Madness and Civilization: A History of Insanity in the Age of Reason is a 1961 book by the French philosopherMichel Foucault. The book was first translated into English - in an abridged edition - in 1964. A new English translation of the complete 1961 edition, titled History of Madness, was published in June 2006. Foucault's first major book, Madness and Civilization is an examination of the evolving meaning of madness in European culture, law, politics, philosophy and medicine from the Middle Ages to the end of the eighteenth century, and a critique of historical method and the idea of history. It marks a turning in Foucault's thought away from phenomenology toward structuralism: though he uses the language of phenomenology to describe an evolving experience of the mad as "the other", he attributes this evolution to the influence of specific powerful social structures.
Background
The book developed out of Foucault's earlier writing on psychology, his own psychological difficulties, and his experiences working in a mental hospital, and was written mainly between 1955 and 1959 while working in cultural-diplomatic and educational posts in Sweden, Germany, and Poland.
Summary
Foucault traces the evolution of the concept of madness through three phases: the Renaissance, the "Classical Age" and the modern experience. He argues that in the Renaissance the mad were portrayed in art as possessing a kind of wisdom – a knowledge of the limits of our world – and portrayed in literature as revealing the distinction between what men are and what they pretend to be. Renaissance art and literature depicted the mad as engaged with the reasonable while representing the mysterious forces of cosmic tragedy but the Renaissance also marked the beginning of an objective description of reason and unreason compared with the more intimate medieval descriptions from within society. Foucault contends that at the dawn of the age of reason, in the mid-seventeenth century, the rational response to the mad, who until then had been consigned to society's margins, was to separate them completely from society by confining them, along with prostitutes, vagrants, blasphemers and the like, in newly created institutions like the General Hospital of Paris all over Europe – a process he calls "the Great Confinement". The condition of these outcasts was seen as one of moral error. They were viewed as having freely chosen prostitution, vagrancy, blasphemy, unreason, etc. and the regimes of these new rational institutions were meticulous programs of punishment and reward aimed at causing them to reverse those choices. The social forces Foucault sees driving this confinement include the need for an extra-judicial mechanism for getting rid of undesirables, and the wish to regulate unemployment and wages. He argues that the conceptual distinction between the mad and the rational was in a sense a product of this physical separation into confinement: confinement made the mad conveniently available to medical doctors who began to view madness as a natural object worthy of study and then as an illness to be cured. For Foucault the modern experience began at the end of the eighteenth century with the creation of places devoted solely to the confinement of the mad under the supervision of medical doctors, and these new institutions were the product of a blending of two motives: the new goal of curing the mad away from their family who could not afford the necessary care at home, and the old purpose of confining undesirables for the protection of society. These distinct purposes were lost sight of, and the institution soon came to be seen as the only place where therapeutic treatment can be administered. He sees the nominally more enlightened and compassionate treatment of the mad in these modern medical institutions as just as cruel and controlling as their treatment in the earlier, rational institutions had been.
Reception
The sociologist José Guilherme Merquior argues that while Foucault raises important questions about the influence of social forces on the meaning of, and responses to, deviant behavior, Madness and Civilization is nonetheless so riddled with serious errors of fact and interpretation as to be of very limited value. Merquior notes that there is abundant evidence of widespread cruelty to and imprisonment of the insane during eras when Foucault contends that the mad were perceived as possessing wisdom, and that Foucault has thus selectively cited data that supports his assertions while ignoring contrary data. Madness was typically linked with sin by Christian Europeans, noted Merquior, and was therefore regarded as much less benign than Foucault tends to imply. Merquior sees Madness and Civilization as "a call for the liberation of the Dionysian id" similar to Norman O. Brown's Life Against Death, and an inspiration for Gilles Deleuze and Félix Guattari's Anti-Oedipus. Kenneth Lewes writes that Madness and Civilization is an example of the "critique of the institutions of psychiatry and psychoanalysis" that occurred as part of the "general upheaval of values in the 1960s". Lewes sees Foucault's work as being similar to, but more profound than, Thomas Szasz's The Myth of Mental Illness. The philosopher Gary Gutting writes:
