The social incorporation of madness

The history of the asylum encapsulates similar trends of development. Like criminality, madness was in prior eras assumed to be an outcome of God's will, the insane being one group among others worthy of receiving a certain level of care from the community. The image of Pinel removing the chains of the insane could be taken to represent the thrust of modernity as a whole. Indeed, the idea of Prometheus unbound, which so inspired Marx, carries a picture of freedom from the shackles of tradition and custom which reappears many times from the Enlightenment onwards. Insanity came to have an `open' horizon in common with all other aspects of established behaviour and social relation. The medicalising of insanity, as `mental illness', is only part of this phenomenon. Insanity was a physical disease, but most forms of insanity were believed to be brought on by social circumstances, and certainly the control of behaviour was a major means of producing supposed cures. Many early psychiatrists, in fact, linked the very aetiological origins of mental illness with social factors, including `civilisation' itself.

Particularly important, however, was the surfacing of the view that mental illness, in common with criminality, and under specific circumstances, could attack anyone in the population. From being a special, although not clearly distinguishable, characteristic of poverty, and therefore clustered among the least privileged groups, mental illness came to be seen as one of the risks modern life brought in its train. `Insanity is peculiar to no grade in life. There are none so elevated as to be beyond its reach ... it has dethroned the monarch, and deepened the gloom of the hovel.' ¹⁸

Asylums were first established with their curative properties in mind. Incarceration was intended to restore mental health through the setting itself, rather than only through the medicines or treatments administered there. The mental hospital was supposed to create an environment which would methodically correct for the deficiencies of the wider social community. Again, a moral dimension to the reform of the afflicted personality was clearly apparent. As in the prison, the maximising of surveillance, in conjunction with the establishing of disciplined routines, were the means of attaining these ends. Insanity, like madness, was

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actively defined in terms of social incapacity: the inability, or unwillingness, to live the required type of life in the outside world.

What is striking about the asylum, in common with the prison, is how much it shares with the wider social environments of modernity. Foucault is wrong to trace this similarity to discipline as such; the forfeiting of various kinds of social and personal rights on the part of those forcibly incarcerated in prisons and asylums is surely central to their character. What they share in common with the broader frameworks of modernity is the attempt to develop reflexive self-control even among minorities who might seem intrinsically recalcitrant. The moral component in both cases soon took second place to other imperatives. What counted as a `cure' lost most of its extrinsic characteristics, becoming measured as to whether a person was able and willing to function satisfactorily in the wider social environment. In other respects, simple custody became a dominant feature: incarceration serves at least to protect those in the outside world from unalterable irregularities in the behaviour of the minority.

`Deviance' came to be `invented' as part of the internally referential systems of modernity, and therefore defined in terms of control. The extrinsic issues and questions which criminality and insanity pose to the population at large are thereby thoroughly repressed. But this is an institutional repression rather than a personal one -- it does not presume an intensifying of `conscience'. It is an exclusion from the core arenas of social life of potentially disturbing issues, values and modes of behaviour. The issues thus repressed are plainly of a moral and existential sort. In behaviour now classified as `mental illness', for example, alternative visions of what passes for everyday reality are pushed far from the preoccupations of daily life. Once the asylum has become established, few people come into contact with the insane in a regular way. Just as invisible are the connections which once linked `poverty' in the old sense to extrinsic moral precepts and traditions. Prisons and mental hospitals rapidly lost most of that exotic quality which early on made them spectacles for the outside world to look upon. Instead, they became settings of technical correction, geared to the transformative relations of modernity.

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Date: 2016-04-22; view: 691