In modern society, the dominant social account of ‘madness’, the attached characteristics, meanings, and treatment is monopolized by psychiatry and medicine, reducing the basis for its existence simply to biological differences. Historically, individuals were provided with socially produced images and descriptions of specific characteristics of madness and insanity, particularly in Western society, beginning with the Biblical imagery of madness as generated by possession by the Devil or promoted by a divine dissatisfaction. The notion of the latter image is continued throughout history, evident in the Renaissance age where the Church promoted the desire to be punished by God, in order to please Him and thus accomplish salvation. Religious reasoning to justify different types of illnesses and diseases was far more common than seeking a Medical cure during this period - if it was divinely ordained by the Lord, it was the Lord and only the Lord who could remedy it. As such, having an illness or condition, whether it be leprosy or insanity, was deemed a blessing from God, each individual being especially ‘chosen’. Even the social exclusion they faced as a repercussion for their presiding identity as ‘other’ in society was met with fulfillment, offering them another chance of communion, patience, and repentance. Over time, however, the medical model of madness, insanity, and sanity become the dominant discourse in Western society, perceived as having the only justified interpretation of mentality and possible cures.
Published in 1961, Madness and Civilisation was Foucault’s first major book, based on his academic thesis and undoubtedly shaped by his own personal experience of psychological difficulties both as a patient and as an informed observer. The book was subjected to both strong criticism and praise, arguably more criticism at the time of publishing and more praise in the twenty-first century. Foucault’s work has been resoundingly deemed as speculative and rather profound, in the sense that the arguments he presents are regarded as contemporary, eliciting numerous criticisms and disputes. The very fact that he, and rather his work, is invested in different disciplines including but not limited to poststructuralism, sociology, and queer theory, serves to confirm his convictions are intrinsically a product of essentialism. For the most part, his work surrounds the connection between knowledge and power and how social institutions such as prisons and schools are used in order to aid social control. As such, in his analyses, he focuses on the social constructs that are prevalent in the relative social and how they operate as a tool for social control, as opposed to solely focusing on social realities.
In Madness and Civilisation, Foucault introduces and extends the principal notion that for individuals, a sense of normality is gained through the suppression and exile of the abnormal, which essentially serves as a microcosm of what exists on a wider scale in modern society. When an individual label another as ‘mad’, they other them by placing themselves as ‘normal’, reinstating their own included position in society. Foucault presents every form of social inclusion as being a form of exclusion, in order for a group of individuals to feel included, others must simultaneously be excluded. The book traces and inspects the fluid meaning of madness throughout history and the stigmas and characteristics attached to the image of the mad, how this influences the treatment of the mad, and social institutions of confinement.
The first chapter explores how the mad were treated during the Renaissance age, initially introducing the structure of the leper houses as empty prisons for the mad, previously having been inhabited by lepers. The “regression of leprosy” throughout Europe led the lazar houses to be reserved for “Incurables and madmen”. Not only did the mad adopt the houses of the lepers, but they also represented the social image of lepers, taking on the identity of the “insistent and fearful figure” that was detached from the lepers as they decreased in volume and thus decreased in the power to elicit fear and terror in others. The social removal of the previous image of the leper meant that this physical human embodiment of sinisterness had to be replaced with another character that was customary in society, Foucault notes that these structures “remain” and the “formulas of exclusion would be repeated”. He observes that although as time changed, along with meaning and culture, the social structures remained intact, particularly that of a “rigorous division which is social exclusion but spiritual reintegration”.
In the chapter Stultifera Navis, Foucault explains the emergence of the Ship of Fools, within the landscape of the Renaissance, not only proving the reality of the Ship of Fools through factual and statistical evidence but also through the frequent representation of ships alike in Renaissance art.
In his conclusion, Foucault notes there is no inherent madness in art, art is the last place madness is allowed to speak and be heard by rational people. He argues that it is the last refuge for a dialogue between madness and reason as we respect the mad artist and works that we cannot explain, but not the mad man. Contrastingly, in some societies, mad people became priests, leaders, and high ordained people, which Foucault argues slowly diminished and ceases to exist in Western societies throughout history. This is particularly evident in today’s society, where madness has become completely institutionalized, serving as a complete opposite of what it was a mere few hundred years ago. Foucault notes that there was a brief reemergence of this previously disappearing role, in the renaissance era, there was a dialogue, according to Foucault between rationality and madness - creating an understanding between delusion and reasoning. He notes that rationality becomes a driving force in classical society, but once the dichotomy of rationality and irrationality is evidenced madness yet again becomes ‘other’ and excluded.
