Foucault, Michel. Madness & Civilization: A History of Insanity in the Age of Reason. New York: Vintage Books, 1988.
Chapter One: “Stultifera Navis”
Michel Foucault begins his book by discussing leprosy, which vanished from the Western world at the end of the Middle Ages. At its peak, lepers were relegated to special sanatoria. These structures were designed to isolate the leper from the community. Although leprosy eventually disappeared, these structures remained in place. The shift from leprosy to madness represents a shift in a concern with diseased bodies to a concern with diseased minds. At the end of the Middle Ages, madmen were seen as dangerous and ambiguous. The Ship of Fools, or Narrenschiff, was a literary device that also existed in real life. Communities would deal with madmen by exiling them out to sea. Madness or folly were especially important in tales and fables. Madness haunted the Western imagination from the fifteenth century on, but eventually the threat that madness posed faded and madness was tamed. The Ship of Fools became moored and was turned into a hospital. The world of the seventeenth century was more hospitable to madness.
Chapter Two: The Great Confinement
The Classical Age reduced madness to silence after the Renaissance liberated it. Houses of confinement were created in the seventeenth century to house “the poor, the unemployed, prisoners, and the insane” (p. 39). From the mid-seventeenth century, madness was linked to confinement. In 1656, Hôpital Général was founded. It was not a medical establishment, but a semijudicial structure meant to control the social sphere and to clean public spaces of “problem” people (p. 41). Foucault saw houses of confinement as places to put those who were seen as abnormal: criminals, those who do not work, and the mad. These individuals were not confined because they needed medical attention, but rather for the purpose of control by the state. By separating the abnormal from the rest of society, the state helped define itself as “normal.” Confinement in the eighteenth century was a police matter. Confinement was first and foremost an imperative of labor, not a place to care for the sick. It was a solution to various economic and social problems in the seventeenth century across Europe as “it was feared the people would overrun the country” (p. 51). Houses of correction spread across the country in the seventeenth century and they were economic institutions. They contained peasants, beggars, disbanded soldiers, impoverished students, and the sick. These houses of confinement emerged at a time when European states were exercising greater control over citizens and sought ways to control and define them. Outside of economic crisis, confinement came to take on a new meaning and its repressive function were put to the task of getting people to work. The Classical Age used confinement as a way to reabsorb unemployment and to reduce labor costs. Labor had an ethical status during this period, it was believed that idleness was a great sin. Houses of confinement sought to instill religious and moral order in their prisoners. Confinement as an institution became important in the history of unreason. It marked the point at which madness became a problem in a society and became bound to reason and morality.
Chapter Three: The Insane
The seventeenth and eighteenth centuries only recognized madness against a backdrop of unreason. The lazy, the violent, tramps, and the mad were defined as abnormal by society. This was not to say that they actually were abnormal, only that it was the label that society had placed on them. Confinement was primarily concerned with scandal. Unreason and madness were hidden away out of shame and the protection of society. The big exception to this rule was the public presentation of madmen in asylums. “Confinement hid away unreason,” Foucault writes, “and betrayed the shame it aroused; but explicitly drew attention to the madness, pointed to it. If, in the case of unreason, the chief intention was to avoid scandal, in the case of madness, that intention was to organize it” (p. 70). Madness had to be revealed in order for it to be organized and observed. This observation was a form of control which Foucault gets into in his later work in Discipline and Punish. This public display of madness differed from that of the Renaissance where madness was a part of everyday experience and there was no desire to control it. Now madness was on public exhibition, but it was from behind caged bars and at a distance. Madmen were shown like animals in a menagerie. Madmen were considered similar to beasts and treated as such. Madness was not linked to medicine or correction, it was thought that the only way to treat animality was through “discipline and brutalizing” (p. 75). Foucault’s discussion of animality and madness is complex and confusing.
Chapter Four: Passion and Delirium
Foucault explores the relationship between madness and passion. Passion created a space where madness could occur. Foucault refers to Descartes who argues that passions are feelings and emotions such as anger, jealousy, and lust that move people to action. They are experienced in the mind, but also have physical effect that can provoke bodily movement. Passion was the place where soul and body met. Before the eighteenth century, madness and passion were closely related. Moralists from the Greco-Latin tradition defined passion as “temporary and attenuated madness” (p. 89). The Classical period offered the chance for madness to enter into the world of reason. Foucault defines hallucination as “beginning with passion, madness is still only an intense movement in the rational unity of the soul and body; this is the level of unreason; but this intense movement quickly escapes the reason of the mechanism and becomes, in its violences, its stupors, its senseless propagations, an irrational movement; and it is then that, escaping the truth and its constraints, the Unreal appears” (p. 93). What distinguished these unreal images from madness was truth. Foucault argued that madness existed when someone believed that fantastic images were true. Imagination was not the same thing as madness. Madness was considered beyond imagination because it asserted that imagination as truth. Foucault stressed the logic of madness. It had its own language and the delusions made sense within the madman’s distorted world. Discourse is a central concept to Foucault, but I found the discussion to be extremely complex and it didn’t make sense to me. I know I am missing something big and important here and will need to revisit.