Rubbing Shoulders with Unreason

Peter Barham

In the 1950s, three individuals, unknown to one another and from different countries, were engaged in what seem, looking back, to have been remarkably similar projects vis-à-vis those whom society designates as mad. One was a philosophy student: ‘I used to work in a psychiatric hospital in the 1950s. After having studied philosophy, I wanted to see what madness was: I had been mad enough to study reason; I was reasonable enough to study madness. I was free to move from the patients to the attendants, for I had no precise role . . . I was actually in a position between the staff and the patients.’

Another was an American sociologist, reporting on fieldwork he had undertaken at a psychiatric institution with more than seven thousand inmates. ‘My immediate object . . . was to try to learn about the social world of the hospital inmate, as this world is subjectively experienced by him. I started out in the role of an assistant to the athletic director, when pressed avowing to be a student of recreation and community life, and I passed the day with patients, avoiding sociable contact with the staff and the carrying of a key.’

The third was a young British psychiatrist who, during his National Service, was assigned to a psychiatric unit at a military hospital, where he openly flouted the rules forbidding the staff from talking to patients, and ‘hung out’ with a manic patient in a padded cell at night, just listening to what he was saying. ‘I felt strangely at home there, lounging on the floor.’

These participatory experiments resulted in three books, all published within a year of each other in 1960 and 1961: Michel Foucault’s Folie et déraison, Erving Goffman’s Asylums and R.D. Laing’s Divided Self, which, along with Thomas Szasz’s The Myth of Mental Illness, also published in 1961, were set to become iconoclastic classics.

There is a revealing passage in History of Madness in which Foucault proposes that ‘the knowledge of madness supposes in the person who holds it an ability to distance the self from it, and to remain aloof from its perils and its charms, a certain manner of not being mad.’ The consciousness of ‘not being mad’, Foucault claims, is ‘at the heart of the positivist experience of mental illness’. This captures exactly the spirit against which these psychiatric rebels were reacting, for what they had in common was a repugnance for this ‘certain manner of not being mad’, and the whole idea of a hard and fast line being drawn between the mad and the not mad.

The coupling of Foucault’s study with the canonical texts of the so-called anti-psychiatry movement may have been fortuitous but it was to prove lasting. Folie et déraison appeared in an abridged translation in 1967 in a series on existentialism and phenomenology edited by R.D. Laing, complete with a eulogistic preface by David Cooper (the South African-born psychiatrist who coined the term ‘anti-psychiatry’). But readers who have to rely on an English translation have had to wait almost four decades to get their hands on a complete version. In important respects the new translation does not disappoint: this is a much subtler, less sensationalist Foucault of 14 chapters as against nine, with numerous other missing sections added, and a wealth of detail on a variety of topics, from the conflict between a tragic and a critical understanding of madness in the Renaissance, to the punishment of the venereally infected in the 17th century (‘sufferers from venereal diseases will only be admitted after correction has been carried out, and after they have been whipped’). All this is strangely reassuring in the face of Foucault’s more fantastic speculations and the broad sweep of his ambitious project.

Having the full text available in English undoubtedly increases one’s admiration for Foucault’s achievement, though a few irritants and some more serious problems remain. Cooper’s precious and self-serving introduction – ‘the true significance of [Foucault’s] book resides most precisely in the terror that it may produce in a significant few of us’ – has mercifully been jettisoned, but in its stead we are given as a frontispiece a reproduction of a banal commendation by R.D. Laing to the publishers of the original translation, as though this were a comic routine in which one partner vacates the scene only for his double to re-enter by another door. Nor is the title quite right. The book’s 1961 title was Folie et déraison: histoire de la folie à l’âge classique, but over the years, the subtitle clambered into first place and usurped the incumbent. As Ian Hacking remarks in a witty and astute foreword, this is rather like the Cheshire Cat leaving behind only its grin. Hacking suggests that the disappearance or suppression of the déraison is a sign that Foucault had changed his mind about madness. Unquestionably he had, but even so all this shuffling has done little to alter the substance of the work. A new reader will soon discover that the cat still stalks the text in full vigour.

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