develops the books image of madness by discussing the works of Goya and Artaud which intimate that in the domain of art madness is “the absence of the work of art, the reiterated presence of that absence, its central void experienced and measured in all its endless dimensions” (1961, p.272). The ontological status here is still unequivocal. Madness exists but as an externality resistant to symbolisation, which through its manifestations traverse and transgress the abstract territory of meaning.

Dreyfus and Rabinow say of Foucault’s project that madness “seems to be a series of approximations to an unseizable ontological condition of pure otherness... ” (1983 p.4). The relevant point in relation to whether Madness and Civilisation contains or enables the extrapolation of an a-historical a-cultural essence is that madness exists in-finitely as an entity inadmissible to the order of meaning that would discover its essence. Any essence of madness is a repetition of the means by which it is subjugated from inside the order of reason. This point is captured by Sprinker who says “no writing can do more than reinscribe the series of terms representing reason's sovereignty over and production of madness” (1980, p.83).

As a compliment to Dreyfus and Rabinow, Slavoj Zizek’s commentary on the book asks the question “is it not a version of the tension between the Real – the hyperbolic excess – and its (ultimately always failed) symbolisation?” (2007, para.14). If madness as a discursive category exists through the functions of power which sustain the discourse that excludes and objectifies it, it is clear that even in reason madness is a historically determined category. There can be no madness outside the social, discursive and institutional practices that exclude it. “Madness in this sense is not directly a phenomenon we can observe, but a discursive construct which emerges at a certain historical moment, together with its double, Reason in the modern sense” (Zizek 2007, para.27). This again restates the point that madness and reason in their material manifestations are both dynamic and culturally conditioned processes.

As with Foucault Zizek sees the term madness signifying a disavowed dimension of subjectivity whose presence persists in concert with rational knowledge. Pushing the relation of symbolised meaning and madness further, Zizek advances the thesis that, to retain his terminology, Madness and Civilisation suggests madness is a silent feature of the process of imposing symbolic order itself onto the undifferentiated chaos of the Real (2007, para.14). Psychoanalysis teaches that the frantic illusory matrixes of meaning created by the mad often constitute a desperate attempt to evade madness. The mad cling to the delusions which sustain their condition as though in reality it were their redemption. Madness inhabits their utterances implicitly, as a silent but obvious companion to explicit meaning. The madness of an utterance is insinuated, it exists simultaneously exterior to yet inseparable from the content of its medium. Where the truth of a rational statement proceeds from semantic relations to the discourse which legitimates it, in speech madness is the indeterminate exteriority of symbolic meaning; it is “the absence of the work”; an absent, impossible target of, and silent addition to symbolisation.

In ultimately formulating madness as the “absence of the work”, Foucault positions the history of madness inside a tradition in philosophy in which “existence precedes essence”. Awarding ontological primacy to existence opens the field of inquiry to levels of analysis which are obscured by the search for a-historical or transcendent essence. For Foucault it is functions of power operating both upon and through discourse in historically local processes that best explain madness. Its existence is certified and elaborated upon by recounting the material processes which produced it, reaching outside an essentialist methodology and allowing this truth of madness to be heard by narrating the process of its silencing. This of corse creates substantial difficulty for speaking meaningfully about madness. If the conversation between reason and madness is really the monologue of reason on madness, Foucault is faced with the risk of participating in the discourse which excludes and subjugates it.

The difficulty of penetrating the book’s presentation of madness is therefore an effect of this problem. In aiming to avoid that which Foucault criticises most heavily in the classical age’s treatment of madness, he is faced with the task of “escap[ing] the objectivist project of classical age reasoning” (Derrida 1978, p.35). The formulation of madness as the absence of the work is a “reappropriation of negativity” (1978, 35). Madness as a palpable exteriority to symbolisation could not be further from an essentialist definition. The extent to which Foucault succeeds in his archaeology of silence corresponds precisely to the extent to which the book has allowed a vision of madness to emerge through this unique utilisation of negativity. His thesis that madness is the absence of the work dissolves the conditions of possibility required for essentialism, and negativity constitutes simultaneously the springboard away from essentialism, and the most difficult obstacle to expression. Both the language of the book and its object appear as a “flight toward a source that is always without light” (Foucault, 1995 p.294). This avoidance of positivity is a properly methodological technique which informs how Foucault conducted the history of madness. In recounting the positive definitions that existed in the classical age most emphasis in interpretation is placed on this tyrannical and silent dimension of reason’s passage to self recognition.

One major message of the book is that the accepted truths of madness in the classical age were multiple, and morphed with time. Conceptions of madness passed through successive continuous and discontinuous regimes of change inside shifting relations of power and discourse. Another major point is that Madness and civilisation is a unique play on the traditional difference between the two senses of the word ‘for’, in thinking “who is the book really written for?” - the two senses of corse being for the attention of an Other or else writing of behalf, in place of an Other. Saying madness is the absence of the work tries to allow madness to remain in the non-identity-bound realm of the negative; the book is written for (on behalf of) a silent other, and defines madness from the perspective of this silence. This is Foucault’s way of remaining faithful to his thesis that the recounted discursive and material changes have circumscribed it from reason and hidden the mad from society, thereby both obscuring and illuminating their silence.

References

Derrida, J 1980, Writing and Difference, trans. Bass, A, University Of Chicago Press, Chicago.

Dreyfus, H & Rabinow, P 1983, Michel Foucault: Beyond Structuralism and Hermeneutics, University of Chicago Press, Chicago.

Fannon, F 1965, The Wretched of the Earth, Grove Press, New York.

Foucault, M 2001, Madness and Civilisation, trans. Howard, R, Routledge Classics, United Kingdom.

Foucault, M, 1995 ‘Madness, the Absence of Work’, trans. Stastny, P & Sengel, D, Critical Inquiry, Vol. 21, no.2, pp. 290-298.

Sprinker, M 1980 ‘Textual Politics: Foucault and Derrida’, boundary 2, Vol. 8, no.3, pp.75-98.

Zizek, S 2007, Cogito, Madness and Religion: Derrida, Foucault and then Lacan, viewed 1 April 2011 http://www.lacan.com/zizforest.html

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As I see it, the most important point in this matter is that our society is ruled by conceptions of normality and these conceptions always leave someone out of it. As such, what is defined as 'marginal' is a consequence of what is considered 'normal'. The thing is, usually, the marginal, abnormal, is something that people want to exclude, suppress, make it disappear; Foucault is pointing to the fact that this "stranger" will never disappear, for when there's a law, there's someone out of it. Considerations toward "normality" as being a measure of what is "good" can be considered a rhetorical figure: "good" is defined by what applies to the largest number of cases, that which is longlasting (this is a 'classical place'); the opposite of this would be "good" is what is rare, ephemeral ('romantic place').

Practical applications of this would be related to considering "abnormalities" as consequences of "normality" as defined by a culture/speeches.

Is a person considered crazy because s/he doesn't fit, or s/he doesn't fit because s/he is considered crazy? Isolating people only worsens the problem; from a psychiatric perspective, socialization is the "cure" for most "illnesses"... but if someone is labeled as inapt, dangerous, etc, chances are people will avoid socializing with him/her. So, according to this, internship should be done only in extreme and unavoidable cases (it would be necessary to define what would be such a case, though). Psychiatric reform is based on this conception.

Rather than considering the 'mentally ill' and other marginalized people as a source of social problems, this issues (illness and marginality) should, actually, be considered as consequences of social practices.

  • What do you mean by 'internship' here? – Mozibur Ullah Dec 14 '12 at 21:04

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