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Foucault's Re-Examination of Disciplinary Power in Psychiatry

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Foucault's Re-Examination of Disciplinary Power in Psychiatry Michel Foucault. Psychiatric Power: Lectures at the College de France, 1973-1974. Basingstoke and New York: Palgrave Macmillan, 2006. xxiv + 382 pp. $28.95, cloth, ISBN 978-1-4039-6922-4. Reviewed by Tiffany Jones Published on H-SAfrica (August, 2007) The vast number of studies that have been in‐ power that produce a more in depth discussion of fluenced by Michel Foucault's writings and the the "apparatus" ("dispositif"), rather than "repre‐ plethora of books about his work are testimony to sentations," of power that were prevalent in his its importance. Yet, many, including himself, have earlier work (p. 13). His lectures delve more into questioned his initial analysis of psychiatry in his the history of psychiatry instead of the history of book, Folie et Deraison: Histoire de la Folie a l'Age madness and briefly discuss the spread of what Classique (or Madness and Civilization), frst pub‐ he calls the "Psy-function" to other arenas, such as lished in 1961, and some have doubted its applica‐ schools, prisons, and the military. In his course bility and even its accuracy.[1] Thus, when a new summary, he also conceptualizes the rise of the collection of Foucault's public lectures about psy‐ "depsychiatrization" movement, what is common‐ chiatric power is published, one could mistakenly ly known as antipsychiatry (p. 342). With these re‐ relegate it to the historical backburner. What is flections, the collection serves as an important ad‐ significant about these lectures, however, is that dition to his existing publications. they reveal Foucault's changing insight into the As an African historian who works on the his‐ nuances of what he calls "disciplinary power" that tory of madness, I was interested in the applica‐ supplement and, in some cases, supplant those in bility of Foucault's revised arguments to my own Folie et Deraison. Foucault delivered these lec‐ research. For those not working on psychiatric tures after he published The Birth of the Clinic history, these lectures offer little to the debates (1963), The Order of Things (1966), and The Ar‐ about colonial power that are not already in his chaeology of Knowledge (1969), but before his f‐ other works. Foucault's comments on colonization nal works Discipline and Punish (1975) and The are limited to a few pages (pp. 68-73, 108-109), and History of Sexuality (1976-1984).[2] Thus, twelve he is more concerned with what he calls "inter‐ years after he published his frst book on the his‐ nal" colonization in Europe than the "external" in tory of madness, these lectures reveal a signifi‐ its colonies (p. 71). Nevertheless, for those of us cant reformulation of his notions of psychiatric H-Net Reviews working on the medical history of Africa, the psychiatry manifested itself differently in Africa question remains as to whether these lectures of‐ than in Europe, Foucault's arguments are none‐ fer any new ideas about psychiatric or medical theless valuable in that they directly assess how power that could facilitate a fresh approach. The power was shaped and constructed among practi‐ answer to this is a somewhat nebulous yes and tioners in Europe. This, at the very least, offers a no, partly because of the pre-existing debates that comparative framework upon which scholars exist among scholars about the relevance of Fou‐ working on various societies can reflect. cault's work to Africa in general. Megan Vaughan, In these lectures, Foucault ardently de‐ for example, has shown how Foucault's notion of nounces the pervasive scientific trajectories of the subjective power as described in Europe was not history of psychiatry that remained popular, i.e. fully applicable to colonial African medicine. She those histories that promoted a linear, progres‐ argues that the colonist had no need to construct sive, and scientific developmental approach to the a deviant "other" as it already had the "other" in origins and development of psychiatry. For exam‐ the form of the "African."[3] Alex Butchart, on the ple, he inverts the customary view of Philippe other hand, argues that Foucault's descriptions of Pinel's great nineteenth-century liberation of psy‐ power can be easily applied to medical views and chiatric patients within the institution, which is practices in colonial Africa, particularly in South often cited as the origins of modern psychiatry, Africa.[4] Butchart, along with others, argue that with the story of the madness of King George the psychiatric projects in South Africa during the III. It is with this story, amongst others, that Fou‐ twentieth century were part of a larger means to cault relates how what he tentatively calls "the control violent resistances to colonial and power of sovereignty" was gradually dominated apartheid policies and were used specifically as a from the sixteenth to the eighteenth century by a form of a disciplinary hegemony.