Madness and Civilization - Discussion of Madness

Discussion of Madness

Foucault traces the evolution of the concept of madness through three phases: the Renaissance, the "Classical Age" (the later seventeenth and most of the eighteenth centuries) and the modern experience. He argues that in the Renaissance the mad were portrayed in art as possessing a kind of wisdom, a knowledge of the limits of our world, and portrayed in literature as revealing the distinction between what men are and what they pretend to be. The art and literature of the Renaissance depicted the mad as engaged with the reasonable, but they marked the beginning of an objective description of madness and reason, as though seen from above, compared with the more intimate medieval descriptions from within society.

In the mid-seventeenth century, in the midst of the age of reason, madness began to be conceived of as unreason and the mad, previously consigned to society's margins, were now separated from society and confined, along with prostitutes, vagrants, blasphemers, orphans and the like, in newly created institutions all over Europe. Their condition was seen as one of moral error, they were viewed as having freely chosen the path of unreason, and the institutional regimes were meticulous programs of punishment and reward aimed at causing them to reverse that choice. The social forces Foucault sees as driving this confinement include the need for an extrajudicial mechanism for getting rid of undesirables, and the regulation of unemployment and wages (the cheap labour of the workhouses applied downward pressure on the wages of free labour). Foucault argues that this confinement made the mad conveniently available to medical doctors who then began to view madness as a natural object, worthy of inquiry; and that the conceptual distinction between the mad and the reasonable was in a sense a product of this physical separation into confinement.

The modern experience began at the end of the eighteenth century with the creation of places devoted solely to the care of the mad under the supervision of medical doctors; born out of a blending of two motives: the new goal of curing the mad away from the family who could not afford the necessary care at home, and the old purpose of confining undesirables for the protection of society. These distinct purposes were soon lost sight of and the institution came to be seen as the only place where therapeutic treatment can be administered. Foucault sees the nominally more enlightened treatment in these new institutions as just as cruel and controlling as that of their rational predecessors.

...modern man no longer communicates with the madman There is no common language: or rather, it no longer exists; the constitution of madness as mental illness, at the end of the eighteenth century, bears witness to a rupture in a dialogue, gives the separation as already enacted, and expels from the memory all those imperfect words, of no fixed syntax, spoken falteringly, in which the exchange between madness and reason was carried out. The language of psychiatry, which is a monologue by reason about madness, could only have come into existence in such a silence.

Foucault, Preface to the 1961 edition.