Madness and Civilization

by Michel Foucault

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Last Updated on May 5, 2015, by eNotes Editorial. Word Count: 975

A conventional history of insanity might take the form of a history of psychiatry that narrates the emergence, progress, and triumph of humane treatment and scientific knowledge of mental illness from the Middle Ages to the present. In Madness and Civilization, Michel Foucault presents a counterhistory of madness. He maintains that treatment of mad people has become increasingly abusive, repressive, and insidious in modern times, silencing what was a vital creative dialogue between madness and reason in Western civilization during the Middle Ages and into the Renaissance. Foucault describes madness in medieval Europe as free to be itself and express itself; madness was everywhere and always present: in wandering mad people in the streets, fools and jesters in the households, and crazy gargoyles and grylli observing life from the Gothic cathedrals. He presents the Middle Ages as a kind of paradise of uninhibited, vitally creative madness, a paradise which the modern world has lost.

Foucault’s historical method is radically unconventional. He rejects narrative and analysis in favor of an imaginative, figurative, intuitive, even mythopoeic understanding of madness in history. In Madness and Civilization, he presents, in vivid images, a succession of mythic events and symbols of madness which he arranges in roughly chronological order but neither interconnects with coherent arguments nor locates exactly in time and place. Foucault’s presentation yields many memorable images but no logical exposition.

Foucault’s first image is the haunting one that sets the tone of Madness and Civilization. In late medieval Europe, after the eradication of leprosy, according to Foucault, thousands of lazar houses, or leprosariums, stood empty of inmates as if awaiting the internment of the insane in early modern times. This image identifies mad people—outcasts, scapegoats, and persecuted deviants—as the new “moral lepers” of Western civilization. According to Foucault, modern mad people assumed the role of medieval lepers and even occupied lepers’ institutional space.

The striking image of the empty leprosarium is the first in a succession of images of madness from which Foucault constructs his history of insanity. His history emerges as a kind of celebratory poetry or mythology of madness. The medieval period is characterized by a kaleidoscope of gargoyles and licensed fools in motley. The Renaissance period follows, with the Ship of Fools, Tom o’Bedlam, satirical praise of folly, King Lear and his fool, and Don Quixote. The Hopital General was founded in Paris in 1657. According to Foucault, this institution symbolized the “Great Confinement” of misfits, including indigent insane people and street people. This Great Confinement was general policy in Western Europe. Misfits were incarcerated in hopitaux generaux in France, Zuchthauser in Germany, and bridewells, or houses of correction, in England. Madness, which had run free in medieval Europe, was now confined.

Foucault’s depiction of the Enlightenment, or the Age of Reason, is deeply disturbing. During this period, interned mad people were treated like animals in the zoo or circus, caged, chained, and put on public display at Bedlam in London, the Bicetre in Paris, and other places elsewhere in Europe. Because the Enlightenment placed such a high premium on reason, society regarded persons bereft of reason as subhuman and treated them abusively. This treatment stood in sharp contrast to the acceptance of madness in the Middle Ages and the curiosity or ambivalence about it during the Renaissance.

Foucault’s images continue with the supposed “liberation” of the insane during the 1790’s by psychiatric reformers such as the French physician Philippe Pinel and the English Quaker philanthropist William Tuke, both inspired by the French Revolution. Here Foucault challenges the conventional image of the heroic Pinel unchaining inmates of the Bicetre in 1794. According to Foucault, Pinel and other reformers did strike off the physical iron chains but they immediately reshackled mad people with invisible moral chains that were even more restricting than iron ones.

The asylum, ostensibly a reform of the early 1800’s, employed mirrors in which inmates were compelled to perceive their own madness, reproach themselves, and be cured. The moral regime of the psychiatric reformers oppressed mad people, ostensibly for their own good. Reformers medicalized madness by “inventing” mental illness to explain abnormal behavior, and they invalidated the experiences of mad people by dismissing them as mere symptoms of an imaginary disease. Foucault’s parting image is one of the modern psychiatric outpatient who is bound with invisible internalized chains and dutifully places himself at the disposal of “scientific” experts on the analyst’s couch or in the therapist’s office.

At this point Foucault begins to develop his celebrated concept of power, which he defines elsewhere as “bio-technico-power.” Power is not simply force or threat of force employed to oppress people. It is a complex web of interrelationships located in the realm of discourse. The oppressed are accomplices to their own oppression by accepting the oppressor’s terms of discourse. This radical idea has wide application, but Foucault uses it particularly effectively in his metaphor of invisible chains. This image and many others in Madness and Civilization tell Foucault’s story forcefully.

Despite its formal arrangement into chapters, Madness and Civilization is actually a construct of these images, which defy capitulation. Its nine numbered chapters appear to cover the history of madness from 1500 to 1800, an unnumbered conclusion brings the history to the twentieth century, and a very brief preface introduces the book in what seems to be a conventional historiographical format. This format is deceptive. The chapters do not parallel one another. Some, such as “The Great Confinement,” recount mythic events; others, such as “Aspects of Madness,” describe static situations; and some, such as “Stultifera Navis,” contain kaleidoscopic images. The argument of Madness and Civilization is also deceptively simple: Madness was once, in the Middle Ages, free, but in modern times madness has been confined in chains, silenced, excluded, invalidated, and banished from culture, society, and experience.


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Last Updated on May 5, 2015, by eNotes Editorial. Word Count: 73

Cousins, Mark, and Athar Hussain. Michel Foucault, 1984.

Megill, Allan. “Foucault, Structuralism, and the Ends of History,” in Journal of Modern History. LI (1979), pp. 451-503.

Merquior, J.G. Foucault, 1985.

Midelfort, H.C. Erik. “Madness and Civilization in Early Modern Europe: A Reappraisal of Michel Foucault,” in After the Reformation: Essays in Honor of J.H. Hexter, 1980. Edited by Barbara C. Malament.

Rosen, George. Madness in Society: Chapters in the Historical Sociology of Mental Illness, 1968.

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