The Republic of Turkey Ankara University Graduate School of Social Sciences Department of Western Languages and Literatures English Language and Literature

Home , Disciplinary institution, Joe Penhall

THE REPUBLIC OF TURKEY ANKARA UNIVERSITY GRADUATE SCHOOL OF SOCIAL SCIENCES DEPARTMENT OF WESTERN LANGUAGES AND LITERATURES ENGLISH LANGUAGE AND LITERATURE

PSYCHIATRIC POWER IN CONTEMPORARY BRITISH DRAMA: TOM STOPPARD’S EVERY GOOD BOY DESERVES FAVOUR, SARAH DANIELS’S HEAD-ROT HOLIDAY AND JOE PENHALL’S BLUE/ORANGE

M.A. Thesis

Nur ÇÜRÜK

ANKARA-2019

THE REPUBLIC OF TURKEY ANKARA UNIVERSITY GRADUATE SCHOOL OF SOCIAL SCIENCES DEPARTMENT OF WESTERN LANGUAGES AND LITERATURES ENGLISH LANGUAGE AND LITERATURE

PSYCHIATRIC POWER IN CONTEMPORARY BRITISH DRAMA: TOM STOPPARD’S EVERY GOOD BOY DESERVES FAVOUR, SARAH DANIELS’S HEAD-ROT HOLIDAY AND JOE PENHALL’S BLUE/ORANGE

M.A. Thesis

Nur ÇÜRÜK

Supervisor Assoc. Prof. Dr. Sıla ŞENLEN GÜVENÇ

Ankara-2019

ACKNOWLEDGEMENTS

First and foremost, I would like to express my deepest gratitude to my supervisor, Assoc. Prof. Sıla ŞENLEN GÜVENÇ for her invaluable guidance, support, and patience during the thesis process. She has provided me with the right balance of independence and guidance, offering me both academic guidance precisely when needed and the freedom to wander intellectually and find my own path. I am grateful for her trust, endless patience, and enormous support. I would also like to extend my sincere appreciation to the valuable members of the committee: Prof. Nazan TUTAŞ and Assist. Prof. Mustafa KIRCA for their suggestions and constructive criticism.

I wish to express my special thanks to Muharrem DEMİRDİŞ, a great companion who inspired, encouraged, and helped me get through the most stressful moments of this period in the most positive way. I would also like to extend my heartfelt thanks to my friends, Ezgi Deniz FESLİOĞLU and Pınar OLGUN for the warm encouragement and support they extended.

Above all, I would like to express my indebtedness to my family, my parents

Meryem and Yusuf ÇÜRÜK and my sister Çiğdem TIKIROĞLU for their faith in me, and encouragement to pursue my dreams. I am grateful for their unconditional love and support throughout my life.

TABLE OF CONTENTS

INTRODUCTION……………………………...………………………………………1

CHAPTER I: Psychiatry as Social Control and Anti-Psychiatry: Theories and

Perspectives……………………………………………………………………………..6

1.1. Psychiatry as Social Control: A Brief History…………………………………..…6

1.2. Anti-Psychiatry Perspectives of Mental Illness and Psychiatry………………...…39

1.3. Psychiatric Power………………………………………………………………….44

CHAPTER II: Psychiatric Power and Contemporary British Drama………....….70

CHAPTER III: Psychiatric Power and Suppression of Political Dissidence: Tom

Stoppard’s Every Good Boy Deserves Favour (1977)……………………………...... 85

CHAPTER IV: Psychiatric Power and ‘Mad’ Women: Sarah Daniels’s Head-rot

Holiday (1992)...... 114

CHAPTER V: Psychiatric Power and Race/Ethnicity: Joe Penhall’s Blue/Orange

(2000)……………………………………………………………….…………………136

CONCLUSION………………………………………………………………….…...165

BIBLIOGRAPHY…………………………………………………………………....178

ABSTRACT…………………………………….……………………………………187

ÖZET………………………………………………………………………...…….....190

INTRODUCTION

Psychiatry is a medical specialty concerned with the diagnosis, treatment, and research of mental, emotional, and behavioural disorders. This field has become an object of considerable criticism and debate throughout its history in terms of its nature, aims, and methods. A great deal of this controversy has centred on non-objectivity of psychiatric diagnosis, involuntary hospitalization of individuals, unlimited power of psychiatrists over patients within institutional areas, excessive use of medication, and implementation of particular treatment modalities such as electro-shock therapy, lobotomy, and insulin coma-therapy that may cause more harm than good. The criticisms revolving around these issues and mainly arguing for a more ‘humane’ psychiatry with ethical and human rights concerns were carried forward in a more radical way in the second half of the 20th century. This was realized through the political and philosophical questionings of the Anti-psychiatry Movement which arose in the socio-political climate of the 1960s.

The term “anti-psychiatry” was coined by South-African born British psychiatrist David Cooper in his study Psychiatry and Anti-psychiatry (1967) to refer to a set of radical ideas expressed by thinkers such as Michel Foucault in France, Thomas

Szasz in the United States, Franco Basaglia in Italy, Erving Goffman in Canada, and

Ronald David Laing in Britain. These thinkers, in contrast to previous critics, did not simply demand more ‘humane’ conditions in psychiatry; they instead problematized the very foundations of psychiatry itself: its raison d’être, its foundational concept of mental illness, and its role within society in terms of the social control of deviant behaviour.

In substance, anti-psychiatrists questioned the existence and reality of mental illness as a medical entity and approached it as a socio-political phenomenon. They attacked the validity and reliability of psychiatric diagnoses, arguing that unlike the criteria for diagnosing a physical disease, the criteria for identifying a mental or

1 psychological disorder cannot be objective since they are closely connected with the cultural, political, or economic conditions and expectations of a particular society and of a particular time. In this argument, they frequently referred to psychiatry’s former disease model of homosexuality which had been considered as a mental disorder until

1973 when it was finally removed from the Diagnostic and Statistical Manual of Mental

Disorders (DSM) with the impact of the changing social norms and the developing

LGBT movements. In this context, these critics approached psychiatry as an institution of social control that provides a legitimate basis for labelling the individuals whose deviant behaviour and ideas pose a danger to the existing social conformity as ‘mentally ill’, and for regulating those perceived deviances in accordance with the common values and norms of society. Anti-psychiatrists generally rejected this ‘normative’ operation of psychiatry over certain members of society.

In the light of anti-psychiatry criticisms, this thesis focuses on how psychiatry and its institutions can be central to the process whereby certain individuals of society fall into the ‘abnormal’ category and in turn become the objects of the correctional and normalizing practises of disciplinary power. For this analysis, contemporary British drama provides a convenient basis through its considerable amount of plays dealing with madness as a socio-political issue. Such plays usually portray mentally ill characters as individuals who either deviate from the established behavioural and intellectual norms of society, or are unluckily ‘maddened’ as a consequence of their exposure to experiences such as social discrimination, oppression, and abuse due to their perceived abnormalities. In the plays, most of these mad characters are compulsorily placed in mental institutions and subjected to disciplinary practices usually targeting their socially undesirable behaviour and attitudes. These common aspects make these contemporary British plays a significant source for the re- interrogation of the disciplinary nature and operations of psychiatry.

In this respect, this thesis aims to study the use of psychiatric procedures – diagnosis, treatment, and hospitalization – for the purposes of social control through the analysis of Tom Stoppard’s Every Good Boy Deserves Favour (1977), Sarah Daniels’s

Head-rot Holiday (1992), and Joe Penhall’s Blue/Orange (2000). These three plays have been specifically chosen for this analysis because each play both takes place in a psychiatric institution and involves characters stigmatized as ‘mentally ill’ due to a different experience of ‘otherness’: In Every Good Boy Deserves Favour (1977), the mentally ill character, Alexander Ivanov who has been imprisoned in a Soviet mental hospital is a political dissident; in Head-rot Holiday (1992), the inmates of Penwell

Special Hospital are three women, Dee, Ruth, and Claudia who have either violated the hetero-normative social roles, or suffered from mental disorder as a result of their experiences of oppression and abuse; and finally in Blue/Orange (2000), the mad character, Christopher who has been compulsorily hospitalized through the criminal justice system is a young coloured man suffering from mental disorder as a destructive effect of his experiences of racial hatred and discrimination due to his ethnic minority identity.

The first chapter of this thesis “Psychiatry as Social Control and Anti-

Psychiatry: Theories and Perspectives” is composed of three sections. The first section

“Psychiatry as Social Control: A Brief History” will provide a historical perspective on the social, cultural, political, and economic conditions that led to the emergence of psychiatry and its institutions in order to provide a better understanding of the disciplinary function attached to this medical field. This historical analysis will cover the historical periods from the Middle Ages to the present, and will mainly focus on how the perception and treatment of madness in Western society have evolved over time in accordance with each period’s own social framework along with the changing cultural, political, and economic realities. The second section “Anti-Psychiatry

Perspectives of Mental Illness and Psychiatry” will touch briefly on anti-psychiatrists and Michel Foucault’s critical views of mental illness and psychiatry. The third section

“Psychiatric Power” will examine Foucault’s analysis of ‘psychiatric power’ in detail with the help of his lectures published as Psychiatric Power: Lectures at the College de

France, 1973-1974 (2003). Psychiatric power will establish the theoretical background of this thesis because unlike other critical analyses of psychiatry, Foucault’s analysis offers a more detailed examination of the strategies and tactics whereby psychiatry can operate as a correctional and normalizing vehicle over the bodies and souls of individuals within the boundaries of a mental asylum. Since Foucault views psychiatry as an agent of disciplinary power, this theoretical analysis will begin with his account of disciplinary power for a better understanding of how and why psychiatry functions as an instrument of disciplinary power over certain members of society.

Chapter II “Psychiatric Power and Contemporary British Drama” will provide a brief survey of the contemporary British plays that highlight the disciplinary function of psychiatry and its institutions through the characters deemed ‘mad’ or ‘mentally ill’ due to their differing social deviances and exposed to the correctional and normalizing operations of mental hospitals. This survey will highlight how mainstream society and psychiatric professionals show a tendency to perceive and treat certain behaviour and attitudes running contrary to the prevalent social norms and values as a form of mental illness.

Following the survey of contemporary British plays, the next chapters which constitute the focus of this thesis will examine Every Good Boy Deserves Favour

(1977), Head-rot Holiday (1992), and Blue/Orange (2000) in relation to Foucault’s analysis of psychiatric power through a focus on how psychiatry serves as an agent of disciplinary power over the individuals diagnosed as ‘mentally ill’ and involuntarily

4 placed in mental institutions due to their certain deviations from the prevalent social norms.

Chapter III “Psychiatric Power and Suppression of Political Dissidence: Tom

Stoppard’s Every Good Boy Deserves Favour (1977)” will specifically explore how psychiatric procedures can be misused for political purposes or for the suppression of individuals whose political ideologies are considered a threat to the prevailing regime.

Chapter IV “Psychiatric Power and ‘Mad’ Women: Sarah Daniels’s Head-rot Holiday

(1992)” will focus on how women deviating from the dominant norms and expectations of hetero-normative society can be labelled and treated as ‘mentally ill’. Finally,

Chapter V “Psychiatric Power and Race/Ethnicity: Joe Penhall’s Blue/Orange (2000)” will analyse how a person from an ethnic minority group can be perceived and treated as ‘mentally ill’ since he is considered ‘abnormal’ according to the dominant cultural expectations of society. The analyses of these three plays will be enriched through the detailed examination of the specific strategies, methods, and techniques whereby the disciplinary power in psychiatric institutions is systematically exercised over such

‘deviant’ members of society with the help of Foucault’s analysis of psychiatric power.

CHAPTER I

PSYCHIATRY AS SOCIAL CONTROL AND ANTI-PSYCHIATRY:

THEORIES AND PERSPECTIVES

1.1. Psychiatry as Social Control: A Brief History

Over the course of history, the perception and treatment of madness have been strongly shaped by each period’s prevalent social conditions and norms. In Medieval

Ages when the Church and religion had a powerful force in shaping the social perception, attitudes towards madness were largely determined by religious and spiritual beliefs. In the dominant “theological” perspective of the period, “which was based on the biblical tradition”, all illnesses and other forms of “misfortune” were essentially interpreted in three main ways: “Disease” was a “punishment” from God for person’s sins, it was a way God tests the “strength” of person’s faith, or it was a way God warned the person and other people to “repent” (Conrad and Schneider 42). Similarly, madness was attributed with these divine interpretations in medieval times and thus, it was considered as a moral punishment from God. The mad were believed to be possessed by evil spirits as punishment and could regain their sanity only after confession of and repentance for their sin. Hence, the mad were treated mostly through spiritual and religious practices such as “exorcism”, “pilgrimage to a shrine”, “Bible-reading”,

“prayer”, and “counsel” (Porter, Madness: A Brief History 19).

Medieval society found a practical way of dealing with its ‘evil spirits’; it

“placed the primary responsibility for caring and coping with these individuals on the family”, and “to a lesser extent, the Church” that was the chief institution of social control in that period (Scull, Madness: A Very Short Introduction 15). The mad were sometimes taken to the shrines of saints by their families in hope of a cure and sometimes were kept within the domestic area, often “hidden away in a cellar” or

“caged in a pigpen”, and “sometimes under a servant’s control” (Porter, Madness: A

Brief History 90). Families tended to hide their mad members because they perceived the presence of these ‘demonic spirits’ as a menace to family honour. The mad were thus left largely to the mercy of their families in medieval times. However, towards the end of the Middle Ages, religious impulses gave way to the emergence of some charitable foundations where the mad were to be cared under the auspices of public. But the “care ideology” of these foundations was to be fundamentally “religious” and

“moralistic” as befitting the period’s spiritual norms; the primary aim was not to provide any medical treatment, but to heal “the sinful souls of the inmates” (Pietikainen

31). In this respect, Andrew Scull argues that in a society where charitable behaviour was motivated only by the spiritual impulses or by “the desire to secure one’s own salvation”, there could be no real hope for a “calculated” and “measured” response to any form of human suffering (Madness: A Very Short Introduction 16). The controversial interventions and unhealthy conditions of London’s Bethlehem1 hospital, which was one of the earliest and the most notorious of these foundations in Europe, seem to justify Scull’s argument. A 1446 indulgence that refers to the mad inmates of this institution makes it clear that physical restraints were preferably used in Bethlehem:

“the miserable persons dwelling there … are so alienated in mind and possessed of unclean spirits that they must be restrained with chains and fetters” (qtd. in Andrews et al. 114). This statement indicates that Bethlehem functioned much more like a place of confinement rather than a hospital for inmates because instead of therapeutic practices, physical restraints were considered as the most appropriate practices for these ‘demonic spirits’.

1 Bethlehem, more commonly known as Bethlem or Bedlam, was first founded as the priory of St Mary of Bethlehem in London in 1247 in order to be used as a refuge for the poor, the sick, and the people in need like many early foundations of Europe. Then, towards the end of the 14th century, the foundation began to specialise in the care of insanity. Finally, it officially became a mental asylum in 1547, which would be the oldest extant psychiatric institution of Europe. 7

In medieval Europe, the perception and treatment of madness were thus largely shaped by religious and spiritual beliefs. In relation to this medieval experience of madness, Michel Foucault draws an analogy between madness and leprosy. He indicates that lepers were similarly believed to have been punished by God for their sins in this world and could only recover through spiritual healing. To substantiate this prevailing belief, Foucault cites the ritual of the Church of Vienne addressing the lepers:

My friend, it pleaseth Our Lord that thou shouldst be infected with this malady, and thou hast great grace at the hands of Our Lord that he desireth to punish thee for thy iniquities in this world (Madness and Civilization 6).

Such rituals of the time aimed to convince the lepers that they fell sick in consequence of the punishment by God for their immoral conducts. They were also assured that this punishment was for their benefit since it was a warning for them to recognize and repent their misdeeds. Foucault draws this comparison between the two diseases because, according to him, the disappearance of leprosy from the Western world actually signalled the emergence of another fearsome figure who was to be similarly isolated from society. This new figure was the madman. When the lepers vanished from the entire society at the close of the Middle Ages, their social outcast status was to be taken over by the mad, and the emptied lazar houses were to remain in place to be reused in the seventeenth century for these “deranged minds” along with other undesirables of society, “poor vagabonds and criminals” (Foucault, Madness and Civilization 7).

However, prior to the reuse of these confinement structures for the mad and other social deviants in the 17th century, the arrival of the Renaissance had brought about a new way to deal with the insane. According to Foucault, this new method was the Narrenschiff, or the Ship of Fools.

The Ship of Fools was actually an allegorical device commonly employed in

Renaissance paintings and literary works. Through this ship and its fool passengers,

8 each of whom represents a certain human misdeed or weakness, authors and painters created in their works a fantastic microcosm where they could vividly portray human vices such as hatred, greed, gluttony, and pedantry. Hieronymus Bosch’s world-wide known painting the “Ship of Fools” (see Fig.1) is one of the best known examples that contain this device.

Fig. 1 Hieronymus Bosch, Ship of Fools

In this work, Bosch portrays the fools of the ship as the revelling gluttons who ceaselessly stuff themselves. At the centre of the vessel, a nun plays the lute and a monk accompanies her, singing. They both bob for a hanging food without using their hands.

Another man climbing the mast of the ship tries to get the roasted goose with a knife.

Besides these fools, one of the naked fools in the water reaches a plate for more food and another fool vomits most probably since he has eaten too much. The paddle of the ship is also a remarkable detail which signifies gluttony as it is in the shape of a large ladle. All these human vices and sins depicted in this painting through the revelling and gluttonous fools significantly provide an insight into the social labels and traits attached to the mad in that period.

In regard to this satiric device, Foucault asserts that among all these devices of the Ship of Fools, “the Narrenschiff was the only one that had a real existence” in the

15th century (Madness and Civilization 8). He gives some historical details to substantiate this claim:

The custom was especially frequent in Germany; in Nuremberg, in the first half of the fifteenth century, the presence of 63 madmen had been registered; 31 were driven away; in the fifty years that followed, there are records of 21 more obligatory departures; and these are only the madmen arrested by the municipal authorities. Frequently they were handed over to boatmen: in Frankfort, in 1399, seamen were instructed to rid the city of a madman who walked about the streets naked; in the first years of the fifteenth century, a criminal madman was expelled in the same manner from Mainz. Sometimes the sailors disembarked these bothersome passengers sooner than they had promised; witness a blacksmith of Frankfort twice expelled and twice returning before being taken to Kreuznach for good. Often the cities of Europe must have seen these "ships of fools" approaching their harbors (Madness and Civilization 8).

In Foucault’s view, this “Ship of Fools” tradition emerged in consequence of “a great disquiet” that suddenly descended upon “the horizon of European culture at the end of the Middle Ages” (Madness and Civilization 13). People living in towns and cities felt uneasy about the presence of the insane on streets, and as a solution, they 10 exiled the mad to open seas through the Ships of Fools. The mad passengers were embarked on the ships in edge cities and driven from town to town along the rivers and canals of Europe. These ships sometimes foundered due to the chaos stemming from the misdeeds of their passengers, and sometimes, the mad moved on with their life on other coasts until they were kicked out and embarked on boats once again. Consequently, the mad were helplessly abandoned to their fate in the midst of open seas. This exile actually carries a highly symbolic meaning. Constantly shuttling between the different coasts, the mad could belong to neither the lands they were expelled from nor the places they were heading towards. They were like struck in purgatory. This detail is remarkable in terms of the period’s spiritual perception of madness because in Christian mythology, purgatory refers to a waiting place where the souls are purified before entering heaven. Similarly, it was expected that these mad passengers were to find their remedy in the vast areas of high seas.

During the Renaissance period, the mad were not just driven away from cities through these Ships of Fools; some of them were also allowed to wander, but only “in the open countryside” where they would not be much in sight, and some were entrusted to the care of “merchants” and “pilgrims” (Foucault, Madness and Civilization 8). In

Stigma and Mental Illness (1992), George Mora touches upon a significant point that provides an insight into why the Renaissance society tended to keep its insane members away from public areas, or continued to hand these individuals over to a person who could constantly supervise them for the benefit of social order. Focusing on the transition process from the Middle Ages to the Renaissance Period, Mora first mentions the great political, cultural, economic, and religious shifts that society underwent with the advent of the Renaissance. He then underlines how these radical changes affecting many aspect of European society caused a general anxiety and created a need for security among the public. In Mora’s view, particularly religious turmoil played a key

11 role in the emergence of this general anxiety because “the theocentric view of universe”, according to which people had largely determined every aspect of their life and in this way had felt safe up to that time, began to decline and “the modern consciousness” based upon “the interiority of moral values” did not rise completely yet (45). Mora thinks this ambiguity inevitably caused “a situation of inner tension” that would result in “a search for security from all sorts of occult, supernatural, or simply unusual beings and forces” (45).

Throughout the Renaissance, madness thus continued to be perceived and treated as a source of public unrest due to both the continuing dominance of spiritual beliefs over social life and the social anxiety stemming from the ambiguous atmosphere of that transition period. With the arrival of the Age of Reason, however, the dominant philosophy of the new period, ‘rationalism’ was to cause more critical consequences for the social treatment of madness: Madness was no longer to be tolerated within domestic areas or be allowed to be a silhouette of countryside; as the symbol of ‘unreason’ and

‘immorality’ it was to be acutely isolated from the rest of society through huge confinement structures where it would be silenced, disciplined, and tamed along with other perceived social deviances.

Rationalism as a movement in Western philosophy emerged during the Age of

Reason of the 17th century and provided a basis for the efforts of the 18th century’s

Enlightenment thinkers to liberate the individual from theological dogmas and superstitions. This movement which regards ‘reason’ as the chief source of knowledge played a crucial role in the 17th-century conceptualization of madness because the human reason became the dominant intellectual virtue and, accordingly, madness which was interpreted as the exact opposite of reason became an important ‘defect’ of individual. More importantly, as Foucault contends, this defect associated with madness was handled as a “moral” defect on the grounds that the insane freely chose unreason

12 over reason and by their own choice they became estranged to human world (qtd. in

Gutting 89). This perception of madness as person’s ‘wilful choice’ between reason and insanity was to cause some critical consequences for the treatment of the mad: The mad were not to be perceived and treated as sick men; as the possessors of a moral failure they were to be punished through confinement and disciplinary practices in some new structures of Europe.

From the mid-17th century onwards, in Western Europe appeared huge confinement houses where the insane were to be incarcerated along with other deviants of society. Foucault termed this process as “the Great Confinement” and examined it with a landmark date, the year 1656 when the Hopital General of Paris was established by King Louis XIII for the confinement of poor vagabonds and other socially undesirables. At that time, this structure incarcerated such a great mass of population that “more than one out of every hundred inhabitants of the city of Paris found themselves confined there, within several months” (Foucault, Madness and Civilization

38). This confinement process in Western Europe roughly encompassed the 17th and

18th centuries, and took place in different forms in each country: In German-speaking countries the Zucht-hausern (penitentiaries), in France the Hopital General, and in

England the houses of correction, workhouses, and bridewells emerged for the incarceration of socially unwanted populations. In England, the origins of these confinement institutions actually date earlier: “The houses of correction” and

“bridewells” had been founded “in the second half of the sixteenth century” (Seddon

20). But they spread across the country particularly towards the seventeenth century.

“By the 1630s”, for instance, “every shire had its own house of correction” (McDonald qtd. in Seddon 20). Besides, “workhouses” also appeared “in the 1630s, and from the

1660s, private madhouses for the insane began to proliferate” (McDonald qtd. in

Seddon 20).

At the outset, the confinement houses largely incarcerated the poor to rid the streets of beggars and idle vagabonds whose number was increasing as a result of the economic depression that emerged in Europe in the early 17th century. However, before long the same structures began to confine other undesirables of society such as

“libertines, prostitutes, criminals, those prone to creating a public nuisance, the wayward sons of the bourgeoisie” and “those individuals modernity would later recognize as suffering from ‘mental illness’” (Tanke 49). All these people who were perceived as a social burden and threat due to varying reasons were thus brought together under a single roof thanks to these confinement houses. According to Doerner, the Age of Reason “put all forms of unreason … under lock and key” in this way (qtd. in Bracken and Thomas 87), and in Foucault’s view, the period separated “all forms of social uselessness” from the mainstream society (Madness and Civilization 58).

Foucault approached the confinement process from the perspective of ‘social uselessness’ because for him, the main reason for uniting all these apparently distinct categories under one roof was “the condemnation of idleness” (Madness and

Civilization 46). All these confined individuals were scandalizing “the bourgeois mind” because “they would not work” (Porter, Mind-Forg’d Manacles 6). They would not comply with ‘the work ethic’ of the newly developing bourgeois society since they either were unable to work due to sickness or a disability, or somehow refused to work.

Madness, which was confined along with these ‘unreasonable’ and ‘useless’ populations under a single roof without any specific classification, was also perceived as a form of social deviance with regard to the expectations of the newly-emerging bourgeois society. For the first time madness was handled “on the social horizon of poverty, of incapacity for work, of inability to integrate with the group” and thus it took its place among “the problems of the city” (Foucault, Madness and Civilization 64).

This perception of madness as a form of social deviance and threat actually revealed

14 itself from the very beginning of the incarceration experience of madness because in the admission process to confinement houses, the mad were not diagnosed as insane by medical doctors; they were “judged by government functionaries as having lost their reason” (Tanke 49). In other words, they were confined not primarily because they were thought to be in need of a medical attention but because they were judged by authorities to have behaved contrary to the prevailing standards of society.

The insane institutionalized in this way were not treated on medical grounds within the confinement houses of the time; they were treated mostly through disciplinary techniques. More importantly, among the entire population confined, including the idle, the spendthrift, and the criminal, the insane became the most unfortunate group who would be subjected to brutal practices in confinement houses.

The insane were treated no better than beasts because according to the ‘rationalist’ philosophy of the time, they were considered to be devoid of the fundamental human quality ‘reason’; they were devoid of what was human in a person. As Foucault points out, this relationship established between insanity and animality inevitably laid the mad open to extremely controversial conditions in the hospitals of the period:

Animality, in fact, protected the lunatic from whatever might be fragile, precarious, or sickly in man. The animal solidity of madness, and that density it borrows from the blind world of beasts, inured the madman to hunger, heat, cold, pain. It was common knowledge until the end of the eighteenth century that the insane could support the miseries of existence indefinitely. There was no need to protect them; they had no need to be covered or warmed (Madness and Civilization 74).

As Foucault puts it, the association of madness with animality caused critical consequences for the institutional care of the mad. The mad inmates were considered to manage very well without heat, hygiene, clothing, and food. It was assumed that they could be held entirely naked in poor sanitary conditions and also be fed with very small amounts of food. These inhumane conditions prevailed in many hospitals and other

15 kinds of institutions where the insane were held in that time. For instance, the Hopital

General of Paris, which Foucault sees as a landmark of the period, was well-known for its poor and unhygienic conditions. A visitor to this institution wrote:

… the unfortunate whose entire furniture consists of a straw pallet, lying with his head, feet, and body pressed against the wall, could not enjoy sleep without being soaked by the water which trickled from that massive stone (Kent 49).

The conditions of the hospital even grew worse during the winter:

When the waters of the Seine rose, those cells situated at the level of the sewers became not only more unhealthy, but worse still, a refuge for a huge swarm of rats which during the night attacked the unfortunates confined there and bit them wherever they could reach them. Madwomen have been found with feet, hands, and faces torn by bites, which are often dangerous, and from which several have died. (Kent 49).

As the quotes above make it clear, the mad inmates of the Hopital General were held in unfortunate conditions that were far from healing. The inmates had only a straw pallet to lie on in their bare cells. They were forced to live in filthy and unsanitary conditions that obviously made them more vulnerable to risky injuries, infections, and finally to death. Similarly in England, when Samuel Tuke visited some workhouses in the southern counties in 1811, he was to witness the same unfortunate conditions. In his report, Tuke was to mention “the cells” where “all the women” were held “entirely naked” and “the daylight” could pass only “through little barred windows that had been cut in the doors” (qtd. in Foucault, Madness and Civilization 74).

Besides these inhumane and unhygienic conditions, as the historical documents and reports testify, the mad inmates were also subjected to physical restraint through the use of various coercive instruments such as chains, handcuffs, shackles, iron rings, and collars. For instance, in London’s infamous hospital Bethlehem, more commonly known as Bedlam, the mad were frequently restrained through iron rings, bars, handcuffs, and chains. Bedlam became so notorious for this cruelty that it entered the

English language as a lexis meaning a scene of ‘uproar’ and ‘confusion’. The following quote from Samuel Tuke’s Report on the Condition of the Indigent Insane exemplifies this fact through the details of a physically repressive system that was meticulously organized to restraint “a reputedly dangerous madman” in Bethlehem:

He was attached by a long chain that ran over the wall and thus permitted the attendant to lead him about, to keep him on a leash, so to speak, from outside; around his neck had been placed an iron ring, which was attached by a short chain to another ring; this latter slid the length of a vertical iron bar fastened to the floor and ceiling of the cell (qtd. in Foucault, Madness and Civilization 72).

The madman mentioned in the quote above looks like a criminal kept in a prison cell rather than a patient held in a hospital room because the enforcement of excessive physical restraint through iron chains and rings resembles a form of punishment rather than a means of cure. All this restraint was most likely to cause the man a physical damage or much deeper psychological trauma. Besides this report, during England’s great period of reform in the first half of the nineteenth century when government committees were investigating Bethlehem, another inquiry in 1815 was to report to the

House of Commons that “patients were often chained to the walls as well as manacled and that one of the female patients had been chained without release for eight years”

(Metcalf 74). Apart from these physical restraints, the mad inmates in Bethlehem were also exposed to some other physically coercive treatments such as “routing, bleeding, vomiting”, and “purging” (Metcalf 74). These traditional treatment methods had actually been rooted in the ancient Greek period. In that period, it had been widely thought that physical and mental illnesses stem from the unbalanced humours in the body and that the methods such as bleeding, purging, and vomiting help to correct these imbalances as they get the disease out of the patient’s body. This humoral approach and its treatment methods such as vomiting, bleeding, and purging also prevailed in

Bethlehem.

Due to these poor conditions and controversial practices, Bedlam attached so much critical attention that it became subject to numerous works of art and literature.

Jonathan Swift’s A Tale of a Tub is one well-known example of these works. In the fifth edition of the work (1710), there is an engraving of Bedlam (See Fig.2), which mirrors the harsh attitudes that were developed towards the mad inmates of this hospital. In the illustration, the madmen are portrayed as nearly naked and chained. They sit uncomfortably on straws in a bare dark cell. The madman foremost pleads most probably for food since he opens his mouth while reaching a bowl. Apart from this pleading man, on the right, there exist two unchained men who perform antics in an attempt to amuse some visitors watching them through the grates:

Fig. 2 Bernard Lens the Younger and John Sturt, Illustration of Bedlam

from A Tale of a Tub by Jonathan Swift

Bedlam’s such controversial conditions and practices that notoriously became subject to literary and artistic works also prevailed in another hospital of London,

Bethnal Green:

… a woman subject to violent seizures was placed in a pigsty, feet and fists bound; when the crisis had passed she was tied to her bed, covered only by a blanket; when she was allowed to take a few steps, an iron bar was placed between her legs, attached by rings to her ankles and by a short chain to handcuffs (Foucault, Madness and Civilization 71-72).

The woman in Bethnal Green was similarly held in insanitary and degrading conditions.

In a room as filthy as a pigpen, she was tied to a bed through rings, handcuffs, and chains in a way that would allow her to take just a few steps.

In France, the mad inmates were subjected to similar unfortunate practices. In La

Salpetriere Hospital, for instance, the mad were forced to live under poor sanitary and physically repressive conditions:

Madwomen seized with fits of violence are chained like dogs at their cell doors, and separated from keepers and visitors alike by a long corridor protected by an iron grille; through this grille is passed their food and the straw on which they sleep; by means of rakes, part of the filth that surrounds them is cleaned out (qtd. in Foucault, Madness and Civilization 72).

As the quote above demonstrates, madwomen of La Salpetriere were shackled in their filthy cells like ‘beasts’. They were kept in total segregation through long corridors and iron grilles only through which they could get their food and a straw that was their entire furniture.

The mad inmates who were compelled to experience such coercive measures as seclusion and physical restraint were also subjected to another controversial practice in some institutions of the time: The insane were exhibited to the public as a means of raising the hospital income. For instance, “as late as 1815, if a report presented in the

House of Commons is to be believed”, Bethlehem hospital “exhibited lunatics for a

19 penny, every Sunday” (Foucault, Madness and Civilization 68). Apart from Bethlehem,

Paris’s Bicetre exhibited its mad inmates to people who were ready “to pay a coin”

(Foucault, Madness and Civilization 68). Actually, the main motive for displaying the insane was not just to provide a financial assistance to hospitals but also to give moral instruction to the public; the exhibition of mad inmates under bad conditions was to be an effective way of illustrating the possible dangers of irrationality and immorality. As a warning that reminds how vulnerable reason and morality are, the watching tours would serve as an excellent source of moral lesson. In relation to the ‘moral lesson’ function of this practice, in 1753 a magazine would state that “there was no ‘better lesson [to] be taught us in any part of the globe than in this school of misery.” (Porter, Madness: A

Brief History 70).

As the historical documents and reports testify, the insane were largely perceived and treated as social deviants during the 17th and 18th centuries. They were not treated as sick men; as the figures of ‘immorality’, having chosen their own irrationality, they were subjected to disciplining, brutal, and inhumane practices.

However, this whole controversial situation continued towards the close of the 18th century when throughout Europe and America an optimistic new approach began to prevail through the attempts of some reformers, who were influenced by the

Enlightenment ideals, to provide more humane care and treatment to the insane. This new humanitarian approach was to cause a revolutionary transformation in the treatment of madness in the early 1800s: Madness was no longer to be perceived as the embodiment of animalistic and irrational features; it was to become an ‘illness’ as an object of medical attention and this transformation in the perception of madness was to lay the foundations for the emergence of psychiatry and the rise of its practitioners,

‘psychiatrists’.

In the late 18th and early 19th centuries, “Pussin and Pinel in France, Tuke in

England, Rush in the United States, and Chiarugi in Italy independently called for the liberation of the insane from shackles and for a humanitarian approach to care”

(Hinshaw 65). In substance, these reformers advocated that the insane were not

“absolutely devoid of reason” (Pinel 103), and that despite their illness, they were still

“human beings who deserved to be cared for and treated with respect and dignity”

(Charland 70). In addition, the reformers underlined that these individuals could be restored to sanity and normalized if they were treated in clean and therapeutic environments where they could experience proper living conditions that would both support their recovery and give them an opportunity to relearn a ‘normal’ life. The most famous architects of this new attitude were the physician Philippe Pinel from Paris and the retired merchant and Quaker William Tuke from York. Pinel and Tuke similarly coined the new strategy as ‘moral treatment’, but put it into practice in their own distinctive ways.

Pinel who was specifically inspired by the French Revolution’s ideals pioneered in ‘moral treatment’ reforms. Pinel advocated that the mad should be treated not like criminals or animals but as human beings suffering from a disease that requires a differential diagnosis and treatment. Appointed as the chief physician and director to the

Bicetre asylum in 1793, and later to the La Salpetriere in 1794, he gained the opportunity to apply his revolutionary ideas. In these hospitals, where prior to his administration patients had been kept in chains, treated poorly, and put on display to the public as a source of entertainment and moral instruction, Pinel “abolished the practice of chaining up all the lunatics” and gave an end to the exhibition of the insane (Lyons and Lyons 98). He removed “patients from dungeons” and provided them with “airy, sunny rooms” (Reisman 8). Furthermore, he “improved rations, stopped bloodletting, and forbade all harsh treatment such as whirling an inmate in a chair” (Hergenhahn and

Henley 474). Pinel thus took the first in a long series of steps toward providing humane care to the mad. In addition to these attempts, Pinel took some other important steps that were then to cause him to be recognized as the father of modern psychiatry. For instance, he “segregated different types of patients”, “encouraged occupational therapy”, and initiated the practice of maintaining “case histories and statistics on his patients, including a careful record of cure rates” (Hergenhahn and Henley 474-475).

Besides, he made notable contributions to the formation of a nosology, classifying

“mental illnesses as being melancholy, mania, idiocy or dementia” (Svab 41), and identifying the causes and the symptoms of various kinds of mental disorders. More importantly, Pinel initiated the therapeutic conversation with patients; he “visited each patient, often several times a day”, “engaged patients in lengthy conversations”, and

“took careful notes over the years” (Miller 38). Pinel’s practice of interacting individually with his patients in a humane manner was then to be interpreted as the earliest form of individual psychotherapy.

