Unreason vs. Madness
Foucault describes how, in a period called the “Great Confinement,” a large number of social ills were classed together under the category of “unreason.” The primary aim of the original General Hospitals was to confine the poor, but others, especially vagabonds, criminals, and the mad, got swept up in the confinement as well. That meant madness, at first, did not have a distinct category. But by the end of the period Foucault describes, madness was separated off from the other forms of unreason. Mental illness started to be seen as something distinct from poverty and criminality, and what’s more, it was seen in some ways as more dangerous. That meant that the prisoners had to be separated from the mentally ill, in order to be protected from them. So madness becomes both more distinct and more feared.
Madness and Confinement
Madness and Civilization is a history of confinement at the same time that it is a history of madness, and Foucault is interested in the different relations between them. He starts with medieval confinement of leprosy, which created the institutions, like distinct spaces or houses of confinement, that the Great Confinement would re-purpose as hospitals for the poor and mad. So the first transition in confinement Foucault describes is from leprosy to poverty and the social ills considered related to it. Eventually, however, madness separated off from the larger category of “unreason,” and so developed its own special form of confinement. The mad had to be confined not only apart from society, but also apart from criminals and the poor. In this transition, madness not only gets a special kind of confinement but also becomes associated with confinement itself: confinement produces madness, and madness is a sign of confinement.
Prisons vs. Asylums
In the classical age (a period running from after the Renaissance to before the revolutionary period of the late 1700s and early 1800s), Foucault describes a big process of confinement that separated a large number of people from “normal” society. The main institution developed during this time period for this confinement was called a “hospital,” but it really operated more like a prison, housing the poor and the criminal. The mad were seen as the same category as these people. But by the end of the period, the mad were sequestered apart from these hospitals or prisons with the birth of the “asylum,” or institution for the treatment of the mentally ill. People like Samuel Tuke in England and Philippe Pinel in France were especially instrumental in this development. This turned madness into a psychological condition to be treated rather than a crime to be punished or a physical disease to be cured.
Private vs. Public Shame
Although madness was caught up in the larger category of “unreason” including poverty and criminality, it nonetheless always had a special relation to publicity. Whereas other perceived social ills were thought of as shameful secrets to be repressed, madness was always a public spectacle. That means the mad were put on display, for instance being placed in cells with barred windows so the outside could watch them, instead of hidden behind solid brick walls. Madness was always a “scandal” rather than a secret, and the public enjoys scandals, rather than feeling ashamed of them. This gives to madness a special quality in how widely it is discussed and imagined in the public sphere.
Physiological vs. Psychological Madness
A major transition Foucault notices in the classical period, parallel to a transition from grouping madness along with other forms of unreason to confining it by itself, was a change in how people theorized the causes of madness. At first, madness was thought of as a physiological problem, like other diseases that affected the body. People developed theories of nerve damage and humors, or fluids circulating in the body that might get blocked and lead to madness. Eventually, however, people came to view madness as a more psychological phenomenon, related to people’s mental lives rather than physical bodies. This led to theories about people becoming mad out of a feeling of guilt over something they had done wrong, for instance. Such a psychological view also made it possible for people to think of madness as a sign of moral failure, more than physiological weakness. But at the same time, Foucault argues, this distinction which is apparent to us today was all blurred during the classical period. That’s because madness was thought of as a “language” that included the body and the mind together.
Madness vs. Civilization
The title of Foucault’s book also outlines the major opposition he studies: between madness and civilization. On the one hand, madness is usually defined as something outside of civilization. Normal, civilized people are sane, while the mad are those who are uncivilized or fail to understand and act in accordance to civilized norms. At the same time, however, Foucault notes how people during the period he studies began to think of madness as something that was caused by civilization. This is because increasing scientific knowledge and modernization, for instance, alienated people from their own bodies and lives, leading to the experience of madness. This strange situation, in which madness seems both outside of civilization and caused by civilization, is complex and paradoxical, and Foucault’s study is about how this paradox develops.
Madness and Art
The relation of madness to art is similar to its relation to civilization: both outside of from it. On the one hand, we think of art as coming from madness, for instance the “mad” genius of someone like Van Gogh. On the other hand, art is opposed to madness, because it was after all created by someone who is skilled and is communicating something. Foucault concludes there is no madness in the work of art itself, but rather in the interaction between the work of art and the world which judges it. People who have tried to tame madness find themselves now confronted by an art that they would have destroyed if they destroyed madness. As Foucault writes, “the world that thought to measure and justify madness through psychology must justify itself before madness.” Thus, art might be a way of shifting the relation between madness and civilization, as it comes from civilization but makes us confront madness.