[5] Thus, there is de-individualized opposite, i.e. disciplinary power in African historical studies a divergence among (p. 42). He relates how this anonymous disci‐ scholars as to the validity and applicability of Fou‐ plinary power was shaped within society and in‐ cault's arguments. stitutions, and how a "battle" ensued against the We can see disagreement in western histories old hierarchy of feudal power within the struc‐ of psychiatry as well. Edward Shorter's History of tures of what he calls a Panopticon-like hospital Psychiatry: From the Era of the Asylum to the Age (p. 7). Sovereign power was not necessarily substi‐ of Prozac (1997), for example, specifically de‐ tuted with disciplinary power, but sovereign pow‐ nounces Foucaultian-influenced and antipsychi‐ er continued in family structures which, when atric arguments and promotes a progressive lin‐ they failed, were meant to be supplanted by insti‐ ear trajectory of psychiatric development in the tutional structures where the so-called "truth" of western world, one that suggests that psychiatry's the "disease" was shaped and manipulated (pp. history was simply the advancement of scientific 79-87, 340). These arguments noticeably incorpo‐ innovations and psychoanalysis was merely a blip rate many of his ideas from his previous works, on the larger somatic history of psychiatry. While while they also foreshadow arguments that would pervasive, this view is not accepted by the majori‐ be raised in forthcoming publications and reveal ty of those studying psychiatric history. Power his precursory thoughts about the construction of structures certainly played a role in the develop‐ disciplinary power relationships in numerous ment of psychiatry and Foucault's arguments can‐ other institutions, such as the military, prison, and not and should not be simply dismissed. As psy‐ school system and even the family in modern so‐ chiatric practices in colonial societies were highly ciety. Yet, these lectures stand alone in that they influenced by those in Europe, even if colonial are not merely duplicates of his arguments in lat‐ 2 H-Net Reviews er works, and reveal some of Foucault's continued L'Archeologie du savoir (1969), trans. Alan Sheri‐ suppositions and re-analysis concerning psychia‐ dan as The Archaeology of Knowledge (New York: try and power. Pantheon, 1972); Surveiller et punir: Naissance de This collection of Foucault's lectures will, no la prison (1975), trans. Alan Sheridan as Discipline doubt, supplement and infrequently replace and Punish: The Birth of the Prison (New York: many of the arguments raised in his 1961 work, Pantheon, 1977); La Volonte de savoir: Volume 1, Folie et Deraison, to which many scholars who Histoire de la sexualite (1976), trans. Robert Hur‐ write on the history of psychiatry refer, and it will ley as The History of Sexuality: Volume 1, An In‐ serve as an important reference when discussing troduction (New York: Pantheon, 1978); Histoire power apparatus in any context. Combining tran‐ de la sexualite 2: L'usage des plaisirs (1984), trans. scriptions from tape recordings of lectures and Robert Hurley as The Use of Pleasure: Volume 2, annotations from lecture notes, Psychiatric Power The History of Sexuality (New York: Random allows readers the opportunity to attend Michel House, 1985); and Histoire de la sexualite 3: Le Foucault's 1973-74 public lectures at the College souci de soi (1984), trans. Robert Hurley as The de France without having actually been there. Care of the Self: Volume 3, The History of Sexuali‐ Foucault's lectures were always popular and the ty (New York: Random House, 1986). editors of this English translation offer a valuable [3]. Megan Vaughan, Curing Their Ills: Colo‐ anthology of his lectures from the early 1970s. nial Power and African Illness (Stanford, Calif.: Arnold I. Davidson's introduction to the text and Stanford University Press, 1991), 101. Jacques Lagrange's comments on the context of [4]. Alex Butchart, The Anatomy of Power: Eu‐ the course offer valuable background for the lec‐ ropean Constructions of the African Body (Lon‐ tures. Moreover, the useful point summaries at don and New York: Zed Books, 1998). the beginning of each lecture, and the thorough [5]. Alex Butchart, Brandon Hamber, Martin index, enables easy reference. In general, the col‐ Terre Blanche, and Mohamed Seedat, "Violence, lection offers a much more in depth application of Power, and Mental Health Policy in Twentieth- Foucault's analysis of power in a mental hospital Century South Africa," in Mental Health Policy Is‐ setting and will no doubt become essential read‐ sues for South Africa, ed. Don Foster, Melvyn ing for any scholar studying the history of psychi‐ Freeman, and Yogan Pillay (Pinelands: Medical atry in the west and elsewhere. Association of South Africa, 1997), 236. Notes [1]. Michel Foucault, Folie et Deraison: His‐ toire de la Folie a l'Age Classique (Paris: Plon, 1961), trans. Richard Howard as Madness and Civ‐ ilization: A History of Insanity in the Age of Rea‐ son (New York: Pantheon, 1965).
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