While Pinel was trying to institute these reforms in France, William Tuke similarly began to improve the conditions of the mental institutions in England. Having witnessed the unfortunate conditions in the York Asylum where a Quaker lost his life,

Tuke decided to found an alternative institution where the insane could be treated more properly. He opened the York Retreat together with the Society of Friends (Quakers) in

1796. The Retreat’s primary function was to provide the patients with a humane and caring environment where they could experience decent living conditions that would help them to regain self-respect and self-discipline in their path to recovery. To this end, new reforms were attempted at the Retreat. First of all, all forms of physical restraint and coercion were forbidden; chains, iron rings, shackles, and handcuffs were no longer employed for the patients. Secondly, a domestic atmosphere was created; the patients

“lived, worked, and dined” together with the staff like a group of family members

(Porter, Madness: A Brief History 104). Another reform that was put into practice at the

Retreat was occupational therapy that was a way of treating mental or physical illness by giving patients some activities and helping them do the things they need to do in their daily life. The York Retreat became an early example of this kind of therapy in the history of mental illness treatment. In a large farm attached to the Retreat, the patients were encouraged to work at farming. As for “the female patients”, they “were employed in sewing, knitting, or domestic affairs” (Tuke 156). According to the reformers, the primary goal of these occupational and domestic tasks was to enable the patients to participate in daily life routines and keep their minds from brooding on negative thoughts by engaging them mentally, physically, and socially. It was also aimed at providing the patients with a sense of usefulness. Besides employment, recreation was similarly thought to have such therapeutic benefits. In line of this thought, some spaces for amusement were designed at the Retreat: “In the nineteenth century”, the institution consisted of “a cricket pitch, tennis courts, and an area for field hockey” and the inmates

“were encouraged to play golf and croquet and to go horseback and bicycle riding”

(Edginton 11). Like occupation and recreation, religion similarly played a major role in the treatment philosophy of the Retreat. William Tuke’s grandson, Samuel Tuke, who was also member of a Quaker family, openly stated their view that religious influences could help to cure the mad:

To encourage the influence of religious principles over the mind of the insane, is considered of great consequence, as a means of cure. For this purpose, as well as for others still more important, it is certainly right to promote in the patient, an attention to his accustomed modes of paying homage to his Maker (102).

Due to this belief that religion contributes to the cure of mental disorders, spiritual and religious exercises occupied a central role in the moral treatment regime of the Retreat.

For instance, “the Bible was read to patients on a regular basis and they were invited to attend religious services” (Loue 3). 23

Most of these reforms led by Pinel and Tuke demonstrate that remarkable steps were taken for the development of a more humane approach to the care and treatment of the mentally ill. The insane were removed from dark bare cells and dungeons, and were put into more humane environments where they would no longer be chained or shackled but be given good food, recreation, and domestic tasks. According to the conditions of the time, all these attempts under the heading of ‘moral treatment’ were positive developments, especially when compared to the traditional treatment methods and conditions they succeeded; however, on the other hand, the moral treatment process involved some apparent contradictions. For instance, although the use of physical restraint was largely prohibited in these reformed asylums, certain physically repressive instruments such as “padded cells, straitjackets, cold wet blanket baths, spinning chairs, purges, emetics and magnetic fields” were still being used in treatments (Green 176).

Pinel who was widely known for relieving his patients of chains and shackles

“continued to use and recommend the straitjacket, both for restraint and punishment”

(Young 234). He “advocated the use of cold baths” as well (Green 214). Besides the continuing use of such physically repressive methods, internal methods of coercion were also employed in the asylums as an essential component of the moral treatment system, whose main focus was to encourage the patients to restore their self-discipline.

At the York Retreat, for instance, “praise and blame, rewards and punishment” were put into practice for the promotion of self-control in patients (Porter, Madness: A Brief

History 104). The use of “fear” was even recommended by Tuke for “the management of the patients” (Tuke 90).

The use of such internal means of coercion indicates that the regimen of the reformed asylums was still coercive because the physical chains of the earlier asylums were minimized, but an equally oppressive atmosphere was created through invisible psychological chains. Through immediate rewards and punishments, or through praise

24 and blame, the patients were compelled to develop self-restraint and act in accordance with the certain moral and behavioural standards established by the asylum staff. At the

York Retreat, for instance, a religious and moral milieu was created akin to that of the community of Quakers, and the patients were encouraged to conform to the principles whereby the members of that community largely try to live their lives. They were encouraged to pray and work on a regular basis. They were expected to “attend the religious meetings” where “their orderly conduct” and “the degree” that they “restrain their different propensities” were gladly observed by “superintendents” (Tuke 161).

Besides religion, work was also imposed on the patients. As Foucault points out, the emphasis on work was not due to its economic value; work was enforced “only as a moral rule” in terms of “a limitation of liberty, a submission to order, an engagement of responsibility” (Madness and Civilization 248). When the patients of the Retreat succeeded to conform to such religious and moral expectations, their reward was to be

“an increase in self-esteem through its recognition by others” (Cousins and Hussain

134). But when they failed to conform, their disobedience was to be immediately followed by “non-corporal” means of punishment “such as segregation and solitary confinement” (Cousins and Hussain 134). Similarly, in Pinel’s Bicetre, disobedience of the patients was to be punished through “straight waistcoats, superior force, and seclusion for a limited time” (Pinel 68).

All these contradictions and dilemmas within the practice of moral treatment were then widely discussed by critics of psychiatry and social historians during the second half of the twentieth century. The debates centred on two main arguments:

Firstly, it was argued whether moral treatment reforms had really contributed to the liberation and the cure of the mentally ill as it had been claimed by the reformers of the time, or had simply replaced the earlier methods of coercion with the new forms of coercion. Secondly, there was a growing belief that moral treatment system had

25 functioned in the asylums as a form of social control, focusing on the control and restraint of ‘inappropriate’ behaviour rather than on the cure of mental illness. In relation to these arguments, the most extensive critique came from Michel Foucault who described the moral treatment system as a “gigantic moral imprisonment” (Madness and

Civilization 278). According to Foucault, the shift that the perception and treatment of insanity underwent in this period had nothing to do with humanitarianism; it was rather a new “political awareness” that was not still opposed to confinement but needed to be more effective in its struggle against unreason (Madness and Civilization 224). For this reason, in Foucault’s account, “liberation of the insane”, “abolition of the constraint”, and “constitution of a human milieu” whereby moral treatment had justified itself were not actually the reforms driven by humanitarian impulses; they were merely

“justifications” (Madness and Civilization 247) for the development of more subtle, intimate, and pervasive means of control within the asylum space:

Everything was organized so that the madman would recognize himself in a world of judgment that enveloped him on all sides; he must know that he is watched, judged, and condemned; from transgression to punishment, the connection must be evident, as a guilt recognized by all (Madness and Civilization 267).

As Foucault points out in the quote above, through the asylum regime more effective means of control began to be practised over the mentally ill individuals. The system was organized in a way that the inmates would continuously find themselves in the midst of what Foucault calls “a juridical microcosm” (Madness and Civilization 265). In this created microcosm, the patients would be subjected to constant surveillance and to a system of rewards and punishments for every detail of their behaviour. Furthermore, since the patients were aware of being continuously watched and of that in case of any transgression they would be immediately punished and blamed in front of other inmates, they would frequently feel obliged to develop self-restraint and act in accordance with the behavioural standards set within the asylum. In this way, to Foucault, the asylum 26 system operated in a way that would foster the internalization of social control by the patients.

In his criticism of moral treatment, Foucault also pointed to the central role that physicians began to play within this ‘juridical’ system. To Foucault, the physician who had had no role in the earlier confinement houses now became “the essential figure” of the asylums, taking a dominating role both in the admission of patients to the asylum and in the treatments therein (Madness and Civilization 270). Since madness began to be acknowledged as an illness requiring medical treatment, the entry of medical personage into the asylum was undoubtedly an inevitable development; however, to

Foucault, the introduction of the doctor into the asylum was not due to his “medical skill or power”; “medical profession” was needed rather as “a juridical and moral guarantee” (Madness and Civilization 270). Foucault meant that the doctor would not serve in the asylum primarily by virtue of his scientific medical knowledge, but by virtue of his moral authority. This authority would be endowed to the physician not because he was “a scientist” but because he was “a wise man” or because he was “a man of great probity, of utter virtue and scruple” (Foucault, Madness and Civilization

270). In this argument, Foucault drew attention to the case of the York Retreat;

“according to Samuel Tuke, the first doctor appointed to the Retreat was recommended by his ‘indefatigable perseverance’” rather than his “particular knowledge of mental illnesses” (Madness and Civilization 271). This detail indicates that any common person without specialist knowledge about mental illness could easily take the place of the doctor at the Retreat. Foucault similarly referred to Pinel who thought that the doctor

“had to act not as the result of an objective definition of the disease or a specific classifying diagnosis, but by relying upon that prestige which envelops the secrets of the

Family, of Authority, of Punishment, and of Love” (Madness and Civilization 273).

According to Pinel, “by bringing such powers into play, by wearing the mask of Father

27 and of Judge”, the medical personage could become “the almost magic perpetrator of the cure” (Foucault, Madness and Civilization 273). Foucault here emphasized that for

Pinel, the authority and the success of the physician were largely dependent on his functioning as a ‘father’ and ‘judge’ rather than as a medical person who would supposedly act on the basis of objective scientific knowledge.

Apart from Foucault, a fierce critic of institutional psychiatry, Thomas Szasz approached the moral treatment system from a critical view. As a libertarian philosopher who attached great importance to the values of individual freedom, autonomy, and responsibility, Szasz specifically focused on the involuntary confinement of mental patients into asylums and the unlimited authority of asylum doctors over patients in Law, Liberty, and Psychiatry (1989). His emphasis on freedom was essentially related to his concern for human dignity; he believed that dignity comes from person’s ability to live a self-determined life. Only when person is free of anyone’s control over his life and only when he is able to take responsibility for his own choices and actions, can he then have a chance of living with dignity. From this perspective, Szasz argued that the patients who had been involuntarily confined to asylums and treated like children in the familial atmosphere of asylums were not exactly liberated; they continued “to be enslaved” (Coercion as Cure 87). They were treated like infants who are usually assumed to be incapable of making their own decisions and to be in need of being continuously protected by others. To Szasz, this paternalistic approach continued to enslave mental patients since it constantly rendered them dependent on their doctors and other asylum staff. He exemplified this argument especially through the paternalistic attitudes of Pinel who had approached his mental patient as “a headstrong, ill-behaved child” and regarded himself as “the patient’s father” whose task was “to break the child’s will and domesticate him” (Szasz,

Coercion as Cure 88).

Besides Foucault and Szasz, sociologist and historian Andrew Scull contributed to the criticism of moral treatment process. Scull specifically underlined the social- control function of the moral treatment system, suggesting that this system “actively sought to transform the lunatic, to remodel him into something approximating the bourgeois ideal of the rational individual” (“Moral Treatment Reconsidered” 111). To

Scull, the main motive behind the creation of this new “mild” system was “no kindness for kindness’ sake”; moral treatment was created because prior to that process, “external coercion” through mechanical instruments such as chains, handcuffs, and shackles had merely enforced “outward conformity”; it had not succeeded, or had probably not aimed, to ensure “the necessary internalization of moral standards” (“Moral Treatment

Reconsidered” 111). However, the asylum together with its surveillance and reward- punishment mechanisms had now become a tailor-made system for the promotion of self-discipline and self-control in patients.

In a similar fashion, David J. Rothman examined the asylum system through the lens of social control. In his comprehensive study The Discovery of the Asylum (2002)

Rothman essentially traced the historical factors that brought about the construction of prisons, reformatories, orphanages, almshouses, and asylums both in America and

Europe in the late eighteenth and early nineteenth centuries. He underlined that this period had witnessed great social, cultural, and economic changes such as the unprecedented rise in the urban area population, new industrial developments which largely changed the nations’ economy, and the intensification of the distinctions among social classes (Rothman 240). Since all these social shifts rendered “the traditional mechanisms for maintaining order less relevant”, the states needed more effective mechanisms to control the “the deviant and dependent population” (Rothman 240). The states’ response to this problem was to be “incarceration” through the construction of new “corrective” institutions such as prisons, reformatories, almshouses, and asylums

(Rothman 240). From this broad historical perspective, Rothman linked the rise of asylums to the states’ attempts to secure social order and stability. In this context, he drew similarities between prisons and asylums. According to him, moral treatment program had an apparent similarity to the goals of prisons; the founders of both institutions had thought that “the removal of deviants and dependents from the community” was a precondition for social “recovery” (Rothman 189). In addition, the founders had similarly believed in the necessity of administering “a strict and regular internal routine” for bringing order to the lives of inmates (Rothman 190). To Rothman, thanks to the arrangement and administration of such disciplined routines, the asylum would be able to “curb uncontrolled impulses without cruelty or unnecessary punishment”, as befitting the aims of the moral treatment program (133).

In addition, and more importantly, Rothman drew attention to the social environment that had been created inside the asylums. To him, the doctors created a social milieu in the asylums according to their own vision of an ideal society; they designed their institutions “with eighteenth-century virtues”, teaching “discipline, a sense of limits, and a satisfaction with one’s position” (Rothman 154). In this way, the asylums would kill two birds with one stone; it would both tackle social disorder and exemplify a proper society for the public by demonstrating the correct principles, norms, and values.

All these arguments on moral treatment and asylum system demonstrate that most of the critiques centred on the issues such as the involuntary institutionalization of mental patients, the use of controversial treatment procedures, the unlimited power of psychiatrists over patients, and the social-control function of the asylum regime. These issues actually provided a fundamental basis for the general criticism of psychiatry because although treatment methods have evolved over time due to scientific advancements and the changing knowledge of mental illness, psychiatry critiques have

30 largely continued to revolve around the same issues. For instance, in the mid to late nineteenth century, the gradual transformation of private asylums into large-scale public asylums and hospitals again raised the debates about the legitimacy of the incarceration of mental patients. This period had witnessed a rapid growth of mental institutions and accordingly a great increase in the number of the hospitalized patients. As Porter states,

"in England, patient numbers rose from perhaps 10,000 (in all types of institution) in

1800 to some 100,000 in 1900” and “in Italy, for example, some 18,000 had been confined in 1881; by 1907 the number had soared to 40,000” (“Madness and Its

Institutions” 294). To Porter, this increase was largely because of the new nation-states’

“immense faith in the powers of institutional solutions”; “schools, reformatories, prisons, hospitals, asylums” – all these institutions would resolve “the superabundant social problems of an age of rapid population rise, urbanization and industrialization”

(“Madness and Its Institutions” 294-295). This faith in institutional solutions to public safety problems also provided the driving force for the creation of large-scale mental asylums. However, these large mental institutions would come in for criticism on the grounds that they did not function like therapeutic institutions, but like custodial institutions due to their overcrowded and health-threatening conditions. As Pietikainen suggests, public asylums even became the places where people would lose their lives:

In overcrowded wards, infectious diseases spread easily, and as many patients were malnourished or in a weak condition already, they easily contracted viral and bacterial diseases, such as meningitis, typhoid fever, pneumonia and hepatitis. Consumption and typhoid fever were especially widespread and deadly diseases in mental hospitals. If hygiene was poor and the therapeutic atmosphere pessimistic, transmission of infection was even more common. Particularly in times of social crisis, hospitals often had to make do with a very sparse diet. (149).

As Pietikainen puts it, the overcrowded, unsanitary, and poor staffing conditions of large-scale mental asylums caused rapid spread of diseases and death of many patients.

Pietikainen’s emphasis on these unfortunate conditions is actually reminiscent of the 31 debates over the 17th century’s confinement houses that had similarly failed to provide proper treatment and care to the mentally ill individuals.

In addition to these unfortunate conditions, public asylums were also criticized on the grounds that they became testing grounds where new controversial treatment modalities would be developed and tried on mental patients. Unlike moral treatment process which had focused on the rational and emotional causes of insanity, “in the late

19th and early 20th centuries”, most physicians held a “somatic view of mental illness”; they assumed that “a defect in the nervous system” lay behind mental health problems

(Meldrum 878). In an attempt to correct this flawed nervous system, the physicians commonly tested a range of somatic treatments such as malaria therapy, hydrotherapy, insulin coma therapy, lobotomy (psychosurgery), and electroconvulsive therapy in most mental asylums of Europe and America. These therapies drew much controversy from both medical community and critics of psychiatry due to their negative side effects and their use as an abusive form of control over the patients. For instance, lobotomy, which was a procedure that involves severing the neutral connections in the brain’s frontal lobe, became the target of considerable criticism since it had “irreversible” negative side effects, including “intellectual impairment, personality change, epilepsy, incontinence, and even complete loss of social skills” (Vickers 18). For lobotomy, Szasz even claimed that it was “synonymous with brain damage” (Coercion as Cure 170); it was “the surgical destruction of healthy brain tissue” (Coercion as Cure 152). Psychiatrist Jay

Hoffman also drew attention to the undesirable side effects the lobotomized patients often suffered:

These patients are not only no longer distressed by their mental conflicts but also seem to have little capacity for any emotional experiences – pleasurable or otherwise. They are described by the nurses or the doctors, over and over, as dull, apathetic, listless, without drive or initiative, flat, lethargic, placid, and unconcerned, childlike, docile, needing pushing, passive, lacking in spontaneity, without aim or purpose, pre-occupied and dependent. (qtd. in Mukundan 65). 32

As Hoffman points out, lobotomy procedure which was applied as a means of treating mental disorder actually produced considerable unpleasant side effects that finally leave the patients unable to act independently. Besides lobotomy, electroconvulsive therapy

(formerly known as electroshock therapy), which was applied by passing an electrical current through the brain and causing a convulsion, also met with much opposition from both its professionals and its recipients due to its potential side effects. Psychiatrist

Peter Breggin, for instance, suggested that electroshock therapy “causes permanent brain damage and dysfunction with widespread cognitive deficits” and that it “greatly elevates the suicide risk, especially in the first week following treatment” (Brain-

Disabling Treatments 218). Apart from Breggin, an ECT survivor, editor, and an activist for human rights, Leonard Frank mentioned about how shock treatment destroyed large parts of his memory, “including the two-year period preceding the last shock” (61). Frank was so negatively affected by this controversial therapy that he resembled “each shock treatment” to “a Hiroshima” (61).

Besides such significant side effects, the use of somatic treatments attracted critical attention within the context of social control as well. The treatments were criticized for having been used to control not the disease but the socially undesirable behaviour and tendencies of individuals. For instance, according to Rosario, as “the documented cases” testify, besides on “schizophrenics” and “psychotics”, electroshock therapy and lobotomy were “commonly” used on “homosexuals” and the individuals engaging in “cross-gendered behavior” (97). As Shaun Best also suggests, “lobotomy” which “was developed and first used in 1935 by Egas Moniz as a cure for schizophrenia” was then used in an attempt “to cure homosexuals, alcoholics and political dissidents” (133). In addition to these, mental health practitioner Diane Hudson drew attention to the relation between psychosurgery and attempts to control women’s behaviour. In Hudson’s view, psychosurgery was recommended by mental health

33 professionals “predominantly” for women “in order to modify behaviour” that was deemed “undesirable” by the persons in their lives, including “husbands” and

“relatives” (110). To substantiate her claim, Hudson gave statistics; since psychosurgical procedures began to be applied in 1888, more women than men received them: “In 1947, the UK Board of Control reported that out of 1000 patients, 65 per cent were women. Tooth and Newton (1961) discovered that 60 per cent of leucotomy patients up to 1954 were female. Post-1970, in the USA, Valenstein reported 56 per cent of all operations were on women” (113). In a similar vein, Breggin pointed to the use of electroshock therapy for political ends; having cited Robert Lifton, who gave the example of the use of shock treatment in the Auschwitz extermination camp in his book

The Nazi Doctors (1986), Breggin questioned the reasons why this therapy had become a choice of ‘treatment’ in the horrific camps of the Nazi regime. To Breggin, it was largely because shock treatment was a method which “fits perfectly into a totalitarian system” since it “suppresses people by damaging their brains and blunting their minds”

(“Psychiatry’s Role in the Holocaust” 146).

Both the custodial conditions of large-scale mental hospitals and the use of somatic treatments as a tool of punishment and social control thus met considerable objection from mental health professionals and the public. However, this controversial situation continued towards the 1960s when a revolutionary movement in mental health care began to prevail internationally. This revolutionary shift would be termed as

‘deinstitutionalization’. Deinstitutionalization was essentially a process in which mental health patients began to be moved from public hospitals into the community. In that process, many long-stay psychiatric hospitals began to be replaced by less isolated community mental health services. As Pietikainen states, “the therapeutic vision behind this transformation was laudable”:

… let us keep the mentally ill in our communities rather than incarcerating them in large, inhumane institutions; and let us establish outpatient clinics, psychiatric wards in 34

general hospitals, day hospitals and social support rather than locked wards, lobotomies and a numb existence in loony bins. (334).

As the quote above makes it clear, the belief that large mental hospitals and their somatic treatments were inhumane became influential in the emergence of this policy change. This emphasis on human rights reached its height in the 1960s and 1970s following the advances in social science and philosophy critiquing psychiatry, and in turn contributed to the mass shift of mental patients from hospitals to the community.

However, besides this growing critical awareness, some other factors contributed to the rise of deinstitutionalization as well. For instance, the emergence of modern psychiatric drugs in the 1950s gave hope that new antipsychotic medications could offer more effective and practical cures outside mental institutions.

Deinstitutionalization was largely considered a progressive development in the mental health arena since it helped to reduce the number of the patients confined to asylums and to reintegrate these people into the community. However, like the previous shifts in mental health system, which had occurred in the earlier ages, this new process was discussed from relatively similar perspectives. First of all, like the moral treatment movement of the late 17th and early 18th centuries, deinstitutionalization policy was questioned whether it had really been motivated by humanitarian compulsions, or had been triggered primarily by economic political concerns and legitimized by humanitarian and scientific justifications. In this argument, deinstitutionalization policy was attributed to cost-saving concerns; through the close of many psychiatric hospitals and the reduction of in-patient populations, the budgets spent by the governments for institutional care would be remarkably cut. In this line of thought, deinstitutionalization was considered “a political and economic measure” that was “designed primarily to sustain near-bankrupt state governments and to establish the basis for transferring funds from public services to the private sector” (Rose 445). In relation to this argument, Scull

35 made a comprehensive analysis. To Scull, the usual explanations for the move toward deinstitutionalization, such as the rise of psychoactive drugs and the growing disappointment with the dehumanizing nature of mental asylums, were unsatisfactory.

For him, the dominant motivation was economic; since “the fiscal pressures on the state intensified during the 1960s and 1970s”, “non-institutional techniques for coping with the criminal and the delinquent” began to “exert an even greater fascination for criminal justice planners and policy makers” (Scull, Decarceration 135). These financial pressures on the states also necessitated the alternatives to long-term psychiatric institutionalization. In the new process, through the development of welfare programs and alternative community services, mental health care would be maintained more cheaply outside mental institutions whose costs had already begun to be a financial burden on the states.

Apart from this argument, deinstitutionalization was criticized for having failed to provide adequate community services for the released mentally ill individuals. It was claimed that deinstitutionalization left many people homeless and vulnerable to new dangers in the community since it failed to provide sufficient aftercare for the people who were vulnerable, helpless, and unable to meet their own maintenance expenses.

Richard Warner who was himself a community psychiatrist suggested that this whole attempt “to rehabilitate patients to decent living conditions and a useful role in the community” then turned into “a rush to dump patients on the streets and in nursing homes in order to save money” (109). In a similar vein, Scull pointed out that the patients discharged from the hospitals were largely abandoned to their fate “in the least desirable parts of cities, where existing inhabitants” were already “too poor and politically powerless to resist”, and that in these underprivileged parts of cities, they had to live “among other marginal people”, including “criminals, addicts, alcoholics, the utterly impoverished” (Madness in Civilization 376). These poor outcomes for the

36 mentally ill populations led Scull to the conclusion that the main reason for undertaking deinstitutionalization was actually economic rather than humanist in motivation. Like

Scull, Pietikainen pointed to the unfortunate effects of deinstitutionalization on the released mentally ill individuals as well. He stated that “in the UK and the United

States, a growing number of mental patients ended up on the streets, in jails or in shelters for the homeless” (Pietikainen 335). According to Pietikainen, this undesirable outcome was largely because “there were not enough day hospitals, outpatient clinics, shelters and other forms of medical, psychological and social support” (326).

Finally, deinstitutionalization process was discussed within the context of social control. It was commonly believed that the shifting of the mentally ill individuals from the state-run mental hospitals into the community did not exactly put an end to the control and surveillance of these individuals; the new mental health policy had brought about new forms of social control. One of these new forms of control was “trans- institutionalization” - “the shifting of a person or population from one kind of institution to another such as a state hospital, jail, prison, nursing home, or shelter” (Halter 596).

The critics thought the released mental patients were actually transferred from one kind of institution to another. As Szasz puts it, “old, unwanted persons, formerly housed in state hospitals” were “now housed in nursing homes”; “young, unwanted persons, formerly also housed in state hospitals” were “now housed in prisons or parapsychiatric facilities” (Cruel Compassion 174). In this debate, a great attention was paid to the inverse relationship between the changing populations of prisons and mental hospitals, which became apparent specifically after the deinstitutionalization process. For instance, Steadman et al. pointed out that “the epidemiologic data on population shifts in the criminal justice and mental health systems in the U.S.” confirmed “an interdependent relationship” between prison and mental hospital populations: “At the end of 1968, there were 399, 000 patients in state mental hospitals and 168,000 inmates

37 in state prisons (475). Within a decade, the hospital population rose 64%, to 147,000 while the prison population rose 65%, to 277,000.” (Steadman et al. 475). These data inevitably caused the critics to conclude that due to its failures in providing aftercare support, deinstitutionalization contributed to the criminalization of the mentally ill and the incarceration of these people in jails or prisons.

Besides trans-institutionalization, the increased use of modern psychiatric drugs in the aftermath of deinstitutionalization became a critical issue in terms of the social- control of mentally ill individuals. For instance, Szasz who was actually a fierce critic of involuntary psychiatric hospitalization argued that there was no contrast between the mental hospital care and the community mental health care because according to him, the old “mechanical straitjackets” were simply replaced by the new “chemical” restraints (Cruel Compassion 171). In his opinion, patients’ dependence on doctors in the asylum space did not come to an end in the community; since mental patients became “sicker and more disabled than before” due to the use of “neuroleptic drugs”, they continued “to depend on family or society for food and shelter” (Szasz, Cruel

Compassion 151-152). Besides Szasz, Breggin drew attention to the behavioural control function of drugs, suggesting that if psychiatric drugs are “sufficiently deactivating”, they can easily be “used on humans and animals alike under any circumstances where an authority desires to impose control” (Brain-Disabling Treatments 37). In a similar fashion, Peter Conrad mentioned about how “pharmaceuticals” can function as “a form of medical social control of deviance” as they “modify everyday behaviour, mood, sexuality, learning abilities, and so forth” (The Medicalization of Society 151-152).

Consequently, when the different historical periods have been examined in terms of the radical changes that the perception and treatment of madness or mental illness have undergone from medieval times to the present, it clearly appears that most of the radical shifts in mental health care have not been shaped just by the scientific

38 advancements in mental health knowledge and practice, but also have been strongly shaped by the prevalent cultural, political, and economic conditions, norms, and expectations of societies. In addition, and more importantly, no matter how the social and scientific attitudes towards madness or mental illness have undergone radical transformations, the tendency to draw a relationship between mental illness and social deviance seems to have continued to prevail among both the public and the mental health community. Therefore, the changing methods or settings have not exactly put an end to the implementation of psychiatric procedures for the purposes of social control.

People deemed ‘mad’ or ‘mentally ill’ have continued to be considered a potential threat and burden on mainstream society, and, in turn, they have either been isolated from society through different kinds of institutions, or continued to be controlled in different ways even when released into the community.

1.2. Anti-Psychiatry Perspectives of Mental Illness and Psychiatry

The Anti-psychiatry movement which emerged in the socio-political climate of the 1960s has problematized the fundamental assumptions and practices of psychiatry.

The movement has called into question the existence and reality of mental illness on the grounds that psychiatric diagnoses cannot be objective since the criteria for identifying mental or psychological disorders are largely shaped by the cultural, political, or economic conditions and expectations of a particular society and of a particular time. In this respect, this movement has viewed psychiatry as an institution of social control that provides a legitimate basis for labelling the individuals whose deviant behaviour and ideas pose a danger to the existing social conformity as ‘mentally ill’, and for regulating those perceived deviances in accordance with the common values and norms of society.

Anti-psychiatrists have generally challenged this ‘social-control’ function of psychiatry.

Each theorist associated with this movement has contributed to the criticism of psychiatry with their distinctive perspectives and concepts. For instance, Hungarian-

American psychiatrist Thomas Szasz who is famous for his slogan “mental illness is a myth” has specifically concentrated on the ‘paternalistic’ role of psychiatry. Paternalism is the intervention of a state or of an individual with another person, against their will, on the grounds that the person intervened with will be kept from harm. According to

Szasz, psychiatric professionals assume this paternalistic role in order to infantilize their patients and limit their rights to autonomy and liberty. They create and employ a

“paternalistic jargon” through the rhetoric of “help” and “compassion”, and thus they both convince themselves that they are acting for the benefit of the Other and justify their coercive treatments (Szasz, Cruel Compassion 22). Thus, psychiatrists reduce the probability of their patients’ resistance to involuntary coercive treatments.

As for the Canadian-American sociologist Erving Goffman, he has contributed to the anti-psychiatry approach through his institutional critiques and his well-known concept of ‘total institution’. In the introduction to Asylums: Essays on the Social

Situation of Mental Patients and Other Inmates (1961), Goffman defines total institution as an enclosed space that brings together a great number of people who share similar social situations such as being orphaned, indigent, criminal or disabled (XIII).

He places psychiatric institutions in the same ‘total institution’ category as prisons, military organizations, monasteries, and concentration camps. According to him, in all this kind of institutions, every second of life is encompassed and monitored within a regulated social environment. Inmates are kept under constant surveillance. Their daily activities like sleeping, dining, and working are pre-planned by the same single authority and are carried out in company with other inmates in the same space. Goffman further adds that the inmates in these institutions undergo a process which systematically mortifies the self (14). Immediately upon entering the institutional area,

40 they are compelled to behave in accordance with the institution’s rigid social norms:

They are forced to conform to the institution’s dress code and not allowed to wear any accessories and costumes that might reveal something about their personal identity or might create a sense of self-identity. In addition, the inmates’ communication with family, friends, and acquaintances outside the institution is restricted and monitored. To

Goffman, through the use of such restrictions and surveillance, psychiatric institution consequently becomes an area which captures something of the time, the space, the identity, and the liberty of individual, as befitting the characteristics of a total institution.

Aside from Goffman and Szasz, social labelling theorists like Thomas Scheff and Howard Becker have also contributed to the criticism of psychiatry. They mainly argue that the labels arbitrarily attached to individuals by society are confirmed and legitimated by psychiatrists in mental institutions. These theorists frequently make a reference to the well-known Rosenhan experiment conducted in 1972 by the American psychologist David L. Rosenhan who wanted to test the validity and neutrality of psychiatric diagnosis on the grounds that psychiatrists do not use the criteria based upon scientific facts. In the experiment, eight pseudo-patients composed of three psychologists, a paediatrician, a psychiatrist, a painter, a housewife, and Rosenhan himself applied to a psychiatric hospital – under phony names to avoid detection - with the complaints of auditory hallucinations. Immediately upon the admission to psychiatric wards, the pseudo-patients began to act normal and reported to the doctors that they were fine and no longer experienced auditory hallucinations. They spoke to both patients and staff as much as possible by responding to the instructions of attendants; however, the hospital administration and doctors did not believe that they completely recovered, and continued medication. Even the one who stayed the shortest in the psychiatric hospital spent seven days there. The doctors diagnosed seven of the

41 pseudo-patients with schizophrenia and one with manic-depressive psychosis. They eventually managed to get out of the hospital and then the experiment went on with different hospitals with the same complaints. Rosenhan concluded the article “On Being

Sane in Insane Places”, which was published in 1973 after the experiment, with the following statements: “It is clear that we cannot distinguish the sane from the insane in psychiatric hospitals. The hospital itself imposes a special environment in which the meanings of behaviour can easily be misunderstood.” (257).

The Scottish existentialist psychotherapist Ronald David Laing, who is viewed as the leading proponent of the Anti-psychiatry Movement, has essentially viewed mental illness as person’s inevitable reaction to unendurable stresses of life and policies of repressive society. Laing has developed a revolutionary approach to the treatment of mental illness through his ‘experimental therapeutic communities’. He founded the

Philadelphia Association in 1965 with Marxist David Cooper and started up over twenty therapeutic communities where non-traditional treatment modalities could be developed and used. Kingsley Hall in London’s East End is probably the best-known of these alternative treatment spaces where Laing aimed to employ egalitarian principles for mental patients. At this centre, Laing provided patients as much freedom as possible with no hierarchies and no chains of authority. The residents were not locked behind walls and were free to come and leave as they wished. Anti-psychotic drugs were not administered compulsorily. Instead, all-night therapies, role-reversal sessions, Friday night dinners, and plays were held. Occasionally, academics and celebrities came to take part in these events. In time, this alternative space became a place that a wider range of people – apart from patients – could come for relief.

Italian psychiatrist and neurologist Franco Basaglia also took revolutionary steps to promote alternative options for the treatment of mental disorder. He is the architect of

Law 180 that marked the beginning of the end for Italy’s asylums in 1968. Basaglia

42 who himself witnessed the life in asylum as the director of a psychiatric hospital in

Gorizia in 1961 decided to eliminate every type of coercive method from the hospital.

He refused to sign the permits for the restraint of inmates, and opened the locked doors of the institution, allowing the patients to enter and leave the hospital during the day.

The doctors in this hospital did not wear white coats and freely socialized with patients.

Furthermore, bars, shackles and strait-jackets were removed from use. Basaglia also founded Psychiatria Democratica – a nationwide association with anti-institutional ideal

– which strove for the closure of asylums and the prohibition of forceful admission of the mentally ill to mental health institutions. The association finally accomplished its purpose with the approval of Law 180 that was the first law in the world to establish the end of psychiatric hospitals. This law offered a wide range of alternative solutions for the treatment of mental illness such as occupational therapy, mental patients communities, and part-time hospitals.

French philosopher Michel Foucault has also been associated with the Anti- psychiatry Movement due to his critical studies that problematize the foundations of psychiatry, although he has never accepted this attachment like R. D. Laing. Foucault has actually interrogated the foundations of the modern human sciences and the functioning of the corresponding institutions on the grounds that they actually did not develop simply as a consequence of the progress in knowledge, but rather emerged as a result of the need for developing more effective and legitimate disciplinary techniques to take the increased populations under control. Foucault essentially approaches psychiatry from this standpoint. He views psychiatry as an apparatus of power which provides a legitimate basis for the application of correctional and normalizing strategies over the individuals whose deviant behaviour and ideas are perceived as a potential threat to the social order and harmony. Foucault’s approach to psychiatry mainly revolves around this function, the functioning as the ‘norm’. He once states that

43 psychiatry is not a form of power that simply targets madness; it becomes a “more general and dangerous” form of power that defines, controls, and corrects what is deemed as “abnormal” by the power and society (Foucault, Psychiatric Power 221). To

Foucault, psychiatric power thus meets society’s vital need for homogeneity as it helps both to identify any deviance from the norm as ‘madness’ or ‘mental illness’ and to regulate that deviance in accordance with the prevailing standards of normality.

1.3. Psychiatric Power

Disciplinary power developed with the advent of modernity, having replaced an older form of power which Foucault terms as ‘sovereign power’. Sovereign power had been exercised in feudal societies through the presence of a sovereign authority figure such as king, queen, or monarch. These highly individualized authority figures had been endowed with such an absolute power that they had even possessed “the right to take life or let live” (Foucault, The History of Sexuality 136); in case of any threat to their authority, they had had the privilege to seize any and all things including the lives of their citizens. As the laws had represented the will of these sovereigns, any transgression of law had been punished not just for the violation of law but also for the challenge to the presence of these authority figures. In this sovereign form of power, the punishments had usually taken the form of “public torture and execution” (Foucault,

Discipline and Punish 32) because in this way, members of society had witnessed the absolute power of the sovereign and learned to obey unconditionally. Sovereign power had secured its position and authority through such punishment rituals based on violent and coercive methods of domination. However, with the birth of capitalist and modern society, this violent and highly individualized form of power began to become less efficient at controlling and regulating the behaviour of the increasing populations. In

Foucault’s opinion, the transition from sovereign power to disciplinary power in

44 western societies took place at this moment “when it became understood that it was more efficient and profitable to place someone under surveillance than to subject them to some exemplary penalty” (Sarup 67).

Foucault elaborates on the rise of disciplinary power through a detailed analysis of the mechanisms of discipline in one of his seminal works, Discipline and Punish: The

Birth of the Prison (1975). Although this comprehensive study deals primarily with the transition from public executions to prisons, it also highlights how the disciplinary mechanisms developed in prisons were then extended to the spaces of other modern social institutions, including hospitals, factories, schools, and workplaces. In Foucault’s view, through this extension of disciplinary mechanisms to a range of modern institutions, “many disciplinary methods”, which had long been used “in monasteries, armies, and workshops” before the eighteenth century, “became general formulas of domination” in modern western societies “in the course of the seventeenth and eighteenth centuries” (Discipline and Punish 137).