In the Birth of the Asylum, Foucault shows the initial liberation of the socially classified ‘mad’ who was then shortly after subjected to ‘freedom’ in the likes of the asylum, mental hospital, or into the care of a psychiatric ward. He notes the movement from the mad being feared by society to the mad becoming afraid themselves that they are not ‘normal’ or deemed acceptable by society. They are forced to believe that they are the minority in society as ‘others’, rather than the normal majority, influencing the creation of their own individual mental confinement. It is the unbearable weight of the social pressure to be included and fit in with others and the human desire to feel as if you belong and are like other individuals, created by society, which unfortunately leads to this new form of confinement, long after the asylums were shut down.
In today’s Western society, asylums have been shut down and replaced with ‘care in the community, but it must be mentioned that a vast majority of individuals in prison or homeless suffer from rather severe mental health problems - more so than the general statistics that represent society as a whole. Foucault notes that although the new modern forms of institutions such as ‘hospitals’ for the mad are no longer physical prisons, or have cells and bars or high walls, the simple fact that the mad are forced to obey orders and fit into the behavioral patterns deemed acceptable by society causes the mad to internalize this oppression. Whilst the mad are physically liberated from their shackles and physical confinement, Foucault argues that it is better to be in a prison rather than these new asylums as they void any possibility of mental freedom as they are constantly being observed and reviewed. The mad are tranquilized with drugs like animals in order to keep them complacent and quite literally force them to fit into society. As humans begin to remove themselves from the animal world, the mad increasingly fit into the image of wildness that was previously reserved for animals/beasts.
Foucault argues that a certain form of the human body became normalized in capitalist society due to the industrial need for a labor force, which ultimately led to the creation of prejudices against ‘other’ bodies such as disabled individuals who failed to fit into the demands of the society. In this society, the madman could go by undetected, confirming himself to social expectations and standards of work out of fear and in order to keep his identity hidden to lessen the chances of being outed and shamed. The emergence of ‘care in the community meant that individuals are now expected to accept their mental illness but strive to live life like a ‘normal person, hiding your illness from others and confirming to society in order to meet the social standard of reason. However, Foucault notes that there is a madness in pretending not to be mad, evidenced by the “tea-parties” with “no intimacy, no dialogue”. This pressure to satisfy normal customs and behaviors instills a sense of fear of being ‘found out and consequently being shamed by society. Although this fear can be seen in a positive aspect, in its ability to envoys genuine emotion from the mad like a sane person, it can thus cause the individual to go deeper into delirium and insanity. Foucault notes that throughout history, the two crucial factors that were constant in relation to the confinement and treatment of the mad, firstly the never-ending and complicated distinction of social inclusion and exclusion and secondly, the existence of liminal spaces reserved for the mad - the physically moving Ship of Fools and the modern crisis of homelessness for those suffering from mental illnesses.
The increase in accessibility of Foucault’s writing becomes apparent in his later works, such as ‘Discipline and Punish’ or ‘The History of Sexuality, with a distinguishable shift in the stylistic methods deployed - it becomes much less dense and more feasible for ordinary people to comprehend. Clearly, his literary techniques and overall style change dramatically as his beliefs and notions change with the assumed increase of knowledge. Foucault himself presents his discourse as accessible and wholly intended for the “user” as opposed to the “reader”, his work simply being a ‘tool’ that this user deploys and puts into practice in the real world in order to assist them in their understanding of their respective societies. Whilst this is true, the most prevalent use of Foucault’s work is found within the realms of academia and is read almost exclusively by intellectuals - differing to perhaps what he intended it to be - Madness and Civilisation probably isn’t the ordinary person’s literary leisure. Foucault did not want subjects who would master his work, rather, using it in a practical sense was his aim in order to better societies. However, in studying and analyzing him, we are in fact evidently attempting to master his discourse.
Foucault argues that he himself cannot give a voice or speak for the mad through his reasoning that psychology and the social oppression of the mad completely restricts and denies them ownership of a voice in society, deeming whatever they say as irrational and thus unable to exist as authentic or justified. However, in doing so, he undermines his portrayal of the mad and negates reason as he undoubtedly presents yet another monologue of madness, employing philosophical and historical arguments, he ends up doing what he argues is impossible - giving a voice to the mad. The undermining of his own argument is mirrored not only in the text but also in Foucault’s position on himself as a philosopher as well as other philosophers. In his works, he seeks to deconstruct dominant discourses as a means to understand them wholly but simultaneously invalidates them, creating a space in society for a new discourse to be created. Although he fervently criticizes these discourses, Foucault never seems to offer real or practical solutions to replace these social structures that reinstate inequalities, he simply undermines the existing structures without having the means to demonstrate his personal ideal substitution or a recommended realistic course of action individuals can take, which is the ultimate criticism of him.