Madness – Week 8 Flashcards
Key Themes:
- Early Modern Madness
- Reforming the Mad
- Getting rid of the mad
Michel Foucault:
French Philosopher, historian and political activist
Madness and Civilisation (1961)
Was particularly concerned with classification and its consequences, examining such issues as the classification of disease and madness and the remapping of the diversity of human sexualities into the clearly defined categories, heterosexual and homosexual.
Foucault argued that such categories literally change the world; by re-classifying people as mad or sane, normal or abnormal, classifications attempt to impose certain ways of living and outlaw others.
He argued that analysing the way such classifications work required a study comparable to an archaeological dig; we need to dig down, through history, through successive layers of evidence, to understand how and why the world has taken the shape it now has.
Early Modern Madness:
Mad behaviours fault of demonic possessions
Social behaviours seen as different over time
Court Jester = the court “fool” or jester was a powerful figure in some ways, licenced to say what no one else at court would dare to
The Madwoman in the Attic = traditionally, “mad” people had often been cared for at home by their families
The Great Confinement – Paris 1656 – 1% of the City’s population incarcerated (mostly poor and homeless)
According to Foucault, from the seventeenth century, the rise of the absolutist centralist state, epitomised by the reign of Louis XIV (the Sun King) in France (16431715), was accompanied by an increasing intolerance of madness and the reclassification of many paupers as mad. The result was increasing imprisonment in hospitals that were little more than prisons.
Reforming the Mad: Philippe Pinel (1745-1826)
Unpardonable to keep the mad in chains
Argued “madmen so intractable only because they have been deprived of air and liberty”
William Tuke and the Retreat:
A similar approach was pioneered by the English Quaker, William Tuke (1732–1822), who founded The Retreat near York in 1796.
Like Pinel, Tuke was a pioneering humanitarian who also banned the use of chains and restraints.
Humane Reformers?
Pinel and Tuke credited with recognising insanity as an illness and restoring the mad to human dignity
“Moral Therapy”
William Tuke’s grandson, Samuel, published his Description of the Retreat, an Institution Near York (1813)
The “Moral Treatment” William pioneered and helped increase “the power of the patient to control the disorder”
A key point was ensuring: “insane patients being under the observation of persons of knowledge, judgement and probity”
Madness and Civilisation:
In Foucault’s view the use of continuous surveillance at the Retreat and the enforcement (however gently) of strict judgements about what counted as normal meant making the madman
The New Moral Prison:
Foucault: “Tuke created an asylum where he substituted for the free terror of madness the stifling anguish of responsibility”
Tuke’s celebrated tea parties forced the madman to repress themselves and conceal their individuality
A New ‘Episteme’:
Foucault acknowledged that Pinel and Tuke’s work marks a shift towards a new episteme: the mad are human again
BUT: they are still isolated and are now subjected to moralising therapies designed to make them conform to society’s codes of behaviour
Despite the shift, the social change of madness is avoided
Foucault claims the psychiatrists are moralists not doctors, since they rarely cure. Their real function is to police the boundaries of acceptable behaviour
Conformity:
Standardisation
“Sane people did what their neighbours did, so that if any lunatics were at large, one might know and avoid them” – George Eliot
Foucault on Freud:
Foucault claims that the almost mystical moral power of the doctor reaches a peak in figure of the analyst
The listening analyst is, according to Foucault, “an absolute Observation”
Anti-Enlightenment:
The Panopticon, an ideal prison, imagined by the English philosopher Jeremy Bentham, c. 1791
Ray Porter (1946-2002)
One of the world’s leading historians of medicine, with a particular expertise in the history of madness
Porter accepted parts of Foucault’s analysis: the mad were treated like animals in Early Modern Europe
BUT, he disagreed with Foucault’s claim of a “great confinement” and rounding up of desirables
Patterns of incarceration varied widely from one country to another:
- Russia: almost no state asylums until late – C19
- England: public money not used to establish institutions until after 1808
Getting rid of the mad:
Growing Pessimism –
1800: between 5,000 and 12,000 mad people incarcerated in Britain, out of a population of c. 10 million
1900: the number had risen to c. 100,000
Evidence of growing pessimism are unchaining the mad and applying moral therapy did not cure them
Also, growing fears of mental and moral degeneration affected psychiatrists, who seemed to have few cures to offer