Madness and Civilzation ( A History of Madness)

by Foucault, Michel -

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  tion. The great cosmic conflict whose peripities had been revealed by the Insane in the fifteenth and sixteenth cen­turies, shifted until it became, at the end of the classical period, a dialectic lacking the heart's mediation. Sadism is not a name finally given 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 conversions 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, confined for over a century and reduced to silence, reappears, no longer as an image of the world, no longer as a figura, but as language and desire. And it is no accident that sadism, as an individual phenomenon bearing the name of a man, was born of confinement and, within confinement, that Sade's entire oeuvre is dominated by the images of the Fortress, the Cell, the Cellar, the Convent, the inaccessible Island which thus form, as it were, the natural habitat of unreason. It is no accident, either, that all the fantastic literature of madness and horror, which is contemporary with Sade's oeuvre, takes place, preferen­tially, in the strongholds of confinement. And this whole sudden conversion of Western memory at the end of the eighteenth century, with its possibility of rediscovering— deformed and endowed with a new meaning—figures fa­miliar at the end of the Middle Ages: was this conversion not authorized by the survival and the reawakening of the fantastic in the very places where unreason had been re­duced to silence?

  In the classical period, the awareness of madness and the awareness of unreason had not separated from one another. The experience of unreason that had guided all the prac­tices of confinement so enveloped the awareness of madness

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  that it very nearly permitted it to disappear, sweeping it along a road of regression where it was close to losing its most specific elements.

  But in the anxiety of the second half of the eighteenth century, the fear of madness grew at the same time as the dread of unreason: and thereby the two forms of obsession, leaning upon each other, continued to reinforce each other. And at the very moment we note the liberation of the iconographic powers that accompany unreason, we hear on all sides complaints about the ravages of madness. Already we are familiar with the concern generated by "nervous diseases," and the awareness that man becomes more deli­cate in proportion as he perfects himself. As the century advanced, the concern became more pressing, the warnings more solemn. Already Raulin had observed that "since the birth of medicine . . . these illnesses have multiplied, have become more dangerous, more complicated, more prob­lematical and difficult to cure." By Tissot's time, this gen­eral impression became a firm belief, a sort of medical dogma: nervous diseases "were formerly much less fre­quent than they are nowadays; and this for two reasons:

  one, that men were in general more robust, and less fre­quently ill; there were fewer diseases of any kind; the other, that the causes which produce nervous diseases in especial have multiplied in a greater proportion, in recent times, than the other general causes of illness, some of which even seem to have diminished. ... I do not hesitate to say that if they were once the rarest, they are today the most frequent."8 And soon men regained that awareness, which had been so intense in the sixteenth century, of the precariousness of a reason that can at any moment be com­promised, and definitively, by madness. Matthey, a Geneva physician very close to Rousseau's influence, formulates the prospect for all men of reason: "Do not glory in your state, if you are wise and civilized men; an instant suffices to

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  disturb and annihilate that supposed wisdom of which you are so proud; an unexpected event, a sharp and sudden emotion of the soul will abruptly change the most reason­able and intelligent man into a raving idiot." The threat of madness resumes its place among the emergencies of the century.

  This awareness, however, has a very special style. The obsession with unreason is a very affective one, involved in the movement of iconographic resurrections. The fear of madness is much freer with regard to this heritage; and while the return of unreason has the aspect of a massive repetition, connecting with itself outside of time, the awareness of madness is on the contrary accompanied by a certain analysis of modernity, which situates it from the start in a temporal, historical, and social context. In the disparity between the awareness of unreason and the awareness of madness, we have, at the end of the eighteenth century, the point of departure for a decisive movement: that by which the experience of unreason will continue, with Holderlin, Nerval, and Nietzsche, to proceed ever deeper toward the roots of time—unreason thus becoming, par excellence, the world's contratempo—and the knowl­edge of madness seeking on the contrary to situate it ever more precisely within the development of nature and his­tory. It is after this period that the time of unreason and the time of madness receive two opposing vectors: one being unconditioned return and absolute submersion; the other, on the contrary, developing according to the chronicle of a history.9

  1. Madness and Liberty. For a long time, certain forms of melancholia were considered specifically English; this was a fact in medicine and a constant in literature. Montes­quieu contrasted Roman suicide, which was a form of moral and political behavior, the desired effect of a con­certed education, with English suicide, which had to be

