by Gary Gutting
Kant’s view of knowledge requires a special dual status for human beings. On the one hand, we are the source of the necessary conditions for the possibility of any knowledge of the world: we belong to a ‘transcendental ‘ domain that is the source of all knowledge in the ‘empirical’ domain. But at the same time we are ourselves knowable (not only by experience but also by the social sciences) and so are objects in the empirical domain. Foucault uses the term ‘man’ to refer to human beings as having this peculiar dual status (as what he calls an ‘empirical-transcendental doublet’). He argues that, in this sense, there was no conception of man prior to the end of the 18th century. Hence his melodramatic declaration that, until the 19th century, ‘man did not exist’ (OT, 308).
In Foucault’s history of modern philosophy, man is the central problem, the difficulty being to understand how a single unified being can be simultaneously the transcendental source of the possibility of knowledge and just another object of knowledge. Chapter 9 of The Order of Things works through the major developments of 20th-century philosophy – particularly the phenomenologies of Husserl, Sartre, and Merleau-Ponty – arguing that none of them are able to develop a coherent conception of man. In every case, there is an illegitimate reduction: either of the empirical to the transcendental (Husserl) or of the transcendental to the empirical (Merleau-Ponty).
This chapter is the closest the mature Foucault ever comes to standard philosophical discourse in the Kantian mode. It can be plausibly read – as I just have – as an effort to show that all modern explications of man (as an empirical-transcendental doublet) have fallen into incoherence. But such a reading – even though it seems to accord with Foucault’s own intentions – falls foul of his archaeological project of The Order of Things. For it puts his discussion on the level of history of ideas, the story of a series of individual thinkers trying to resolve a problem, not an archaeological investigation of the unconscious structures subtending such history. Further, as history of ideas, it can only tell us that these particular thinkers have failed to solve their problem, not that there are reasons in principle (presumably at the archaeological level) for the failure. If, however, we reconstrue Foucault’s treatment as a genuinely archaeological account, then the apparent incoherence of the concept of man shows nothing more than that our thought is no longer guided by the modern episteme, with the result that we are, like readers of Borges’ Chinese encyclopedia, faced with ‘the stark impossibility of thinking that’. In neither instance has Foucault made an effective case for or against a standard philosophical position. Nor is that, on his own account, surprising, since making such a case would require Foucault to operate within the modern episteme itself (the framework of philosophy in the Kantian sense), thereby giving up the historical distance required by his archaeological methodology. I conclude, then, that even in his most apparently philosophical moments, Foucault is not a participant in the debates of modern post-Kantian philosophy.
There remains, however, a further possibility, one that has attracted some readers of The Order of Things. This is that Foucault, following Heidegger, is trying to open a path to a new mode of philosophical thinking that will take us beyond the modern episteme. There are certainly Heideggerian elements in The Order of Things. Most prominent is the very critique of representation and of the philosophy of experience, which distinctly evokes a main theme of Being and Time; and, if Foucault suggests that Heidegger himself does not escape from the representationalist picture, that is a standard move in Heideggerian critiques of the master. There are also ruminations about the relation of language to being that surely have Heidegger’s later writings in mind: ‘What relation is there between language and being, and is it really to being that language is always addressed?’ (OT, 306). And the opening and closing attacks on the idea of ‘man’, with their intimation that we are moving to a new age in which ‘humanism’ will vanish, seem calculated to put Foucault on Heidegger’s side in his famous attack on Sartre in the ‘Letter on Humanism’.
But these Heideggerian features are just what separate The Order of Things from the rest of Foucault’s books. Nowhere else are philosophical themes so prominent, nowhere else is there so little connection of the discussion with the ethical and political issues characteristic of a ‘history of the present’. Although written as an archaeology of the social sciences, it is extremely difficult to connect its analysis with the system of domination in which these disciplines are, as Foucault’s later work shows, so closely implicated. The idea of ‘man’ may be an arbitrary constraint on our thought, but we have no sense that going beyond it will be anything more than an exercise in intellectual freedom. It is also worth remembering that large portions of The Order of Things are quite non-Heideggerian, particularly in their meticulous concern with the details of scientific modes of thought. But to the extent that the book is Heideggerian, it demonstrates that his other books are not.
Chapter 7
Madness
I had been mad enough to study reason; I was reasonable enough to study madness.
For us, ‘mad’ and ‘mentally ill’ are synonyms. We know that the sorts of people who cannot stop shouting obscenities at strangers or who think they receive radio messages from Pluto via their dental fillings have not always been regarded as suffering from an illness. They were said to be possessed by a god, in league with the devil, or simply subhuman animals. But we think that alternative views of madness are signs of ignorance if not malice; they lost all intellectual respectability after our modern discovery that madness is mental illness.
