Michel Foucault’s premise in Madness and Civilization is that madness is the mirror image of sanity, a dark looking glass through which sane people can recognize their own features, if somewhat distorted and reversed. According to Foucault, madness is not in itself something apart and other, since its alienation and exclusion are the historical processes which Madness and Civilization recounts. Nor is madness a morbid entity that infects and attacks people who become mentally ill. He dismisses the concept of mental illness as a fiction which the psychiatric reformers such as Philippe Pinel invented to rationalize their newly acquired power over mad people. In short, the history of insanity is the story of the alienation of one aspect of the human condition. Foucault’s work actually resembles a psychiatric case history of split personality: It begins in the healthy Middle Ages but ends in a modernity alienated from itself.
This story can also be told in spatial terms. Madness during the Middle Ages was undifferentiated experience coextensive with everyday life and reality. A differentiation occurred during the Renaissance, when madness became located on the margins of life. The Renaissance ambivalence toward madness expressed itself in symbols such as the Ship of Fools and Tom o’Bedlam, madness confined in a ship in order to be liberated on the waterways of Europe and madness liberated on the highways of England in order to be confined in the role of Poor Tom. These symbols placed madness “betwixt and between,” on the threshold, on the inside of the outside and on the outside of the inside—in other words, in the position of liminality which explains its prominence in Renaissance culture.
The Great Confinement, which Foucault dates between 1657 and 1794, forced madness out the door, and reason then slammed the door shut. Thus, during the Age of Reason madness was excluded; its voice was silenced. The supposed “liberation” of the insane in fact intensified its exclusion in the moral space of the new asylum. Although psychoanalysis, the principles of which were first advanced around 1900, recognized once again what Sigmund Freud called “the psychopathology of everyday life,” it perpetuated the asylum in a new structure, transference, the mystification of the analyst-patient relationship. Mad people are still confined today, according to Foucault, though behind invisible walls of otherness erected by arbitrary definitions of normality. Madness is still excluded and silenced, still in chains, chains forged by alienation and the authority of the medical model of mental illness.
This audacious argument presupposes a conceptualization of madness that differs radically from the various models of madness in modern Western civilization, such as the medical, psychoanalytic, moral, conspiratorial, and psychedelic models. One can appreciate the importance of these models by considering the analogous situation of alcoholism and drug addiction, which when considered diseases are treated one way but when considered moral failings or crimes are treated quite differently. Although Foucault at points in his argument comes close to both the conspiratorial and the psychedelic models of madness and consistently attacks the medical model, his conceptualization of madness is quite different from models of any sort and is rather philosophical and aesthetic. Foucault appears to argue that madness is one essential aspect of the human condition. At the beginning of his preface, almost as...
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- Critical Essays