Michel Foucault: His book on madness severely criticized as unreliable





History of Madness is the book that launched Michel Foucault’s career as one of the most prominent intellectuals of the second half of the twentieth century. It was not his first book; that was a much briefer volume, Maladie mentale et personnalité, that had appeared seven years earlier, in 1954, in the aftermath of a bout of depression and a suicide attempt. (A translation of the second edition of that treatise would appear in English in 1976, in spite of Foucault’s vociferous objections.) But History of Madness was the first of his works to attract major attention, first in France, and a few years afterwards in the English-speaking world. Still later would come his swarm of books devoted to the “archaeology” of the human sciences, the place of punishment in the modern world, the new medical “gaze” of Paris hospital medicine, the history of sex – the whole vast oeuvre that constituted his deconstruction of the Enlightenment and its values, and that served to launch the Foucault industry, influencing and sometimes capturing whole realms of philosophical, literary and sociological inquiry.

But in the beginning was Madness – a book introduced to the anglophone world by a figure who then had an iconic status of his own, the renegade Scottish psychiatrist R. D. Laing. It was Laing, fascinated by existentialism and other things French, who recommended the project to the Tavistock Press, pronouncing it “an exceptional book . . . brilliantly written, intellectually rigorous, and with a thesis that thoroughly shakes the assumptions of traditional psychiatry”. In those days, his imprimatur counted for much....

Madness and Civilization was not just short: it was unhampered by any of the apparatus of modern scholarship. What appeared in 1965 was a truncated text, stripped of several chapters, but also of the thousand and more footnotes that decorated the first French edition. Foucault himself had abbreviated the lengthy volume that constituted his doctoral thesis to produce a small French pocket edition, and it was this version (which contented itself with a small handful of references and a few extra pages from the original text) that appeared in translation. This could be read in a few hours, and if extraordinarily large claims rested on a shaky empirical foundation, this was perhaps not immediately evident. The pleasures of a radical reinterpretation of the place of psychiatry in the modern world (and, by implication, of the whole Enlightenment project to glorify reason) could be absorbed in very little time. Any doubts that might surface about the book’s claims could always be dismissed by gestures towards a French edition far weightier and more solemn – a massive tome that monoglot English readers were highly unlikely, indeed unable, to consult for themselves, even supposing that they could have laid their hands on a copy.

None of this seems to have rendered the book’s claims implausible, at least to a complaisant audience. Here, indeed, is a world turned upside down. Foucault rejects psychiatry’s vaunted connections with progress; he rejects the received wisdom about madness and the modern world. Generation after generation had sung paeans to the twin movement that took mad people from our midst and consigned them to the new world of the asylum, capturing madness itself for the science of medical men; Foucault advanced the reverse interpretation. The “liberation” of the insane from the shackles of superstition and neglect was, he proclaimed, something quite other – “a gigantic moral imprisonment”. The phrase still echoes. If the highly sceptical, not to say hostile, stance it encapsulates came to dominate four decades of revisionist historiography of psychiatry, there is a natural temptation to attribute the changed intellectual climate, whatever one thinks of it, to the influence of the charismatic Frenchman. But is it so? There were, after all, myriad indigenous sources of scepticism in the 1960s, all quite separately weakening the vision of psychiatry as an unambiguously liberating scientific enterprise....

But what even a weak translation does not disguise is the kind of evidence upon which Foucault erected his theory. Those thousand and more untranslated footnotes now stand revealed, and the evidence appears for what it is. It is not, for the most part, a pretty sight.

Foucault’s research for Madness was largely completed while he was in intellectual exile in Sweden, at Uppsala. Perhaps that explains the superficiality and the dated quality of much of his information. He had access to a wide range of medical texts from the seventeenth and eighteenth centuries – English, Dutch, French and German – as well as the writings of major philosophers like Descartes and Spinoza. A number of the chapters that now appear for the first time in English make use of these primary sources to analyse older ideas about madness. One may object to or accept Foucault’s reconstructions, but these portions of his argument at least rest on readings of relevant source material. By contrast, much of his account of the internal workings and logic of the institutions of confinement, an account on which he lavishes attention, is drawn from their printed rules and regulations. But it would be deeply naive to assume that such documents bear close relationship to the realities of life in these places, or provide a reliable guide to their quotidian logic. There are, admittedly, references to a handful of archival sources, all of them French, which might have provided some check on these published documents, but such material is never systematically or even sensibly employed so as to examine possible differences between the ideal and the real. Nor are we given any sense of why these particular archives were chosen for examination, what criteria were employed to mine them for facts, how representative the examples Foucault provides might be. Of course, by the very ambitions they have set for themselves, comparative historians are often forced to rely to a substantial extent on the work of others, so perhaps this use of highly selective French material to represent the entire Western world should not be judged too harshly. But the secondary sources on which Foucault repeatedly relies for the most well-known portions of his text are so self-evidently dated and inadequate to the task, and his own reading of them so often singularly careless and inventive, that he must be taken to task.



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