Foucault explains disciplines as a series of techniques which make possible both

“the meticulous control” of individuals and the creation of ‘docile’ and ‘useful’ subjects in modern societies (Discipline and Punish 137). The ultimate aim of disciplines is to make individuals develop self-control and take responsibility for regulating their own behaviour in socially desirable ways. To these ends, disciplinary power operates in fundamentally different ways from sovereign power. First of all, it is not exercised through “the dazzling force” of a sovereign figure; it is practised “through networks”, therefore, it is a “discreet” and “distributed” form of power (Foucault, Psychiatric

Power 22). It is discreet because while the pressure of the sovereign over the individuals could be visible in public executions, the pressure exerted over the individuals in modern societies could be visible only “in the obedience and submission” of people “on whom power is silently exercised” (Foucault, Psychiatric Power 22). Therefore, while

45 the existence of the sovereign is visible in sovereign power, in disciplinary power, the individual is made visible. Disciplinary system is also distributed because it does not act from top downwards as in sovereign power; it operates on all levels of society, dissipating through the whole society within social networks and giving shape to all relations of the individuals. Furthermore, discipline organizes the space strategically; it distributes the individuals in the space. This distribution sometimes involves

“enclosure” in “a protected place” such as a factory, hospital, school, or barracks

(Foucault, Discipline and Punish 141). These enclosed disciplinary spaces are fundamentally “cellular” and are used “on the principle of partitioning” which ensures that “each individual has his own place; and each place its individual” (Foucault,

Discipline and Punish 143). Foucault explains the advantages of this art of distributions with the following words:

One must eliminate the effects of imprecise distributions, the uncontrolled disappearance of individuals, their diffuse circulation, their unusable and dangerous coagulation; it was a tactic of anti-desertion, anti-vagabondage, anti-concentration. Its aim was to establish presences and absences, to know where and how to locate individuals, to set up useful communications, to interrupt others, to be able at each moment to supervise the conduct, of each individual, to assess it, to judge it, to calculate its qualities or merits. It was a procedure, therefore, aimed at knowing, mastering and using (Discipline and Punish 143).

As Foucault puts it in the quote above, through distribution, the space becomes a disciplinary area that gives no way to any uncontrolled behaviour because each movement of the individual can be monitored and his presences or absences can be easily followed. In such a disciplinary space, the system needs “a procedure of continuous control” in which one is continually kept “under someone’s gaze” (Foucault,

Psychiatric Power 47). Through this perpetual surveillance, people are compelled to develop self-discipline and to regulate their own behaviour in accordance with the correct rules and procedures. Thanks to the effects of this uninterrupted surveillance,

46 disciplinary power can consequently produce what Foucault calls “docile and useful bodies” (Discipline and Punish 231).

The continuousness of surveillance is highly significant because disciplinary mechanism concentrates on “potential behaviour” (Foucault, Psychiatric Power 51); it supervises “the process of the activity” (Foucault, Discipline and Punish 137). While in sovereign power the focus had been laid on the result of acts and on the punishment, in modern societies, the focus is laid on the process in which any potential social threat might arise. Therefore, as Foucault argues, “there is no reference to an act, an event” in disciplinary power; there is rather a reference “to a final or optimum state” because disciplinary power “looks forward to the future, towards to the moment when it will keep going by itself and when discipline, consequently, will have become habit”

(Psychiatric Power 47). That is to say, the individual is not under the gaze of the authority just for an action made once; the person is always visible and under surveillance against the potential transgressions. In this way, disciplinary power becomes “a total hold” or “an exhaustive capture of the individual’s body, actions, time, and behaviour” (Foucault, Psychiatric Power 46).

For this total and perpetual control of individuals, disciplinary power needs to write “everything that happens, everything the individual does and says” because thanks to writing and recording, any information about individuals can be transmitted “from below up through the hierarchical levels” and can be made “accessible” at any time

(Foucault, Psychiatric Power 48). Thus, power follows everything so continuously that it can react promptly to any potential threats. Foucault in this respect gives the example of the system of workshop discipline that was developed in the eighteenth century. In the workshop regulations, there is similarly “a comparative supervision of workers”: the

“lateness and absences” of workers are written down “to the last minute”, and any act that might cause “distraction” is directly “punished” (Foucault, Psychiatric Power 51).

In Foucault’s account, this surveillance aspect of disciplinary power is its

“panoptic character”, which means “the absolute and constant visibility surrounding the bodies of individuals” (Psychiatric Power 52). The term “panoptic” has actually been derived from the English philosopher and social theorist Jeremy Bentham. The panopticon is a type of institutional building and a system of control which was designed by Bentham at the end of the eighteenth century. This institution model is widely known as an architectural form for a prison; however, as Bentham states, it is not only a model of a prison; it is a sort of mechanism that can be used in any institution where the power operating in that institution wants to gain maximum strength:

No matter how different, or even opposite the purpose: whether it be that of punishing the incorrigible, guarding the insane, reforming the vicious, confining the suspected, employing the idle, maintaining the helpless, curing the sick, instructing the willing in any branch of industry, or training the rising race in the path of education: in a word, whether it be applied to the purposes of perpetual prisons in the room of death, or prisons for confinement before trial, or penitentiary houses, or houses of correction, or work-houses, or manufactories, or mad-houses, or hospitals, or schools (34).

As Bentham states, the panoptic mechanism can function in multiple institutions such as school, hospital, and factory since its basic principle is the perpetual surveillance and control of the individuals. This mechanism fundamentally has an architectural structure of a circular building. At the centre of the building, there is a tower in which an observing authoritative figure resides. The cells line the circumference of the outer building and each cell is separated from one another in order to prevent the prisoners from collaborating. Every cell is necessarily in full view of the central tower and every cell has plain view of the central tower. The cells themselves have windows on the outside, and grated doors on the inside, facing the central tower. The windows are large and let in enough light to make the prisoner clearly visible to the authority in the tower and to allow the prisoner to be aware of the central tower. In this architectural design, the core principle is the total and constant surveillance of prisoners. Individuals have no 48 privacy and they are aware of being continuously watched by an authority figure residing in the central tower. Even though prisoners never know exactly when they are being observed, they think that they are being watched all the time. As a result, prisoners always feel compelled to conform and act in accordance with the rules set by the authorities. In his analysis of disciplinary power, Foucault specifically refers to this control mechanism because according to him, the panoptic principle is a major characteristic of disciplinary power since it continuously compels individuals to develop self-discipline and take responsibility for regulating their own behaviour.

For Foucault, another feature characterizing a disciplinary apparatus is its being

“isotopic” and this concept means that “every element in a disciplinary apparatus has its well defined place” along with its “subordinate” and “superordinate” elements

(Psychiatric Power 52). Foucault exemplifies this isotopic character with the grades in army or in the school; a student’s place in class, for instance, is “determined by where” he is “ranked in his school results” (Psychiatric Power 52). Through this example,

Foucault emphasizes that what is called “the individual’s locus” is actually “both his place in the class and his rank in the hierarchy of values and success” (Psychiatric

Power 52).

For Foucault, isotopic also has two other meanings. First, it means that “there is no conflict between different disciplinary apparatuses”, that is to say, each disciplinary apparatus connects up with one another (Foucault, Psychiatric Power 53). For instance,

“the hierarchism in the disciplinary and military system” maintains “the disciplinary hierarchies found in the civil system” (Foucault, Psychiatric Power 53). It is actually the same again with the school system where the hierarchical relationships among students, teachers, and school principals conjure up the conditions and relations of the hierarchy prevailing in the military system. The hierarchical forms of relations have been necessarily transformed in different disciplinary areas in accordance with the

49 changing atmosphere, function, and procedures of each institution, but yet, the hierarchical nature of human relations continues to prevail in each disciplinary institution. Secondly, to Foucault, isotopic means that “the principle of distribution and classification of all the elements” in disciplinary systems requires the presence of

“something like a residue”, that is to say, there is always something like “the unclassifiable” in disciplinary systems (Psychiatric Power 53). Foucault means that while classifying and hierarchizing the individuals, disciplinary power also comes up against certain individuals who refuse to be classified or refuse to adopt a rank. Foucault designates such individuals as “the residual”, “the irreducible”, and “the inassimilable”

(Psychiatric Power 53). These individuals are actually the persons who do not comply with the standards, consciously or unconsciously. Therefore, these people cannot be distributed in the space as is required, or cannot be assimilated into the system in accordance with the dominant values, norms, or expectations. In this context, Foucault views mentally ill individuals as “the residue of all residues”; on the grounds that they cannot be assimilated into “all of a society’s educational, military and police disciplines” (Psychiatric Power 54).

In Foucault’s view, the presence of such ‘residual’ individuals in a society is necessary for the continuity of disciplinary systems because thanks to these unassimilated people, power can legitimize the establishment of some “supplementary disciplinary systems” (Psychiatric Power 54). For instance, for “the feeble-minded” who are assumed to be “inaccessible to school discipline”, “schools for the feeble- minded” have been created by the system (Foucault, Psychiatric Power 54). It is actually again the same with other residues of society such as the mentally ill, the disabled, and the criminal. Disciplinary power necessarily produces these “residual abnormalities, illegalities, and irregularities” so that it can create disciplinary areas where it can apply its normalizing mechanisms and procedures (Foucault, Psychiatric

Power 110). Furthermore, thanks to the presence of these residual abnormalities, the system has produced “a source of profit”; it has extracted profit from the presence of these individuals (Foucault, Psychiatric Power 110). First, the system has

“marginalized, disapproved, and inhibited” certain people and certain patterns of behaviour and then through these undesirable elements, it has created “a reserve army” on which “the State apparatuses” can carry out their “normalizing policies” and from which it can drive a profit (Foucault, Psychiatric Power 112). For this reason, Foucault thinks the State apparatuses have both economic and political motives.

Through the analysis of these ‘residual’ members of society, Foucault also comes to a conclusion that disciplinary power always tends to discard certain members of society. It first brings “anomie” to light, and then normalizes it, therefore, power continuously invents “new recovery systems”, always “re-establishing the rule”

(Foucault, Psychiatric Power 54). Thus, the essential characteristic of disciplinary power is this “never ending work of the norm in the anomic” (Foucault, Psychiatric

Power 54).

All these main characteristics of disciplinary power analysed by Foucault indicate that this modern mechanism of power fundamentally functions to transform the individuals into the conforming members of society. Through the techniques such as perpetual supervision, permanent writing, and potential punishment, disciplinary power attempts to constitute docile and useful subjects in modern societies. In Foucault’s account, the origins of these disciplinary techniques and practices essentially lie in the human sciences such as criminology, sociology, psychology, and psychiatry. In his view, the human sciences have developed certain knowledge and discourses in relation to ‘what is normal’. They have established an average standard according to which each individual is measured as the sane person, the law-abiding citizen, or the obedient child.

Such ‘normal’ categories in turn paved the way for the emergence of ‘abnormal’

51 categories such as the insane person, the criminal, or the deviant. Thus, the modern human sciences and the corresponding institutions have contributed to the emergence of a regime of power that describes and controls human behaviour based upon a series of norms. In Foucault’s view, from the outset, psychiatry has always assumed this disciplinary responsibility in western societies; with its privilege to define ‘what is abnormal’ and accordingly ‘who is insane’, psychiatry has produced norms and discourses related to how individuals must behave in order to be socially accepted and approved. Thus, this discipline has become a mechanism of regulation that distinguishes between normal and deviant behaviour and in turn has served as a mechanism that ensures the social control of the deviances from the norm.

In his ground-breaking lectures published as Psychiatric Power: Lectures at the

College de France, 1973-1974, Foucault places great weight on how psychiatry functions in this disciplinary framework. He delves into the disciplinary techniques and practices that are deployed in psychiatric institutions in order to ensure the maximum obedience of each individual. In these lectures, Foucault specifically focuses on the workings of the asylum system because he aims to make intelligible how the power in a mental hospital operates so systematically that it can take a coherent form and can penetrate into the souls and the bodies of individuals.

Foucault begins his lectures by citing François-Emmanuel Fodere’s description of an ideal form of asylum:

I would like these homes to be built in sacred forests, in steep and isolated spots, in the midst of great disorder, like at the Grande-Chartreuse, etcetera. Also, before the newcomer arrives at his destination, it would be a good idea if he were to be brought down by machines, be taken through ever new and more amazing places, and if the officials of these places were to wear distinctive costumes. The romantic is suitable here, and I have often said to myself that we could make use of those old castles built over caverns that pass through a hill and open out onto a pleasant little valley... Phantasmagoria and other resources of physics, music, water, flashes of lightning,

thunder, etcetera would be used in turn and, very likely, not without some success on the common man. (qtd. in Psychiatric Power 1).

Fodere’s ideal mental asylum is acutely separated from the outside world and only accessible through machines since it is quite protected by high hills. Due to this physical separation, there is always a barrier to social connection with the outside world. Inside the building, there is a regulated social environment in which all aspects of the inmates’ life are surrounded and penetrated through the permanent regulation and surveillance of their time, space, and activities. This separation of lives also continues to exist inside the ‘castle’ with the attendants’ distinctive costumes that successfully distinguish themselves from the inmates.

Foucault interprets this ideal asylum model as a setting where “order, the law, and power reigns” (Psychiatric Power 2). This power in the asylum “surrounds, penetrates, and works on bodies”, permanently regulating the “time, activities, and actions” of the individuals (Foucault, Psychiatric Power 2). In this context, Foucault views the mental asylum as a “panoptic machine”; he thinks the elements which were formalized in Bentham’s Panopticon are set to work within the space of asylums

(Psychiatric Power 102). In his view, although the particular architectural arrangements of Bentham’s design have been modified in mental asylums, the basic principles of this design yet prevail in these institutions’ system. The first of these principles, which

Foucault thinks play an influential role in the treatment operations of the asylum, is

“permanent visibility” (Psychiatric Power 102). To Foucault, in accordance with this principle, the physical environment of the asylum is regulated in such a way that ensures the permanent observation of patients.

The second principle, “central supervision”, which was ensured through a central tower in panoptic prison, has been provided in the asylum through the relationships established “within the hierarchy of warders, nurses, supervisors, and

53 doctors” (Foucault, Psychiatric Power 103). According to Foucault, in the disciplinary setting of the asylum, the authority is endowed with an “unlimited power” that any person can hardly oppose (Psychiatric Power 3). However, this unlimited authority is not only the power or the authority the doctor exercises over his patients because in

Foucault’s account, power cannot be simply something that someone possesses or holds. In his view, power corresponds to a relation or, a network of relations that leave an impression on the other’s actions. For this reason, Foucault says power “does not belong to anyone or event to a group; there is only power because there is dispersion, relays, networks, reciprocal supports, differences of potential, discrepancies, etcetera”

(Psychiatric Power 4). In line with this relational character of power, Foucault explains the power exercised in the asylum through a range of “relays around the doctor” such as

“supervisors” and “servants”, all of whom he thinks largely contribute to the distribution of disciplinary power within the asylum space (Psychiatric Power 4-5).

In this chain of authority, servants “hold the last link” and supervisors are “the master” of these “last masters” (Foucault, Psychiatric Power 5). Supervisors constantly observe the patients and report to the doctor about all their behaviour. Thanks to their

“discourse, gaze, observations, and reports”, supervisors also make possible the formation of a “medical knowledge” (Foucault, Psychiatric Power 5). With regard to the vital characteristics of a supervisor, Foucault cites Fodere who mentions about how an effective supervisor must necessarily be:

In a supervisor of the insane it is necessary to look for a well proportioned physical stature, strong, and vigorous muscles, a proud and intrepid bearing for certain occasions, a voice with a striking tone when needed. In addition, he must have the strictest integrity, pure moral standards, and a firmness compatible with gentle and persuasive forms (…) and he must be absolutely obedient to the doctor’s orders. (qtd. in Psychiatric Power 5)

As Fodere states in the quote above, a supervisor who represents a crucial relay for the doctor’s authority must have very specific features. First of all, a supervisor must stand as a mighty body before the patient, and he must necessarily appear determined and proud. He must also act as a role model for the patients with his flawless moral standards. Additionally, he must be obedient so that in all cases he can abide by the doctor’s commands.

As for “servants”, Foucault states that they must “only pretend to serve” the patients; while providing the patients with “material assistance”, they must essentially watch them “at the level of their daily life” and “report anything worth noting to the supervisor, who will report it to the doctor” (Psychiatric Power 5). In addition, if the patient makes a demand that must never be met, the servant’s duty must be not to fulfil what the patient demands, but to “appeal to the great anonymous authority of the rules or to the doctor’s particular will” (Foucault, Psychiatric Power 5). In this process, servants in a way “set up the patients” because the patient who makes demands on the servant finally realizes that he has already been encircled “by the doctor’s will”

(Foucault, Psychiatric Power 5). Through these relays of power, patients consequently find themselves under a never-ending gaze. The power exercised in the asylum becomes so distributed across the whole space that nothing or nobody can escape from the attention and the gaze of the institution staff. For Foucault, this hierarchical arrangement is “a tactical functioning of power” and only through “this schematic tactical arrangement”, perpetual surveillance may become possible in the asylum (Psychiatric

Power 6).

Having examined this tactical functioning of psychiatric power, Foucault also concludes that “there is something, a force, that is dangerous” within the field of such asylum regulations (Psychiatric Power 6). He thinks if an asylum is organized “so obsessed with these kind of relays of power”, “it is because before the problem being

55 one of knowledge, or rather, for the problem to be able to be one of knowledge, of the truth of the illness, and of its cure, it must first of all be one of victory (Foucault,

Psychiatric Power 6-7). Foucault means that if such a tactical arrangement whereby a network of authority is strictly secured through the relays is necessarily applied within the asylum, it is primarily because the authority is considered more vital than the treatment. For this reason, Foucault resembles the asylum space to a “battlefield”

(Psychiatric Power 7), where “the confrontation of two wills”, that of the doctor and that of the patient, takes place (10). In his view, what is involved in psychiatric operations is actually “a relationship of force” (Foucault, Psychiatric Power 10).

Foucault exemplifies his claim with an example treatment scene from Pinel’s Traite

Medico-Philosophique. Pinel’s patient, Pussin is a young man suffering from religious biases. This man thinks that he has to reject “not only all the pleasures of the flesh, but also all food” for his salvation (Foucault, Psychiatric Power 10). The treatment scene takes place as follows:

In the evening, citizen Pussin appears at the door of his chamber in a frightening get up, with fiery eyes and a striking voice, and accompanied by a group of assistants close by who are armed with strong chains that they shake noisily. The soup is placed by the lunatic who is given the most precise instruction to take it during the night if he does not wish to incur the most cruel treatment. They withdraw and leave him in the most painful state, wavering between the idea of the threatened punishment and the terrifying perspective of the other life. After an inner struggle of several hours, the first idea wins and he decides to take his food. He is then subjected to a suitable diet for his recovery; sleep and strength return by degrees, as also the use of reason, and in this way, he avoids a certain death (Pinel qtd. in Foucault, Psychiatric Power 10).

Pussin who refuses to be fed for his salvation is compelled by Pinel and a group of his assistants to make a choice between the two options, between having the soup he is served and consenting to suffer a cruel treatment. Following an internal feud of several hours in a painful state, Pussin decides to have his soup and in this way he is rescued from death. What is striking about this treatment operation is that Pinel admits that

56 during the recovery period, his patient frequently confesses to him that he suffered a cruel distress and confusion during the night of his ordeal.

In relation to this scene, Foucault argues that this therapeutic operation was not practised through the doctor’s identification of the cause of the illness. He thinks the doctor did not need “any work of diagnosis or nosography” for the achievement of his operation, or he did not apply “a technical medical formula”; the operation just involved

“the confrontation of two wills”, of the doctor’s will and the patient’s (Foucault,

Psychiatric Power 10). For all these reasons, Foucault resembles the asylum space to a battlefield where the victory of one will to another takes place.

In this context, Foucault also reminds of Pinel’s fundamental definition of psychiatric therapeutics. According to Pinel, the therapeutics of madness is “the art of subjugating and taming the lunatic by making him strictly dependent on a man who, by his physical and moral qualities, is able to exercise an irresistible influence on him and alter the vicious chain of his ideas” (qtd. in Foucault, Psychiatric Power 8). Foucault’s critical approach to psychiatric practice is actually similar to Pinel’s because Foucault thinks the patient is strictly dependent on a certain power which can be held by one and only one man who operates it in the asylum, and this power exerts its authority not so much “on the basis of a knowledge”, but much more on the basis of “the physical and moral qualities” that allow him to exert an influence which can be both unlimited and hard to resist (Psychiatric Power 8). In Foucault’s view, only in this way can it be possible “to change the vicious chain” of the patient’s ideas; only “on the basis of this moral orthopaedics”, can the cure become possible (Psychiatric Power 8).

Besides these principles of permanent visibility and central supervision, “the principle of isolation” is similarly adopted in the asylum system on the grounds that it has “a therapeutic value” (Foucault, Psychiatric Power 103). This is the principle of keeping the individual away “from all effects of the group, and of the assignation of the

57 individual to himself” (Foucault, Psychiatric Power 103). In relation of the isolation of patients, Foucault reminds of some objections the asylums have often met: “Is it really a good idea, medically, to put all the mad people together in the same space? First of all, won’t the madness be contagious? And secondly, won’t seeing others who are mad induce melancholy, sadness, etcetera, in those placed amongst them?” (Psychiatric

Power 103). According to Foucault, doctors have responded to such objections “Quite the reverse” on the grounds that it is very good for a patient to witness the madness of other madmen on the condition that this patient recognizes the other madmen around him in the same way that the doctor sees them (Psychiatric Power 103). In other words, a madman cannot immediately adopt the same viewpoint on himself as his doctor because “he is too attached to his own madness”, however, “he is not attached to the madness of others” (Foucault, Psychiatric Power 103). For this reason, provided that the doctor succeeds to show each patient “how all the other patients around him are really ill and mad”, the patient who discovers the madness of others “in a triangular fashion” consequently ends up “understanding what it is to be mad, suffer delirium, be maniacal or melancholic, and suffer monomania” (Foucault, Psychiatric Power 103-

104).

Finally, with regard to the elements of the Panopticon, Foucault suggests that asylum operates through “the play of ceaseless punishment” (Psychiatric Power 104).

In the asylum, perpetual punishment is set to work either “by the personnel”, who must be necessarily always present and close to each patient, or “by a set of instruments”

(Foucault, Psychiatric Power 104). Before the nineteenth century, there had been a considerable amount of “corporal apparatuses”, including “chastity belt”, “the water torture”, and “branding the shoulder or forehead with a letter” (Foucault, Psychiatric

Power 105). However, during moral treatment period, the use of such corporal restraints were largely forbidden, and instead of these physical instruments, the asylum staff

58 began to serve as the functionaries of some kind of moral restraint. In relation to this seemingly radical shift, Foucault cites “a letter sent by the reverend Mother Superior, in charge of the nuns at Lille, to her colleague, the Superior at Rouen”, in which she said:

“You know it’s not that serious. You too can do what we do at Lille. You can easily remove these instruments on condition that you place an ‘imposing nun’ beside all the lunatics you have set free” (qtd. in Psychiatric Power 104). These words are significant as they reveal the fact that restrictive procedures were not completely abandoned in the asylums of that time. Furthermore, besides this authoritarian role of the staff, some constraining physical mechanisms continued to be widely used. For instance, after

Pinel’s well-known unchaining of patients at Bicetre – “throughout the years from 1820 to 1845” – there were still a range of instruments of physical restraint such as “the fixed chair, handcuffs, muffs, straitjacket, the finger-glove garment, wicker caskets”, and

“dog collars”, all of which Foucault thinks make up a highly interesting “technology of body” (Foucault, Psychiatric Power 105). In Foucault’s view, besides these major types of physical apparatuses, there was also another type of instrument which he thinks emerged in that “moral treatment” period when the foundations of psychiatry were laid

(Psychiatric Power 105). He calls this type of apparatuses as “orthopedic instruments” by which he means the instruments whose function is “correction, training, and taming of the body” (Foucault, Psychiatric Power 105-106). In Foucault’s view, this type of instruments must be “homeostatic” in the sense that “the less one resists them the less one feels them, and the more one tries to escape them, the more one suffers”

(Psychiatric Power 106). For instance, in the system of straitjacket, the more a patient struggles, the tighter it gets. It is the same again with the system of the chair that gives a patient vertigo: if the patient does not move he is comfortably seated, but if he gets restless “the chair’s vibration” causes him to feel “seasick” (Foucault, Psychiatric

Power 106). This is the basic principle of orthopedic instruments. Having referred to all

59 these changes in the forms of punishment, Foucault underlines that punishment has always played a central role in the treatment of mental illness; simply a choice has been made between “the intervention of personnel” and “the use of an instrument”

(Psychiatric Power 104).

All these methods employed within the asylum involve a disciplinary function and are usually unpleasant for the patients because these methods both physically restrain the patients and compel them to act in accordance with the doctors’ will. In relation to these methods employed in psychiatric institutions, Foucault also argues that they involve much more “a technique of direction” rather than “a therapeutic aim”

(Psychiatric Power 180). That is to say, such methods are used not primarily to cure the patients but to direct them to behave in accordance with the staff’s will. Foucault thinks the use of medication similarly involves a disciplinary function because according to him, medication is “the extension of asylum discipline into the body” (Psychiatric

Power 181). Since medication, which does not have to be applied only within the institutional areas, helps to keep individuals docile and numb, and in turn helps to control and modify their undesirable behaviour, it serves to render individuals disciplined and tamed. For Foucault, many tranquilizers widely prescribed and used today involve the same function; they are used as the same kind of disciplinary practice; they become “the extension of the asylum regime, the regime of discipline, inside the patient’s body” (Psychiatric Power 181).

Besides physical instruments and drugs, “questioning” is another disciplinary method of the asylum regime (Foucault, Psychiatric Power 234). According to

Foucault, questioning is a specific way of “fixing the individual to the norm of his own identity” because the individual is pinned to “his social identity” and to “the madness” attributed to him by his own social sphere through specific questions such as “Who are you? What is your name? Who are your parents? What about the different episodes of

60 your madness?” (Psychiatric Power 234). In this questioning process, the individual is compelled to “recognize himself in his past, in certain events of his life” (Foucault,

Psychiatric Power 270). In other words, he is forced to remember the certain moments of his life and to recognize himself through those moments. Furthermore, Foucault contends that psychiatric questioning plays a crucial role in establishing a junction between “responsibility” and “subjectivity” (Psychiatric Power 273); the individual is given the responsibility of expressing his own madness or his own fault. While he tries to recall the faulty moments of his past, the psychiatrist is in a position that says “Give me some symptoms, I will remove the fault” (Foucault, Psychiatric Power 273). The psychiatrist is exactly in a position that compels the patient to give the reasons why he is held in that institution. In this process not only does the patient recognize the presence of his mad ideas or his hallucinations, but also actualizes his madness. This actualization takes place at the very moment when the patient “confesses” his delusions; at the moment when he says “Yes, I hear voices! Yes, I have hallucinations!” (Foucault,

Psychiatric Power 274). What the patient is here expected to say is that “Really, I am someone for whom a doctor was needed, I am sick and, since I am sick, it is clear that you, whose major function is to confine me, are a doctor” (Foucault, Psychiatric Power

274). Of the treatment operation, the most crucial and necessary moment is when the patient makes this confession and admits his delirious behaviour or ideas. “This is the end to which” Foucault thinks “psychiatric questioning must lead” (Psychiatric Power

274). The cure is accomplished at exactly that moment on the part of the doctor.

Foucault draws a striking comparison between psychiatric questioning and the technique of religious confession. According to him, like the person who confesses his sins to secure his salvation, the patient has to confess his madness or fault in order to be cured. When the psychiatrist says “I will free you from your madness on the condition that you confess to me your madness” (Foucault, Psychiatric Power 275), the patient is

61 obliged to give his doctor the reasons why he is confined there, and only in this way, can he be freed from both his madness and his confinement.

In the light of all these techniques, procedures, and methods examined above,

Foucault points to the disciplinary nature and operations of psychiatry. In addition to these disciplinary mechanisms, Foucault also distinguishes psychiatric institutions from all other disciplinary apparatuses; he argues that mental asylum has very specific features that make it distinctive among other disciplinary areas. First, asylum has a

“medical stamp” that legitimizes the disciplinary power exercised and distributed within its space (Foucault, Psychiatric Power 188). According to Foucault, this medical stamp has been ensured through a series of elements. The presence of a doctor is one of these elements; the profession of psychiatrist is needed because the power in the asylum needs to be medicalized. Besides this, asylum must have “a therapeutic function” whereby the disciplinary system operated in that institution can legitimize itself

(Foucault, Psychiatric Power 129). On the one hand, Foucault thinks it is true that psychiatry has rapidly attempted to develop itself as a “scientific discourse” especially through the efforts of the psychiatrists of the early nineteenth century (Psychiatric

Power 133). In that process, the field has produced two kinds of discourse. One of these is “the clinical or classificatory, nosological” discourse which describes madness as an illness or as a range of mental illnesses, each having its own “symptomatology, development, diagnostic and prognostic elements” (Foucault, Psychiatric Power 133).

The second is “anatomical pathological knowledge” which specifically questions “the organic correlatives of madness” (Foucault, Psychiatric Power 133). According to

Foucault, psychiatric practice developed under the guarantee of these two types of discourse in the nineteenth century, however, he contends that psychiatry “never used” these discourses” or it “only ever used them by reference” (Psychiatric Power 134). For this reason, Foucault believes there was always a contradiction between “medical

62 theory” and “asylum practice” (Psychiatric Power 180). Foucault explains this contradiction with the conditions on which the psychiatrists of that period – the time when the asylum world was established and organized – had thought the recovery could be accomplished. At that period, recovery was considered a sort of process in which the patients were expected to react positively to the combination of certain elements:

… first, isolation in the asylum; second, physical or physiological medication with opiates, laudanum, etcetera; third, a series of restraints peculiar to asylum life, such as discipline, obedience to a regulation, a precise diet, times of sleep and work, and physical instruments of constraint; and then, finally, a sort of psychophysical, both punitive and therapeutic medication, like the shower, the rotary swing, etcetera (Foucault, Psychiatric Power 143-144).

To Foucault, all these combined elements, which set the framework of psychiatric treatment, were not based upon a medical theory because the patient was supposed to be recovered only when he began to comply with the asylum regulations. As long as he acted in accordance with the asylum’s rules, he was acknowledged to have been healed.

Under these conditions, the cure of the individual was actually considered in parallel to his conformity to certain norms. In relation to this contradiction between medical theory and asylum practice, Foucault also refers to the ways in which the mentally ill were distributed in the asylums of the nineteenth century. To Foucault, the distribution of the patients within the asylum space had nothing to do with “the nosographic division of mental illnesses”, which is mentioned “in theoretical texts” (Psychiatric Power 180). He argues that the divisions made among the patients were fundamentally the differences between “the curable and the incurable, the calm and agitated patients, obedient and insubordinate patients, patients able to work and those unable to work and those punished and those unpunished” (Foucault, Psychiatric Power 180). Having underlined this fact, Foucault argues that nosological and anatomical pathological discourses, which contributed to psychiatry’s gaining a scientific status, were not actually taken into

63 account for the distribution of the patients in asylums; they just served as two kinds of

“guarantees of truth” for psychiatric operations (Psychiatric Power 134). That is to say, these discourses helped to validate and legitimize the psychiatric practices that would be applied within the space of asylum.

With regard to the legitimization of psychiatric power with the help of these scientific discourses, Foucault makes psychiatric power speak in the following words:

The question of truth will never be posed between madness and me for the very simple reason that I, psychiatry, am already a science. And if, as science, I have the right to question what I say, if it is true that I may make mistakes, it is in any case up to me, and to me alone, as science, to decide if what I say is true or to correct the mistake. I am the possessor of, if not of truth in its content, at least of all the criteria of truth. Furthermore, because, as scientific knowledge, I thereby possess the criteria of verification and truth, I can attach myself to reality and its power and impose on these demented and disturbed bodies the surplus-power that I give to reality. I am the surplus power of reality inasmuch as I possess, by myself and definitively, something that is the truth in relation madness. (Psychiatric Power 134).

As Foucault underlines in the quote above, psychiatry has an ultimate power in itself as a field of science. It can justify its operations through the knowledge and discourses it has developed. Since these knowledge and discourses have a scientific character, the field leaves almost no place for any objection. Having established its own truth, it can easily turn into a power of reality. For Foucault, all these statements of psychiatry consequently indicate “what a psychiatrist” calls as “the imprescriptible rights of reason over madness” (Psychiatric Power 135).

As Foucault states before the quotation above, at the time of the establishment and organization of the asylum world, psychiatric practices were not applied so much on the basis of the medical theory. However, on the other hand, Foucault thinks despite this initial appearance of psychiatry, mental health practices have then developed until our own time through a series of “plans, tactical produces, and strategic elements”

(Psychiatric Power 144). Foucault calls these new elements as “a number of game plans 64 or maneuvers” (Psychiatric Power 145). One of these elements is “the maneuver of creating an imbalance of power” (Foucault, Psychiatric Power 146). To Foucault, in the asylum, “right from the start” power must be flown “in one and only one direction”, that is to say, must be flown “from the doctor” (Psychiatric Power 146). In the first confrontation between the patient and the doctor, there must be a “show of force” where

“there is no sharing out, reciprocity, or exchange” (Foucault, Psychiatric Power 146).

Foucault exemplifies this “show of force” through a scene of confrontation between the patient, M. Dupre and a pioneer of French psychiatry, François Leuret:

The first time I approach M. Dupre in order to treat him, I find him in a huge room filled with the supposedly incurable insane. He is sitting, waiting for his meal with his stupid look, indifferent to everything going on around him, completely unaffected by the dirtiness of his neighbors and himself, and seeming to have only the instinct to eat. How to bring him out of his torpor, to give him some real sensations, to make him a bit attentive? Kind words do nothing: would severity be better? I pretend to be unhappy with his words and conduct; I accuse him of laziness, vanity, and untruthfulness, and I demand that he stand upright and bareheaded before me (Leuret qtd. in Psychiatric Power 146).

Foucault thinks this first encounter between Leuret and his patient shows what he calls as “the general ritual of the asylum” (Psychiatric Power 146). In this scene, there is certainly an imbalance of power. It is striking that the psychiatrist thinks kindness never works. He thinks he must be in a position that continuously accuses and commands his patient. He must necessarily look dissatisfied with the patient’s appearance, behaviour, and statements. There is evidently a relation of force in this scene, which pushes the patient down to the bottom while pushing the doctor up to the top.

Besides this power imbalance, the second maneuver developed in the asylum practices is “the reuse of language” (Foucault, Psychiatric Power 149). The language which is repeated or reused by the psychiatrist is usually the language of commands. It is a language “peculiar to the asylum”; it is “the master’s language” (Foucault,

Psychiatric Power 151). Through this sort of language, the patient does not discover anything during interviews; he is rather directed to notice “the reality of an order, of a discipline, of a power imposed on him” (Foucault, Psychiatric Power 151). In addition to the use of that language of commands, the third maneuver set up in the asylum is “the management or organization of needs” (Foucault, Psychiatric Power 152). To Foucault, psychiatric power first creates “needs” for individuals and then manages these

“deprivations it establishes” in order to compel the patients to act in accordance with its ultimate aim (Psychiatric Power 155). In the case of Dupre’s treatment, the doctor,

Leuret employs this principle.

Dupre never wants to work since he does not believe in the value of money; he says “there is nothing but counterfeit money since I, Napoleon, am the only person who has the right to mint coins” (Foucault, Psychiatric Power 152). In this case, the first thing to be done for Dupre is making him realize the need for money. One day, Leuret forces him to work, but he hardly does work. At the end of the day, although Dupre is suggested to take his salary in return for his day’s work, he refuses to take the money on the grounds that it has no value. However, he is forced to put the money into his pocket and sent to his ward with no food or drink for the night and the following day as a punishment for having refused to take his salary. Meanwhile, a nurse who has been prepared in advance is sent to him. The nurse says: “Ah! Monsieur Dupre, how I pity you not eating! If I was not afraid of Moniseur Leuret’s authority and punishment I would bring you something to eat; I am prepared to take this risk if you give me a little reward” (Foucault, Psychiatric Power 153). Thus, M. Dupre is encouraged to give her some money from his pocket. At that moment, Dupre begins to recognize “the meaning, or, at least, the usefulness of money” (Foucault, Psychiatric Power 153). Then, Dupre begins to go to work in order to get the price for a day’s work. As Foucault states, this tactic establishes the patient “in a state of deprivation” (Psychiatric Power 153). The

66 individual is first deprived of something and then he is encouraged to behave according to the rules in order to get the thing he is deprived of. To Foucault, above this food deprivation and all other possible deprivations, the great deprivation set to work in the asylum is “the deprivation of freedom” (Psychiatric Power 155). He thinks only through the deprivation of freedom, the patient can easily be compelled to act in accordance with the dominant will of the doctor.