Standard histories of psychiatry have canonized this view. During the French Revolution, Philippe Pinel protested against chaining the mad like animals and went to the house of confinement at Bicêtre to release them. There he was confronted by Courthon, a fanatical member of the Republican government, who objected. Foucault quotes the story with predictable irony:
10. Pinel Freeing the Insane (1876), oil painting by Tony Robert-Fleury
Turning to Pinel [Courthon said]: ‘Now, citizen, are you mad yourself to seek to unchain such beasts? Pinel replied calmly: ‘Citizen, I am convinced that these madmen are so intractable only because they have been deprived of air and liberty.’ ‘Well, do as you like with them, but I fear you may become the victim of your own presumption.’ Whereupon, Couthon was taken to his carriage … Everyone breathed again; the great philanthropist immediately set to work.
(cited in MC, 242)
Such stories – there are similar ones about Samuel Tuke, who founded a Quaker asylum (the ‘Retreat’) in England about the same time – portray their heroes as brave and compassionate men who rejected superstitions in favour of scientifically based treatment of what enlightened thought showed to be an illness. But, Foucault maintains, ‘the truth was quite different’ (MC, 243).
Tuke’s work, for example, had religious and moral, not scientific, motivations. The Retreat freed the mad from chains and physical abuse and placed them in a halcyon setting. But in this setting they were strictly monitored for any deviations from conventional behaviour. The therapy consisted in making the madman ‘feel morally responsible for everything in him that may disturb morality and society, and must hold no one but himself responsible’ (MC, 246). The upshot was that ‘Tuke created an asylum where he substituted for the free terror of madness the stifling anguish of responsibility’ (MC, 247).
An exemplary moment in Tuke’s treatment was his famous ‘tea-parties’, ‘social occasions in the English manner’, Foucault tells us. Here the mad are guests of the directors and staff of the Retreat and (here Foucault quotes Tuke’s account) ‘vie with each other in politeness and propriety’. Remarkably, ‘the evening generally passes with the greatest harmony and enjoyment … and the scene is at once curious and affectingly gratifying’ (MC, 249). But Foucault has a very different reading of these occasions: ‘The madman is obliged to objectify himself in the eyes of reason as the perfect stranger, that is, the man whose strangeness does not rev
eal itself. The city of reason welcomes him only with this qualification and at the price of this surrender to anonymity’ (MC, 249–50).
Foucault resists the picture of Tuke and Pinel as humanitarians because he rejects their view that ‘humanity’ entails the values of modern bourgeois society: ‘Now the asylum must represent the great continuity of social morality. The values of family and work, all the acknowledged virtues, now reign in the asylum’ (MC, 257), which Foucault insists ‘is not a free realm of observation, diagnosis, and therapeutics’ but ‘a juridical space where one is accused, judged and condemned’. The mad are freed from their chains but they are ‘imprisoned in a moral world’ (MC, 269). There is a ‘gigantic moral imprisonment’ that, Foucault sneers, ‘we are in the habit of calling, doubtless by antiphrasis, the liberation of the insane’ (MC, 278).
We may well see something preciously unrealistic in Foucault’s sarcasm. After all, the mad are not rebels against a particular social or moral system; they are radically dysfunctional in any meaningful human context. If Tuke’s tea parties help control a psychotic who would otherwise try to kill anyone he met, then why worry that they reinforce bourgeois morality?
Foucault, who had worked with the mad, presumably knew that often a psychotic is just a psychotic, and he would surely have welcomed a treatment that returned delusional murderers to conventional morality. His outrage is directed, rather, against a perception of madness that admits no meaningful alternatives to our standards of normality and puts all belief and behaviour that seriously deviate from these standards outside the pale. On Foucault’s view, madness as a general phenomenon should be seen as a creditable challenge to normality, even though there are insane horrors to which normality would be a welcome relief.
But this response on Foucault’s behalf assumes that madness might be something besides beyond the pale. Is this really possible? If we don’t think so, Foucault says, this is because of the way madness has, historically, come to be perceived by our culture. His History of Madness is a sustained argument for this conclusion.
He begins with a cursory but crucial survey of madness in the Middle Ages and the Renaissance. Then, he maintains, madness was seen as an integrally human phenomenon. Madness was opposed to reason, but as an alternative mode of human existence, not a simple rejection of it. Consequently, madness (even if disdained or abhorred) was a meaningful challenge to reason. It could engage in ironic dialogue with reason (as in Erasmus’ In Praise of Folly) or claim a domain of human experience and insight not available to reason (as in Bosch’s paintings or Shakespeare’s tragedies). The point, in any case, is that in the past madness had a significant role in our culture’s understanding of human possibilities.
