After arduous reading I finally finished Foucault’s Doctoral Dissertation: “Folie et Déraison: Histoire de la folie à l’âge classique”( I have the Norwegian translation).
I found the book earlier this year as I went through my grandfather’s library and as “insanity” doesn’t interest him much I took the book with me home to England. The physical book in and of itself is gorgeously old-fashioned and reeks of quality. Beautifully designed for anyone who appreciates real books. The topic is one that will instantly pique the interest of anyone interested in psychology and/or psychiatry, but be warned. Foucault’s work is not one based solely on empiric data. It is not written in a direct scientific language. Rather he expresses himself with big, wide, brush strokes, filled with tiny embellishments and un-expected twists and turns, sporadically breaking into Latin. An allegorical writer he sought to use pieces of art along with his own artistic interpretation of historical documents to describe the development of how madness was being treated and perceived overall by society through the “classical period.”I guess he felt that madness was not best described through only words, especially clinical terms.
He seeks to find out where everything “went wrong” in terms of how the mad are incarcerated and put under conservatorship with the doctor presiding over the institutionalised like a God.
It’s a beautifully complex and heavy read. I’ve found myself reading some of the sentences, in fact entire pages over and over again, in order to fully grasp what the author is trying to communicate. 😛
The book’s topic is actually perfectly summarised in the introductory essay penned by Norwegian academic Erling Sandmo, so if you want to keep things easy, you don’t have to read the whole thing … but that of course means that you will miss out on all the best bits, which are well hidden. Packed into elaborate sentences and vivid descriptions.
What is truly fascinating is how heavily modern perceptions are moulded by past definitions of melancholy and mania. With what confidence “experts” of the past passed their verdict in regards to ailments of the mind! Makes one wonder how history will judge our modern science. How much will be laughed at? How much of it will be debunked? Yet, the “scientists” of the past were on to something, but I guess their vision was clouded by their time’s superstitions and technological shortcomings.
Doctor’s struggled to define the causes for Hysteria and Hypochondria which were put in the same box of sorts, just like melancholy & mania ( this was before manic depression/bipolar disorder was coined as a maladie on its own). Foucault follows the gradual learning curve of the medical community citing the times of Hippocrates when it was thought that “the uterus was travelling around the body” to the eventual conclusion that Hysteria had to stem from the nerves in the body, hence our “bad nerves” saying.
The book follows the various “treatment” methods that were intended to firmly plant the mad back into the moral, righteous path of God. The “prescriptions” were neither particularly conversational nor pharmaceutical. They relied on warm or cold baths to manipulate the inner bodily functions (apparently the manic were almost immune to cold temperatures, which is why they could “thrive” in cold cells or go naked into the winter), doctors relied on what would classify as torture by today’s standards ( even though these descriptions are rather few in the book ) like causing blisters and sores so that un-wanted “vapours” could leave the body. They put the mad into hard labour as this was the surest way back to salvation, or they partook in the delusional’s delusion so as to communicate with the mad on their level. Like a man who believed himself to be dead and therefore refrained from eating, which nearly killed him. His imminent death was prevented by the medical staff dressing themselves up, pretending to be dead men that were eating. This bizarre banquette of the dead, convinced the man who thought of himself as dead, that he too had to eat, which saved his life.
Madness was defined as: Applying logical thinking to obsessive irrational beliefs and conclusions about the self and/or the world. It is actually quite a fascinating view of madness.
At the dawn of institutionalisation, the mad, the poor, the unemployed, the drunk, the beggar, the maimed, were all thrown into the same place. These were the people who society rejected. Many “normal” inmates complained loudly about having to share cells with the mad that were “raving furious” and “screaming incoherently.” Just like prison guards complained of what a humiliation it was to house those who had gone astray with the irredeemably insane. The conditions described of the chained mad put on display for the bourgeois to see, resembles that of a zoo where humanity’s rotten apples are animalised.
Despite his communist leanings, the author chose to be loyal to historical facts and admitted in his writings that over taxation on businesses had led to un-employment and destruction of companies’ possibilities to employ the working class. By imprisoning the poor and forcing them into cheap labour, the initiative eventually led to the gutting of the already employed, turning it into a vicious cycle, where actions fuelled by a desire for social reform, led to the total opposite.
At a certain point, the destitute were freed from their imprisonment as it made no sense to keep them there. The poor were more profitable outside of institutions while the view on how convicts deserved to be treated changed to. Political prisoners were still kept hidden, somewhere, but now the time had arrived for the introduction of what we today would refer to as the asylum.
In the last section of his Doctoral Dissertation he describes William Tuke and Phillippe Pinel’s treatment methods and the transition from the neglect and blatant abuse of the mad to the dawn of modern psychiatry. Foucault seems to argue that this “improvement” wasn’t so much so as the marginalised, betrodden mad were still not in a particularly good place; but I have to say that from what Foucault describes I cannot help but feel that there were wast improvements made to the general treatment of the deranged.
Foucault leaves us, flirting with, but not really delving into Freud. Describing that a “family structure” had been established within the asylum due to Tuke and Pinel, with the mad’s role being that of a child whereas the doctor symbolised the father.