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  considered as an illness since "the English kill themselves without any apparent reason for doing so; they kill them­selves in the very lap of happiness." It is here that the milieu plays its role, for if happiness in the eighteenth cen­tury is part of the order of nature and reason, unhappiness, or at least whatever deters from happiness without reason, must be part of another order. This order was sought first in the excesses of the climate, in nature's deviation from its equilibrium and its happy mean (temperate climates are caused by nature; intemperate climates by the milieu). But this was not sufficient to explain la maladie anglaise; already Cheyne had declared that wealth, refined food, the abun­dance all the inhabitants enjoyed, the life of pleasure and ease the richest society led, were at the origin of such ner­vous disorders. Increasingly, a political and economic ex­planation was sought, in which wealth, progress, institu­tions appear as the determining element of madness. At the beginning of the nineteenth century, Spurzheim made a synthesis of all these analyses in one of the last texts de­voted to them.10 Madness, "more frequent in England than anywhere else," is merely the penalty of the liberty that reigns there, and of the wealth universally enjoyed. Free­dom of conscience entails more dangers than authority and despotism. "Religious sentiments . . . exist without re­striction; every individual is entitled to preach to anyone who will listen to him," and by listening to such different opinions, "minds are disturbed in the search for truth." Dangers of indecision, of an irresolute attention, of a vacil­lating soul! The danger, too, of disputes, of passions, of obstinacy: "Everything meets with opposition, and oppo­sition excites the feelings; in religion, in politics, in science, as in everything, each man is permitted to form an opinion;

  but he must expect to meet with opposition." Nor does so much liberty permit a man to master time; every man is left to his own uncertainty, and the State abandons all to their

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  fluctuations: "The English are a nation of merchants; a mind always occupied with speculations is continually agi­tated by fear and hope. Egotism, the soul of commerce, easily becomes envious and summons other faculties to its aid." Besides, this liberty is far from true natural liberty: on all sides it is constrained and harried by demands opposed to the most legitimate desires of individuals: this is the lib­erty of interests, of coalitions, of financial combinations, not of man, not of minds and hearts. For financial reasons, families are here more tyrannical than anywhere else: only wealthy girls are able to marry; "the others are reduced to other means of satisfaction that ruin the body and derange the manifestations of the soul. The
same cause favors libertinage, which predisposes to madness." A mercantile liberty thus appears as the element in which opinion can never arrive at the truth, in which the immediate is neces­sarily subject to contradiction, in which time escapes the mastery and certainty of the seasons, in which man is dis­possessed of his desires by the laws of interest. In short, liberty, far from putting man in possession of himself, ceaselessly alienates him from his essence and his world; it fascinates him in the absolute exteriority of other people and of money, in the irreversible inferiority of passion and unfulfilled desire. Between man and the happiness of a world in which he recognizes himself, between man and a nature in which he finds his truth, the liberty of the mer­cantile state is "milieu": and to this very degree it is the determining element of madness. When Spurzheim was writing—at the height of the Holy Alliance, during the restoration of the authoritarian monarchies—liberalism was readily blamed for all the sins of the world's madness: "It is singular to see that man's greatest desire, which is his per­sonal liberty, has its disadvantages as well." But for us, the point of such an analysis is not its critique of liberty, but its very employment of the notion that designates for Spurz-

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  heim the non-natural milieu in which the psychological and physiological mechanisms of madness are favored, ampli­fied, and multiplied.

  2. Madness, Religion, and Time. Religious beliefs pre­pare a kind of landscape of images, an illusory milieu fa­vorable to every hallucination and every delirium. For a long time, doctors were suspicious of the effects of too strict a devotion, too strong a belief. Too much moral rigor, too much anxiety about salvation and the life to come were often thought to bring on melancholia. The Encyclopedic does not fail to cite such cases: "The intem­perate impressions made by certain extravagant preachers, the excessive fears they inspire of the pains with which our religion threatens those who break its laws, produce aston­ishing revolutions in weak minds. At the hospital of Montelimar, several women were reported suffering from mania and melancholia as a result of a mission held in that city; these creatures were ceaselessly struck by the horrible images that had thoughtlessly been presented to them; they spoke of nothing but despair, revenge, punishment, etc., and one of them absolutely refused to undergo any cure, convinced that she was in Hell and that nothing could ex­tinguish the fire she believed was devouring her." Pinel fol­lows the line of these enlightened physicians—forbidding books of devotion to be given to "melancholics by piety," even recommending solitary confinement for "religious persons who believe themselves to be inspired and who seek to make proselytes." But this again is more of a critique than a positive analysis: the religious object or theme is suspected of arousing delirium and hallucination by the de­lirious and hallucinatory nature attributed to it. Pinel re­ports the case of a recently cured madman who had "read in a religious book . . . that each man has his guardian angel; on the following night, he thought he was sur­rounded by a choir of angels and imagined he heard celes-

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  tial music and received revelations." Religion is considered here only as an element in the transmission of error. But even before Pinel, there had been analyses of a more rigor­ous historical nature, in which religion appeared as a milieu of satisfaction or repression of the passions. In 1781 a Ger­man author described as happy those distant eras when priests were endowed with absolute powers: then idleness did not exist, every moment was marked by "ceremonies, religious practices, pilgrimages, visits to the poor and the sick, calendar festivals."11 Time was thus assigned to an organized happiness, which left no leisure 'for empty pas­sions, for disgust with life, for boredom. If a man felt guilty, he was subjected to real, often material punishment which occupied his mind and gave him an assurance that the transgression was redressed. And when the confessor encountered those "hypochondriacal penitents who came too often to confession," he assigned them as penance ei­ther a severe hardship that "diluted their too thick blood," or long pilgrimages: "The change of air, the length of the road, absence from home, distance from the things which upset them, their associations with other pilgrims, the slow and energetic movement of walking, had more effect upon them than the comfortable journeys . . . that in our day take the place of pilgrimages." Finally, the sacred nature of the priest gave each of his injunctions an absolute value, and no one dreamed of trying to avoid it; "usually the whims of sick people deny all this to the physician." For Moehsen, religion is the mediation between man and trans­gression, between man and punishment: in the form of an authoritarian synthesis, it suppresses the transgression by imposing the punishment; if, on the contrary, religion loosens its hold but maintains the ideal forms of remorse of conscience, of spiritual mortification, it leads directly to madness; only the consistency of the religious milieu can permit man to escape alienation in the excessive delirium of