The last maneuver of the asylum system is “the statement of truth” that is the last phase of the therapy, in which the patient must be compelled “to tell the truth”

(Foucault, Psychiatric Power 157). In the example of Leuret’s treatment, Dupre claims that “Paris was not Paris”, “the king was not the king”, “himself was Napoleon”, and

“Paris was only the town of Langres that some people disguised as Paris” (Leuret qtd. in

Foucault, Psychiatric Power 157). Following these claims, Leuret takes his patient to

Paris and organizes a tour in company with an intern. The intern shows Dupre the various monuments of Paris and asks him if he does not recognize Paris, but Dupre replies “No, no, we are here in the town of Langres. Several of the things in Paris have been copied.” (qtd. in Foucault, Psychiatric Power 157). When Dupre is taken back to the hospital at Bicetre, he still refuses to have visited Paris. This time Leuret puts his patient in the bath and under cold water. Thanks to this punishment, Dupre says everything his doctor wants to hear. However, when he is taken out of the bath, Dupre returns to his mad ideas. Leuret then gives his patient a notebook on which he commands Dupre to give the written answers to the questions he asks him:

Your name? – Dupre. – Your profession? – Lieutenant. – Your place of birth? – Paris. – How long were you at Charenton? – Nine years. – And at Saint Yon? – Two years and two months. How long have you been in the section for the treatment of the insane at Bicetre? – Three months; for three years I have been incurably insane. – Where did you go yesterday? – In the town of Paris. – Do the bears talk? – No. (Leuret qtd. in Foucault, Psychiatric Power 158).

Leuret carries out this stage several times along with the punishment of cold shower.

While repeating the stage, he keeps writing on the notebook Dupre’s story or, everything Dupre can recall of his childhood; he writes down the name of Dupre’s lodgings, the name of his schools, teachers and schoolfellows (Foucault, Psychiatric

Power 158). Thus, the psychiatrist introduces “the auto-biographical account” into his psychiatric practice (Foucault, Psychiatric Power 158). Through this example scene,

Foucault emphasizes the importance of “telling one’s life story” in terms of the disciplinary function of this final episode of treatment (Psychiatric Power 158).

According to him, “the truth” here does not actually have to be recognized by the patient; the truth “has to be said” by the patient even if it is said under the restraint of a punishment (Foucault, Psychiatric Power 159). Therefore, Foucault argues that no matter whether the patient really perceives the truth about himself, it is highly important for the patient to confess or actualize the truth that is imposed on him by the power in the asylum.

When all these asylum elements, techniques, methods, and maneuvers have been examined based on Foucault’s analysis, it clearly appears that Foucault does not view psychiatric practice as a therapeutic intervention or as an effort simply made for the cure of mental illness; he rather approaches it as a specific way of managing, directing, and taming the individual. For exactly this reason, he states that psychiatric power is

“mastery, an endeavor to subjugate” (Foucault, Psychiatric Power 174). Through the following quote which presents the self-questioning of the Saint-Yon asylum’s director,

Foucault actually points to that main function of psychiatric power:

In the asylum, I direct, I praise, reward, reprimand, command, constrain, threaten, and punish every day; and for why? Am I not then a madman myself? And everything I do, my colleagues all do likewise; all, without exception, because it derives from the nature of things. (qtd. in Psychiatric Power 174).

The director questions his and his colleagues’ function in the asylum, contemplating on the reasons why they direct, restrain, judge, command, and threaten the patients. The director’s answer lies in “the nature of the things”. In substance, this answer points to what Foucault tries to unveil throughout his whole analysis of psychiatric power because all these unfavourable acts of the staff are attributed by the director to the inescapable elements of what Foucault actually analyses as the disciplinary nature of psychiatry.

CHAPTER II

PSYCHIATRIC POWER AND CONTEMPORARY BRITISH DRAMA

Contemporary British drama presents a considerable amount of works dealing with the theme of madness as a socio-political issue. These plays usually tell the stories of individuals who are defined as ‘mad’ due to their ‘deviant’ behaviour or thoughts that do not meet the prevailing social standards of normality. In some plays these characters appear as political dissidents exposed to stigmatization in a totalitarian society which does not tolerate political opposition, or in some others, they are coloured people excluded and marginalized due to racial conflict. Such characters, who ‘fail’ or refuse to meet social expectations in one way or another, usually experience mental health problems as a consequence of social oppression exerted upon them for either their perceived abnormalities or for disrupting the existing social harmony. Perceived as a challenge and threat to the prevailing social order, most of these characters are compulsorily placed in mental institutions and subjected to disciplinary practices for the correction and normalization of their ‘deviances’ in accordance with the commonly held social expectations.

Psychiatric treatments in these institutions generally include oppressive practices such as isolation in locked wards, involuntary medication, electric shocks, constant surveillance, physical constraint, and verbal violence, all of which look like punishments rather than therapeutic interventions. Through a focus on such coercive practices taking place in mental institutions and usually targeting the socially undesirable behaviour and attitudes of characters, these plays direct a remarkable criticism at the association of mental illness with social deviance and the disciplinary function of psychiatric institutions over the certain members of society. Thus, the plays contribute to an argument which has always been mounted by social scientists and even by psychiatrists about whether madness is really a medical disease that can be correctly

70 diagnosed and cured, or merely a phenomenon socio-politically constructed to punish and eliminate the ‘abnormalities’ that might violate the existing social order.

Playwrights who explore the theme of madness as a socio-political issue all contribute to this argument by creating certain socially unwanted mad characters in line with their individual concerns. British dramatist Sarah Daniels who has feminist concerns identifies madness as a phenomenon usually attributed to women who deviate from the gender-based expectations of patriarchal society. In her play, The Devil’s

Gateway, for instance, she portrays Betty as a woman who can be easily labelled as

‘mad’ by her husband as soon as she deviates from her domestic role. In the play, the husband actually defines any woman who does not share his thoughts and values as

‘mad’ or as a ‘lunatic’. In Scene One, when Betty’s mother mentions the women protesting nuclear weapons, he takes pleasure in labelling those women as “lunatics”:

Carol Where’ve you been? There are a group of women living rough on some common as a protest. Betty What protest? What common? Carol They don’t like the idea of nuclear weapons. Betty Oh. (Pause.) Does anyone? Carol But it’s a bit naïve, not to say daft. Betty But why live on a common? Why not sit in the Houses of Parliament? Jim (exasperated).Because the common is where the government is hoping to put the missiles. Betty Oh. Jim It’s silly because they think they’ll stop them. Ha ha ha. Bunch of lunatics. (Daniels, Sarah Daniels Plays: 1 82).

In a similar vein, in Daniels’s another play, Gut Girls, Arthur attributes his wife’s ‘deviation’ from her role as a wife to suffering from a mental disorder. The play follows the stories of women struggling to earn a decent living, working twelve hours a day at Deptford Foreign Cattle Market. These women are maltreated and marginalised, and stuck in an undesirable way of life until the upper-class Lady Helena decides to

‘improve’ them and teach them to be ‘proper’ ladies, training them for a life as domestic servants. In the play, Arthur thinks his wife should behave in accordance with her social status and her role as a ‘dutiful’ wife, accompanying him to the feasts that Lady Helena gives: “You are my wife. It’s your duty to come with me. Besides I promised Helena you’d be there. Stop this reclining nonsense.” (Daniels, Sarah Daniels Plays: 2 83-84).

When his wife does not act in accordance with his expectations, he labels her as

‘insane’:

Arthur (exasperated) … My dear, if you carry on like this I shall be left without excuse or option but to call the doctor in, for there is plainly something wrong with your head. Priscilla It is not my head but my heart. Arthur Healthier looking women than you are filling up the asylums today. Priscilla (panics) No, I’m perfectly sane. Perfectly. Arthur Of course you’re not, and I shall vouch for that fact, why would a sane woman refuse to see her friends? Priscilla They’re not my friends, merely acquaintances of yours. Arthur Refuses to go out with her husband, refuses to leave the house, preferring instead the servants for entertainment. My dear, these are the values of a mad woman. (85).

As the lines above demonstrate, Arthur thinks as a ‘dutiful’ wife, Priscilla has to accompany him to the feasts and must show her respect to his acquaintances even though she does not want to go out for any reason. However, Priscilla does not comply with such marital expectations of his husband and prefers to socialize with the servants instead of going to the feasts with her husband. For that reason alone, Arthur labels her wife as ‘insane’ and goes so far as to think that she can be confined to a mental asylum.

Daniels’s plays explore the issue of madness in women specifically linked with men’s physical, emotional, and sexual abuse as well. Her madwoman figures usually experience mental and psychological disorders following an abuse case mostly caused by male family members such as fathers or father figures. In Beside Herself, for instance, Evelyn is a mentally ill character who struggles with the trauma of her father’s

72 sexual abuse in her childhood years and in The Madness of Esme and Shaz, Shaz is again a woman who was taken into special care after being sexually abused by her father as a child.

Anthony Neilson’s The Wonderful World of Dissocia also provides a significant example to the connection between women’s experience of sexual abuse and their deteriorating mental health. In this play, the mentally ill character, Lisa who suffers from dissociative identity disorder is possibly a victim of sexual abuse. In the first act of the play, Lisa is visited by a mysterious visitor – a watch repairman – who explains to her that her watch is not slow; she has in fact lost an hour of her life since she was on a transatlantic flight when the clocks changed. As the repairman claims, Lisa’s recent troubles stem from this accidental loss of an hour of her life. As he further asserts, Lisa has to visit Dissocia in order to get back the moments she has lost and to regain her psychological balance. To this end, in the first act, Lisa goes to Dissocia – a colourful, funny, exciting, brutal and surreal landscape – where she meets a singing polar bear, a talking scapegoat, and bumbling insecurity guards. In the play, the possibility that Lisa may have experienced mental disorder due to her experience of childhood sexual abuse is actually underlined by the Goat who attempts to rape her in Dissocia and questions her about her childhood, implying that she can blame him for something bad:

Goat How about your childhood? You could blame me for that. Pause. Lisa There’s nothing to blame you for. Goat Nothing? Lisa I had a very happy childhood, thank you. I was a very happy little girl. (Neilson, The Wonderful World of Dissocia & Realism 37).

In these lines, Lisa thinks she was happy when she was a child though in reality she was a victim of sexual abuse. However, she created an alternative personality at the time of her sexual abuse which is hinted in the play. Lisa’s mental disorder, dissociative identity

73 disorder, which is commonly accepted to develop as a response to trauma caused by the instances of physical, sexual, or emotional abuse in early childhood, also indicates that her multiple personality disorder is related to the abuse she experienced during her childhood.

Another contemporary British playwright, Sarah Kane’s maddened characters are generally the victims or the witnesses of various human rights violations. For instance, in 4.48 Psychosis, a significant paragraph implies that the mentally ill character feels a kind of collective guilt for all crimes against humanity:

I gassed the Jews, I killed the Kurds, I bombed the Arabs, I fucked small children while they begged for mercy, the killing fields are mine, everyone left the party because of me, I’ll suck your fucking eyes out send them to your mother in a box and when I die I’m going to be reincarnated as your child only fifty times worse and as mad as all fuck I’m going to make your life a living fucking hell I REFUSE I REFUSE I REFUSE LOOK AWAY FROM ME (Kane 227).

Through the lines above, Kane essentially underlines that it is quite difficult for sensitive persons who cannot be deaf to the violence in society to remain sane.

In a similar fashion, Scottish playwright Anthony Neilson’s Penetrator presents a character who suffers from post-traumatic mental disorder as a consequence of his exposure to violence as witness and victim. Tadge is a soldier who has just escaped military service during the Gulf War since he experienced intense traumatic events including mass killings, rape and torture. He is no longer the person that his friends Max and Alan once knew. He speaks and acts in a strange, unpredictable fashion that causes them to think he is mentally deranged. For instance, Tadge does not want Max to call him by his former name any longer, and when he is asked his name, Tadge replies, “I don’t know, do I? I don’t have a name.” (Neilson, Anthony Neilson Plays: 1 98). He also claims Ronnie is not his real father, and it is the US army general Norman

Schwarzkopf, commander of the American forces in the 1991 Persian Gulf War,

74 instead. In addition, Tadge frequently mentions a group of “penetrators” who inflicted him with extreme violence and torture. Even when he is not in danger, he uncontrollably believes that they are constantly following him: “No they’re everywhere, not just the army, not just the ... the Penetrators, they’re every ... you don’t know ...”

(102). He often has flashbacks and tells the scary moments of torture and abuse he experienced and witnessed in military service:

Tadge You don’t know what it was like. In the dark. All shrivelled up. Just my hatred keeping me alive. Their hands all over me. And you never came for me. Their dirty cocks in my mouth, up my arse. I know how to kill a man. I’m not afraid. I’ve seen guys get their ears cut off. I’ve seen lassies with their cunts shot out. (109).

As the play progresses, the devastating impact of violence and abuse on the character’s psychology and mental health becomes clearer through his odd behaviours. At one point, his friend Alan refers to him, saying “He is off his nut! He is a psychopath! We should call a doctor that’s what we should do!” (90).

In addition to the plays already mentioned, Caryl Churchill’s The Hospital at the

Time of Revolution, Linda Mclean’s Every Five Minutes, and David Edgar’s The Jail

Diary of Albie Sachs also present ‘mad’ characters who have been victimized by socio- political conditions. The Hospital at the Time of Revolution takes place in a psychiatric hospital of the 1950s Algeria during its struggle for independence from France. Among the patients treated in this hospital, the play presents the teenage daughter of a French

Algerian civil servant, a group of revolutionists who feel shell-shocked and a French

Algerian policeman who wants to quit his job because of his tendency to commit violence towards his family at home which most likely stems from the use of force in his line of work. The play points out that it is almost impossible to keep one’s sanity in a society suffering from the turmoil of battle and the sickness of racism under colonial rule.

As for Every Five Minutes, it tells the tragedy of Mo who was imprisoned unfairly and subjected to torture for years. Having returned home, Mo cannot escape from his bad memories. He consequently begins to suffer from a kind of dream-reality confusion and turns into a mentally-deranged person; he cannot differentiate between what is real and what is nightmare. Similarly, in David Edgar’s The Jail Diary of Albie

Sachs, the character who tries to retain his sanity is a character who has experienced injustice. He is a South African lawyer subjected to prolonged isolation in a concrete cell without a chair and just the Bible to read. He is kept under the 90-day Law without any specific charge due to his speech against apartheid law.

Scottish playwright Iain Crichton Smith’s Lazy Bed tells the story of a character whose ‘odd’ behaviour and thoughts are again attributed to suffering from madness.

This time, the deviance of the insane character is his reluctance to work. The middle- aged man, Murdo insists on staying in bed since he sees no point in working in a world where there is no belief in aims and purposes for the human race anymore (Smith,

Lazybed 340). A series of visitors come and try to convince “useless” Murdo to get out of bed while the neighbours think he is either lazy or mental. The minister, for whom the purpose of work is the kingdom of god, finds Murdo’s views on life and work dangerous, and believes that he has “delusions of grandeur” and is “a limb of Satan”.

(327). Murdo’s brother accuses him of having always been “odd”, defining him as a

“nutcase” and disgrace for being a fully grown man who refuses to leave his bed.

Among all these visitors, there is a specialist whose materialistic comments about the

“idleness” of Murdo provide a remarkable source for criticism of capitalist culture which actually does not care about the physical or mental health of people but just focuses on making a profit even in their grief and poverty. For instance, when Murdo asks the specialist whether or not the drugs will give him back his will to work, he says,

“I cannot say about that but their sale will help the drug company.” (337). It is worth

76 noting that the contemporary plays which depict madness as a political concept within the frame of abnormality or social deviance also direct a particular criticism at the profit motive of pharmaceutical companies which attempt to drive the drugging of a wide range of people by playing upon their complex personal or social problems.

British playwright Lucy Prebble Connie’s The Effect remarkably contributes to the argument about the controversial functioning of drug companies. The play is about a four-week pharmaceutical clinical trial for a new antidepressant run by a pharmaceutical company called Rauschen. The guinea pigs, Tristan and Connie, isolated from the outside world and under the supervision of doctors, are medicated with a powerful psychiatric drug which causes aggressive behaviour and paranoia. As the doses get stronger, Tristan and Connie begin to experience worse side effects of this unnamed drug which has been designed to increase dopamine levels and make the patient happier.

Although the trial director, Dr James wishes to discontinue using the drug due to its negative side effects, the other doctor, Toby refuses with the excitement of the possibility that the drug company has discovered “a Viagra for the heart” because he notices that the trialists have weirdly developed an emotional attraction and this attraction has turned into deeper feelings with dosage increase (Prebble 57). Though this cause could be interpreted and questioned ethically in terms of manipulating the individuals’ emotions and feelings, Toby prefers to see the case as a cause celebre and a possibility of making great profit. In this context, Kane’s 4.48 Psychosis presents a noticeable detail about the controversial effects of psychiatric drugs and the profit motives of companies as well. In the play, the mental patient who has been affected adversely by the increased doses of drugs suddenly begins to have “homicidal thoughts” towards several doctors and “drug manufacturers” (Kane 224).

In David Edgar’s Mary Barnes, which takes place at Kingsley community centre, there is a significant scene which points out the economic grounds that

77 psychiatry securely depends on. But this time, the emphasis lays on how the capitalist system itself plays a great role in the emergence of people’s psychological distress and maddening. One of the characters, Brenda states the main point during a dinner talk of the residents:

Brenda You see, the very word is invalid. Invalid. You know, in feudal times, there were no mad, or sane defined as such. Communities supported those who couldn’t work, quite automatically. But then, when people started being paid in cash, as individual workers, then the criminal, the ill, the lunatic, were separated off. Defined as ‘other’. On the grounds of being unexploitable. Their functioning impaired. Douglas You what? Brenda It’s even more. … People are defined by their relations to commodities. I own, therefore I am. You are the things you buy. Douglas And that’s …? Brenda (impatiently). I mean, the system, buying, selling, people viewed as things, that drives them mad. (Edgar 116-117).

Brenda makes a criticism of the ‘invention’ of madness on the ground of exploitation.

Because the system of capitalism depends on the productive labour of individuals, the mentally or physically impaired individuals who cannot work productively are perceived as an economic burden for society and their functioning turns into a ‘defect’.

For the system, these individuals become “invalid”. In the play mentioned above, Lazy

Bed, Murdo is also considered “inefficient” and “mental” by his surroundings and some authorized persons simply because he fails or refuses to work. They also think he poses a threat to society since he would set a bad example for the rest of society. For this reason, the minister visiting Murdo worries about the possibility that he might affect the others in the village negatively: “What if everybody in the village took to their beds?”

(Smith, Lazybed 327). In the quote from Mary Barnes, Brenda also points out the consumerist culture that defines individuals not with the humanitarian values such as kindness, honesty, respect but with the goods they can afford to possess. This consumerist culture consumes everything in general, but especially humans. People

78 always desire to possess as the consumerist system constantly invites them to obtain products and goods in excess of their basic needs such as having sufficient food, clothing and shelter. In time, people become estranged from their own personal interests, purposes and concerns. And especially when they cannot afford to possess, they are inevitably driven to psychological distress and depression.

Scottish playwright Anthony Neilson’s Normal has special importance in that it provides a different perspective on insanity. The play, as a whole, explores how Peter

Kurten who experienced a violent and abusive childhood turns into a serial killer. In other words, the play examines how a victim becomes a victimizer. But more importantly, the play highlights the notion of ‘danger’ frequently attributed to insane persons by the majority of society. At the very beginning of the play, when the naive young lawyer, Justus Wehner remembers the moment he was appointed to defend

Kurten, a serial killer who committed nine murders in 1929 in Düsseldorf explains why he intended to prove his client ‘insane’:

Wehner So that was my gift: I was to be his defence lawyer. It was a prestigious case, and in those still liberal times it seemed that it might easily be won. After all, I did not have to prove him innocent, Just insane. And he was surely that. (Neilson, Anthony Neilson Plays: 1 6).

When Wehner is inducted as his defence lawyer, he feels that he can easily save

Kurten from death penalty by proving him to be insane. This detail is crucial in that it implies the social perception that views mental illness as a state of mind which liberates or makes the person poised for committing crime. Wehner wants to take the advantage of this social perception of insanity that stigmatizes mentally deranged individuals as dangerous people inclined to crime. As it is not difficult to criminalize mentally ill

79 people, this perception also renders it possible to compound a criminal’s felony by claiming that he was insane at the time of the crime.

All the plays mentioned above present an array of characters who are either labelled as ‘mad’ due to any deviance from the established behavioural and intellectual norms of society, or unluckily ‘maddened’ as a result of exposure to abuse and violence as witness or victim. In the plays, these insane characters are generally incarcerated in an enclosed area like a hospital room, ward or cell and forced to get involuntary psychiatric treatment. The treatments frequently include physically or verbally violent practices which seem to have no therapeutic purpose and even cause the patient to experience much worse situations. Through these violent ‘treatment’ scenes, the plays essentially pose a question about whether the purpose of psychiatric implementations is to treat the unsound individuals or to punish the so-called misfits of society through the enforcement of certain norms.

Sarah Kane, in almost every play, raises the issue of institutional violence exercised over the ‘mad’. For instance, in Cleansed, the tragedy of mental patients begins in the family circle and then continues in the hospitalization period with constant surveillance, physical beatings, involuntary medication, commonly used instructive words and brutal sexual assaults. Taking place in an old university campus which is now used as a mental institution, the play presents extremely violent scenes where the hospital looks like a concentration camp, and the doctor Tinker seems much more like a torturer rather than a medical practitioner. Throughout the play, Tinker continually watches and controls the inmates everywhere in the institution. He tests the patients’ limits and punishes them through cruel acts in any case of non-obedience. In Scene

One, for instance, he heats up and then injects heroin to Graham’s eyes and finally causes his death. In Scene Four, he has another inmate, Carl beaten by a group of men in the institution:

Carl is being heavily beaten by an unseen group of men. We hear the sound of the blows and Carl’s body reacts as if he has received the blow. Tinker holds up his arm and the beating stops. He drops his arm. The beating resumes. Carl Please. Doctor. Please. Tinker holds up his arm. The beating stops. Tinker Yes? Carl I can’t – Any more. Tinker drops his arm. The beating continues methodically until Carl is unconscious. Tinker holds up his arm. The beating stops. (Kane 116).

Such violence on inmates continues throughout the play as in Scene Sixteen in which the doctor kills Rod by cutting his throat and tells Carl to burn him. Besides the doctor’s extreme acts of violence, the institution seems to have inhumane and unhygienic conditions as well since rats continually scuttle around the inmates.

In Kane’s another play 4.48 Psychosis, the hospitalized mental patient feels frightened and ashamed under the permanent surveillance of doctors. S/he repeatedly utters the lexis, “shame”, and says “Look away from me!” (Kane 230). When the unnamed patient once attempts to leave the hospital against medical advice, she is immediately restrained by three male nurses twice her size. In addition, after each medicalization, s/he experiences much worse situations like short term memory loss, increase of paranoid thoughts and emergence of more delusional ideas, all of which bring into question the therapeutic use of psychiatric medications.

In a similar fashion, Lucy Prebble Connie’s The Effect points out the controversy surrounding the efficiency and reliability of psychiatric drug treatments. Prebble’s inspiration to write this play comes from a drug trial held in Northwick Park Hospital in

North London in 2006 which went frightfully wrong and consequently caused six male volunteers to suffer horrific side effects such as multiple organ failure as well as lost

81 fingers and toes. The Effect, as mentioned above, takes place at a psychiatric hospital for a pharmaceutical clinical trial for a new antidepressant in which Tristan and Connie sign a protocol to become guinea pigs. As the dose of the drug gets stronger, they begin to experience side effects such as increased pulse, feeling of sickness, shaking, giddiness, poor appetite, enhanced perception, and insomnia which would also worry the trial director, Dr James. Tristian repeatedly says “Something’s wrong, I can feel it.” due to the drug-induced tension. As the play progresses, it manifests Dr James’s inner thoughts about the therapeutic efficacy of psychiatric drugs: “It is essential. You know, the history of medicine is mostly just the history of placebo since we know now almost none of it worked.” (Prebble 72). Moreover, he once says “there is no real evidence for the efficacy of anti-depressants, there never has been. / Everyone knows, knows this has been the biggest disaster in the history of medicine!” (Prebble 84). These words are significant in that they present the confession of a psychiatrist to her colleague about the non-therapeutic operations of psychiatry.

In contemporary political plays which depict the notion of madness, doctors or psychiatrists are not usually portrayed like this character, Dr James who actually raises ethical questions concerning the treatments administered over the mad. Psychiatrists in most political plays are portrayed as persons whose mission is not to cure the patients but to punish and correct their socially undesirable behaviour and attitudes. In the plays, the authorized persons who apply these treatments are not just psychiatrists but also nurses, social workers, community carers, guards or religious officials. They commonly become the persons who operate on the souls and bodies of individuals in an attempt to correct and normalize their perceived deviances in accordance with social norms and values. In Caryl Churchill’s Lovesick, for instance, the psychiatrist Hodge who

82 approaches love and desire as no different from sickness practises aversion therapy2 in an attempt to regulate the sexual orientation of his patients. This remarkable detail indicates that the psychiatrist functions as a sort of moral and juridical authority in accordance with his own beliefs and values rather than a medical practitioner who acts on the basis of objective scientific knowledge.

In another play, Daniels’s Beside Herself, there is a significant scene that similarly points out the juridical attitudes of doctors towards mental patients. In Scene

Two, the management committee of St. Dymphna’s Community Group Home gather in order to discuss who should be admitted to that mental facility. During that meeting, when Evelyn asks “Suppose someone’s so depressed they don’t talk at all?” (Daniels,

Sarah Daniels Plays: 2 126), the psychiatrist, Roy finds the chance to belittle women:

“I have a foolproof method, Evelyn, for spotting depression, in women at least. If it gets past four o’clock in the afternoon on the day they’re admitted and they still haven’t asked for a cup of tea – they’re depressed.” (126). The psychiatrist’s comment actually reflects his hatred, dislike, mistrust, or mistreatment of women since he specifically needs to say “in women at least”.

The verbal and physical violence that mad characters experience in psychiatric institutions throughout the plays indicate that these authorized persons – psychiatrists, nurses, or guards – have an unlimited and unquestionable power in meeting the expectations of society. For instance, In 4.48 Psychosis, the doctor is seen by the patient as “the saviour, the omnipotent judge, the priest, god, and the surgeon of soul” (Kane

233). S/he wants to be judged, legalized and forgiven by the omniscient and competent doctor. But on the other hand, s/he also says “Stop judging by appearances and make a right judgement.” which points to the non-objectivity of psychiatric diagnoses. (229).

2 Aversion therapy is a kind of psychotherapy in which the patient is administered nausea-inducing drugs and is confronted with the images of his/her ‘undesirable’ behaviour and habits. In the process of this therapy, the patient is expected to associate his/her ‘abnormal’ behaviour or habits with nausea and vomitting. For instance, a person with alcohol problems is confronted with the images of alcoholic beverages while he/she is nauseated by drugs. 83

Such scenes strikingly highlight the arbitrary attitudes of doctors towards their patients. This arbitrariness is also emphasized through petty but striking details in the plays. For instance, in Smith’s Lazybed, when the specialist comes to convince Murdo to get up to start working, he says for the tablets he advises, “You must take two of these tablets every day. They are a nice colour: I chose it myself. Also they are very cheap.” (337). The specialist’s choice of tablet does not depend upon the type of the mental disorder that he thinks Murdo suffers from, but upon the nice colour the tablets have. This remarkable detail is sarcastically underlined by the psychiatrist himself.

As it can be observed from this brief survey, in most of the contemporary British plays dealing with the theme of madness, ‘mad’ or ‘mentally ill’ characters are usually portrayed as individuals who have either deviated from the established behavioural norms of a particular society, or have been unluckily ‘maddened’ as a result of their unfortunate experiences mostly caused by social factors such as oppression, discrimination, violence, or abuse. In addition, most of these ‘mad’ characters appear to be considered a potential threat and burden on mainstream society. Therefore, they are involuntarily placed in psychiatric institutions and exposed to disciplinary practices in those institutions for the suppression and correction of their socially unwanted behaviour and attitudes.

CHAPTER III

PSYCHIATRIC POWER AND SUPPRESSION OF POLITICAL DISSIDENCE:

TOM STOPPARD’S EVERY GOOD BOY DESERVES FAVOUR (1977)

The twentieth century witnessed a rise in the misuse of psychiatric procedures – diagnosis, treatment, and detention – for political purposes by some totalitarian regimes.

In this respect, Nazi Germany under Hitler and the Soviet Union became probably the most notorious instances. In Nazi Germany, psychiatry was abused for the government’s racist and eugenic ideologies (Lifton, 1986; Friedlander, 1995; Proctor,

1998). Since the National Socialist government dreamt of “a perfectly rational social order based on the purity of race” (McFadyen 85), it designed its policies to eliminate all groups of people whose presence it thought would hinder the realization of that dream. Among these groups were “communists”, “liberal democrats”, “inferior races

(Slavs and Poles)”, “racial enemies (Gypsies and Jews)”, and “the mentally handicapped” (McFadyen 85). In the brutal oppression and the mass murder of these populations considered a social threat and an economic burden on the State, psychiatrists along with other physicians took an active role, working in a close

“collaboration with police and local government authorities” (Kershaw 103).

Psychiatrists provided the theoretical support, sharing “the analysis about degeneration among the lower classes advanced by their colleagues from the fields of biology, genetics, and anthropology” and transforming “the term ‘degeneracy’ into a

‘diagnostic concept’ by applying it to such conditions as alcoholism, homosexuality, and hysteria” (Bergmann, Czarnowski, and Ehmann 122 qtd. in Friedlander 9). Thus, psychiatrists facilitated the transfer of many undesirable individuals from all over

Germany to psychiatric institutions. In addition, they even provided the transfer of hundreds of psychiatric inmates from hospitals to “euthanasia institutions” that were placed “across Germany, at Brandenburg, Grafeneck, Hartheim, Sonnenstein, Bernburg,

85 and Hadamar” (Strous 27 qtd. in Cohen 183). At these centres, many of the targeted people mentioned above were gassed and killed. “In May 1943 the psychiatric hospital at Hadamar”, for instance, “began exterminating Jewish children”; “more than 5,000 children were killed” only “in this first phase of the German euthanasia program”

(Mielke and Mitscherlich qtd. in Proctor 188). In addition, “From July 1944 through the spring of 1945”, “400 Russians and Poles were gassed in the psychiatric hospital at

Hadamar” (Mielke and Mitscherlich qtd. in Proctor 209). Furthermore, “In June 1940” when “the first gassings of Jews took place”, “two hundred men, women, and children died in the Brandenburg facility”, having been transferred there “from the Berlin-Buch mental institution” (Lifton 77). These statistical data show that hundreds of men, women, and children, who were perceived by the Nazis as a threat and burden on the state and the society due to their either ethnicity or physical and mental disabilities, were gassed and killed by the regime, and psychiatric professionals participated in the construction and implementation of these racial and eugenic policies.

In a similar, but not quite identical, way, psychiatric procedures were misused in the Soviet Union for political purposes. In the Soviet Union, political opposition to the regime was interpreted by the authorities as a form of mental illness and dissidents were compulsorily incarcerated in mental institutions. In this process, probably the most infamous of the diagnoses used by Soviet psychiatrists was “sluggish schizophrenia” which involved such symptoms as “philosophical intoxication” and “delusions of reformism” (Park et. al. 365 qtd. in Cohen 187). Some other “key phrases” usually employed in the “clinical reports” to advocate this diagnosis were “uncritical attitude to his abnormal condition”, “overestimation of his own personality”, and “poor adaptation to the social environment” (Bloch and Reddaway 41). In terms of its medical legitimacy, this diagnosis category “was repeatedly challenged by psychiatrists from around the world, who raised particular concerns about the dubiously defined manner in

86 which it was diagnosed” (Hurst 14). Such concerns revolving around the ambiguity of diagnosis caused suspicions about the non-objectivity and reliability of this diagnosis and therefore caused it to be seen as a condition invented by the regime to legitimize the incarceration of dissidents in psychiatric hospitals. “The poet Natalya Gorbanevskaya” was one of such dissenters “diagnosed along with hundreds of others with ‘sluggish schizophrenia’”; she “spent three years in a prison psychiatric hospital” (Judt 575).

Among them, another dissident, “Vladimir Bukovsky” was put into a mental hospital

“for compulsory treatment” since he was accused of possessing “anti-Soviet” literature” when he was “arrested by the KGB in 1963” (Judt 425).

The treatments of such political dissidents in Soviet psychiatric hospitals were mostly “not different” from the treatments other “regular persons with mental illness had to endure”; dissidents were similarly “injected with massive loads with psychotropic drugs” and were exposed to “sulphozine-therapy”, “during which a mixture of sulphur and preach extract was injected intravenously in order to induce high fever and coma in order to ‘burn out the poison of mental illness’” (Van Voren 206).

However, according to “the testimony” of some dissidents such as “Vladimir Bukovsky,

Leonid Plyushch, Vladimir and Viktor Fainberg”, there was “a harrowing picture” in special psychiatric hospitals:

… the words punitive, inhumane, cruel and oppressive emerge as common epithets. Corroboration by outside forces is unavailable since, to our knowledge, no Westerner has ever been allowed in an SPH. But the dissenters’ accounts of various SPHs are highly consistent. Brutality by the staff, especially the orderlies, is commonplace. Punishments are regularly meted out. Beatings seem to be the commonest form but have been supplemented by other more “exotic” methods such as the “wet pack”. Wet canvas is tightly bound around the patient from head to foot and as it dries out the canvas gets progressively more taut causing great difficulty in breathing. The administration of drugs is also applied as a punitive measure. (Bloch and Reddaway 27).

From the quotation above, it is understood that the inmates of special psychiatric hospitals had to endure oppressive conditions and practices; they were subjected to surveillance, judgement, verbal violence, and physical restraint. Additionally, no authorities or no visitors from the West were allowed to enter these hospitals.

Special psychiatric hospital (SPH) was one of the two categories of Soviet mental hospitals. Unlike the ordinary psychiatric hospitals (OPH) which were in the jurisdiction of the Ministry of Health, the SPHs were under the direction of “the security forces of the Ministry of Internal Affairs” and the “staffs” were also the “members of these security organs” (Lewy 25). This “connection” with the Ministry of Internal

Affairs created “a direct structural link to government or Party directives” in terms of the hospitalization of political dissenters (Smith and Oleszczuk 31). Hence, rather than the OPHS, the SPHs became “the customary destination” for a dissident “on the grounds that he poses a special danger to society” (Bloch and Reddaway 23).

In the light of the above-mentioned examples, it can be concluded that political dissent was interpreted by the Soviet regime as a form of mental illness and was supressed through the compulsory incarceration of political opponents in psychiatric institutions. Tom Stoppard’s Every Good Boy Deserves Favour (1977) provides a significant example to the use of psychiatric hospitalization as a punitive measure for ideological nonconformity because this play tells the story of a character, Alexander who is confined to a Soviet mental asylum due to his opposition to the prevailing regime. From this point of view, this chapter examines how Every Good Boy Deserves

Favour reflects the abuse of psychiatric procedures for political purposes, or for the oppression of people whose ideologies are considered a threat to the prevailing regime.

With the help of Foucault’s Psychiatric Power, this examination proceeds with the detailed analysis of the specific strategies, methods, and maneuvers whereby the

88 disciplinary power in a Soviet mental hospital is systematically exercised over a political dissident.

Born in 1937 in Zlin, Czechoslovakia, Tom Stoppard whose original name was

Tomas Straussler “spent his earliest years avoiding the Second World War” (Brassel 3).

His Jewish family first had to immigrate to Singapore in 1939 due to the Nazi invasion and then to India in 1942 when Japan invaded Singapore (Brassell 3-4). When Tom, his brother, and his mother moved to India, his father who remained in Singapore was killed not long after his family fled. After the war, Tom’s mother remarried Kenneth

Stoppard, an officer in the British army and the family finally settled in England in

1946, assuming the surname “Stoppard” (Brassell 4). Educated at schools in

Nottingham and in Yorkshire, Stoppard never went to university; he left school at the age of seventeen and began his career as a reporter on the Western Daily Press in 1954, then switching to the Evening World in 1958, where he worked as a second-string theatre critic and wrote weekly film reviews (Brassell 4). Stoppard’s interest in theatre arose in this period. He began his playwriting career with radio and television plays such as A Walk on the Water (1960) which was also staged under the title of Enter a

Free Man in 1968, The Dissolution of Dominic Boot (1964), A Separate Peace (1966),

Albert’s Bridge (1967), Another Moon Called Earth (1967), Neutral Ground (1968), and The Real Inspector Hound (1968). In his early years, Stoppard produced non- dramatic works as well; he wrote a novel, Lord Malquist and Mr Moon (1966) and three short stories, including “The Story”, “Life, Times, Fragments”, and “Reunion”. Late in

1962, he also worked as a drama critic for a new London magazine, Scene where he found the opportunity to review numerous plays.

Stoppard’s biggest success in his playwriting career came with his existentialist tragicomedy, Tony Award winning Rosencrantz and Guildenstern are Dead (1964) which presents an alternative standpoint to Shakespeare’s Hamlet, bringing the

89 characters Ros and Guil into the foreground to tell their own stories. The play premiered at the Edinburgh Fringe Festival in 1966 and was produced at the National Theatre in

1967. This production made Stoppard the youngest playwright to have a play performed at this prestigious theatre of Britain and brought him worldwide success; within its first year the play “was staged in twenty-three countries and was soon translated into over twenty languages” (Fleming, Tom Stoppard’s Arcadia 4). After the success of his first major work, Stoppard continued his productive career with a series of successful plays such as Jumpers (1972), Tony Award winning Travesties (1974), Every Good Boy

Deserves Favour (1977), Professional Foul (1977), The Real Thing (1982), Arcadia

(1993), The Invention of Love (1997), The Coast of Utopia (2002), and Rock ‘n’ Roll

(2006).

In general, Stoppard’s plays present sophisticated debates on a diverse range of themes such as philosophy, ethics, revolution, politics, society, art, metaphysics, science, and history. His plays involve an intellectual playfulness; he examines serious issues within the context of comedy, often through allusions, puns, farcical scenes, witty repartees, word plays, and allusive characters. He usually presents contradictory perspectives, making his characters raise ontological questions and come up with different ideas contradicting each other's views endlessly.

In the early phase of his career, Stoppard avoided entering the debates on political issues. His avoidance from the political debates in his early plays has been interpreted as a deliberate avoidance by some literary critics. John Bull in his essay

“Tom Stoppard and Politics” states that Stoppard refrained from the political issues not because “he was uninterested in politics as such, but rather he put more trust in the process of questioning rather than in attempts to create a fixed ideological position”

(Bull 137). However, towards the end of the 1970s, Stoppard began to address politics more directly. His later plays such as Dogg's Hamlet, Cahoot's Macbeth (1979), The

Coast of Utopia (2002), Rock ‘n’ Roll (2006), Professional Foul (1977) and Squaring the Circle (1984) deal with the political themes of censorship, human rights violations, and state oppression. Stoppard began to engage in such political issues because he was deeply affected by what he saw when he travelled to the Eastern Bloc countries such as the Soviet Union, Poland, Hungary, and Czechoslovakia with a member of Amnesty

International in the late 1970s. During these visits, Stoppard had the opportunity to talk to refugees, prisoners, dissidents, asylum-seekers, exiles and to witness human rights abuses first hand. In these countries, he met the most outstanding political figures who were silenced and subjected to undemocratic experiences. For instance, in Moscow in

1976, he met Victor Fainberg who was sent into exile after five years of imprisonment in the Soviet prison-hospital system. Fainberg was amongst the persons who had been arrested at a protest in Moscow’s Red Square against the Warsaw Pact invasion of

Czechoslovakia in 1968. As a result of this protest, Fainberg had been declared mentally insane by the Soviet regime and incarcerated in a prison-like psychiatric hospital. In addition, in Czechoslovakia, Stoppard met the dissident playwright and the future

President Vaclav Havel who had been imprisoned again for non-conformism.

Influenced by the meetings with such political dissidents, Stoppard developed a specific interest in the issues of human rights and freedom of expression. He “became involved with Index on Censorship, Amnesty International, and the Committee Against

Psychiatric Abuse”, and also “wrote various newspaper articles and letters about human rights” (Srinivasan 61). However, Stoppard still did not use politics in his plays to promote any specific political view or ideology; he employed politics for its moral and humanistic aspects, as he believed “all political acts must be judged in moral terms, in terms of their consequences …” (qtd. in Brassell 158). For this reason, Stoppard specifically concentrated on the realities and the difficulties that dissidents experienced under the oppressive totalitarian regimes. Stoppard’s main motivation behind writing

Every Good Boy Deserves Favour (1977) was also related to his aim to point to the unfair punishment of people for their contradictory ideas and acts with the totalitarian regimes.

Stoppard’s idea for writing Every Good Boy Deserves Favour (1977) first came from the conductor of the London Symphony Orchestra, Andre Previn who invited

Stoppard in 1974 to write a play that would include a live full-size orchestra. Having accepted this offer, Stoppard “spent the next eighteen months searching for an appropriate topic” (Fleming, Stoppard’s Theatre 121). “In October 1974” he started taking notes for “a play about a millionaire who made money selling fruit and who played the triangle in an orchestra he owned”, and “by January 1975” he had made the decision that “the orchestra” would only exist “in the imagination of the millionaire, who was now a lunatic in a padded cell” (Fleming, Stoppard’s Theatre 121-122).

However, Stoppard then noticed that “since the orchestra was in the mind of a lunatic, there was no need for the madman to be a millionaire” (Fleming, Stoppard’s Theatre

122). In the meantime Stoppard was “reading about Soviet dissidents whose political activities” caused their confinement to lunatic asylums (Fleming, Stoppard’s Theatre

122). Besides these readings, Stoppard’s meeting with the political dissident Victor

Fainberg in April 1976 also became influential in the coming out of the play’s subject matter.

Every Good Boy Deserves Favour largely takes place in a Soviet mental asylum.

The play tells the story of a political dissident, Alexander Ivanov who is imprisoned in a mental asylum, from which he will not be released until he acknowledges that his statements against the government were caused by a (non-existent) mental disorder. The play opens with the scene of the unlit hospital “cell” where Alexander meets his ward- mate, also named Ivanov, who is a genuinely disturbed schizophrenic and believes he has a symphony orchestra under his command. These both men are treated by a doctor

92 who plays in a real orchestra. As the play progresses, the hospital scene sometimes changes to a school classroom where Alexander’s son, Sacha appears with his teacher who tries to convince her student of the genuineness of his father’s mental illness.

Although the play proceeds in a gloomy tone due to Alexander’s traumatic memories, it unexpectedly ends on a hopeful note “Everything can be all right!” (37) when both inmates, Alexander and Ivanov are incidentally released from the hospital since their names are mistaken by the colonel during the commission.

In line with Foucault’s analysis of psychiatric power, in Every Good Boy

Deserves Favour (1977), psychiatry is reflected as a form of disciplinary power that serves to define, control, and correct what is deemed as ‘abnormal’ by power and society. In the play, the main character Alexander’s political dissent is perceived as an abnormality which must be suppressed and corrected for the benefit and continuity of the regime. Thus, his political dissidence is labelled as a form of mental disorder and he is involuntarily put in a psychiatric hospital.

From the very beginning of the play, Alexander himself reveals the real reason for his incarceration, saying to Ivanov that it was “political” (18). Alexander then tells the beginning of that process in another scene in more details:

Alexander One day they arrested a friend of mine for possessing a controversial book, and they kept him in mental hospitals for a year and a half. I thought this was an odd thing to do. Soon after he got out, they arrested a couple of writers, A and B, who had published some stories abroad under different names. Under their own names they got five years’ and seven years’ hard labour. I thought this was most peculiar. My friend, C, demonstrated against the arrest of A and B. I told him he was crazy to do it, and they put him back into the mental hospital. D was a man who wrote to various people about the trial of A and B and held meetings with his friends E, F, G and H, who were all arrested, so I, J, K, L and a fifth man demonstrated against the arrest of E, F, G and H, and were themselves arrested. D was arrested the next day. … (23)

The chain of these events continues in the same way with different writers and different friends; all of them were arrested and sent to mental institutions due to their political 93 opposition. Alexander is similarly arrested and put in a psychiatric hospital since he writes to newspapers and foreigners to inform them that sane people were being put in mental hospitals for their political opinions. As the course of the events shows,

Alexander and his friends were hospitalized not because they were medically diagnosed to suffer from a mental disorder but because they were judged to have acted against the regime. As Şenlen Güvenç states, “It clearly appears in the play that mental hospitals are used to extend the views of the ‘state’ and to ‘treat’ the individuals who adopt

‘wrong’ opinions” (32). Thus, psychiatric hospitalization and treatment were not used for any therapeutic function in the play; these psychiatric procedures were utilised by the regime to manage, direct, and tame these non-obedient individuals.

According to Foucault’s analysis of disciplinary power, it is possible to say that

Alexander and his friends are ‘residual’ characters. In disciplinary systems, while classifying and hierarchizing the individuals, disciplinary power comes up against some individuals who refuse to be classified or refuse to adopt a rank. These individuals cannot be assimilated into the system in accordance with the dominant norms, values, and expectations. Similarly, Alexander and his friends cannot be assimilated into the dominant political culture of their country. They cannot be convinced to comply with the certain norms and expectations of their country’s political culture. For this reason, they are placed in a “supplementary disciplinary system” (Foucault, Psychiatric Power

54) which has already been established for such residual members of society to maintain the continuity of the disciplinary system. They are placed in a psychiatric hospital in order to be transformed into the conforming members of society.

As the play progresses, when the hospital scene changes to a school classroom, it appears that the play takes place in another disciplinary space as well. These two institutions – the school and the psychiatric hospital – seem to function for similar disciplinary purposes. In his analysis of disciplinary power, Foucault points to that

94 similarity through his concept of “isotopic”. To Foucault, “a disciplinary apparatus is isotopic” and one of the meanings of this term is that “there is no conflict between different disciplinary apparatuses” (Foucault, Psychiatric Power 52-53). In the play, there is indeed no conflict between the functions of two institutions, psychiatric hospital and school. Both of them complete one another, maintaining similar disciplinary purposes and conditions. For instance, Sacha’s experiences at school are very similar to his father’s in the psychiatric hospital. While Alexander is compelled by the doctor to accept his (non-existent) mental disorder, Sacha is exposed to similar persuasion attempts of his teacher at school. Thus, the same ‘truth’ created by the regime is imposed on each individual in both institutions. In addition, while the doctor talks to

Alexander in an accusatory manner due to his opposing political views, the teacher also approaches her student in the same way due to his father’s dissidence. The teacher thinks Sacha has a “notorious” name which “goes round the world by telegram, is printed in newspapers and spoken on the radio” (19). During her talk to Sacha, she constantly reminds him of his father’s dissidence and incarceration in a mental asylum.

For instance when Sacha does not want to play in the orchestra, she perceives this rejection as a form of protest and says, “Detention is becoming a family tradition” (19).

Orchestra is actually a significant metaphor. Since it consists of a certain group of people who should always be in harmony with one another and should play in the same rhythm at the same notes not to destroy the music, orchestra can be considered as a metaphor for the State or the society in both of which the members are expected to live in harmony, conforming to the common rules and norms rather than pursing their individual values and ideas not to damage social harmony. Therefore, Sacha who rejects being part of an orchestra and deviates from what the majority does is perceived by his teacher as a potential threat to the public order like his father.

The following quote exemplifies the teacher’s negative approach to Sacha and also shows her negative thoughts related to the people incarcerated in psychiatric hospitals:

Teacher: Open the book. Pencil and paper. You see what happens to anti-social malcontents. Sacha Will I be sent to the lunatics’ prison? Teacher Certainly not. Read aloud. Sacha ‘A point has position but no dimension.’ Teacher The asylum is for malcontents who don’t know what they’re doing. Sacha ‘A line has length but no breadth.’ Teacher They know what they’re doing but they don’t know it’s anti-social. Sacha ‘A straight line is the shortest distance between two points.’ Teacher They know it’s anti-social but they’re fanatics. Sacha ‘A circle is the path of a point moving equidistant to a given point.’ Teacher They are sick. Sacha ‘A polygon is a plane area bounded by straight lines.’ Teacher And it’s not a prison, it’s a hospital. (Pause.) Sacha: ‘A triangle is the polygon bounded by the fewest possible sides.’ Teacher: Good. Perfect. Copy neatly ten times, and if you’re a good boy I might find you a better instrument. (19-20)

The teacher who repeatedly breaks into her student’s reading to dictate her own ideas actually represents the dominant characteristic of the regime. She thinks being an outsider is enough to be incarcerated in a mental hospital. She gives her student the message that anyone who is unsatisfied with the existing conditions and who tends to rebel and create problems for the society can be put in a mental hospital like his father.

However, while doing that, the teacher constantly contradicts herself, negating her own statements. First, she mentions the asylum as a place for “malcontents” who do not know what they are doing. Then, she says they know what they are doing but they do not know it is “anti-social”, and then she negates this statement again, adding a new word “fanatics”. Finally, she decides that they are “sick” and the place they are put in is

96 not a prison but a hospital. This final remark indicates that the teacher is actually aware of the misuse of psychiatric institutions as a means of political repression. For this reason, she needs to emphasize that asylum is not a prison. Through these dictations, the teacher tries to convince Sacha that his father has been institutionalized since he is really sick. However, Sacha does not believe that his father is genuinely mentally ill and he does not think his father is being held in a hospital. In another scene, he says to his teacher:

Sacha: A plane area bordered by high walls is a prison not a hospital. Teacher: Be quiet! Sacha: I don’t care! – he was never sick at home. Never! (Music.) Teacher: Stop crying. (Music.) Everything is going to be all right. … (26)

From the school scenes above, it is obvious that the teacher usually talks to her student in such an aggressive manner that she cannot hide her hostile feelings about the hospitalized dissidents. Therefore, the teacher does not seem to be talking about a fact that everybody knows as such; she rather seems to be making her own judgmental comments on why those people are being diagnosed as mentally ill and hospitalized in that way. This significant detail essentially underlines how the perception of mental illness can easily shape according to the norms, expectations, and values of a particular society and even of a particular person.

Foucault’s term, “isotopic” also provides an insight into why the teacher adopts such negative attitudes toward her student. According to Foucault, isotopic also means that “every element in a disciplinary apparatus has its well-defined place”, along with its

“subordinate” and “superordinate” elements (Psychiatric Power 52). For instance, a student’s “locus” at school is not only his place in the classroom; it is also his “place” or

“rank” within “the hierarchy of values” (Foucault, Psychiatric Power 52). In the play,

Sacha similarly has his own well-defined place at his school. His locus in the classroom has already been determined by his father’s political dissidence. For this reason, he cannot escape from his teacher’s negative perceptions and attitudes. Similarly, in the hospital, Alexander’s locus is not just his place in his ward or cell; his locus additionally involves his ‘failure’ to conform to the politically reinforced norms and expectations of his country.

As Foucault points out in his analysis of psychiatric power, mental asylums function as disciplinary areas that make possible both the continuous control of individuals and the transformation of those individuals into docile and useful subjects.

This disciplinary function is ensured through the implementation of a series of disciplinary elements, methods, techniques, and maneuvers in asylums. First of all, a disciplinary power reigns in the asylum and this power “surrounds, penetrates, and works on” the “bodies” of each individual, permanently regulating their “time, activities, and actions” (Foucault, Psychiatric Power 2). For this reason, Foucault views the mental asylum as a ‘panoptic machine’ in which he thinks Bentham’s panoptic principles are set to work for the maximum obedience of individuals. These panoptic principles are permanent visibility, central supervision, isolation, and ceaseless punishment. In the play, the Leningrad Special Psychiatric Hospital where Alexander was first incarcerated due to his political dissent is such a hospital similar to what

Foucault calls as ‘panoptic machine’. This fact is understood from Alexander’s traumatic memories related to that institution, which he now tells his present doctor:

Alexander … they put me in a mental hospital. And you are quite right – in the Arsenal’naya they have cells. There are bars on the Windows, peepholes in the doors, and the lights burn all night. It is run just like a gaol, with warders and trusties, but the regime is more strict, and the male nurses are convicted criminals serving terms for theft and violent crimes, and they beat and humiliate the patients and steal their food, and are protected by the doctors, some of whom wear KGB uniforms under their white coats. 98

For the politicals, punishment and medical treatment are intimately related. I was given injections of aminazin, sulfazin, triftazin, haloperidol and insulin, which caused swellings, cramps, headaches, trembling, fever and the loss of various abilities including the ability to read, write, sleep, sit, stand, and button my trousers. When all this failed to improve my condition, I was stripped and bound head to foot with lengths of wet canvas. As the canvas dried it became tighter and tighter until I lost consciousness. They did this to me for ten days in a row, and still my condition did not improve. Then I went on hunger strike. And when they saw I intended to die they lost their nerve.

… (29)

From the very beginning of the above quotation, it appears that this psychiatric hospital resembles a prison on the part of Alexander because he prefers to employ the word

‘cell’ instead of ‘ward’. He thinks so because he both knows the real reason for his incarceration and views the treatments applied in that institution as punishments for his dissidence. Indeed, this psychiatric hospital involves all the elements of a panopticon prison. First of all, it seems that through the peepholes in the doors and the lights burning all night, the patients were subjected to constant surveillance in this hospital.

The perpetual surveillance is a disciplinary method as it continuously compels the inmates to develop self-control. Secondly, the presence of a network of authority indicates that the patients were subjected to central supervision. Besides the doctors, through warders, trusties, and male nurses, the patients were continuously supervised.

To Foucault, the creation of such a network of authority is a “tactical functioning of psychiatric power” because thanks to this network, disciplinary power can be distributed across the whole space of the asylum (Psychiatric Power 4-5). In this hospital, the patients could be watched and controlled at every corner of the institution thanks to this chain of authority. Additionally, from the barred windows and the cells, it can be understood that the inmates were acutely isolated both from the outside world and from the other inmates inside the hospital. Finally, from the considerable unpleasant effects of these treatment methods, it is understood that Alexander and other patients were frequently exposed to punitive measures in this institution. 99

The punishments in this hospital took different forms. First of all, the asylum staff, some of which were the sentenced criminals, resorted to physical and psychological violence. They beat, humiliated the patients and even stole their food.

Besides, physical restraint was applied to the patients. For instance, Alexander was exposed to a specific method called ‘wet canvas’, which is mostly mentioned in the accounts of the dissidents incarcerated in the special psychiatric hospitals. This method, also mentioned as “wet pack”, is applied through a “wet canvas” which is “tightly bound around the patient from head to foot” and gets increasingly “more taut causing great difficulty in breathing” as it dries out (Bloch and Reddaway 27). Alexander’s treatment additionally involved the injection of some antipsychotics that caused him both to suffer severe physical discomfort and to lose his intellectual skills like writing and reading. Foucault points to the unpleasant effects of these methods in his analysis and argues that authority is considered more vital than treatment in mental asylums. He further suggests that all these asylum methods are used primarily for the purpose of

“direction” rather than for “therapeutic aims” (Foucault, Psychiatric Power 180). He means that the primary function of these methods is to direct individuals to behave in accordance with the will of the asylum staff. Indeed, the methods such as constant surveillance, physical restraint, and drug injection, all of which seem to cause unpleasant effects on the patients, were applied to Alexander for disciplinary purposes.

Since his dissent is perceived by the system as an irregularity and accordingly a major threat to the society, these methods were applied to him in order to suppress and correct his ‘deviant’ thoughts and acts.

As the play progresses, it is understood that Alexander has been transferred from this special psychiatric hospital to an ordinary psychiatric hospital where he now stays in the same ward together with Ivanov. Alexander has been transferred because the authorities of the special psychiatric hospital could not convince Alexander to put an

100 end to his hunger strike although they even used his son to persuade his father.

However, in this ordinary psychiatric hospital, Alexander is exposed to similar disciplinary conditions and practices. In this hospital, there is again an authority which attempts to suppress and correct his non-obedience. This authority exercises disciplinary power on both Alexander and Ivanov in order to direct their behaviour and ideas in accordance with its will. This is ensured through a series of disciplinary strategies and methods. One of these strategies is “the management or organization of needs”

(Foucault, Psychiatric Power 152). Foucault argues that psychiatric power first creates certain “needs” for the individuals and then utilizes these “deprivations it establishes” in order to convince the inmates to act in accordance with certain norms (Psychiatric

Power 155). He adds that “the deprivation of freedom” is the greatest of all the possible deprivations (Foucault, Psychiatric Power 155). Through this statement, he means that any person who is deprived of his freedom can be convinced more easily to act according to the norms. In the play, Alexander is similarly deprived of his liberty in order to be convinced to acknowledge that his statements against the government were caused by a mental disorder. As long as he does not admit that, his deprivation of freedom will continue as a form of punishment. Alexander’s deprivation of freedom actually produces another kind of deprivation on the part of his son; Sacha is deprived of his father. This condition is also utilised by the hospital staff to persuade Alexander to act in accordance with their will. In a scene where Alexander does not react positively to his doctor’s persuasion attempts, the doctor immediately reminds him of his son’s deprivation of father; “What about your son? He is turning into a delinquent.

He is a good boy. He deserves a father.” (29).

The creation of “an imbalance of power” (Foucault, Psychiatric Power 146) is another disciplinary strategy developed in the asylum space in order to maximize the patients’ obedience. According to Foucault, “right from the start”, power flies “in one

101 and only one direction” in the asylum and this power always flies “from the doctor”

(Psychiatric Power 146). This imbalance of power appears most intensively in the first confrontation between the doctor and the patient. The first encounter usually involves a

“show of force” and during this “show”, there is “no sharing out, reciprocity, or exchange” (Foucault, Psychiatric Power 146). In other words, when the doctor and the patient encounter for the first time, the doctor does not usually establish a reciprocal communication with his patient as he concentrates much more on demonstrating his ultimate power. In the play, there is similarly a show of force in the doctor’s first interview with Ivanov in his office:

Doctor Now look, there is no orchestra. We cannot make progress until we agree that there is no orchestra. Ivanov Or until we agree that there is. Doctor (Slapping his violin, which is on the table) But there is no orchestra. (IVANOV glances at the violin.) I have an orchestra, but you do not. Ivanov Does that seem reasonable to you? Doctor It just happens to be so. I play in an orchestra occasionally. It is my hobby. It is a real orchestra. Yours is not. I am a doctor. You are a patient. If I tell you you do not have an orchestra, it follows that you do not have an orchestra. If you tell me you have an orchestra, it follows that you do not have an orchestra. Or rather it does not follow that you do have an orchestra. Ivanov I am perfectly happy not to have an orchestra. Doctor Good. Ivanov I never asked to have an orchestra. Doctor Keep saying to yourself, ‘I have no orchestra. I have never had an orchestra. I do not want an orchestra.’ (21)

As it can be observed from the quote above, while the doctor tries to convince his patient that he has no real orchestra, he adopts an authoritarian and sarcastic tone. He specifically draws a clear-cut distinction between himself and the patient. He implies that whatever he says as a doctor is unquestionably true and whatever Ivanov says is

102 wrong only because he is a patient. The doctor’s emphasis on this distinction indicates his authoritarian role over his patient.

The psychiatrist’s language plays a great role in the creation of this power imbalance. To Foucault, psychiatrists employ a specific language in the asylum; it is

“the master’s language” (Psychiatric Power 151). Psychiatrists usually employ this language through repetitions and commands. Foucault further argues that through this sort of language, patient does not actually discover anything; he is rather directed to notice “the reality of an order, of a discipline, of a power imposed on him” (Psychiatric

Power 151). At the scene above, the doctor seems to employ that kind of language in order to make Ivanov realize his ultimate power. For instance, he tells Ivanov to repeat what he says: “Keep saying to yourself, ‘I have no orchestra. I have never had an orchestra. I do not want an orchestra.’” (21). Ivanov does not really discover that he has no real orchestra; he rather notices the ultimate authority of his doctor. For this reason, he just acts on his doctor’s command and repeats the given statements. The fact that

Ivanov does not discover anything becomes evident in another office scene where a similar dialogue takes place between Ivanov and his doctor:

Doctor Next! … Hello, Ivanov. Did the pills help at all? … Ivanov I have no orchestra! … Doctor Wait a minute! – what day is it? Ivanov I have never had an orchestra! … Doctor What day is it? Tuesday? … Ivanov I do not want an orchestra! … Doctor (Horrified) What time is it? I’m going to be late for the orchestra! (The DOCTOR grabs his violin case and starts to leave. IVANOV strikes his triangle.) 103

Ivanov: There is no orchestra! Doctor: (Leaving) Of course there’s a bloody orchestra! (Music – one chord. IVANOV hears it and is mortified. More chords. The DOCTOR has left.) Ivanov (Bewildered) I have an orchestra. (Music.) I’ve always had an orchestra. (Music.) I always knew I had an orchestra. (32-33)

As the course of the dialogue reveals, Ivanov cannot establish reciprocal communication with his doctor. Although the doctor asks him a different question at every turn, Ivanov continually repeats the same statements that had been previously told him by the doctor.

This is largely because Ivanov has not discovered anything related to his delusions; his doctor’s language of commands has caused him just to recite the given statements. For this reason, when the doctor gets angry and says there is an orchestra, Ivanov immediately relapses into his delusions.

A similar scene takes place where the doctor and Alexander encounter for the first time in the office. In that scene, Alexander mistakes the doctor for a patient and the doctor reacts to this mistake by emphasizing the distinction between a doctor and a patient: “No, I am a doctor. You are a patient. It is a distinction which we try to keep going here.” (26). The doctor is so obsessive about his unlimited authority that he cannot stand being confused with a patient. In the same scene, when Alexander states that he has a complaint, first, the doctor does not let his patient share his problem; he immediately opens a file and reads Alexander’s diagnosis, “I know – “pathological development of the personality with paranoid delusions” (26). Similar to the scene above, there is no conversation on the basis of reciprocity in this scene as well. The doctor cares primarily about the diagnosis written in Ivanov’s file rather than listening to him. File is a significant element according to Foucault’s analysis of disciplinary

104 power. According to him, disciplinary power needs to record “everything the individual does and says” because thanks to recording, any information about the individual can be transmitted “from below up through the hierarchical levels” and can be made

“accessible” at any time (Foucault, Psychiatric Power 48). Thus, disciplinary power follows everything so continuously that it can react promptly to potential threats.

Similarly, in this scene, when the doctor recognizes that Alexander has a problem, he immediately opens his file before listening to him because on the part of the doctor, the writings in the file provide more reliable source than Alexander’s own statements. In addition, this move of the doctor has another important function; it makes Alexander realize that the doctor already has any necessary information about himself.

As the same scene proceeds, it becomes apparent that Alexander’s trouble is with Ivanov; “My complaint is about the man in my cell.” (26). Alexander employs the lexis ‘cell’ instead of ‘ward’ because he still thinks he is being held in a prison. He has been transferred from a special psychiatric hospital to an ordinary psychiatric hospital but he is still being incarcerated due to his political opinions. However, as soon as

Alexander employs that word, the doctor immediately corrects him. This rapid manoeuvre of the doctor shows that he has been accustomed to the use of this term by the hospitalized political dissidents.

The doctor’s advice for Alexander’s complaint is interesting; taking “a red pill box from the drawer”, he tells Alexander to “suck one of these every four hours” (27).

Alexander gets surprised when his doctor gives him pills as a solution to his ward- mate’s aggressiveness and states that Ivanov is “a raving lunatic” (27). Alexander’s use of this term is significant because according to Foucault, mentally ill inmates are put in wards or cells together with other patient/s intentionally “on the grounds that it is very good for a patient to witness the madness of other madmen on the condition that this patient recognizes the other madmen around him in the same way that the doctor sees

105 them” (Psychiatric Power 103). Indeed, Alexander recognizes his ward-mate in the same way that his doctor sees him. His awareness of the reality of his ward-mate’s mental disorder creates an opportunity for the doctor to give the message that only the genuinely mentally deranged are incarcerated by Soviet psychiatrists in mental hospitals:

Doctor Of course. The idea that all the people locked up in mental hospitals are sane while the people walking about outside are all mad is merely a literary conceit, put about by people who should be locked up. I assure you there’s not much in it. Taken as a whole, the sane are out there and the sick are in here. For example, you are here because you have delusions, that sane people are put in mental hospitals. (27)

The doctor turns the presence of a genuine lunatic in Alexander’s ward into an opportunity to confute the argument that sane people are labelled by the regime as mentally ill and put in mental institutions due to their political views. In this way, the doctor again attempts to convince Alexander that he is genuinely mentally ill.

In the same scene, Alexander once again employs the word ‘cell’ and the doctor this time reminds of the distinctions between ‘ordinary’ and ‘special’ psychiatric hospitals:

Alexander … Could I be put in a cell on my own? Doctor Look, let’s get this clear. That is what is called an Ordinary Psychiatric Hospital, that is to say a civil mental hospital coming under the Ministry of Health, and we have wards. Cell is what they have in prisons, and also, possibly, in what are called Special Psychiatric Hospitals, which come under the Ministry of Internal Affairs and are for prisoners who represent a special danger to society. Or rather, patients. … (27)

While underlining the difference between ‘ordinary’ and ‘special’ psychiatric hospitals, the doctor contradicts himself. First, he mentions the people confined to special psychiatric hospitals as “prisoners”, but then he corrects himself, saying “patients”. This detail indicates that although the doctor seems to be talking overconfidently, he himself is confused about the function of those ‘special’ institutions that are termed as

106 psychiatric hospitals but are utilised as prisons. For this reason, the doctor hesitates for a moment about which term he must use for those people confined to special psychiatric hospitals.

The scene proceeds with another controversial issue that Foucault mentions in his analysis of psychiatric power. According to Foucault, in the moral treatment period when the foundations of psychiatry were laid, the introduction of psychiatrists into mental asylums was not due to their “medical skill or power”; psychiatrists were needed because they would function as a “juridical and moral guarantee” (Madness and

Civilization 270). Foucault means that early psychiatrists entered the asylum space primarily to exert a sort of juridical and moral authority over patients. Foucault further argues that these early psychiatrists were endowed with authority not because they were

“scientist” but because they were “wise” men or, men “of great probity, of utter virtue and scruple” (Madness and Civilization 270). In the following part of the above scene, there is a significant detail that supports this argument. In this scene, when Alexander requests being put in another ward, he accidentally learns that the doctor who decided on his ward-mate is a doctor of philology, who has never been trained in the field of psychiatry:

Alexander Could I be put in a ward on my own? Doctor I’m afraid not. Colonel – or rather Doctor – Rozinsky, who has taken over your case, chose your cell – or rather ward-mate personally. Alexander He might kill me. Doctor We have to assume that Rozinsky knows what’s best for you; though in my opinion you need a psychiatrist. Alexander You mean he’s not really a doctor? Doctor Of course he’s a doctor and he is proud to serve the State in any capacity, but he was not actually trained in psychiatry as such. Alexander What is his speciality? Doctor Semantics. He’s a Doctor of Philology, whatever that means. I’m told he is a genius. (27-28)

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From the quotation above, it is obvious that Colonel Doctor Rozinsky who has never been trained in psychiatry could easily take the place of a psychiatrist. He both followed up Alexander and decided on his ward-mate. This controversial situation corresponds to what Foucault argues about the main function of early psychiatrists. Rozinsky has been considered appropriate for this profession not because he has specialist knowledge about mental illness but because he is “proud to serve to the State in any capacity”.

Rozinsky is also mentioned by the doctor as a “genius”, however, his genius does not lie in the field of psychiatry, but in the field of semantics. These statements imply that

Rozinsky is not a psychiatrist, but an important authority figure who is ready to act in accordance with the wills of the State, or the regime.

According to Foucault, all these disciplinary strategies and methods deployed in the mental asylum must lead to the ultimate stage where the patient must confess his delusional ideas. Foucault calls this stage as “the statement of truth” (Psychiatric Power

157). According to him, the patient must confess that truth in order to be released from the hospital. In addition, the patient does not actually have to recognize or understand that truth; he only has to say it even if he says under the restraint of a punishment

(Foucault, Psychiatric Power 159). Therefore, no matter whether the patient really perceives the truth about himself, it is highly important for the patient to confess, or actualize the truth imposed on him by the power in the asylum. From the very beginning to the end of the play, Alexander is frequently directed by his doctor to admit and state

‘the truth’ imposed on him by the regime. However, as the play progresses, it becomes apparent that all those persuasion attempts of the doctor are actually a rehearsal for the last phase of Alexander’s involuntary hospitalization. If Alexander states ‘the truth’, or if he confesses that his political statements against the regime were caused by his (non- existent) mental disorder in the impending “Examining Commission”, he will be

108 considered recovered and be released from the psychiatric hospital. In the following quote, the doctor informs Alexander about this commission for the first time:

Alexander (Angrily) I won’t see him. Doctor It may not be necessary. It seems to me that the best answer is for you to go home. Alexander Thursday? Doctor Why not? There is an Examining Commission on Wednesday. We shall aim at curing your schizophrenia by Tuesday night, if possible by seven o’clock because I have concert. (He produces a large blue pill box.) Take one of these every four hours. Alexander What are they? Doctor A mild laxative. Alexander For schizophrenia? (28)

At the beginning of this quotation, when Alexander says he does not want to see

Colonel Doctor Rozinsky, the doctor first implies that he may return his home very soon and then mentions about the impending commission. This dialogue is actually significant in that it clearly shows how the doctor’s statements and acts are away from scientific truths. First, the doctor implies that they will have cured Alexander by

Tuesday night and even by seven o’clock since he must get to his concert in time. Then, he gives Alexander a box of laxatives that are actually prescribed for constipation.

These both details correspond to Foucault’s arguments related to the contradiction between medical theories and asylum practices. According to Foucault, in most of the psychiatric treatment scenes, there is actually no “application of a technical medical formula”; psychiatrists do not need “any work of diagnosis or nosography” for the achievement of their therapeutic operations (Psychiatric Power 10). In his account, psychiatric operations just involve “the confrontation of two wills”, of the doctor’s will and the patient’s (Foucault, Psychiatric Power 10). For this reason, Foucault resembles the asylum space to a ‘battlefield’ where the victory of one will to another takes place.

Indeed, from the very beginning to the end of the play, there has always been a

109 contradiction between the doctor’s practices and scientific procedures. Throughout the play, the doctor has never referred to any psychiatric theory to explain Alexander’s mental state and his treatment. He has never used a scientific discourse while interviewing his patient. He has rather concentrated on Alexander’s political dissent and tried to convince him to acknowledge that he was mentally ill while he was speaking out against the policies of the regime. The main reason underlying these non-scientific and non-objective attitudes of the doctor is that he thinks Alexander is mentally ill since he is a political dissident. For instance, in a scene where he interviews Alexander, he openly states his thought about Alexander’s mental illness; “Your opinions are your symptoms. Your disease is dissent.” (30). These statements clearly show how the doctor perceives his patient’s political dissidence as a form of mental disorder. In line with this perception, the doctor thinks Alexander can be cured only if he admits his ‘delusional’ political thoughts. The following scene exemplifies this:

Doctor … Did the pills help at all? Alexander I don’t know. Doctor Do you believe that sane people are put in mental hospitals? Alexander Yes. Doctor They didn’t help. (32)

The dialogue above provides probably the most obvious example to the use of psychiatric procedures primarily for disciplinary purposes because it clearly shows that the doctor believes the pills will have cured Alexander only if they help to change his political opinions.

As stated above, Alexander has to state ‘the truth’, which is imposed on him by both the hospital staff and the regime, before the commission to be able to get out of the psychiatric hospital. The commission expects Alexander to state that he really had schizophrenic delusions and spoke out against the government under the influence of these delusions. To this end, in the following quotation, the doctor prepares Alexander

110 for the commission, telling him how he must answer the possible questions of the commission:

Doctor Yes. Incidentally, when you go before the Commission try not to make any remark which might confuse them. I shouldn’t mention War and Peace unless they mention it first. The sort of thing I’d stick to is ‘Yes’, if they ask you whether you agree you were mad; ‘No’, if they ask you whether you intend to persist in your slanders; ‘Definitely’, if they ask you whether your treatment has been satisfactory, and ‘Sorry’, if they ask you how you feel about it all, or if you didn’t catch the question. (28)

This quotation actually exemplifies Foucault’s argument related to the stage of “the statement of truth” because all the statements the doctor wants Alexander to say before the commission are just the truths of the doctor and also of the regime. In line with

Foucault’s argument, these truths do not have to be recognized or perceived by

Alexander; they have to be only said by him before the commission. Only his confession of these truths will be enough for his ‘cure’ and release from the psychiatric hospital.

The final scene of the play presents the ultimate stage of the whole disciplinary process that Alexander has been subjected to throughout the play. In that scene, the commission comes together to question Alexander and Ivanov to decide about their discharge from the hospital. In Foucault’s words, this scene is the stage of “the statement of truth” when the patient is compelled “to tell the truth” (Psychiatric Power

157). Alexander has two options; he will either state ‘the truth’ imposed on him by the regime and legitimize his psychiatric hospitalization, or continue his resistance, pursuing his own ideals and values. This scene actually involves a significant disciplinary method, ‘questioning’. In Foucault’s view, psychiatric questioning plays a crucial role in establishing a junction between “responsibility” and “subjectivity”

(Psychiatric Power 273). He means that the patient is given the responsibility of expressing his own madness/fault during questioning and expected to give the reasons

111 why he is being held in a mental asylum. Similarly, in the scene above, Alexander is directed by the doctor to give the reasons why he has been put in this psychiatric hospital; he is compelled to state that his ‘delusional’ ideas caused him to speak out against the regime.

