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Madness and Civilization: A History of Insanity in the Age of Reason Paperback – November 28, 1988
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One of the biggest questions Foucault strives to answer is whether or not madness is a social construction. In exploring the idea, the author is able to negate many classical ideas that have dominated culture in recent years. He even relates treatment of madness to the process that eliminated leprosy as he states, "the formulas of exclusion would be strangely repeated" with "poor vagabonds, criminals and `deranged minds'."
While this book centers on the treatment of the insane in the clinical settings, it also explores other facets of mental health. In this book, Foucault talks about early doctors and nurses in psychiatry. He also explores the relationship between religious fanaticism and the concept of moral treatment for those who were deemed insane. This makes for an intriguing book that is also easily accessible for readers of varying levels.
Foucault is also the author of the book "Discipline & Punish: The Birth of the Prison", a book that is comparable to "Madness and Civilization". Both are books about society's reactions to something deemed "not normal." On the same topic, I really like the work of Sander Gilman, who applies his understanding of psychology and psychiatry to role as historian when writing the books Seeing the Insane.
"Madness and Civilization" is a great choice for anybody working or interested in working in the field of mental health. This book encompasses a wide range of ideas from art, literature, history and philosophy as they relate to confinement, delusions and social ideology. As a philosopher contemplating madness, Foucault is a genius.
He wrote in the Preface to this 1961 book, "We have yet to write the history of that other form of madness, by which men, by an act of sovereign reason, confine their neighbors, and communicate the recognize each other through the merciless language of non-madness... We must try to return, in history, to that zero point in the course of madness at which madness is an undifferentiated experience, a not yet divided experience of division itself. We must describe... that `other form' which relegates Reason and Madness to one side or the other of its actions as things henceforth external, deaf to all exchange, and as though dead to one another... Then, and then only, can we determine the realm in which the man of madness and the man of reason, moving apart, are not yet disjunct... In the serene world of mental illness, modern man no longer communicates with the madman: on one hand, the man of reason delegates the physician to madness... on the other, the man of madness communicates with society only by the intermediary of an equally abstract reason which is order, physical and moral restraint, the anonymous pressure of the group, and the requirements of conformity... the constitution of madness as a mental illness, at the end of the eighteenth century, affords the evidence of a broken dialogue... thrusts into oblivion all those stammered, imperfect words ... in which the exchange between madness and reason was made. The language of psychiatry, which is a monologue of reason ABOUT madness, has been established only on the basis of such a silence."
He notes that after "Leprosy disappeared, the leper vanished... from memory; these structures remained. Often, in these same places, the formulas of exclusion would be repeated... Poor vagabonds, criminals, and `deranged minds' would take the part played by the leper, and we shall see what salvation was expected from this, for them and for those who excluded them as well. With an altogether new meaning and in a very different culture, the forms would remain---essentially that major form of a rigorous division which is social exclusion but spiritual reintegration." (Pg. 18)
He observes, "Confinement hid away unreason, and betrayed the shame it aroused; but it explicitly drew attention to madness, pointed to it. If, in the case of unreason, the chief intention was to avoid scandal, in the case of madness that intention was to organize it. A strange contradiction: the classical age enveloped the madness in a total experience of unreason; it reabsorbed its particular forms... into a general apprehension in which madness consorted indiscriminately with all the forms of unreason. But at the same time it assigned to this same madness a special sign: not that of sickness, but that of glorified scandal." (Pg. 65)
He suggests, "it must not be forgotten that throughout his human life Christ honored madness, sanctified it as he sanctified infirmity cured, sin forgiven, poverty assured of eternal riches... To respect madness is not to interpret it as the involuntary and inevitable accident of disease, but to recognize this lower limit of human truth, a limit not accidental but essential. As death is the limit of human life in the realm of time, madness is its limit in the realm of animality, and just as death had been sanctified by the death of Christ, madness, in its most bestial nature, had also been sanctified." (Pg. 73-74)
He contends, "Sadism is not a name given finally to a practice as old as Eros; it is a massive cultural fact which appeared precisely at the end of the eighteenth century, and which constitutes one of the greatest conversion of Western imagination: unreason transformed into delirium of the heart, madness of desire, the insane dialogue of love and death in the limitless presumption of appetite. Sadism appears at the very moment that unreason... reappears... as language and desire. And it is not accident that sadism... was born of confinement and, within confinement, that Sade's entire oeuvre is dominated by images of the Fortress, the Cell, the Cellar, the Convent, the inaccessible Island which thus form... the natural habitat of unreason." (Pg. 171)
He points out, "No medical advance, no humanitarian approach was responsible for the fact that the mad were gradually isolated, that the monotony of insanity was divided into rudimentary types. It was the depths of confinement itself that generated the phenomenon; it is from confinement that we must seek and account of this new awareness of madness." (Pg. 182)
He argues, "Civilization, in a general way, constitutes a milieu favorable to the development of madness. If the progress of knowledge dissipates error, it also has the effect of propagating a taste and even a mania for study; the life of the library, abstract speculation, the perpetual agitation of the mind without the exercise of the body, can have the most disastrous effects." (Pg. 176) Later, he asserts, "The asylum is a religious domain without religion, a domain of pure morality, of ethical uniformity. Everything that might retain the signs of the old differences was eliminated. The last vestiges of the rite were extinguished... Now the asylum must represent the great continuity of social morality." (Pg. 207)
This book---Foucault's first---is one of his most interesting and influential... even outside the realm of philosophy. Not only those interested in philosophy, but those interested in psychology and mental illness will be highly interested in the book.