This fruitful understanding of madness ended around the middle of the 17th century, just at the beginning of what the French call the Classical Age. In contrast to medieval and Renaissance views, the Classical Age saw madness as merely the negation of the essential human attribute of reason. It was regarded as unreason (déraison), a plunge into an animality that had no human significance. There was, accordingly, a conceptual exclusion of the mad from the human world. So, for example, Descartes in his First Meditation entertains a range of possibilities as grounds for doubting his beliefs: the senses might be deceptive, he might be dreaming, there might even be an omnipotent evil demon bent on deceiving him at every turn. But, Foucault notes (HF, 56–8) there is one possibility at which Descartes balks. After suggesting that his beliefs might be unreliable because he is like those who think their heads are pumpkins or made of glass, he immediately rejects the possibility: ‘But they are mad, and I would be mad myself if I thought for a moment that I was like them’ (Meditation I). (Foucault and Jacques Derrida had a tense debate over the interpretation of this passage.)
Correlative to this conceptual exclusion, there was a physical exclusion of the mad effected by their confinement in institutions that isolated them from ordinary human life. This was most strikingly signaled in France by the ‘Great Confinement’ of 1656, when, within a period of just a few months, over 1% of the population of Paris was compelled to live in the dispersed sections of the Hôpital Général. (One of these sections was Salpêtrière, today a modern hospital, where – irony of ironies – Foucault himself died in 1984.) But Foucault maintains that similar confinements occurred throughout Europe.
The conceptual and physical exclusion of the mad also reflects a moral condemnation. The moral fault, however, is not the ordinary sort, whereby a member of the human community violates one of its basic norms. Rather, madness corresponds to a radical choice that rejects humanity and the human community in toto in favour of a life of sheer (nonhuman) animality. On the Classical view, the animality of the mad is expressed in their domination by passions, a domination that leads them to a delirium in which they mistake the unreal for the real. Passionate delirium thus results in a fundamental blindness that cuts the mad off from the light of reason.
The modern therapeutic view of madness is a sharp break with the Classical view, what Foucault later calls a change in episteme or discursive formation. The mad are returned to the human community, no longer animals beyond the human pale. But, within that community, the mad are now moral offenders (violators of specific social norms), who should feel guilt at their condition and need reform of their attitudes and behaviour. Correspondingly, the characteristic modern mode of treating the mad not only isolates them but subjects them to a moralizing therapy. Still, this move from the custodial confinement of the Classical Age to the modern therapeutic asylum continues to deny madness as a humanly significant challenge.
We may object that the quite explicit moral orientation of Pinel and Tuke excludes them as founders of modern psychiatry, which is avowedly ethically neutral in treating a disease that is not regarded as the patient’s fault. Surely there is a distinction between these early moral therapies and the subsequent medicalization of the treatment of the mad? Foucault’s response is that the most striking feature of the moral domination of the asylum was ‘the apotheosis of the medical personage’ (MC, 269). We, convinced that the mad are simply ‘mentally ill’, think it inevitable that doctors should control their care. But Foucault claims that, in the asylum, the rule is never so much by medical as by moral authority. Doctors have authority not because they have the knowledge to cure (this is haphazard at best) but because they represent the moral demands of society. This is evident today in psychiatric practice. This wears the trappings of medical science, but the key to therapy remains the personal moral authority of the therapist, who serves as an instrument of social values. Hence, for example, the essential role of transference in psychoanalytic treatment.
Foucault’s account seems implausible only if we continue to insist that the identification of madness as mental illness is an objective scientific discovery. His history, however, suggests that the identification was, on the contrary, introduced as a means of legitimating the authority of physicians in the asylum once the idea of a distinctively moral therapy was abandoned. The fact that physicians came to be in charge of asylums initially had little to do with their medical expertise. The moral treatments recommended by Tuke and Pinel were not essentially medical and could be carried out by any person with moral authority. However, as the 19th century developed, medicine became dominated by the ideal of objective, value-free knowledge, which left no room for value-laden moral therapies. The idea of a distinctively mental sort of illness was introduced primarily to justify the continuing authority of doctors over the mad, not because of its scientific truth or curative success.
But even if contemporary psychiatry falls short of the claims of scientific objectivity it sometimes makes, we might still ask if it really allows no meaningful interaction with the mad. Isn’t psychoanalysis an obvious counter-example, since it removes patients from the strictures of the asylum and actually listens to them? Foucault agrees that Freud eliminates most features of the asylum, retaining only the core relation of doctor to patient. But
, as we’ve seen, this relation is at the heart of the modern domination of the mad. Moreover, according to Foucault, Freud ‘amplified … the thaumaturgical powers’ of the ‘medical personage’, giving it a ‘quasi-divine status’ (MC, 277). In the person of the analyst, Freud ‘focused … all the powers … of the asylum’ (MC, 277–8). The analyst does listen to the patient but, silent behind the couch, is transformed into ‘an absolute Observation, a pure and circumspect Silence, a Judge who punishes and rewards in a judgment that does not even condescend to language’. As a result, psychoanalysis ‘has not been able, will not be able, to hear the voices of unreason’. It is effective in some cases but, in the end, ‘remains a stranger to the sovereign enterprise of unreason’ (MC, 278).