In spite of all these disciplinary procedures that must be followed for

Alexander’s ‘treatment’ and release, the final scene of the play proceeds in an unexpected way when the colonel mistakes the names of Alexander and Ivanov. When

Ivanov is asked if he believes that sane people are put by Soviet doctors into lunatic asylums, he gets baffled and says, “I shouldn’t think so. Why?” (37). On the other hand, when Alexander is asked if he has an orchestra, he answers “No.” (37). Following these statements, both Alexander and Ivanov are considered to have been cured and they are incidentally discharged from the psychiatric hospital thanks to the colonel’s mistake.

Although the play ends with Alexander’s accidental release from the hospital,

Every Good Boy Deserves Favour strikingly dramatizes how political dissidence can be suppressed and punished by the power through the legitimate basis that psychiatry provides for the social control of the deviant’ behaviour and thoughts of individuals. In the play, Alexander’s political opposition to the regime is interpreted as a form of mental disorder and he is punished by being involuntarily placed in a Soviet mental hospital that usually functions as a prison for political dissidents. In this hospital,

Alexander’s psychiatric treatment proceeds as a disciplinary process since he is expected to change his political thoughts in accordance with the regime’s will. In line with Foucault’s analysis of psychiatric power, Alexander is subjected to a series of disciplinary methods and techniques such as isolation, perpetual surveillance, ceaseless punishment, questioning, and involuntary medication in the hospital in order to be transformed into an obedient and useful subject for the benefit of the regime and of the prevailing social order. Consequently, this play portrays how psychiatric power

112 functions as a form of disciplinary power over the individuals in a mental asylum in accordance with Foucault’s arguments.

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CHAPTER IV

PSYCHIATRIC POWER AND ‘MAD’ WOMEN:

SARAH DANIELS’S HEAD-ROT HOLIDAY (1992)

The use of psychiatric diagnosis and treatment for the purposes of social control has also been discussed in terms of the condition of women in patriarchal societies. The issue of ‘madness and women’ has been discussed from various feminist critical perspectives (Busfield). The debates generally fall into two main categories. The first approaches madness in women as a social construct, arguing that male-dominated societies show a tendency to label the women whose behaviour and tendencies run contrary to the patriarchal definitions of normality as ‘mad’ or ‘mentally ill’. The second argument explains women’s madness as a real experience but as a product of society’s enforcement of rigid gender or sexual norms. This argument underlines how the enforcement of cultural norms related to women’s ‘proper’ place in family and in society can drive women into psychological problems and mental disorders as a result of the intensive stress they suffer to conform to those norms. In addition to the stress caused by the enforcement of gendered roles that women are usually forced to adopt in society, the latter argument also points out that women’s more frequent exposure to oppression, domestic violence, physical and sexual abuse places women at a greater risk of suffering from a mental or a psychological disorder.

With regard to this critical issue of ‘women and madness’, Sarah Daniels’s

Head–rot Holiday portrays how women failing to meet the expectations of mainstream society can be potentially labelled as mentally ill, or how they can be unluckily maddened due to their exposure to oppression, abuse, and violence in family and in social sphere. Head-rot Holiday tells the story of three female patients who have been confined to a special psychiatric hospital. These characters are subjected to a form of disciplinary power in the psychiatric hospital since they are usually directed by the

114 hospital staff to comply with the commonly-held norms and expectations of mainstream society. Since psychiatric treatment functions as the norm over these female characters, the play provides a remarkable source for the analysis of psychiatric power. In this context, this chapter aims to study Head-rot Holiday in terms of how these three female characters experience a disciplinary process within the borders of a special psychiatric hospital due to their ‘failure’ to meet certain norms and expectations of society.

The British playwright, Sarah Daniels (1956- ) began her playwriting career at the Royal Court Theatre in London. Daniels can be acknowledged as one of the radical women playwrights since she raises concerns over the taboo issues such as patriarchal oppression, domestic violence, pornography, lesbianism, and sexual child abuse most of which are usually swept under the carpet in mainstream society. Her earliest plays include Ripen Our Darkness (1981) exploring the oppressive hetero-patriarchal structure of the family, Masterpieces (1983) dealing with the negative effects of pornography on women, and Neaptide (1986) telling the story of a lesbian mother who struggles to retain custody of her seven year-old daughter. Furthermore, other major works include The Devil’s Gateway (1983) focusing on women’s protest against nuclear war, Byrthrite (1986) dealing with the issue of women and reproduction, and The Gut

Girls (1988), which is about the exploitation of working women.

In her later works such as Beside Herself (1990), Head-rot Holiday (1992), and

The Madness of Esme and Shaz (1994), Daniels appears to be more concerned with the issue of madness. In these plays, as an effect of her feminist concerns, Daniels portrays women’s madness as a destructive effect of their experiences of male oppression, violence, and abuse. Her madwoman figures generally appear as the characters who suffer from mental and psychological problems following a physical, emotional, or sexual abuse mostly caused by their male family members such as fathers or father figures. For instance, in Beside Herself (1990) the mentally ill character, Evelyn is a

115 woman who has been victimized by her father’s sexual abuse in her childhood years. In

The Madness of Esme and Shaz (1994), the mad character, Shaz is similarly a victim of childhood sexual abuse; she is taken into special care after having been sexually abused by her father as a child.

Head-rot Holiday (Clean Break Theatre Company, 1992) is another play whereby Daniels explores the theme of ‘madness and women’. In the introduction to

Daniels Plays: 2, she explains how she decided to write this play with the following words: “I became interested in how women’s mental health is defined and I wanted to write something specifically about a woman detained in Broadmoor or a ‘special hospital’ – the new euphemism for an institution for the ‘criminally insane’.” (Daniels

2). As Daniels states, her main motivation behind writing Head-rot Holiday was to give voices to the women confined to special hospitals. To this end, prior to writing her play,

Daniels came together with Clean Break Theatre that is a feminist theatre company whose primary mission is to provide an insight into the injustice women face in the criminal justice system by bringing their hidden stories to the stage. This company commissioned Head-rot Holiday and provided Daniels with the opportunity to “talk to ex-patients, psychiatrists, clinical psychologists, social workers and solicitors” by organizing a “research” process before she began to write her play (Daniels 2).

Head-rot Holiday takes place in Penwell Special Hospital in 1991/2. The play tells the stories of three women named Dee, Ruth, and Claudia who have each been incarcerated in a psychiatric prison for various offenses. In the play, it is time for

Christmas disco that means a great opportunity for the female patients to prove their

‘normality’ and accordingly their sanity in their path to the parole ward for an early release. The recipe for the parole ward is dressing in typically feminine ways, being polite, and socializing with a male patient even if he is a dangerous serial killer or a convicted rapist. The play proceeds through the struggles of these women to prove their

116 sanity to the staff in order to be sent to the parole ward and released early from the hospital. However, despite all the attempts of these female characters, the play ends with their continuing detention and with an emphasis on their hopeless future.

Head-rot Holiday begins with the arrival of a new nurse named Sharon at

Penwell Special Hospital. The nurse, Jackie welcomes her new fellow nurse, Sharon with the following greeting: “Hello. (Grins.) With the emphasis on hell. Welcome to

Head-rot Hotel.” (193). Jackie’s greeting to Sharon is ironical in that it emphasizes the stark contrast between the common perception of a hotel and the reality of the special hospital’s closed and painful world. Following this ironical emphasis on Penwell’s hell- like atmosphere, Jackie implies to Sharon that she must be cautious towards the female patients whom she introduces as “the most dangerous people in the country” (200).

Although the female inmates, also including the primary characters Dee, Ruth, and

Claudia, are identified by Jackie as the most dangerous members of society, as the patients’ case stories are unfolded in the course of the play, these women appear to be socially disadvantaged and victimized individuals who have either fallen into the

‘abnormal’ category of society, or exposed to injustice, oppression, and abuse in family or in society.

Claudia is a young woman whose children were fostered when she was first hospitalized due to her depression caused by unemployment and economic problems.

Claudia’s detention in Penwell Special Hospital occurs after a chain of events following her being cut off from her children. When Claudia was discharged from the hospital after six weeks, during which her medication had deepened her depression, she could not have her children back in spite of her social worker, Chris’s promise. She got so furious at the “‘If-you-behave-well-enough-you-can-have-your-children-back’ game”

(217) that she chased her social worker across the balcony and attacked him with a potato peeler. Although it is later revealed that Claudia actually ended up just tearing

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Chris’s coat, she has been transferred to Penwell on the grounds that she was

“potentially violent” (217). Claudia’s tragedy of misplacement in this special hospital is highlighted through her social worker’s monologue in Scene Seven where he confesses that Claudia “wasn’t well enough to have her children back but she wasn’t ill enough to go there.” (219). Chris expresses his sadness over his role in “a terrible chain of events which has taken years and two children from a young woman’s life” (219). His monologue essentially indicates how Claudia has been unjustly treated and victimized by a system that remains both insensitive to women’s poor economic conditions and incapable of identifying and eliminating the underlying causes of women’s psychological and mental problems.

Another primary character of the play, Dee is a lesbian who thinks she has never led an easy life: “I certainly never got no favours handed to me on no plate. No one would deny that.” (209). Dee seems to be aware of how her deviation from the norms of mainstream hetero-normative society has contributed to her life’s turning into “crap”:

Dee Cold. I wasn’t cut out to be wet and feminine. I always liked toys that worked. But then I used to break loads of things. On purpose. I know it sounds like crap. Well, what’s new, the majority of my life has been crap. I tell you my background makes that fairy story ‘The little Match Girl’ look like ‘Dallas’. People don’t have lives like mine. They get a break. They get a head. They – (209-210)

Due to her deviation from the hetero-sexual norms of mainstream society, Dee apparently feels socially disadvantaged; she thinks her life has always been difficult to manage unlike other ‘normal’ people’s lives.

Besides her lesbian identity, Dee appears in the play as a character who has been subjected to physical harassment and domestic violence. During her seclusion in Scene

Twelve, her monologue shows that Dee feels anxious and suffers from difficulty falling asleep as she recalls how she “was locked in a room for a few weeks when” she “was

118 about three” (229). In the same scene, Dee also recalls how she had to punch a policeman since she was physically harassed by him (230).

The last of the primary characters, Ruth is a young woman who has been victimized by her father’s sexual abuse. Ruth has been incarcerated in the special hospital for attacking her step-mother who witnessed that traumatic incident but denied what was happening. Ruth’s exposure to her father’s sexual abuse seems to have left a strong negative impact on her mental and psychological health; she constantly hears voices and is usually medicated since she cannot stand recalling her traumatic memories any more. As an attempt to endure the burden of her past abuse, Ruth frequently contemplates on language, sound, and eternal circularity of life: “Around. Round.

Sound goes round. It never dies. It is connected to going round. And then there’s a connection between words that rhyme. So sound and round –” (194). When Dee asks

Ruth why she has to “talk daft all the time”, Ruth implies that it is a kind of survival mechanism: “I don’t have to but it helps.” (194).

As it can be observed from the characters’ case stories, these three women have either deviated from the widely-held norms and expectations of mainstream society, or have been turned into a mentally deranged person as a result of exposure to unfortunate experiences such as injustice, domestic violence, and sexual abuse in family or in society. In line with Foucault’s analysis of disciplinary power, it is possible to say that these women are ‘residual’ members of society because ‘the residual’ refers to a category of individuals who cannot be disciplined or cannot be assimilated into the dominant system due to their certain behaviour and tendencies that run contrary to the commonly-held social norms. In the play, Dee, Ruth, and Claudia similarly appear as the individuals who are perceived as a threat to the social and the familial order since they have ‘failed’ to meet certain standards of mainstream society. These women’s experiences of victimization have played a major role in their maddening and their

119 placement in the disciplinary system of a psychiatric institution to be taken under control and corrected in accordance with the common expectations of society.

Throughout the play, Penwell Special Hospital functions as a disciplinary space for these mentally ill characters. This disciplinary function is ensured through the implementation of some disciplinary maneuvers, methods, and techniques. First of all, there is ‘an imbalance of power’ in the hospital, which can be realized specifically from the sharp distinction that is continuously drawn by the staff between themselves and the patients. From the very beginning of the play, the nurse, Jackie’s authoritarian attitude towards the patients clearly reveals this distinction between the patients and the hospital staff. In Scene One, while Jackie throws the clothes, which have been washed for the impending Christmas disco, to the inmates across the room, she talks to the patients in a highly sarcastic tone. In Foucault’s words, she employs ‘the master’s language’ that is full of commands and repetitions: “Roll up, roll up. Your dirty laundry’s back. Clean.

Come on you lot settle down.” (191).

In this first scene of the play, Jackie, an icon of ‘normality’, makes sarcastic comments about the patients’ physical features and misshapen clothes. First, waving a jumper in the air, she teases Margery: “It’s yours Margery isn’t it? () Well I’ve seen you wear it. () You reckon? Shrunk? It’s you that’s put on weight. Like your food a bit too much.” (191). Then, holding up a dye-streaked shirt, she says to another inmate: “You what? () Look, I know it’s the pantomime season but for your information my name is not Widow Twanky. And you know you’re not encouraged to wear blokes’ clothes anyway. Gawd.” (191-192). Jackie’s remarks seem to involve some “moral” messages for the patients as well since she implies that a woman must not dress up like a man or in a masculine manner. Later, diving into the bin, Jackie brings out a fist-full of bras and says “Not worth burning that for Women’s Lib, eh? Mind you, with your track record dear no one would have believed it was a political act. Just another arson offence.”

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(191-192). Jackie’s reference to Women’s Lib indicates the very real possibility that there may be feminist and politically active women in this hospital as well.

In line with Foucault’s argument, through the nurse’s master language, the patients are directed to recognize the reality of a disciplinary power imposed on them in the hospital. In addition, as befitting Foucault’s argument related to the primary function of asylum doctors, Jackie functions primarily as a sort of moral and juridical authority rather than a medical practitioner because she attempts to impose her own views and values upon the patients, making sarcastic and flippant comments about their clothing preferences and political tendencies. There is another significant detail related to this character; Jackie does not actually have a particular knowledge of mental illness to work as a nurse in a psychiatric hospital. This fact appears through her monologue in

Scene Five where she reveals the fact that she was working as a cashier “in the B&G

Superstore” before her recruitment to this special hospital (212). From these remarkable details, it can be concluded that the nurse, Jackie does not actually serve as the possessor and practitioner of any scientific medical knowledge of mental health care; she rather serves as an enforcer of the common norms, values, and expectations of mainstream society in the hospital space.

In addition to the above examples from the first scene, there are some other moments in the play, which reveal the distinction that is usually kept between the patients and the staff. In Scene One, for instance, when Claudia who also serves as a ward worker in the hospital comes up to Dee and Ruth, Dee gets surprised and needles her friend, saying: “Still speaking to us then Claudia? I thought Ward Workers were s’posed to behave more like staff.” (195). Dee’s remark indicates the patients’ awareness of that distinction always drawn between themselves and the hospital staff.

The patients seem to be aware of their powerless, minority position in the hospital as

121 well. In Scene Two where Dee meets the new nurse, Sharon for the first time, she openly states that Sharon is fortunate since she is “not in the minority” (203). Dee’s use of the lexis “minority” is important in that it points out the presence of an imbalance of power continually maintained between the patients and the staff. In addition to these scenes, in another scene where Dee ironically implies that the nurses are using seclusion rooms arbitrarily in order to punish any patient whose behaviour disturbs them, Barbara clearly underlines the distinction between themselves and her patient:

Dee It says in Her Majesty’s guidelines does it not, that seclusion should not be used just cos you don’t like the look on a patient’s face. Barbara Her Majesty doesn’t run this place. We do. (247)

Apart from this power imbalance, another disciplinary maneuver, “the management or organization of needs” (Foucault, Psychiatric Power 152) is also set to work at Penwell. According to Foucault, psychiatric power first creates certain “needs” for individuals and then manages these “deprivations it establishes” in order to direct patients to behave in accordance with certain rules (Psychiatric Power 155). Thus, individuals are first deprived of something and then they are encouraged to fall in line with the rules to get back the thing they are deprived of. Foucault further contends that among all the possible deprivations, “the deprivation of freedom” is the most effective one for the direction of the patients (Psychiatric Power 155). In the play, the mental inmates confined to Penwell are similarly compelled to act in accordance with the staff’s will through detention and deprivation of freedom. This disciplinary strategy seems to have affected Dee most negatively when compared to the other patients in the hospital.

In the play, Dee is aware of her impending tribunal and wants to be sent to the

Parole Ward to secure her early release from the hospital. To this end, Dee decides to change her “undesirable” behaviour and attitudes in accordance with the doctors’ will 122 until her tribunal. In Scene One, she tells Claudia that she has to “start doing what they want when they want” in order to get a chance for her early release (198). In the same scene, she tells Claudia her plans and asks her for help:

Dee I want to impress them. Claudia Oh yeah? How? Dee Get done up properly and that. You know, make-up, a dress. The works. Claudia You do? Dee Will you help us? Please? What you looking like that for? Claudia This is some attitude change, Dee. (198)

Dee’s plans indicate that her psychiatric detention has served a disciplinary function for this lesbian character because although Dee does not like looking feminine, she decides to make up and wear a dress for the impending Christmas disco. More importantly, as it is later revealed in the play, although Dee is a lesbian, she plans to flirt with the male patients at the disco on the grounds that it would go down well with the doctors. Dee evidently thinks if she displays feminine appearance, wearing dress and making up and if she socializes with someone from the opposite sex, she can look more ‘normal’ and in turn can be considered sane by the doctors. Hence, in the following scene, Dee explains to Sharon after the Christmas disco why she actually needed this attitude change:

Dee I got all dolled up. You saw me. I did it so I would be thought of as more normal and therefore more better I mean betterer. You know what I mean less mad. Am I making any sense? Sharon Put it this way: I don’t feel I should be part of Mensa before I let you go any further. Dee So I’d made up my mind that I would socialise with the blokes and talk politely, not swear. … (237)

Dee seems to be aware of the staff’s perception of her lesbianism as an abnormality that must be supressed and corrected in the hospital in accordance with the heterosexual norms of mainstream society. Dee believes that she can gain her freedom only if she proves herself as ‘normal’ and accordingly ‘sane’ by socializing with someone from the

123 opposite sex. Dee’s statements in the quote above essentially support Foucault’s main argument that psychiatry has always assumed a disciplinary responsibility in western societies, with its privilege to define ‘what is abnormal’ and accordingly ‘who is insane’. Dee feels compelled to behave in accordance with the dominant heterosexual norms in order to be approved by his doctors because the disciplinary power in this special hospital interprets her appearance and behaviour as ‘normal’ or ‘deviant’ based on the widely-held norms and expectations of society.

Foucault’s term of “isotopic”, which he employs in his analysis of disciplinary power, also provides an insight into why Dee feels obliged to change her unfeminine appearance and behaviour in order to be considered ‘normal’ and sane by the doctors.

According to Foucault, each disciplinary institution is isotopic and this means that

“every element in a disciplinary apparatus has its well-defined place” (Psychiatric

Power 52). For instance, a student’s “locus” at school is not only his place in the classroom; it is also his “place” or “rank” within “the hierarchy of values” (Foucault,

Psychiatric Power 52). In the play, Dee similarly has her own well-defined place at

Penwell; her locus in the hospital has already been determined by her deviation from the common norms and expectations of hetero-normative society. Therefore, this character needs to socialize with the male patients in order to be approved and acclaimed by the doctors.

Besides looking feminine and socializing with the male patients, Dee also has another plan to prove her sanity to the doctors; she thinks she must work. In relation to this emphasis on work in mental asylums, Foucault contends that work is enforced on mental patients primarily “as a moral rule” in terms of “a limitation of liberty, a submission to order, an engagement of responsibility” (Madness and Civilization 248).

In other words, work is enforced on mentally ill individuals as a disciplinary method that restricts their freedom and necessarily directs them to take on responsibility and to

124 follow an order of routines in the asylum. In line with this argument, Dee’s plan to work is actually her attempt to prove that she has started to take on responsibility and to submit to the order imposed on the patients in this hospital. In a way, she attempts to prove her obedience to the authority.

All these attempts of Dee can also be explained through Foucault’s argument that most of the psychiatric operations involve “the confrontation of two wills”, of the doctor’s will and the patient’s (Psychiatric Power 10). In Dee’s case, there is similarly a confrontation of two wills, of her own will and of the doctors. If she behaves in a feminine manner, socializes with the male patients, and works properly, she will be considered ‘normal’ and accordingly ‘sane’. However, if she follows her own will, or if she behaves according to her own ‘deviant’ sexual identity, she will be perceived as an

‘abnormal’ individual whose detention will be considered necessary for the suppression and normalization of her deviation through some disciplinary procedures. In this case,

Dee’s recovery and discharge depends primarily on her conformity to certain norms and rules in the hospital rather than on the successful implementation of any medical procedure. This controversial situation corresponds to Foucault’s argument that there is a contradiction between the medical theories and the asylum practices.

The following scene similarly provides a significant example to the contradiction between medical procedures and asylum practices. This time, this contradiction becomes apparent through the clear divergence of opinion between the two nurses as to the implementation of a medical procedure. In this scene, the nurses,

Sharon and Barbara visit Dee to control the wound on her foot. When Sharon sees that

Dee is involuntarily shaking, she asks Barbara if the resident medical officers use

“lignocaine” (235), which is a medicine for pain relief, while stitching the patients’ wounds up. Sharon gets shocked by Barbara’s answer:

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Barbara No. Sharon The RMO’s never give any pain-killer when stitching women up? Barbara Never. Not for self-inflicted wounds. It only encourages them to go on doing it. Besides they can’t feel it. Sharon But they can. You should have seen the way her body shook afterwards. Barbara They can’t feel it when they do it. … Sharon Imagine the pain she must have been in to do it. Barbara Talk to yourself Barbara, what have I just been saying, she wasn’t in any pain. She wouldn’t have felt it. Sharon Oh, yes she was. … Barbara At least we agree that they can’t feel it. Sharon By the time it comes to being sewn up, they can feel it. Barbara We’ll obviously have to agree to differ. Sharon Excuse me but if they can’t feel it how would giving them a pain-killer encourage them to do it again, then? Barbara I haven’t got time to go ail round the houses with you now, Nurse. (235-236)

From the dialogue above, it appears that there is a clear divergence of opinion between the two nurses as to the use of painkillers for switching the patients’ wounds up.

Barbara insists that the patients do not feel any pain but, her contradictory statements in the course of the dialogue reveal that the chief nurse actually aims to punish the patients’ misbehaviour in this way. Hence, at the beginning of the quotation, she states that if they use painkiller, it only encourages them to go on harming themselves.

Barbara evidently acts in a contradictory way with the medical procedures in order to punish the female patients.

As the play progresses, it becomes more evident that Penwell Special Hospital functions as a disciplinary setting quite similar to what Foucault terms as ‘panoptic machine’. All the panoptic principles seem to be applied in this hospital. First of all, the mental inmates are subjected to perpetual surveillance and control by the hospital staff.

The permanent visibility of the patients is usually ensured in the hospital through the implementation of another panoptic principle that Foucault terms as ‘central

126 supervision’. As Foucault argues, central supervision is provided in mental asylums through the relationships established “within the hierarchy of warders, nurses, supervisors, and doctors” (Psychiatric Power 103). Thanks to all these relays of power, disciplinary power is distributed to the whole space of the hospital so that nothing or nobody can escape from the attention and the gaze of the institution staff.

In the play, a network of authority is created in the hospital through the hierarchical organization of doctors, nurses, occupational officers, and ward workers.

These relays of power watch and control the patients so continuously that they can react promptly to any faults or threats that take place in the hospital space. In Scene Three, for instance, when the occupational officer, who continually watches the working patients, witnesses that Sharon helps Dee and Ruth with their work, he immediately interferes, beckoning to Sharon since he does not want the nurse to communicate with the patients. In addition to this scene, some dialogues in the play reveal the fact that these relays of power constantly inform each other in detail on what happens in the hospital. Thus, the whole staff manages to ensure the permanent visibility and control of each patient in the hospital. For instance, the dialogue between Barbara and Jackie in

Scene Eleven shows that although Barbara does not witness any moment Sharon helps the patients with their works, she is nevertheless aware of Sharon’s ‘fault’: “Well.

Anyway. At least she’s stopped wandering around doing the patients’ sewing for them.”

(228). Similarly, another scene in the play shows that although Barbara does not witness

Ruth’s stepmother’s visit to the hospital and though everyone in the hospital thinks it was her aunt, Barbara who has already been informed by Sharon seems to know all the details related to that visit. The following scene, where Barbara and Jackie discuss about why Ruth lost her temper and got into a fight during the Christmas disco on the previous day, reveals this fact. When Jackie thinks Ruth’s aunt’s visit could have had upset her, Barbara corrects what Jackie knows about that visit:

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Barbara No it was before that, that visit – Jackie What, her Aunt upset her? Come off it, that is scraping the bottom of the barrel. Barbara It wasn’t her Aunt though, it was her step-mother. Jackie Oh. Has she been before? Hang on, here wasn’t it her step-mother that she attacked? Barbara It would appear that it wasn’t fatal. Barbara No, she knows she’s still alive, no thanks to her she nearly did kill her. Jackie I wonder what she wanted after all these years, then? Barbara Sharon said – Jackie She’s really trying to ingratiate herself isn’t she? (227)

From the quotation above, the chief nurse, Barbara appears to have already been informed by Sharon about all the details related to Ruth’s stepmother’s visit.

The quote above is also important in that its last line points out the power relationship among the nurses. This fact is revealed especially through the rest of the dialogue where Jackie states that Sharon is “lucky” since Barbara has not “grassed on her” although she wanders “around doing the patients’ sewing for them” (228). This detail reveals the fact that the hierarchical relationships between the patients and the staff prevail among the nurses in the hospital as well.

Another disciplinary practice is also carried out at Penwell in order to ensure the perpetual surveillance and control of the patients. Foucault contends that disciplinary power needs to record “everything that happens, everything the individual does and says” because any information about the individuals can be thus transmitted “from below up through the hierarchical levels” and made “accessible” at any time

(Psychiatric Power 48). In the play, the patients’ files similarly provide the continuous control of the patients by the staff. For instance, in Scene Twenty One, from the dialogue between Claudia and Barbara, it appears that every detail related to what

Claudia says and does in the hospital was written down on her file. When Claudia examines her file, she sees the detailed notes written about herself: “Walks arrogantly, talks in a loud voice, claims racism, paces up and down in her room at night, calls us 128 white trash.” (253). Furthermore, when Claudia gets furious at these distorted notes,

Barbara warns her that if she does not go back in seclusion, her “disruptive behaviour will be well documented in that file” (254). This detail indicates that the patients are being subjected to constant surveillance in the hospital and every detail of their behaviour is being recorded in their files. Through this disciplinary practice, the patients are compelled to develop self-restraint and act in accordance with the behavioural standards set within the hospital.

Besides perpetual control and surveillance, the female patients of Penwell are subjected to ‘isolation’ that is another panoptic principle set to work in mental asylums in Foucault’s view. In the play, the patients have been involuntarily confined to a special hospital and isolated from society. The patients seem to have been held in this enclosed space for long periods of time. In Scene One, Claudia implies this fact, asking ironically if there is anyone who has been there for “less than eight years” (196). The same scene reveals the fact that Claudia has been there “for seven years” (196) and

Ruth, for “twelve” years (195). Furthermore, the patients seem to think that they have no chance of escaping or getting discharged from the hospital in the near future. For instance, Ruth says: “No one gets out of here in a year unless they top themselves.”

(196). She also believes that if anyone is “not mad” when she first comes to that hospital, she will get mad by the time she gets out of there (196). Ruth’s remark essentially points out the over-long detention and isolation of these patients from society.

In the play, the patients are also isolated from the other patients inside the hospital through the use of seclusion rooms and locked wards. In Scene Two, while

Barbara checks whether the new nurse, Sharon who had worked in a psychiatric hospital before knows anything about the function of special hospitals, she reveals the fact that the patients of Penwell are kept in locked wards:

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Barbara … you’ve no doubt discovered by now it must be very similar to where you’ve worked before – Sharon Umm, quite. Barbara But you’ve worked in a psychiatric hospital before? Sharon Yes. Barbara Of course you must have to be a RMN. You must have seen locked wards? Sharon Yes, of course. Barbara Well, this isn’t that different surely? Sharon No but – (200)

The patients are isolated from the other patients in the hospital through the use of seclusion rooms as well. In the play, seclusion essentially refers to another panoptic principle that Foucault terms as ‘ceaseless punishment’ since it is frequently used by the staff as a punishment for the patients’ disobedience. All three of the primary characters,

Dee, Ruth and Claudia are punished through seclusion in the hospital. Dee is secluded since she fists a male patient who mauls Ruth at the Christmas disco. Although Dee previously plans to socialize with the male patients in order to prove her ‘normality’ to the doctors, she unexpectedly attacks a male patient at the disco. In Scene Fourteen, Dee attempts to explain to Sharon how that event resulting in her seclusion actually broke out:

Dee So I’d made up my mind that I would socialise with the blokes and talk politely, not swear. So this bloke started talking to me – Sharon: Actually he was talking to Ruth – Dee No, this was before that. The bloke I was talking to started telling me what he was in for. A whole host of right gory details and I thought yeah, who are you to judge, don’t judge him because no one’s in here for picking– Sharon Daisies. Dee Their nose. But then I saw he was getting off on it. I felt furious. Furious. Fur – Sharon You felt furious. Dee Yes, but I didn’t do nothing. I just started to walk away. Then the next thing I see is that other bloke mauling Ruth and I couldn’t stand it. She didn’t want it. Why didn’t you lot stop it? (237)

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As it can be understood from her explanations, Dee first gets furious with a male patient boasting of the “gory details” of his crimes and then she cannot contain her fury with that man when she sees another male patient mauling Ruth. More importantly, Dee implies that the hospital staff did not prevent the male patient from abusing her friend.

This scene is significant as it reveals how the women’s exposure to men’s abuse and violence in their family and in society similarly continues in the hospital space.

Following this incidence at the Christmas disco, Dee and Ruth are put in the seclusion rooms as a punishment for their aggressive behaviour. However, Ruth and

Dee’s reaction to the abusive male patients seems to have been misinterpreted by the hospital staff. For instance, just after the incidence, Jackie condemns Dee for being

“aggressive queer” (228) and Sharon refers to Dee as “mad tiger” and “short-sighted”

(226). More importantly, Jackie condemns Ruth for “letting” the male patient maul her

(239) and refers to her as a “slag” and “little slut” (227). Apparently, the nurses employ quite offensive and sexist terms to refer to these female patients and they evaluate the women’s behaviour according to their sexually biased perceptions. The following scene also reveals that while the nurses condemn these women’s reaction to the abusive male patients, they do not question the male patients’ role in that unfortunate incident. This fact is revealed through the following quote where Dee questions this absurdity of the hospital system:

Dee Did either of those blokes get banged up? No. They most probably got parole for showing such normal behaviour. Secondly, if I was on the outside and I made a relationship with a serial killer or rapist or both you’d consider me mad but that’s what you have to do in here to prove you’re sane. Now what’s more loony, me or that? Sharon You can’t get away with hitting people no matter what the circumstances. Dee You reckon? (She stands up.) In here you can get away with anything as long as you’re not a patient. (237-238)

Dee claims that while she is accused and secluded for her rightful reaction to her friend’s abuse by a male patient, those men who are actually responsible for that 131 incident have not been punished and may have even been rewarded on the grounds that they exhibited ‘normal’ behaviour. Dee further adds that if she stroke up a relationship with any of those men, with a convicted rapist or a serial killer outside the hospital, she would most probably be considered mentally deranged. However, according to Dee, the logic is completely different in the hospital since she is expected to socialize with someone from the opposite sex even if he is a dangerous serial killer or a rapist.

Drawing attention to these critical contradictions, Dee essentially questions what constitutes sanity and insanity in this hospital. Her questionings also significantly underline how the perception of madness or mental illness can be easily shaped by certain norms, expectations, and values of mainstream society.

Apart from Dee and Ruth, another primary character, Claudia is subjected to seclusion in the hospital as well. Claudia is secluded because she is accused of having hit Ruth in the seclusion room. The chain of the events leading to Claudia’s seclusion starts with Jackie’s visit of Ruth in her seclusion room. When Jackie visits Ruth to bathe her, she discovers a deep cut on the side of Ruth’s head. Although she attempts to determine who has caused that deep cut, she cannot learn anything from Ruth. Then, from the dialogue between Jackie, Barbara, and Sharon in the same scene, Jackie appears to be accusing Claudia of having gashed Ruth’s head on the grounds that she is the only person who could have visited Ruth in her seclusion room. Based on this assumption, Jackie suggests Barbara to “bung Claudia in seclusion” (243).

Later, in Scene Seventeen, Ruth who has been got out of the seclusion room commits suicide by hanging herself in the washroom. Although Claudia helps Ruth and saves her life when she finds Ruth hanging herself, she is nevertheless secluded on the grounds that she is responsible for Ruth’s injury and her suicide attempt. Ruth is unjustly punished because as the following dialogue between Jackie and Ruth reveals, the person who hit Ruth in the seclusion room is actually the chief nurse, Barbara:

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Jackie If someone smacks you, you smack them back harder. You shouldn’t let that Claudia get away with it. She struts around here like she’s Miss Penwell Hospital ’92. Ruth laughs. Jackie Yeah, she does doesn’t she? Ruth It wasn’t Claudia. Jackie Oh. Who was it, then? Ruth You don’t want to know. Jackie Course I do. Ruth You’ll hate me if I tell you. Jackie Of course I won’t, tell me. Ruth Barbara. (251)

Barbara’s hypocrisy and violence towards the patients are also revealed by

Claudia who gets furious at the distorted notes about herself in her file in Scene

Twenty-One: “She’s bashed patients around for years and got away with it but now she’s decided to start blaming it on the other patients.” (254). Both Claudia’s claim and

Ruth’s confession show that Barbara resorts to physical violence in the hospital.

Furthermore, she puts the blame on the patients. In Ruth’s case, she puts the blame on

Claudia and secludes her.

In Scene Twenty-Three, Barbara confesses her guilt to the administrators, giving the details of her violent behaviour towards Ruth:

Barbara … My keys knocked against her head. () She was just sitting there. () On her mattress. () In seclusion. Passive, well inert, except for her head which was rocking rhythmically from side to side like some great pendulum, on a Grandfather clock. Tick, tock, tick, tock and I hit her. () How? I took my bunch of keys and swung them round in the air several times – I swear to God if she’d said ‘please don’t’ if she said anything even, then I wouldn’t – but she just kept doing it so I timed it for when her head came back to my side of her and bang, caught her full on the side of her head. … (259)

Barbara does not deny having engaged in physical violence against her patient. She further states that she did not stop hitting because Ruth did not resist her beatings.

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Barbara’s statements reveal the fact that the patients are also punished through the staff’s physical beatings in this special hospital.

Besides seclusion and physical beatings, the excessive use of anti-psychotics causing considerable negative side effects functions as a form of punishment for the patients. For instance, Ruth who is constantly medicated throughout the play experiences the body- and mind-numbing effects of anti-psychotic medication. In Scene

Six where Claudia and Ruth get ready for the Christmas disco, Ruth who has had a lot of medication has much difficulty speaking, standing without shaking, and buttoning her cardigan. She cannot put her lipstick on with her shaking hands. When Claudia offers her friend help, asking if she would like “a hand” Ruth says “Yes, one that doesn’t shake.” (215). Ruth evidently cannot control her body’s movements and cannot act independently due to the negative side effects of her heavy dosage of medication.

Apart from Ruth, Dee experiences the considerable negative side effects of antipsychotic drugs as well. Dee, who has been once identified by the nurses as

“aggressive” (228), and “mad tiger” (225), now appears, in Scene Twenty-Two, to be sitting motionless in a chair while Sharon tries to give her “a fistful of tablets” – “all colours of the rainbow” (258). Dee’s physical inertia can be understood from Sharon’s statement “Let’s hope these (Meaning the tablets.) pep you up then.” (258). Sharon tries to convince Dee to take the tablets on the grounds that they will bring her back to life, however, the drugs only seem to cause Dee to suffer from inertia. Dee also suffers from thirst as an unpleasant side effect of her medications. While Sharon attempts to convince her to take the tablets, Dee can use her energy only to ask for water to slake her constant thirst: “Please, would yer, I’m – I can’t seem to stop being thirsty.” (258).

All these negative side effects the patients experience due to heavy dosages of medication bring to mind Foucault’s argument related to the disciplinary role of psychiatric medication. Foucault contends that medication involves a disciplinary

134 function; it is essentially “the extension of asylum discipline into the body” (Psychiatric

Power 181). Since the drugs keep the patients docile and numb, they help the hospital staff to control and modify the patients’ undesirable behaviour. They serve to render the patients disciplined and tamed. In the play, the nurses similarly administer medication as an attempt to take the patients under control and make them submissive to the staff’s authority.

