Say Michel Foucault and you say The History of Madness, in the original French version ‘Folie et déraison. Histoire de la folie à l’âge classique’ (History of madness in the classical period). What are the key points from this extensive and important work in the field of psychiatry? Foucault also discusses the work of Samuel Tuke and Pinel.
Michel Foucault
- Madness through the ages
- Foucault’s views and views
- Tuke and Pinel
Madness through the ages
The extensive History of Madness was Foucault’s first major work, which he wrote while he was director of the Maison de France in Sweden. It describes the ideas, actions, institutions, arts and literature related to madness in Western history. He begins his history with the Middle Ages, with the social and physical exclusion of lepers. His theory is that with the disappearance of leprosy, the insane took over their position as heretics of society. In the 18th century, madness was seen as the opposite of rationality, and finally only in the 19th century as a mental illness.
Foucault also says that madness was silenced by Reason. He examines the rise of scientific and ,humane, treatments for the insane, especially those of Philippe Pinel and Samuel Tuke. His contention is that these treatments were no less coercive than earlier methods. Tuke’s Retreat in York was an attempt to push the insane into behaving ,normally,. Pinel’s was also very coercive, trying to break people’s bad habits by putting them in an ice-cold shower or putting them in a straitjacket. It was a repetition of brute force until the patient came to see it as normal.
Foucault’s views and views
Faucoult rejects locking up the insane with criminals and lists predecessors who were involved in this in his book. Of course he also has opponents in this. They believe that criminals can be put to work and be productive, while madmen are good for nothing and it is better to lock them up. An example of this is the Frenchman Mirabeau.
The situation changes when poverty increases and becomes an economic issue. Wealth can only exist through poverty. Foucault therefore believes that poverty should be praised. Wealth has its foundation in a large population. The internment of the poor was therefore also an economic mistake, because it shrinks the labor market. What changed in the course of the 18th century is not the treatment of the mad, but the naturalness of their internment. The legislator had a problem because, if he wanted to stop the internment, he did not know in which social space to place the madmen.
Following the lettres de cachet, the internment of madmen must be reduced as much as possible. People should not simply be interned unless they pose a danger to themselves or others. Mentally ill people who had not broken any laws were to be released in accordance with the Declaration of Human Rights. They then had to be treated in special homes. According to a law from 1791, family members had to be held responsible. The madmen then acquire a kind of animal status. There are no special mental asylums yet. The first center that serves this purpose is Bicetre, but serious abuses exist here.
Tuke and Pinel
In the 19th century, asylums were established in which no or only limited coercion was used. This appeared to have a positive effect on the patients. They were actually seen as children and could therefore be re-educated. Samuel Tuke’s book The Retreat is frequently discussed in Foucault’s book. In his myth, the family was the counterpart of the environment, which was seen as the source of madness at the end of the 18th century. An idea that is also gaining more and more support is that the asylums must be freed from religious influences, because this can also be the source of madness. This is substantiated by statistics. Pinel is one of the people who defends this statement. In contrast, at least outwardly, to freedom, Pinel proposes an institution with a uniform field of legislation and a place of moral syntheses. According to him, three key points are important: silence. Prisoners would be humiliated if they were not spoken to and this would make him repent. And then there is the recognition in the mirror and the constant condemnation that should point out his wrong behavior.
Pinel is seen as the first to exchange physical coercion for mental coercion. He used means such as the cold shower to show insane people that their behavior was incorrect. This is of course not nice, but it is still fairly gentle for the time. He also observed people a lot, up to two years, and then started conversations. Pinel and Tuke showed that the moral ascendancy of the physician was not necessarily due to any scientific competence.