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  transgressions. By accomplishing its rites and its require­ments, man avoids both the useless idleness of his passions before the transgression, and the vain repetition of his re­morse once the transgression is committed; religion organ­izes all human life around fulfillment of the moment. That old religion of happier times was the perpetual celebration of the present. But once it was idealized in the modern age, religion cast a temporal halo around the present, an empty milieu—that of idleness and remorse, in which the heart of man is abandoned to its own anxiety, in which the passions surrender time to unconcern or to repetition in which, fi­nally, madness can function freely.

  3. Madness, Civilization, and Sensibility. 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 specula­tions, the perpetual agitation of the mind without the exer­cise of the body, can have the most disastrous effects. Tissot explains that in the human body it is those parts subject to frequent work which are first strengthened and hard­ened; among laborers, the muscles and fibers of the arms harden, giving them their physical strength and the good health they enjoy until an advanced age; "among men of letters, the brain hardens; often they become incapable of connecting their ideas," and so are doomed to dementia. The more abstract or complex knowledge becomes, the greater the risk of madness. A body of knowledge still close to what is most immediate in the senses, requiring, accord­ing to Pressavin, only a little work on the part of the inner sense and organs of the brain, provokes only a sort of phys­iological happiness: "The sciences whose objects are easily perceived by our senses, which offer the soul agreeable re­lations because of the harmony of their consonance . . . perform throughout the entire bodily machine a light ac-

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  tivity which is beneficial to all the functions." On the con­trary, a knowledge too poor in these sensuous relations, too free with regard to the immediate, provokes a tension of the brain alone which disequilibrates the whole body; sci­ences "of things whose relationships are difficult to grasp because they are not readily available to our senses, or be­cause their too complicated relations oblige us to expend great application in their study, present the soul with an exercise that greatly fatigues the inner sense by a too con­tinuous tension upon that organ." Knowledge thus forms around feeling a milieu of abstract relationships where man risks losing the physical happiness in which his relation to the world is usually established. Knowledge multiplies, no doubt, but its cost increases too. Is it certain that there are more wise men today? One thing, at least, is certain: "there are more people who have the infirmities of wisdom." The milieu of knowledge grows faster than knowledge itself.

  But it is not only knowledge that detaches man from feeling; it is sensibility itself: a sensibility that is no longer controlled by the movements of nature, but by all the hab­its, all the demands of social life. Modern man—but woman more than man—turns day into night and night into day: "The moment at which our women rise in Paris is far re­moved from th
at which nature has indicated; the best hours of the day have Slipped away; the purest air has disap­peared; no one has benefited from it. The vapors, the harm­ful exhalations, attracted by the sun's heat, are already ris­ing in the atmosphere; this is the hour that beauty chooses to rise."12 This disorder of the senses continues in the the­ater, where illusions are cultivated, where vain passions and the most fatal movements of the soul are aroused by arti­fice; women especially enjoy these spectacles "that inflame and arouse them"; their souls "are so strongly shaken that this produces a commotion in their nerves, fleeting, in truth, but whose consequences are usually serious; the

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  momentary loss of their senses, the tears they shed at the performances of our modern tragedies are the least acci­dents that can result from them."13 Novels form a still more artificial milieu, and are more dangerous to a dis­ordered sensibility; the verisimilitude modern authors at­tempt to produce, and all the art they employ to imitate truth, only give more prestige to the violent and dangerous sentiments they seek to awaken in their female readers: "In the earliest epochs of French gallantry and manners, the less perfected minds of women were content with facts and events as marvelous as they were unbelievable; now they demand believable facts yet sentiments so marvelous that their own minds are disturbed and confounded by them; they then seek, in all that surrounds them, to realize the marvels by which they are enchanted; but everything seems to them without sentiment and without life, because they are trying to find what does not exist in nature."14 The novel constitutes the milieu of perversion, par excel­lence, of all sensibility; it detaches the soul from all that is immediate and natural in feeling and leads it into an imag­inary world of sentiments violent in proportion to their unreality, and less controlled by the gentle laws of nature; "The existence of so many authors has produced a host of readers, and continued reading generates every nervous complaint; perhaps of all the causes that have harmed women's health, the principal one has been the infinite mul­tiplication of novels in the last hundred years ... a girl who at ten reads instead of running will, at twenty, be a woman with the vapors and not a good nurse."15