All these disciplinary methods and techniques applied in Penwell Special

Hospital consequently demonstrate that the female characters, Dee, Ruth, and Claudia experience a disciplinary process in this hospital. These women are subjected to involuntary psychiatric hospitalization and treatment as a consequence of their exposure to some unfortunate experiences such as sexual abuse, domestic violence, and social oppression. Their victimization in society and in family has played a significant role in the development of their psychological and mental health problems. Placed in a special hospital, which means a psychiatric prison for women, these characters are subjected to a disciplinary process for their transformation into docile and obedient subjects for the benefit of the familial and the social order. The characters are exposed to isolation, perpetual surveillance, central supervision, and ceaseless punishment in order to be compelled to develop self-discipline and regulate their own ‘undesirable’ behaviour and tendencies in accordance with the staff’s expectations.

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CHAPTER V

PSYCHIATRIC POWER AND RACE/ETHNICITY:

JOE PENHALL’S BLUE/ORANGE (2000)

‘Race/ethnicity’ has become another issue of interest within the debates of psychiatry. Many studies and researches called into question the possible influences of ethnic/racial and cultural differences on psychiatric diagnoses through the statistical data that reveal the overrepresentation of coloured and ethnic-minority groups in mental health system. Some of these studies have specifically focused on the higher incidence rates of mental disorder and compulsory detention among the coloured people living in the United Kingdom than in the white British population. For instance, Fearon et al. in the AESOP study (2006) examined the incidence of schizophrenia and of other psychotic disorders among ethnic minority groups in “South East London”, “Bristol”, and “Nottingham”, and consequently found that “African-Caribbeans and Black

Africans appear to be at especially high risk for both schizophrenia and mania.” (1541).

In another national survey, Nazroo found that “the prevalence rates for depression among Caribbean individuals were 60 per cent higher than the white group” (qtd. in

McGeorge and Bhugra 136). The studies also showed that ethnic minority groups in the

UK, including “the Black Caribbean, Black African and Other Black Groups” are more likely to be compulsorily admitted to psychiatric hospitals through “the criminal justice system” rather than through “GPs or community mental health systems” (Commission for Healthcare Audit and Inspection 39).

The higher prevalence of psychological and mental disorders and the higher risk of compulsory hospitalization among coloured and ethnic minority groups have largely been related to a variety of social factors including the experiences of racial discrimination and the poor socio-economic inequalities such as high unemployment, poverty, homelessness, and limited educational opportunities. For instance, a study by

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Wallace et al. (2016) showed that ethnic minority people who are frequently exposed to racial discrimination in society are more likely to suffer from psychological and mental disorders. Another study by Memon et al. (2016) drew attention to the challenges that black and minority ethnic (BME) communities usually face in seeking help and accessing appropriate mental health services due to “language barriers, poor communication between service users and providers, inadequate recognition or response to mental health needs, imbalance of power and authority between service users and providers, cultural naivety, insensitivity and discrimination towards the needs of BME service users” (1).

Joe Penhall’s Blue/Orange is a significant play that touches upon this critical issue of “mental illness and racial/ethnic minorities”. The play tells the story of a young coloured man who is sectioned through criminal justice system and involuntarily placed in a psychiatric hospital. Revolving around this coloured character, the play both raises a concern over the inclusion of cultural factors in psychiatric diagnoses and highlights how exposure to racial hatred and discrimination can drive a person into severe mental and psychological disorders. The play also deals with the power relations in a psychiatric institution through the two doctors’ hierarchical power struggle over their patient, which sacrifices their patient’s right of an objective diagnosis and finally causes him to experience an identity crisis. In the light of these details, this chapter aims to examine Blue/Orange in terms of how psychiatric institutions and professionals serve a disciplinary function over this young coloured man with the help of Foucault’s analysis of psychiatric power.

John Penhall (1967- ) is an Austrian-British playwright and screenwriter. Penhall began his playwriting career with a one-act play about friendship and violence, Wild

Turkey (Old Red Lion Theatre, 1993). He then wrote his first full-length play, Some

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Voices (Royal Court Theatre, 1994), which brought him national and international success. This play portrays the difficulties that mentally ill individuals have in integrating into the community. Penhall’s some other major works can be listed as Pale

Horse (Royal Court Theatre, 1995) about a bar keeper disillusioned by the sudden death of his wife, Love and Understanding (The Bush Theatre, 1997) exploring the institution of marriage, The Bullet (The Donmar Warehouse, 1998) about the story of a suburban family and Blue/Orange (The Cottesloe Theatre, 2000) which centres on the issues of race and mental illness.

Blue/Orange (2000) takes place over twenty four hours in a London psychiatric hospital. The play tells the story of a young Afro-Caribbean man, Christopher who has been sectioned by the police following an incident in Shepherd’s Bush Market.

Christopher has been detained under Section 2 of the Mental Health Act, which allows his compulsory hospitalization and assessment for a period of up to 28 days. In the play, it is time for Christopher’s release since his twenty-eight days are up, however, the two doctors, Bruce and Robert cannot reach an agreement on their patient’s diagnosis and discharge. While Bruce who is in his first year of training asserts that Christopher needs a Section 3 for further observation on the grounds that he may be a paranoid schizophrenic, Bruce’s consultant and mentor, Robert who is in his fifties and ambitious to become a professor advocates that Christopher must be immediately released on the grounds that his section has been successfully completed and it is their responsibility to discharge him. The play proceeds with this main issue of whether Christopher, who claims that oranges are blue and Ugandan dictator Idi Amin is his father, should be released from the hospital into the community.

In Blue/Orange, the mentally ill character, Christopher has been sectioned by the police following an incident that Bruce – the doctor – refers to as “something funny”:

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Robert Before he was admitted. What happened? Bruce He was … he was in the market … doing … I dunno, something funny. Robert He was doing “something funny” in the market. Which market? Bruce Does it matter? Robert I’m curious. Bruce Shepherd’s Bush. Robert “Funny” strange or “funny” ha-ha? Bruce It’s in the file. Read the file. (21)

Although the incident which led to Christopher’s compulsory psychiatric detention is not revealed throughout the play, the doctor’s use of the lexis “funny” implies that this young man has not been sectioned since he committed a serious crime or harmed someone; he has been detained most probably because he acted ‘strangely’ in public.

The fact that Christopher did not cause harm or injury to anyone is also revealed in another scene where the senior Robert asks Bruce if Christopher has ever attempted to harm himself or anyone else, and Bruce replies “Of course not” (20).

The scene above involves a significant detail in relation to disciplinary power;

Christopher was not first diagnosed by psychiatrists as mentally ill; he was arrested by police on the grounds that he did something “funny” in the market and then has been hospitalized under Section 2 of the Mental Health Act. This collaboration between the two different institutions, which results in Christopher’s compulsory hospitalization and treatment can be explained through Foucault’s concept of “isotopic”. According to

Foucault, “a disciplinary apparatus is isotopic” and this means that “there is no conflict between different disciplinary apparatuses” (Psychiatric Power 52-53). In the play, there is similarly no conflict between the functions of the institutions, police and psychiatry. These two institutions seem to serve similar disciplinary purposes:

Christopher is first arrested by the police since he is considered to disrupt the public order and then involuntarily confined to a psychiatric institution for his transformation into someone who will not pose a threat to social order any more. The two institutions

139 apparently complement each other for similar disciplinary functions in accordance with

Foucault’s argument.

Christopher who has been sectioned through the collaboration between mental health and criminal justice systems appears to be a ‘residual’ character in the play as an

‘inassimilable’ member of a disciplinary society. The ‘residual’ refers to a category of individuals who cannot be assimilated into the system due to their certain deviations from the norm. In Foucault’s view, this kind of individuals who fail to meet the widely- held social standards appear as a problem for disciplinary power and society, and are in turn placed in supplementary disciplinary systems where their deviations could be suppressed and corrected for the benefit of power and society. In the play, Christopher falls into that category of ‘Otherness’ due to his ethnic minority identity and his different cultural background. Since he is considered to act in a contradictory way with the dominant cultural expectations of society, he is perceived as a potential threat to the public order and is in turn placed in a supplementary disciplinary system, in a psychiatric hospital in order to be transformed into a docile and conforming individual.

Christopher’s ‘residual’ position in mainstream society becomes more apparent in his dialogues with his doctors throughout the play. Christopher seems to think that his ethnic minority identity has played a major role in his psychiatric diagnosis and hospitalization process. In Act One, when Bruce attempts to make the diagnosis of

“Paranoia. Persecution Delusion” for Christopher, Christopher reveals his belief that he has been deliberately diagnosed with paranoia since he is a coloured man:

Bruce (To Robert.) Paranoia. Persecution Delusion – Christopher ’Cos I’m an “uppity nigga.” Bruce No. You always say that and I always tell you the same thing. No. (14)

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Christopher employs that offensive term, “nigga” to refer to himself during most of his interviews with the doctors in the play. The following scene where Christopher wants a drug from his doctor provides a significant example:

Christopher … Where’s the drugs, man? Bruce … Oh the drugs. Of course … Christopher It’s all that innit. “Where’s the drugs man? Oh man, these patients giving me massive big headache man, massive big headache, what have I got in my doctor’s bag, gimme some smack, where’s some smack? Where’s the Tamazie Party? This bad nigga patient I got. This bad nigga dude I know. My God! I Can’t Take The Pressure!” (8)

In this scene, Christopher who is disturbed by the hospital noise wants a drug from

Bruce; he wants to have Temazepam that is a hypnotic drug used for the treatment of insomnia. However, while asking for that drug, Christopher both refers to himself as a

“nigga”, which is actually used as an ethnic slur against coloured people, and implies that as a coloured man, he is a potential drug user in the eyes of his doctor.

In another scene where Bruce gets angry with Christopher who talks to the consultant Robert loudly, staring at him, Christopher similarly assumes that his doctor will address him as an “uppity nigga”:

Bruce Calm down. Now you are acting like a – Christopher A what? A what. Go on say it. An “uppity nigga.” (14-15)

Christopher’s repeated use of the term “nigga” implies that he has always been labelled in that way in society and has consequently come to terms with that stigma.

Christopher’s repetitions of that racist epithet also indicate that he has been frequently subjected to social exclusion and marginalization due to his racial and ethnic origin.

This fact becomes more evident through Christopher’s reflections on the most racially fraught moments of his life. In Act Two, he tells Robert some of those moments and also adds that he has changed his mind about leaving the hospital: 141

Christopher I … I … I don’t have a home. I’m not … I’m not ready. Robert What happens to you when you go home? Christopher I told you about the Fuzz. Robert OK. Fine. But apart from … the “fuzz.” What else happens to you? … Christopher People stare at me. Like they know … like they know about me. Like they know something about me that I don’t know. Robert Such as? Christopher Eh? Robert What could they know that you don’t know? Christopher I don’t know. They hate me. They think I’m bad. Robert Which people? Christopher Eh? Robert Who are these people who … think you’re bad? Christopher I hear noises. At night. Outside my window. Sometimes I hear … talking about me. Robert Talking about you? Christopher Laughing sometimes. (38-39)

Although Christopher looks forward to his impending release at the beginning of the play, he now says that he is not ready to leave the hospital and go back to the community. Christopher changes his mind because he fears he will not be safe in the community where he seems to be continually bothered by the police whom he mentions as “fascists” (24) in another scene, and by other people staring and laughing at him.

In the scene above, Christopher’s statement “I don’t have a home” actually involves a deep psychological meaning because home is usually considered a place where one usually feels safe and happy, or where one feels like nobody can touch or harm him since he is there. Home is also the place where someone collects his family and childhood memories. Christopher who says that he has no home evidently feels insecure and rootless in the community. These negative feelings of Christopher appear to be an inevitable effect of his ‘residual’ position in mainstream society and of his unfortunate experiences of racial hatred, discrimination, and oppression.

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As the play proceeds, Christopher gives more details related to his racist experiences that seem to have left a strong impact on both his psychological well-being and his mental health. In the following scene, for instance, Christopher tells Robert how he has been exposed to racial discrimination and bullying at work and at home:

Christopher I am being harassed. I’m in fear of my life. I live in fear. They Know Who I Am. Robert Who does? Christopher The men. Where I live. The noises. The … the police. Work men … police men. Robert They’re … look … it’s … they’re just ordinary men. Work men … police men. Christopher Other men too. Another man. He throws bananas at me. Robert Bananas? Christopher When I’m at work. Even at work – d’you know what I mean! Big bloke with a little pointy head. … Very white skin. … I see him at night. He bangs on my door. Says he’s coming to get me. He says he’ll do me and nobody would even notice and I believe him. There’s a whole family of them. A tribe. I don’t like them at all. They’re a race apart. Zombies! The undead. Monsters! Manchester United fans. (42)

Christopher is in fear of his life from police and racist skinheads who continually bother him both at work and at home. Due to such unfortunate experiences, Christopher feels so threatened in the community that he decides not to leave the hospital. However, as the play progresses it becomes apparent that Christopher feels threatened in the hospital as well; this time he is afraid of being assimilated by the “typical white” (8) doctors and of losing his own cultural identity. The following scene where Christopher says that he undergoes an identity crisis reveals this fear of Christopher. In this scene, Bruce asks

Christopher what people are going to think about him if he continues staring at people when he gets out of the hospital:

Bruce What are people going to think? … Christopher I don’t fucking know. Bruce Well what do you think they’re gonna think? Christopher I don’t know.

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Bruce They’ll think you’re a, a, an “uppity nigga,” that’s what they’ll think. Kissing your teeth. It’s not you. It’s silly. It’s crazy. You’re not a, a, a, some type of “Yardie” – Christopher Now you’re telling me who I am? Bruce No, I’m – Christopher You’re telling me who I am? Bruce I’m telling you … to be You. Christopher That’s rum that is. That’s rich. Now I’ve got an identity crisis. … (15)

The doctor warns Christopher that if he continues staring at people and kissing his teeth when he goes back to the community, he will be considered by people as an “uppity nigga” and “yardie”. When the doctor further warns Christopher to be himself, implying that he is not actually such kind of a person who deserves to be called as a “nigga” or

“yardie”, Christopher feels confused and thinks he is having an identity crisis.

Christopher’s feeling like he is experiencing an identity crisis can be explained through

Foucault’s argument related to the psychiatrists’ disciplinary role over their patients because in this scene, Bruce essentially performs a disciplinary function over

Christopher, directing him to develop self-discipline and take responsibility for regulating his own socially ‘undesirable’ behaviour. Bruce actually dictates a standard of behaviour on his patient, telling him not to stare at people, and thinks Christopher can be socially accepted and approved only if he changes that socially unwanted behaviour, following his directions. Christopher who is aware of the disciplinary attempt of his doctor perceives this direction as a threat to his self-identity.

Another factor which contributes to the development of Christopher’s identity crisis is the doctor’s use of racist epithets such as “nigga” and “yardie” while warning his patient. It is significant that Bruce does not simply say to Christopher that he will be considered a person with aggressive behaviour or tendencies if he keeps on kissing his teeth and staring at people; he rather employs racist terms to refer to those people who he thinks cannot be socially accepted due to their aggressive attitudes. Bruce’s choice of such racist, offensive terms indicates his negative perception of coloured people because 144 he directly associates these socially undesirable attitudes with racial and ethnic minority people. This negative attitude of the doctor towards his patient brings to mind

Foucault’s argument related to the psychiatrists’ function as a sort of juridical authority over their patients because as a medical practitioner, Bruce is normally expected to employ a scientific and objective discourse while talking to his patient; however, he employs clearly racist terms that will cause his coloured patient who has already been racially discriminated in the community to feel much worse and humiliated, and accordingly will deepen his psychological and mental distress. The doctor’s employment of such racist terms as “nigga” and “yardie” reveals the fact that

Christopher’s exposure to racial discrimination in the community actually continues in this psychiatric institution.

Christopher’s worries in relation to losing his self-identity can also be seen in some other scenes of the play. In the following scene, for instance, when Robert implies to Christopher that he has decided not to leave the hospital since Bruce’s thoughts could have discouraged him, Christopher worries about the possibility that he may have begun to act under the influence of his doctor:

Robert I think that someone else’s thoughts have scared you. Christopher You think … I’m thinking someone else’s thoughts? (Pause.) Whose thoughts? Robert I’m saying … look … Maybe Doctor Flaherty “projected” his fears of letting you go home onto you and now they’re your fears. I’m saying maybe, just maybe Doctor Flaherty … unconsciously put his thoughts into your head. Christopher He put his thoughts in my head. In my head … ? (45-46)

When Robert implies that Christopher has changed his mind about leaving the hospital since he has fallen under Bruce’s influence, Christopher worries since he is afraid of changing gradually into someone that his “typical white” (8) doctors want him to be.

Robert’s claim worries Christopher so greatly that when he again changes his opinion,

145 deciding to leave the hospital and to become an out-patient of Robert, he asks Bruce to learn if he has really put some thoughts in his head:

Christopher The thoughts I have are not my thoughts. He said that I think your thoughts. Bruce Doctor Smith said? Christopher And that’s why I have to get out of here. Bruce That’s not what I said. Christopher I’ve gotta get outta here ‘cos of you, man! Bruce Look … Christopher ‘Cos you’re bad. Robert OK … Christopher – Christopher And now I don’t, I don’t, I don’t know what to think! I don’t know what to think any more. When I do think, it’s not my thoughts, it’s not my voice when I talk. You tell me who I am. Who I’m not. I don’t know who I am any more! I don’t know who I am! (65-66)

The scenes above demonstrate that Christopher suffers from a confusion related to his sense of identity as a negative effect of his doctors’ power struggle over him as well because Christopher’s behaviour and thoughts are continually directed by his doctors in accordance with their own wills. While trying to conform to the expectations of each of his doctors who hold entirely divergent views and ideologies, Christopher ends up being constantly forced to change his behaviour and thoughts and accordingly to sacrifice something of his identity. For instance, when he talks to Bruce who thinks Christopher should not be released into the community on the grounds that he is not ready yet,

Christopher worries about the possible difficulties he may come across in the community and decides to stay in the hospital. However, when he talks to the senior

Robert who thinks that Christopher “will become institutionalized” and will “get worse” if he is detained “longer” (23), he changes his mind again and decides to leave the hospital as soon as possible. Due to these different directions of the doctors, Christopher continually moves back and forth, and cannot even think about his own wishes or needs since he is continually directed by his doctors to decide and act in accordance with their 146 own wills. Thus, Christopher who is caught up in the power struggle of his doctors experiences a sense of divided identity in the hospital.

Throughout much of the play, Christopher falls victim to this power struggle between his doctors. The doctors who suggest entirely different diagnoses for

Christopher continually debate over whether they must continue detaining their patient in the hospital. While Bruce interprets Christopher’s unstable and highly animated behaviours as the symptoms of paranoia, the senior Robert thinks that such behaviours are not enough to diagnose someone as mentally ill. Robert further attributes these behaviours to the human condition and claims that they can be witnessed in anyone else:

Robert And you can add, reckless, impulsive, prone to extreme behavior, problems handling personal life, handling money, maintaining a home, family, sex, relationships, alcohol, a fundamental inability to handle practically everything that makes us human – and hey Some People Are Just Like That. Borderline. On the border. Occasionally visits but doesn’t live there. See, technically he’s not that mentally ill. We can’t keep him here. It’s Ugly but it’s Right. (Pause.) Shoot me, those are the rules. (Pause.) (19)

Robert confirms the diagnosis of borderline personality disorder for Christopher.

Borderline personality disorder is a kind of mental disorder that influences the way a person thinks and feels about himself and other people and that causes the person to suffer some difficulties functioning in daily life. In this context, Robert suggests that

Christopher’s behaviours which Bruce defines as the symptoms of paranoia are normal for a person with borderline personality disorder and are not enough to diagnose someone as mentally ill. In line of this thought, Robert advocates that they cannot keep

Christopher in the hospital any longer. In the rest of this scene, Robert also warns Bruce to follow the mental health diagnostic guidelines, reminding his colleague that they have to “stick to the ICD 10 Classification” (19) that is the tenth version of the

International Statistical Classification of Diseases.

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The two doctors’ radical divergence about their patient’s diagnostic fate is a significant detail in relation to Foucault’s argument that there is always a contradiction between the asylum practices and the medical theories. Foucault argues that most of the psychiatric operations just involve “the confrontation of two wills”, of the doctor’s will and the patient’s (Psychiatric Power 10). For this reason, Foucault resembles the asylum space to a ‘battlefield’ where the victory of one will to another takes place. In the play, there is similarly a contradiction between medical theories and the doctors’ attitudes toward their patient. Under the effect of their career-conscious power struggles, the doctors cannot provide an objective diagnosis for their patient. For instance, Robert worries about his career; he fears he will not be able to get professorship if they renew Christopher’s detention section. When Bruce wants a

Section 3 for Christopher, Robert reveals his career-conscious worries: “There’d be scandal. They’d have my arse out of here faster than his and you’d be next. That’s right.

I’ll never make Professor.” (17). In an attempt to convince his colleague, Robert further threatens Bruce, implying that he will give him a rough time when he supervises him in specialist registrar training in the following year: “Well, your Specialist Registrar

Training. And, I said, for the coming year I am prepared to supervise you, I’ll be your

‘Mentor,’ I’ll teach you ‘all I know’ … but you have to play the game.” (17). Thus,

Robert asserts his authority over Bruce and compels him to act in accordance with his own will. These details demonstrate that the confrontation of two wills, which Foucault argues takes place between the doctor and the mental patient, does not only occur between the doctors and the patient in this hospital; it also occurs between the two doctors throughout the play. In addition, and more importantly, these details show that

Christopher’s cure and release depend primarily on the result of the confrontation between his doctors’ wills rather than on the outcome of an objective diagnostic process.

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In the play, the debates between the senior Robert and his colleague on

Christopher’s diagnosis and release essentially raise serious questions about the objectivity and reliability of psychiatric diagnoses. Robert fundamentally accuses Bruce of ‘ethnocentric bias’; he implies to Bruce that he could have been negatively influenced by his patient’s ethnic minority identity and his different cultural background in the diagnostic process. In the following scene, Robert implies this for the first time in the play:

Robert You know, there is nothing wrong with your patient Bruce. He may be a bit jumpy, he may be a bit brusque, a bit shouty, a bit OTT – but hey, maybe that’s just what you do where he comes from. Bruce “Where he comes from”? Robert His “community.” Bruce He comes from Shepherd’s Bush. What exactly are you trying to say? (21-22)

Robert implies to Bruce that his approach to Christopher’s mental state may involve some cultural and ethnic prejudices. Robert implies that, referring to where Christopher comes from, Shepherd’s Bush that is a district in the west London and has a large amount of coloured and ethnic minority population. In the following quote, Robert explains more clearly that the cultural and linguistic differences could have intervened in Bruce’s psychiatric diagnosis of his patient:

Robert OK look. I’m merely pointing out that sometimes our analysis is Ethnocentric. In this case you are evaluating the situation according to your own specific cultural criteria. Bruce “Ethnocentric”? Robert Our Colonial Antecedents are latent and barely suppressed. We are intuitively suspicious because of our cultural background. For example, on the way back from the rugby the other night we stopped at the off-license for a bottle of wine. I noticed that the Hindu gentleman behind the counter said neither Please nor Thank You. I had to ask myself, is he just like that – or is he just rude? Or is it because there is no such thing as Please and Thank You in Hindi – is it not customary in his culture? Bruce What are you talking about? He always says Please and Thank You.

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Christopher OK fine. So perhaps I should ask myself, Is it me? What are my cultural expectations? (32)

In this scene, Robert essentially points to the cultural content of psychiatric diagnoses.

He questions how cultural beliefs, values, practices, and norms can play a key role in the formation of psychiatric diagnoses. Based on this assumption, Robert attempts to question their ‘normative’ function as psychiatric professionals over the individuals diagnosed as mentally ill:

Robert We spend our lives asking whether or not this or that person is to be judged normal, a “Normal” person, a “Human”, and we blithely assume that we know what “Normal” is. What “Human” is. Maybe he’s more “Human” than us. Maybe we’re the sick ones. Bruce He’s “more human than us”? Robert Yes. Bruce And we’re the sick ones. Robert Maybe. (Pause.) Bruce Why? (Silence.) Robert … But maybe, just maybe he’s a right to be angry and paranoid and depressed and unstable. Maybe it’s the only suitable response to the human condition? (22)

Robert points out the elusive and ambiguous nature of psychiatric diagnoses, emphasizing the relationship usually established between the notions of ‘normality’ and

‘sanity’ in psychiatric practices. He asserts that psychiatrists who suppose they exactly know ‘what is normal’ and ‘what is abnormal’ can also be mistaken related to the frames of normality. He further implies that they can also fall into the categories of

‘abnormal’ and ‘mentally ill’ according to the changing cultural conditions and expectations of society. Robert’s emphasis on the possibility that what may seem like mental illness in a particular culture may be healthy in another cultural context brings to mind Foucault’s main argument related to mental illness and psychiatry. In substance,

Foucault approaches madness or mental illness as a social construct rather than as a medical entity independent of historical and social factors. According to him, the

150 definition and treatment of madness or mental illness are largely determined by the cultural, political, or economic conditions and expectations of a particular society and of a particular time. In line of this thought, Foucault approaches psychiatry in terms of its

‘normative’ function; he argues that psychiatry has always served a disciplinary function in western societies; with its privilege to define ‘what is abnormal’ and accordingly ‘who is insane’. It has produced medical discourses related to how individuals must behave in order to be socially accepted and approved and thus, it has become a mechanism of regulation that distinguishes between normal and deviant behaviour. In the scene above, Robert’s questionings bring to mind these arguments because the doctor both raises questions about the association of certain behaviour and thoughts labelled as ‘abnormal’ due to cultural factors with mental disorders, and draws attention to their role as psychiatrists in the enforcement of the dominant social norms over the mentally ill individuals as befitting Foucault’s argument.

At the end of the quotation above, Robert further implies that Christopher has a right to show his anger due to his exposure to racial hatred and discrimination in the community. To substantiate his point of view, Robert refers to the Scottish existentialist psychotherapist, R. D. Laing who attributes mental illness as person’s inevitable reaction to unendurable stresses of life and policies of repressive society. Through this reference, Robert attempts to explain Christopher’s mental health problems as a natural response to the oppression he has experienced in the community due to his ethnic minority identity. This attempt of Robert becomes more evident when Bruce asserts that

Christopher seriously suffers from schizophrenia on the grounds that he claims that oranges are blue in colour and former Ugandan president Idi Amin is his father. Robert who researches and writes a book on the cultural determinants of human behaviour interprets these delusional ideas of Christopher as a product of his cultural background and as a natural response to the social pressure Christopher has experienced in the

151 community. For instance, he attributes Christopher’s delusion of blue oranges to the possibility that he could have been influenced by a book entitled Tin-Tin and the Blue

Oranges:

Robert … It’s about a “mad professor” who invents an orange which will grow in the Sahara. Only trouble is its bright blue and tastes salty. Tin-Tin was banned in the Belgium Congo. They taught he was a communist. But in colonial Uganda the notoriety no doubt made Tin-Tin a “must-read” for the bourgeoisie. He was a cultural icon and a symbol of middle class insurrection. A delusion waiting to happen. BPD with Delusion. (30) Besides this probability, Robert further claims that it is also possible that Christopher’s mother could have read the poem by Paul Eluard, “Le Monde Est Bleu Comme Une

Orange” (The Earth Is Blue Like An Orange) him as a child and that poem could have created an image in his mind. According to Robert, there are similarly logical grounds for Christopher’s belief that his father is Idi Amin: “it’s quite possible he’s heard some family story, handed down through the generations, some apocryphal story, maybe Idi

Amin came to town, to the village, de da de da, Chinese whispers, it’s just gathered importance, gained in stature and now he believes this. It happens.” (31). Thus, unlike

Bruce, Robert contemplates on Christopher’s past-life experiences and his cultural background to find out the possible reasons for his delusional ideas.

In the light of the above explained scenes from the play, it can be concluded that in the play, Christopher is subjected to a disciplinary process in the psychiatric hospital as befitting Foucault’s argument related to the mental institutions. In the hospital,

Christopher’s behaviour and thoughts are attempted to be regulated in accordance with each doctor’s own interests, values, and principles. In the play, this process involves the implementation of various disciplinary elements, methods, techniques, and maneuvers that Foucault mentions in his analysis of psychiatric power. First of all, there is an imbalance of power in the psychiatric hospital and Christopher realizes this power

152 imbalance mostly through his doctors’ power relations and their authoritarian language.

From the very beginning of the play, this sort of language becomes apparent in the first scene where Bruce interviews with Christopher in a consultation room. In this scene,

Christopher is quite happy and excited since he thinks he will be released from the hospital very soon, however, his doctor seems to be indifferent to his patient’s joyful excitement:

Bruce Take a seat. Christopher The pleasure today is mine. D’you know what I mean? Bruce Plant your arse. Christopher It’s mine! It’s my day. Innit. My big day. What can I say…? Bruce Yes well yes – sit down now. Christopher Gimme some skin. Bruce Why not. Christopher I’m a free man. D’you know what I mean? Bruce Well … a-ha ha … OK. Christopher I’m a happy man. Bursting with joy. Bruce Chris? (6)

In this first dialogue between Christopher and his doctor in the play, the doctor seems to employ a specific language peculiar to asylums; he uses ‘the master’s language’ in

Foucault’s words. He gives Christopher commands and actually pays no attention to what his patient tries to tell. As the same scene proceeds, the doctor’s master’s language becomes more evident through his use of repetitions and his attempts to make

Christopher recite some rules he most probably taught his patient before. In this scene, the doctor asks Christopher if he wants to drink something and when Christopher wants to have Coke, the doctor reminds his patient of the rules on drinks:

Bruce What did I tell you about Coke? Christopher I’m going home tomorrow. Bruce What’s wrong with drinking Coke? Christopher But I’m going home. Bruce Chris? Come on you know this, it’s important. What’s wrong with Coke? 153

Christopher It rots your teeth. Bruce No – well yes – and …? What else does it do to you? Christopher Makes my head explode – oh man – I know – I get you. Bruce It’s not good for you is it? Christopher No. It’s bad. Bruce What’s the first thing we learnt when you came in here? Christopher No coffee no Coke. Bruce No coffee no Coke, that’s right. ... (6)

There is no actually a reciprocal communication between the doctor and the mental patient in this scene because no matter what Christopher says, Bruce continually asks his patient the same questions to make him repeat the never-ending rules. Furthermore,

Christopher does not really discover anything in this scene; he only realizes the reality of an authority imposed on him and therefore just recites the given statements in order to be approved by his doctor. The fact that Christopher does not discover or realize anything through this sort of language becomes clearer when he once again wants to have coffee in another scene where Bruce reminds of the same rules on drinks: “Chris

… Chris come on! What’s the rule on coffee? No Coke no coffee.” (13).

With regard to the doctor’s master’s language, there is another significant detail in the play, which points out the presence of an imbalance of power in the hospital. For instance, in a scene of Act One, although Bruce himself first refers to the patients in the hospital as “crazy”, when Christopher employs the same word for the patients, Bruce corrects Christopher, saying that as doctors, they do not normally use the term “crazy”

(9) since it may be “offensive” for the patients (10). Here, the doctor actually draws a distinction between himself and the patient. Although Bruce and Christopher employ the same term to refer to in-patients, Bruce implies that he can sometimes make mistakes as a doctor, but Christopher can never as a patient. The doctor’s emphasis on this distinction actually indicates his authoritarian role over his patient.

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This distinction between the doctor and Christopher also prevails in the relationships between the two doctors throughout the play. As Foucault argues through his concept of “isotopic”, each person in this disciplinary apparatus has his own “well- defined place” along with the “subordinate” and “superordinate” (Psychiatric Power

52). There is apparently a hierarchical relationship between the two doctors. The senior

Robert continually reminds Bruce and Christopher that he is a consultant and he has ultimate authority in the hospital. In Act One, when Bruce does not agree with Robert who says that they must be careful about ethnocentricity, Robert reminds his colleague why he is there:

Robert The point is, this is my Province, Doctor. That’s why you asked me here. Because I know how many beans make five. I am, as they say, an “expert.” I am Senior Consultant and I am here to be “consulted.” I am not here to be “bounced off.” To “run it up the flagpole and see who salutes.” I’m here because “I know.” (32-33)

Robert draws a clear-cut distinction between himself and his colleague. He implies that whatever he says is unquestionably true since he is a senior consultant. In another scene from the same Act, where Robert once again gets angry with Bruce, he similarly reminds Bruce of his hierarchical superiority: “And for the last time I’ll remind you that you are under my Supervision, you are my subordinate, and your tone is beginning to sound dangerously insubordinate if not nakedly insulting.” (34). In line with Foucault’s argument about the isotopic character of disciplinary apparatuses, each character’s place in the hospital has been well-defined along with the subordinate and superordinate elements.

Besides the imbalance of power, another disciplinary strategy is also set to work in the psychiatric hospital. This strategy is “the management or organization of needs”; psychiatric power first creates specific “needs” for the individuals and then manages these “deprivations it establishes” in the asylum to direct them to behave in accordance

155 with certain rules (Foucault, Psychiatric Power 152-155). In the play, Christopher has been deprived of his freedom, being involuntarily placed in a mental hospital. In the hospital, the doctors utilize this deprivation of Christopher in order to direct him to behave in accordance with their own wills. For instance, in Act One, while Bruce and

Robert question Christopher about his father, Robert threatens Christopher, who does not want to answer on the grounds that his doctors will incriminate him, warning that if he does not speak, he will not be released from the hospital: “If you can’t tell us who he is – it’ll be tricky for us to send you home. You will have to stay here.” (27).

Inside the hospital, Christopher is also deprived of certain drinks; he is not allowed by Bruce to drink coke and coffee. Bruce utilizes this deprivation of drinks in order to compel Christopher to behave in accordance with his own expectations. For instance, in Act Three, when Bruce learns from Robert that he is being investigated for incompetence and a racist attitude due to Christopher’s complaint to the hospital administration, he tries to prove his innocence in front of Robert, making Christopher say that he has not actually upset his patient. In this scene, when Christopher refrains from giving any answer, Bruce compels him by utilizing his deprivation of drinks:

“You’ll get a Coke if you answer my question.” (61). The doctor’s offer also demonstrates that the rules established by the doctors in the hospital are not actually being applied primarily for the cure of the patients but rather for the direction of the patients by the staff in accordance with their wills.

In addition to all these disciplinary maneuvers, the psychiatric hospital in the play seems to function as a ‘panoptic machine’. First of all, Christopher is isolated from the community; he is involuntarily held along with other patients in the enclosed space of a psychiatric hospital. Christopher’s detention along with other patients in the same space is significant in terms of Foucault’s argument that the mentally ill inmates are

156 placed in asylums with other patient/s intentionally. To Foucault, mentally ill individuals are distributed in the same space because they are expected to witness other patients’ madness; they are expected to recognize other individuals’ madness in the same way that their doctor recognizes. In Foucault’s view, since a madman is considered to be too attached to his own madness but not to others’, the doctors think it is necessary for a patient to see his hospital mates in the same way that they see. The patient in this way ends up understanding that he is really being held in a mental hospital and he has been hospitalized due to his mental illness. In the play, Christopher similarly recognizes the other patients in the hospital in the same way his doctor sees them. The following scene from Act One reveals this fact:

Christopher … It’s mad innit. It’s bonkers. Mad shit. First thing I said when I arrived. When I first come in here. I had a look, I saw all the all the, you know, the others, the other geezers and I thought … Fuck this. My God! These people are insane! Ha ha ha ha ha … Get Me Outta Here – Bruce Ha ha yes – Christopher It’s a nuthouse, man. (9)

In this scene, since Christopher wants to be released from the hospital, he tries to convince his doctor that he is not genuinely mentally ill. To prove his sanity, he mentions about the reality of the other patients’ mental illness. This awareness of

Christopher essentially provides a legitimate basis for the doctor to hold his patient there and enables him to continue carrying out his psychiatric practices upon him in line with Foucault’s argument.

In the play, another panoptic principle, ‘permanent visibility’ is also ensured in the psychiatric hospital. Christopher’s surveillance in the community continues in the hospital; he is subjected to perpetual control and observation by his two doctors. This can be understood from Christopher’s statements that apparently show his feeling of being always watched. Throughout the play, he usually seems to feel under the gaze of

157 his doctors. In Act One, for instance, he gets angry with Robert since he thinks the doctor watches him, and Bruce tries to calm him down, saying “Nobody’s looking at you funny Chris.” (16). Surveillance in the hospital is also ensured through the Senior

Robert’s records in his diary. Robert records everything that takes place in the hospital.

Furthermore, he not only writes about the patient’s but also about his colleague’s behaviour and statements. In Act Three, he reveals this fact while talking to Bruce:

Robert … While I’m here I should mention that I’ve been keeping a diary. Bruce A diary? Robert A diary of my research but there are things in it which might be relevant to your case. (He produces a diary from his jacket pocket.) Now you’ve stopped blustering I should read you some things before my patient returns. Bruce You just happened to have it on you. Robert (Reading.) “Twenty-sixth of October: Mention Antecedent Programme to Doctor Flaherty and he laughs. Not interested in providing African-Caribbean and African patients for research purposes.” Bruce I didn’t laugh … I … this is silly … (57)

The senior Robert seems to be recording in his diary every detail of what his colleague does and says within the boundaries of the hospital. This detail shows that both the patients and the personnel are subjected to a permanent surveillance in this hospital.

Christopher is subjected to another panoptic principle, ‘ceaseless punishment’ in the hospital. First of all, his compulsory detention in itself serves as a form of punishment for this character. Since Christopher thinks he has been diagnosed as paranoid and hospitalized due to his ethnic minority identity, he perceives his involuntary hospitalization as a kind of punishment. His statements throughout the play show that he feels like a prisoner who counts down the remaining days and hours to his freedom: “I’m twenty-four hours away from freedom. Out of this hole. D’you know what I mean? (Pause.) Forty-eight hours tops.” (13). These statements indicate that

158 since Christopher has been compulsorily detained, he does not feel like he is being held in a hospital where he must normally feel calm and secure.

In Act Two, the senior Robert also implies that Christopher has been hospitalized as a punishment for the colour of his skin:

Robert … our response to you is weighted by our response to your colour. I personally feel that should be the case; it should be a factor in your treatment and that we shouldn’t overlook such a thing. Otherwise what happens, in institutions such as this, there develops what’s termed “Ethnocentricity”; which ordinarily is fairly harmless but in certain instances is not far off … well … it is the progenitor of “Cultural Oppression,” which in turn leads to what we call “Institutionalized Racism.” Christopher Racism? Robert Yes. And the danger is that in a sense you maybe end up, in a sense, being “punished” for the colour of your skin. (Beat.) For your ethnicity and your attendant cultural beliefs. (Beat.) You are Sectioned and locked up when you shouldn’t be. (Beat.) Because you’re “black.” (Pause.) Christopher I’m being punished? (49)

The senior Robert underlines the very real possibility that Christopher’s ethnicity and his cultural beliefs could have resulted in his compulsory detention. The doctor’s statements show that Christopher is not the only person who thinks he has been punished for his ethnic and cultural background.

Apart from this scene, in another scene in Act Three, where Robert and Bruce again discuss about Christopher’s mental state, Robert suggests that the hospital is functioning like a prison for Christopher:

Bruce He’s depressed because he’s Schizophrenic. Robert He’s depressed because he’s here. Exactly how old is Christopher? Bruce He’s the same age as me. Robert The same age as you. And how do you think it feels for Christopher – a bright, fun, charismatic young man – to be locked up with chronic, dysfunctional mental patients twice his age? People with drug problems, who are suicidally depressed, who scream and laugh and cry routinely for no apparent reason – when they’re not catatonic. Have you thought about how intimidating and frightening that must be for him? Night after night, with no let up. It’s Like Going To Prison. It’s cruel. … (60) 159

Robert draws attention to how the hospital negatively affects Christopher’s psychological and mental health. He claims that the hospital functions like a prison for

Christopher.

Christopher is subjected to another disciplinary method in the hospital in relation to Foucault’s analysis of psychiatric power. This disciplinary method is questioning; through psychiatric questioning, the individual is pinned to his social identity and to the madness attributed to him by his own social sphere (Foucault, Psychiatric Power 234).

Through the specific questions related to his own identity, the individual is compelled to recognize himself through certain events from his own past (Foucault, Psychiatric

Power 270). In the play, Christopher is similarly questioned by the two doctors about his ethnic roots and his cultural identity. The doctors usually compel him to say something about his mother and father, his community, and his unfortunate experiences that have seem to have contributed to his psychological and mental problems. Faced with those crucial questions, Christopher feels embarrassed and worries about the possibility that he may be condemned by his doctors. For instance, in Act One, when

Bruce and Robert compel Christopher to say his father’s name, he finds it embarrassing and refrains from speaking:

Bruce Who’s your father Chris? (Pause.) Christopher It sounds silly. Bruce For Christ’s sake – Christopher It’s embarrassing. Bruce Chris! Christopher How can I say it, in all honesty, without you thinking I’m off the stick? How do I know it won’t criminate me, d’you know what I’m saying? (27)

Since Christopher believes that the exiled Ugandan dictator is his father, he feels embarrassed and does not want to reveal his father’s name. He is also afraid of the possibility that he may be incriminated by his doctors. In line with Foucault’s argument

160 related to psychiatric questioning, Christopher is compelled to recognize himself through the certain moments of his life and to recognize himself through those moments. He is forced to remember the certain details related to his identity. The beginning of this scene is also significant in relation to Foucault’s argument about psychiatric questioning because Bruce actually tries to prove the genuineness of

Christopher’s mental disorder by making him reveal his delusional ideas related to his family roots in front of the senior Robert:

Bruce What’s his name? Christopher I already told you. Bruce Tell me again. In front of Robert. Christopher Why? Bruce Just … please Chris … it’s a simple question. Christopher It’s difficult to answer. D’you know what I mean? Bruce No I don’t, why? Christopher If I ask you who your father is nobody gives a shit. With me it’s front- page news. D’you understand? Bruce No, I don’t understand. Why is it front-page news? Christopher ’Cos of who he is. Robert Who is he? Christopher I’m not telling you. Bruce … Please. Help me out here. Christopher You want me to help you? Now you want me to do your job. Robert If you can’t tell us who he is – it’ll be tricky for us to send you home. You will have to stay here. Do you understand? (27)

This scene is significant in relation to Foucault’s argument that psychiatric questioning plays a crucial role in establishing a junction between “responsibility” and

“subjectivity” (Psychiatric Power 273). According to Foucault, during psychiatric questioning, the individual is given the responsibility of expressing his madness or his fault. The individual is expected to recall the faulty moments of his past and to give his doctors the reasons why he is being held in a psychiatric hospital. As Foucault argues, in that questioning process, the patient does not only recognize the presence of his mad

161 ideas or his hallucinations; he also actualizes his madness. By confessing that he hears some voices or he has some hallucinations, he actualizes his mental disorder and in this way legitimizes his psychiatric detention and treatment. For Foucault, of the treatment process, the most crucial and necessary moment is when the patient makes this confession and admits his delirious behaviour or ideas. In this scene, Christopher is similarly compelled to give the reasons why he has been hospitalized; he is directed by

Bruce to express his delusionary ideas in front of Robert to prove that Christopher really needs psychiatric hospitalization and treatment. Furthermore, as befitting Foucault’s argument, Christopher is not actually expected to recognize the unreality of his delusional ideas; he is only expected to confess the truth that has caused his compulsory detention and treatment. In this scene, Bruce essentially attempts to legitimize his patient’s hospitalization in front of the senior Robert.

A similar scene takes place in the last Act of the play, where Bruce again tries to make Christopher reveal his delusional ideas as an attempt to legitimize his psychiatric detention and treatment. In this Act, when Bruce learns that he is being investigated for

“negligence”, “abuse”, and “racist harassment” (59), he attempts to prove his innocence and the genuineness of his patient’s mental disorder, questioning him in front of Robert.

Although Robert thinks it is not a good idea to question Christopher once more again,

Bruce insists on asking Christopher if he has upset him. Bruce wants Christopher to peel the oranges and say what colour they are, and also questions him about his father. Bruce who realizes that he is about to lose his job due to his patient’s complaint apologizes to

Christopher for having upset him. However, Christopher who thinks Bruce is only trying to get himself out of that hole does not believe in his doctor’s sincerity and accuses him of his racist remarks:

Christopher I don’t believe you. You call me a nigga. You say it’s voodoo. Bruce It was a joke!

162

Christopher Oh funny joke. Do you see me laughing? I’ve got one for you. I’m gonna press Charges. ’Cos I ain’t staying here, man. You’ll never keep me locked up, white man. This is one nigga you don’t Get to keep, white man. ’Cos I’m gonna bark every time you come near. D’you understand? Bruce Is this You or is it … someone else? Is this the illness or is it … (Pause.) Maybe you’re just like this. Maybe you’re just … A Wanker. I mean … why do you say these things? Christopher ’Cos you ruined my life! ’Cos you’re Evil. And you’re a Fascist. (69-70)

When Christopher reminds Bruce that he used the term “nigga” to refer to his patient and attributed his mental disorder to “voodoo” that is a religious cult practised in

Caribbean countries, Bruce claims that all his comments were only a joke. However, the doctor then employs another offensive term “wanker” to refer to Christopher.

Christopher seems to have been affected by the doctor’s such offensive and derogatory remarks that he addresses his doctor as an “evil” and a “fascist” who has ruined his life.

Following this scene, Bruce loses his temper and insults his patient, calling him a

“fucking idiot”, “mad bastard”, “moron”, and “stupid fool” (70). In response to the doctor’s use of these highly offensive words, Christopher once again states that he does not want to be held in this hospital, saying “That hurt, man. I can’t stay in here if you’re gonna say shit like that. D’you know what I mean? Running your mouth. It’s rude.”

(71). This scene significantly shows that the doctor, Bruce acts like a juridical authority over Christopher; he employs highly offensive terms to refer to his patient and does not act like a medical practitioner. Following this scene, the play ends with Christopher’s release from the hospital through the senior Robert’s decision.

Consequently, in Blue/Orange, the mentally ill character appears a ‘residual’ individual who has been subjected to unfortunate experiences such as racial discrimination, humiliation, and exclusion in the community and has been in turn made more vulnerable to experiencing some psychological and mental problems. In the play, the psychiatric hospital serves a disciplinary function for Christopher, where he is

163 subjected to a series of disciplinary methods and strategies such as deprivation of freedom and of certain drinks, perpetual surveillance and control, ceaseless punishment, and psychiatric questioning in order to be directed to behave in accordance with his doctors’ wills. In the light of these details, Blue/Orange reflects the disciplinary and normative functioning of psychiatric institutions over the ‘residual’ members of society, who are perceived as a potential threat and burden on society.

164

CONCLUSION

Over the course of history, the perception and treatment of madness have undergone radical transformations in Western society. When these changing perceptions and treatments have been examined closely, it appears that they have been shaped not only by the scientific advancements in mental health knowledge and practice but also by each period’s own social framework along with its prevalent cultural, political, and economic conditions and expectations. It also seems that no matter how the social and scientific attitudes towards madness or mental illness have evolved over time, the tendency to draw a relationship between mental illness and social deviance has continued to prevail among both the public and the mental health community. In turn, the individuals deemed ‘mad’ or ‘mentally ill’ have continued to be perceived as a threat and burden on society and to be restrained through differing social control mechanisms in each historical period.

In the Middle Ages when religion had a powerful force in shaping the social perception, the mad were perceived as the possessors of ‘evil spirit’ and as a threat to family honour, they were hidden within domestic areas, often in cellars and under a servant’s control. In the Renaissance period, when the great political, cultural, economic, and religious changes affecting many aspect of European society caused a general anxiety and created a need for security among the public, the presence of the

‘mad’ on the streets caused a public nuisance. Therefore, they were exiled from cities to open seas through the Ships of Fools, or were allowed to wander only in the open countryside where they would be out of sight. In the Age of Reason of the 17th century when ‘reason’ was glorified as the dominant intellectual virtue, the insane were considered to have a ‘moral defect’ as the possessors of ‘unreason’. They were incarcerated in enormous confinement structures in order to be silenced, disciplined,

165 and tamed along with other ‘socially unwanted’ populations such as criminals, prostitutes, and libertines. In another period, the early 19th century when the first mental asylums and psychiatrists appeared in Western society through ‘moral treatment’, the mentally ill were subjected to a new kind of social control mechanism through the ‘internal’ means of coercion. In asylums, they were compelled to develop self-restraint and act in accordance with certain moral and behavioural standards through constant surveillance and a juridical system of rewards and punishments for every detail of their behaviour. In the mid to late 19th century, private asylums were transformed into large-scale public mental asylums and hospitals due to the new nation- states’ immense faith in institutional solutions to public safety problems. Large numbers of the mentally ill placed in those ‘custodial’ institutions were exposed to crowded and unsanitary conditions, and to a range of somatic treatments such as malaria therapy, hydrotherapy, insulin coma therapy, lobotomy, and electro-shock therapy that caused them considerable negative side-effects. Such physical treatments were also used as medical forms of social control over some ‘socially undesirables’ such as homosexuals, individuals engaging in cross-gendered behaviour, alcoholics and political dissidents for the suppression of their perceived deviant behaviour and tendencies. Finally, towards the 1960s, through deinstitutionalization movement, the mentally ill were moved from large-scale mental hospitals to community, but anyway continued to be restrained through excessive use of psychiatric drugs and through mental health laws that allow for the compulsory hospitalization and treatment of individuals.

The historical outlook on the changing perceptions and treatments of madness from the earlier historical periods to the present evidences that society and social norms have always had a direct effect on the development of certain attitudes towards madness. It also proves that a close relationship has been drawn between madness and social deviance in each historical period. Behaviour and attitudes running contrary to

166 social standards of normality have been attributed to suffering from madness or mental illness. In turn, the individuals defined as ‘mad’ or ‘mentally ill’ have maintained their social outcast role and have continued to be isolated, suppressed, silenced, and disciplined through differing social control mechanisms.

The critics of psychiatry have usually made references to such historical data in order to both shed light on the historical conditions in which psychiatry and its institutions emerged and give an insight into how this field has become an institution that contributes to the social control of deviance. Especially the thinkers associated with the Anti-psychiatry movement such as Michel Foucault, Thomas Szasz, Franco

Basaglia, Erving Goffman, and Ronald David Laing traced the social control function of psychiatry back to the historical evolution of the ways of defining and dealing with madness. In contrast to other critics of psychiatry, these thinkers did not simply argue for a more ‘humane’ psychiatry. They did not merely focus on issues such as involuntary hospitalization of individuals, unlimited authority of psychiatrists over patients in mental institutions, excessive use of psychiatric drugs, and implementation of some treatment methods such as electro-shock therapy and lobotomy that may cause more harm than good. These thinkers instead interrogated the very foundations of psychiatry itself: its raison d’être, its foundational concept of mental illness, and its role in society in terms of the social control of deviant behaviour.

In substance, anti-psychiatrists problematized the existence and reality of mental illness as a medical entity and approached it as a social phenomenon. They mainly argued that psychiatric diagnoses cannot be objective on the grounds that the criteria for identifying a mental or psychological disorder are closely connected with the cultural, political, or economic conditions and norms of a particular society and of a particular time. In this context, these critics drew attention to the social-control function of

167 psychiatry. They argued that psychiatry provides a legitimate basis for the labelling of the deviant behaviour and thoughts perceived as a threat to social order as ‘mental illness’, and for the regulation of those perceived deviances in accordance with the common norms and expectations of society. Anti-psychiatrists generally criticized this

‘normative’ function of psychiatry.

Among these thinkers, Michel Foucault provided probably the most comprehensive critical analysis of psychiatry through his seminal works that essentially interrogate the foundations of the modern human sciences and the functioning of their corresponding institutions. According to Foucault, the modern human sciences which appear to be inherently neutral did not develop simply as a result of the progress in knowledge; they also emerged as a result of the need for providing more effective and legitimate ways of taking the increasing populations under control. The modern human sciences and the related institutions have produced certain knowledge and discourses related to the standards of normality. Based on these standards, they have constructed oppositions such as ‘normal’ versus ‘mad’, ‘normal’ versus ‘criminal’, ‘normal’ versus

‘dangerous’, and ‘normal’ versus ‘disobedient’. Through such binary oppositions, disciplines have classified people and subjected them to a process of normalization.

Thus, the human sciences and the related institutions have contributed to the development of a regime of power that defines and controls human behaviour based upon a series of norms. In Foucault’s view, psychiatry has always taken on this disciplinary responsibility in western societies, with its privilege to define ‘what is abnormal’ and accordingly ‘who is insane’. It has produced knowledge and discourses related to how individuals must behave in order to be socially accepted and acclaimed.

Thus, psychiatry has served as an agent of disciplinary power that defines, controls, and corrects what is deemed as ‘abnormal’ by the system or by the majority of society.

Consequently, it has provided a legitimate basis for the application of correctional and

168 normalizing strategies over the individuals whose deviant behaviour and ideas are perceived as a potential threat to the social order and harmony. Foucault’s approach to psychiatry mainly revolved around this disciplinary function, the functioning as the

‘norm’.

Foucault explicated how psychiatry and its institutions function in such disciplinary framework through his lectures published as Psychiatric Power: Lectures at the College de France, 1973-1974. In those lectures, he delved into the strategies, methods, and techniques whereby psychiatry can function as a correctional and normalizing power over the bodies and souls of individuals in mental asylums. Foucault essentially approached mental asylum as a disciplinary setting where an authority permanently surrounds the individuals and regulates their times, activities, and actions.

In this context, he viewed mental asylum as a ‘panoptic machine’ where Jeremy

Bentham’s panoptic principles – isolation, permanent visibility, central supervision, and ceaseless punishment – are set to work to ensure the perpetual surveillance and the maximum obedience of individuals. In Foucault’s view, these principles are necessarily applied in mental asylums because they make it possible to direct the individuals to develop self-discipline and take responsibility for regulating their own ‘undesirable’ behaviour in accordance with certain norms and expectations. Besides these panoptic principles, Foucault also drew attention to the disciplinary function of some other psychiatric practices such as medication and questioning. Psychiatric medication involves a disciplinary function since it helps to keep individuals numb and suppress their undesirable behaviour. As for psychiatric questioning, it compels individuals to give the reasons why they have been diagnosed as mentally ill and hospitalized. To

Foucault, all these methods employed within the asylum space involve much more a disciplinary function rather than a therapeutic function; they are used as ‘direction techniques’ in order to compel the individuals to act in accordance with certain

169 behavioural standards. When these asylum strategies and techniques have been examined from Foucault’s perspective, it clearly appears that he did not view psychiatric practice as a therapeutic intervention or as an effort simply made for the cure of mental illness. He rather approached it as a specific way of managing, directing, and taming the individual.

In the light of these historical and theoretical backgrounds, this thesis has focused on the use of psychiatric procedures – diagnosis, hospitalization, and treatment

– for the purposes of social control. This analysis has been made especially through the study of dramatic texts because as dynamic texts, they have provided a fertile ground for the in-depth analysis of the power relations taking place in psychiatric institutions and of the disciplinary practices that mentally ill characters experience in those institutions. Dramatic works have also been preferred to study because theatre which often addresses political and social issues and has a potential to raise critical consciousness, has provided a convenient basis for the critical analysis of the disciplinary role of psychiatry and its institutions.

The scope of the study has been limited to the contemporary British plays taking a socio-political approach towards the theme of mental illness. These plays have usually portrayed mentally ill characters as individuals who have either deviated from the established behavioural and intellectual norms of mainstream society, or have been unluckily driven to mental and psychological disorders as a consequence of their exposure to experiences such as social discrimination, oppression, and abuse due to their perceived abnormalities. In the plays, most of such characters have been perceived as a threat to the prevailing social order and in turn have been involuntarily confined to psychiatric institutions for the suppression and correction of their perceived deviances in accordance with the dominant norms and expectations of society. These common

170 aspects have made these contemporary British plays a significant source for the analysis of the disciplinary function of psychiatry and its institutions with the help of Foucault’s approach of ‘psychiatric power’.

In this thesis, three contemporary British plays, namely Tom Stoppard’s Every

Good Boy Deserves Favour, Sarah Daniels’s Head-rot Holiday, and Joe Penhall’s

Blue/Orange have been chosen for the detailed analysis of the social control function of psychiatry. These three plays both take place in a psychiatric institution and involves characters stigmatized as ‘mad’ or ‘mentally ill’ due to a different experience of

‘otherness’. In Every Good Boy Deserves Favour, the mentally ill character, Alexander

Ivanov who has been imprisoned in a Soviet mental hospital is a political dissident. In

Head-rot Holiday, the inmates of Penwell Special Hospital are three women, Dee, Ruth, and Claudia who have either violated the hetero-normative social roles, or suffered from mental disorder as a result of their experiences of oppression and abuse in family or in society. Finally in Blue/Orange, the mad character, Christopher who has been compulsorily hospitalized through the criminal justice system is a young coloured man suffering from mental disorder as a destructive effect of his experiences of racial hatred and discrimination due to his ethnic minority identity. In each play, these characters have been subjected to a series of disciplinary strategies, methods and techniques in psychiatric institutions for their transformation into docile and useful individuals for the benefit of social order.

In Every Good Boy Deserves Favour, the disciplinary role of psychiatry has been explored through the compulsory incarceration of a political dissident in a Soviet mental hospital. Alexander Ivanov’s opposing political views and acts have been interpreted by the regime as a manifestation of mental disorder and in turn he has been involuntarily placed in a mental hospital. Thus, in the play, psychiatry has been

171 portrayed as an instrument of disciplinary power, which provides the political power with a legitimate basis for labelling the political dissidents who do not act with the dominant ideology as ‘mentally ill’ and suppressing them through compulsory detention and treatment.

In the mental hospital, Alexander experiences a disciplinary process whereby he is compelled to change his opposing political views and to acknowledge that his previous statements and acts against the government were caused by a (non-existent) mental disorder. He is subjected to a series of disciplinary methods and techniques for his transformation into an obedient person who will not speak out and act against the regime any more. First, in the Leningrad Special Psychiatric Hospital where he was previously incarcerated due to his political dissidence, he was subjected to perpetual surveillance through the peepholes in the doors, the lights burning all night, and through a large network of authority consisting of doctors, warders, trusties, and male nurses. In addition, since Alexander did not change his mind related to the regime’s oppressive policies, he was exposed to punitive measures through the staff’s physical and psychological violence and through the use of some antipsychotics that caused him severe physical discomfort and loss of some intellectual skills. All these panoptic principles deployed in the special psychiatric hospital caused Alexander to resemble that hospital to a prison; he frequently preferred to employ the lexis ‘cell’ in place of the

‘wards’ of the hospital.

In the actual hospital where the play takes place, Alexander is similarly exposed to a set of disciplinary methods and techniques for his transformation into an obedient citizen supporting the regime. In this hospital, Alexander is continually medicated and questioned by his doctor who tries to convince him to state that his opposition to the regime was an effect of his (non-existent) mental disorder. Alexander’s recovery and

172 release from the hospital are considered possible by the doctors only if he acknowledges that he was mentally ill while he was speaking and acting out against the regime.

Consequently, both the hospitalization process and the disciplinary practices that

Alexander experiences throughout the play demonstrate that psychiatric procedures have not been used for any therapeutic aim; these procedures have been utilized by the regime just for disciplinary purposes. In other words, they have been used for the suppression of a political dissident whose views are considered a threat to the prevailing system. Through this focus on the disciplinary use of psychiatric procedures, Every

Good Boy Deserves Favour has provided a convenient basis for the analysis of psychiatric power.

In Head-rot Holiday, the social-control function of psychiatry has been portrayed through the compulsory hospitalization and treatment of three female characters Dee, Ruth, and Claudia who have ‘failed’ to meet the widely-held norms and expectations of mainstream society. In the play, all these women appear as characters who have paid the price for being poor, abused, and disadvantaged with being criminalized and labelled as mentally ill, and ending up in a special hospital – a psychiatric prison for women. Dee is a lesbian who feels socially disadvantaged due to her deviation from the hetero-sexual norms of mainstream society and who has been subjected to physical harassment and domestic violence. Another mentally ill character,

Ruth is a victim of her father’s sexual abuse. She has been hospitalized for attacking her step-mother who witnessed that traumatic incident but denied what was happening. The last of the primary characters, Claudia is a young woman who has paid the price for poverty with losing her children and being confined in a special hospital.

In the special hospital, these female characters undergo a disciplinary process whereby they are directed to develop self-discipline and take responsibility for

173 regulating their socially ‘undesirable’ behaviour and tendencies. In the hospital, they are subjected to permanent surveillance and control through a large network of authority consisting of doctors, nurses, occupational officers, and ward workers. They are watched and controlled by these relays of power so continuously that the mentally ill characters can never escape from the attention and the gaze of the institution staff. The characters are subjected to perpetual control through the files as well; every detail of their behaviour is continually recorded in their files and these notes are utilized by the staff to compel the patients to act in accordance with the behavioural standards set within the hospital. When the characters violate these standards, they are promptly punished by the staff through seclusion, physical beatings, verbal violence, and excessive use of anti-psychotics causing considerable negative side effects.

In the play, the most visible effects of these disciplinary methods and techniques are seen in Dee’s attempts to prove her ‘normality’ and accordingly her ‘sanity’.

Although Dee does not like looking feminine, she plans to make up and wear a dress for the impending Christmas disco. More importantly, although she is a lesbian, she decides to flirt with the male patients at the disco on the grounds that it would go down well with the doctors. Dee actually thinks she can look more ‘normal’ and less ‘insane’ to the doctors if she displays feminine appearance, wearing dress and making up, and if she socializes with someone from the opposite sex in accordance with the hetero-sexual norms of society.

Especially through its lesbian character compelled to act in accordance with the norms and values of hetero-normative society in order to prove her sanity, Head-rot

Holiday has portrayed how psychiatric institutions and practices can function in a disciplinary framework. The play has also pointed out the close relationship drawn by

174 both mental health practitioners and the public between the perceptions of ‘normality’ and ‘sanity’.

In the last play, Blue/Orange, the disciplinary role of psychiatric procedures has been explored through the compulsory psychiatric detention of a young Afro-Caribbean man who is perceived as a potential threat to the public order due to his ethnic minority identity and his different cultural background. Christopher is a young coloured man who seems to suffer from a mental disorder as a result of his exposure to racial hatred and discrimination in the community. In the play, his psychiatric detention occurs through a collaboration of two different disciplinary institutions, psychiatry and police. First, he is arrested by the police on the grounds that he did something ‘funny’ in a market and then he is hospitalized under Section 2 of the Mental Health Act, which allows his compulsory detention for a period of up to 28 days. Due to that collaboration between the two disciplinary institutions, Christopher thinks his ethnic minority identity has played an important role in his psychiatric hospitalization process.

In the play, Christopher always finds himself caught in the power struggle of his two doctors, Robert and Bruce who make entirely different diagnoses for him. While

Bruce confirms schizophrenia for his patient on the grounds that Christopher believes his father is Ugandan dictator Idi Amin, Robert attributes the patient’s delusional ideas to his cultural background and his exposure to racial discrimination and oppression in the community. Through this radical divergence of the two doctors about their patient’s mental state, the play has raised significant doubts related to the objectivity and reliability of psychiatric diagnoses.

The play has also portrayed the psychiatric institution as a space where a disciplinary power reigns in accordance with Foucault’s ‘psychiatric power’.

Throughout the play, Christopher experiences a disciplinary process in the psychiatric

175 hospital; both his doctors attempt to transform him into a docile and obedient individual who will not disturb the social order any more. To this end, he is subjected to some disciplinary strategies and methods such as deprivation of freedom, isolation, perpetual surveillance, ceaseless punishment, and psychiatric questioning. In that disciplinary process, Christopher suffers from an identity crisis since his two doctors who hold entirely divergent views and ideologies continually direct him to behave in different ways. While trying to conform to the different expectations of each doctor, Christopher ends up being constantly forced to change his behaviour and thoughts and accordingly to sacrifice something of his identity.

Consequently, Blue/Orange has provided a considerable source for the analysis of psychiatric power through its coloured character who is compulsorily hospitalized as he ‘fails’ to meet the dominant cultural expectations of society and accordingly as he is perceived as a potential threat to the public order. Furthermore, the play has provided a convenient basis for the examination of the disciplinary methods and techniques applied in mental hospitals to ensure the direction of individuals in accordance with the doctors’ will.

In conclusion, the three contemporary British plays analysed in this thesis are explicitly concerned with the use of psychiatric procedures for disciplinary purposes over the ‘residual’ individuals who fall outside of the widely-held norms and expectations of mainstream society. Through the ‘mentally ill’ characters deviating in some way from the established norms and expectations of mainstream society, the plays have portrayed how the perception of mental illness can be closely associated with the perception of abnormality. In addition, through the characters’ disciplinary experiences in psychiatric institutions, the plays have highlighted how psychiatry can serve the disciplinary system or the power, providing a legitimate way of taking socially deviant

176 individuals under control and applying some normalizing disciplinary strategies over them for the benefit of the prevailing social order and homogeneity.

177

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ABSTRACT

Contemporary British Drama presents a considerable amount of plays dealing with the theme of mental illness as a socio-political issue. In these plays, mentally ill characters usually appear to be either labelled as ‘mad’ or ‘mentally ill’ due to their deviations from the commonly-held norms and expectations of mainstream society, or driven to mental and psychological disorders as a consequence of their exposure to unfortunate experiences such as discrimination, oppression, and abuse due to their behaviour and ideas deemed ‘abnormal’. In the plays, most of these characters are involuntarily incarcerated in psychiatric institutions and subjected to some disciplinary and punitive practices in order to be transformed into ‘docile’ and ‘obedient’ individuals for the benefit of the prevailing social order. All these details make these contemporary plays a significant source for the examination of the disciplinary function of psychiatry and its institutions over the individuals falling outside of social norms in line with

Foucault’s analysis of ‘psychiatric power’.

In this thesis, Tom Stoppard’s Every Good Boy Deserves Favour (1977), Sarah

Daniels’s Head-rot Holiday (1992), and Joe Penhall’s Blue/Orange (2000) have been studied for the analysis of the use of psychiatric procedures – diagnosis, treatment, and hospitalization – for the purposes of social-control. These plays have been specifically chosen because each play both takes place in a psychiatric institution and focuses on characters stigmatized as ‘mentally ill’ due to a different experience of ‘otherness’: In

Every Good Boy Deserves Favour (1977), the ‘mentally ill’ character, Alexander

Ivanov who has been imprisoned in a Soviet mental hospital is a political dissident; in

Head-rot Holiday (1992), the inmates of Penwell Special Hospital are three women,

Dee, Ruth, and Claudia who have either violated the hetero-normative social roles, or suffered from mental disorder as a result of their experiences of oppression and abuse;

187 and finally in Blue/Orange (2000), the mad character, Christopher who has been compulsorily placed in a mental hospital through the criminal justice system is a young coloured man subjected to racial hatred and discrimination in the community due to his ethnic minority identity.

This thesis has first begun with a brief history of psychiatry within the frame of its social-control function, anti-psychiatry perspectives of mental illness and psychiatry, and with a detailed examination of psychiatric power. After providing a historical and theoretical background, the thesis has then moved on with a brief survey of the contemporary British plays which highlight the disciplinary function of psychiatry through the characters deemed ‘mad’ or ‘mentally ill’ due to their differing social deviances and exposed to the correctional and normalizing operations of psychiatric institutions. The last three chapters of this thesis have studied Every Good Boy Deserves

Favour (1977), Head-rot Holiday (1992), and Blue/Orange (2000) in relation to

Foucault’s analysis of ‘psychiatric power’.

Chapter III has analysed Every Good Boy Deserves Favour (1977) in relation to the use of psychiatric procedures for the control and the suppression of political dissidents. Chapter IV has studied Head-rot Holiday (1992) within the frame of the normalizing and correctional functioning of psychiatric institutions over the women who deviate from the widely-held norms of hetero-normative society. Finally, Chapter

V has examined Blue/Orange (2000) in terms of the disciplinary role of psychiatric institutions and professionals over a young coloured man who does not meet the dominant cultural expectations of society. The analyses of these three plays have been enriched through the examination of the specific strategies, methods, and techniques whereby the disciplinary power in psychiatric institutions is systematically exercised over such ‘deviant’ members of society with the help of Foucault’s ‘psychiatric power’.

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Key Words: Tom Stoppard, Every Good Boy Deserves Favour, Sarah Daniels,

Head-rot Holiday, Joe Penhall, Blue/Orange, Michel Foucault, psychiatric power, mental illness, social control.

189

ÖZET

Çağdaş İngiliz Tiyatrosu’nda akıl hastalığı temasını sosyo-politik bir konu olarak ele alan birçok eser mevcuttur. Bu oyunlarda akıl hastası olarak değerlendirilen karakterlerin genellikle toplumun genel kabul görmüş norm ve beklentilerine uyum sağlamamaları nedeniyle ‘deli’ veya ‘akıl hastası’ olarak etiketlendikleri ya da

‘anormal’ olarak algılanan düşünce ve davranışları sebebiyle ayrımcılık, baskı ve kötü muamele gibi olumsuz durumlara maruz kalmaları sonucu akli ve psikolojik bozukluklar yaşadıkları görülmektedir. Oyunlarda bu karakterlerin çoğu, psikiyatri kurumlarına kendi istekleri dışında kapatılmakta ve var olan toplumsal düzenin yararı adına, ‘uysal’ ve ‘itaatkar’ bireylere dönüştürülmek üzere birtakım disipliner (ıslah edici) ve cezalandırıcı uygulamalara maruz bırakılmaktadır. Tüm bu detaylar bu oyunları Michel Foucault’nun ‘psikiyatrik iktidar’ analizi ışığında, psikiyatri ve kurumlarının toplumsal normların dışında kalmış bireyler üzerindeki disipliner işlevini incelemek için önemli bir kaynak haline getirmektedir.

Bu tezde Tom Stoppard’ın Every Good Boy Deserves Favour (1977), Sarah

Daniels’ın Head-rot Holiday (1992) ve Joe Penhall’ın Blue/Orange (2000) oyunlarında, psikiyatrik prosedürlerin – tanı, tedavi ve hastaneye yatırma – toplumsal kontrol amaçlı kullanımları incelenmektedir. Bu üç oyun, her birinin özellikle bir psikiyatri kurumunda geçmesi ve toplumda ‘öteki’ durumuna düştüğü için ‘akıl hastası olarak’ etiketlenen bir karaktere odaklanması nedeniyle seçilmiştir. Every Good Boy Deserves Favour (1977) adlı oyunda, bir Sovyet akıl hastanesine kapatılan ‘akıl hastası’ karakter, Alexander

Ivanov bir politik muhaliftir; Head-rot Holiday (1992) oyununda, Penwell Özel

Psikiyatri Hastanesinin mahkumları, Dee, Ruth ve Claudia ya heteronormatif toplumsal rollere uyum göstermeyen ya da baskı ve istismara uğradıkları için ruhsal bozukluk yaşayan üç kadın karakterdir. Son olarak, Blue/Orange (2000) adlı oyunda, ceza adalet

190 sistemi aracılığıyla zorla akıl hastanesine kapatılan Christopher etnik azınlık kimliği nedeniyle toplumda ırkçılığa ve ayrımcılığa maruz kalmış bir siyahi karakterdir.

Bu tez ilk olarak psikiyatri ve kurumlarının toplumsal-kontrol işlevi

çerçevesinde kısa bir tarihçesi, ‘anti-psikiyatri’ akımının akıl hastalığı ve psikiyatriye ilişkin eleştirilerinin bir özeti, ve Foucault’nun ‘psikiyatrik iktidar’ analizinin detaylı bir incelemesi ile başlamaktadır. Bu tarihi ve teorik analizler sonrasında tez, norm dışı kalmaları nedeniyle ‘deli’ ya da ‘akıl hastası’ olarak değerlendirilip psikiyatri kurumlarına kapatılan ve bu kurumlarda birtakım ‘ıslah edici’ ve ‘normalleştirici’ uygulamalara maruz bırakılan karakterleri aracılığıyla akıl hastalığı kavramı ve psikiyatri kurumuna eleştirel bir bakış sağlayan çağdaş Britanya oyunlarının kısa bir incelemesi ile devam etmektedir. Çalışmanın son üç bölümünde ise Every Good Boy

Deserves Favour (1977), Head-rot Holiday (1992) ve Blue/Orange (2000) oyunları

Foucault’nun ‘psikiyatrik iktidar’ analizi ile ilişkili olarak incelenmektedir.

Bölüm III, Every Good Boy Deserves Favour adlı oyunu psikiyatrik prosedürlerin, politik muhaliflerin kontrolü ve sindirilmesi amacıyla kullanımı açısından analiz etmektedir. Bölüm IV, Head-rot Holiday adlı oyunu psikiyatri kurumlarının, heteronormatif toplumun normları dışında kalan kadınlar üzerindeki normalleştirici and

ıslah edici işleyişi açısından incelemektedir. Bölüm V ise Blue/Orange oyununu psikiyatristlerin ve psikiyatri kurumlarının toplumun baskın kültürel normlarını karşılamayan bir siyahi karakter üzerindeki disipliner (ıslah edici) işlevi açısından analiz etmektedir. Oyun analizleri, psikiyatri kurumlarındaki disipliner iktidarın, toplumun

‘anormal’ ya da ‘alışılmışın dışında kalmış’ bireyleri üzerinde etkili bir şekilde uygulanmasını sağlayan strateji, yöntem, ve tekniklerin detaylı incelemesi ile zenginleştirilmektedir. Bu inceleme Foucault’nun psikiyatrik iktidar analizi yardımıyla yapılmaktadır.

191

Anahtar sözcükler: Tom Stoppard, Every Good Boy Deserves Favour, Sarah

Daniels, Head-rot Holiday, Joe Penhall, Blue/Orange, Michel Foucault, psikiyatrik iktidar, akıl hastalığı, toplumsal kontrol.

192