By Linda Zerilli
At the seminar on Psychiatric Power, I plan to focus my remarks on this question: what does the figure of the hysteric do for Foucault’s (emergent) theory of disciplinary power? I will be looking at the way in which power is figured as tactical, as involving “networks, currents, relays, points of support, differences of potential,” and how this gets played out in the relationship between hysterics and their doctors. My analysis will be aimed at the kind of resistance that Foucault finds in hysterics and especially the simulation that he argues to be the historical problem of psychiatry and the ultimate failure of psychiatry. Part of what I want to get at here is the question of whether the dependence of the doctor on the hysteric and the hysteric on the doctor, the relations of reciprocity, so to speak, are really ones that allow new practices of resistance to power to emerge.
In other words, I think that these lectures, Psychiatric Power, point forward to his later work, where he explicitly argues for the “capacity to act otherwise.” Although in the mid-1970s Foucault was thinking more in terms of subjects who reproduce the discourses by which they are constituted, he find in the hysteric something like the opening to this capacity. There is, in effect, a relation but also a difference between thinking about the panopticon as the figure of disciplinary power and thinking of the hysteric.
That said, the capacity to act differently, which he will later tie to critique and to what it means to be governed “like this, not like that,” presupposes certain intersubjective relations between subjects that I would like to question. It tends to secure freedom at an ontological level. Can we, at this level, think of resistance and freedom politically? Can we posit what Castoriadis calls “figures of the newly thinkable”? If the hysteric is in a game of tactics, can s/he actually start a different (language) game? And what might that look like without jumping over one’s own shadow and unlearning all Foucault teaches us here and elsewhere about power?
“We salute the hysterics as the true militants of antipsychiatry” (254), declares Foucault at the end of his January 23rd lecture on Psychiatric Power. What exactly does Foucault, genealogist of power, find in—or better—what does he want from “the hysterics, those famous, dear hysterics”? How can a psychiatric patient, most likely female and working class, and therefore also most vulnerable to the invasive and often reckless forms of medical treatment that took place in the at once hidden and open spaces of the large European public hospitals and asylums of the 19th century, figure what Foucault calls “the militant underside of psychiatric power”? How can her “actions,” restricted for the most part to the mute or nonsensical exhibition of the whole repetoire of hysterical symptoms (trembling and shaking, convulsions and paralysis, uncontrolled sobbing and laughing) count as meaningful resistance? How can this otherwise voiceless feminized object in the androcentric theatrical spaces of psychiatric authority lorded over by men like Jean Martin Charcot, who called the Salpêtrière a “living pathological museum” that contained a “considerable amount of material,” possibly figure the very gravedigger of such authority and indeed psychiatry as a knowledge/power relation?
Let me put my cards on the table: If I had my choice, I would not choose the hysteric to figure resistance to power, let alone proto-feminism. But of course it is not feminism as such that the hysteric figures for Foucault either. It is something more like a blind spot in a certain technology of power, namely, disciplinary power, that the hysteric makes visible and, in so doing, exposes its necessary if denied condition: the subject’s freedom or the capacity to act otherwise. So I will argue. Whether this exposure amounts to the militant resistance that Foucault claims for it is another question.
The 1974-74 lectures that make up Psychiatric Power narrate the birth of psychiatry as part of a larger story about the emergence of disciplinary power and its difference from the power of sovereignty. The 14th of November lecture, which lays out what Foucault calls the “great founding scene of modern psychiatry,” dramatizes the difference between these two forms of power: namely, the famous scene “in which [Phillipe] Pinel removes the chains binding the raving lunatics, …[who] express their gratitude” (19) and become available for being cured. It is, however, not so much this but another scene to which Foucault calls our attention, in which mad George III of England is told that “he is no longer sovereign but that he must henceforth be obedient and submissive,” not to another king but to a form of power that “differs term by term” from the power of sovereignty, “is anonymous, nameless, and faceless,” “a power that is expressed through an implacable regulation” (21) and whose presence “is only found in the obedience and submission of those on whom its is silently exercised” (22).
The most vivid expression of this new power is Bentham’s Panopticon, with its de-individualization and disembodiment of power and the “endless extraction of knowledge” from the individual on whom such power is pinned, “pinned in a given space and followed by a potentially continuous gaze.” In his sense, “panopticism could appear and function within our society as a general form; we could speak equally of a disciplinary society or of a panoptic society. We live within generalized panopticism by virtue of the fact that we live within a disciplinary society” (77, 78, 79).
But if panopticism captures the essence of disciplinary power, it does so at the risk of blinding us to that which such power takes for granted but does not think through: freedom or the subject’s capacity to act otherwise. This capacity would be at the heart of what the later Foucault defines as a relation of governance, where to be governed involves “an encounter between technologies of domination of others and those of the self.” Whereas the former “determine the conduct of individuals,” the latter “permit individuals to effect by their own means, or with the help of others, certain number of operations on their own bodies and souls, thoughts, conduct, and way of being.” It is not that Foucault discovers the freedom of the subject only later, when he embarks on an analysis of governmentality (as critics accuse). It is rather that, like the technology of domination called disciplinary power, the author of these lectures did not really think through the freedom of the subject to act otherwise that the later Foucault would see as what such power took for granted, but also as potentially leading to the undoing of such power itself. Thus when Foucault, in the 1980 “Sexuality and Solitude,” observes, “When I was studying asylums, prisons, and so on, I perhaps insisted too much on the techniques of domination” (177), he is not conceding the denial of freedom that his critics claim to find in the earlier writings; he is noting that he, the earlier Foucault, had not clearly thought through the ways in which freedom shaped the working of disciplinary power.
But there is in fact a place in Foucault’s 1973-74 text where such freedom, if not exactly thought through, surfaces as something other than the kind of resistance that Foucault had associated with power/knowledge regimes like the asylum and the prison. This resistance comes not in the form of countervailing regimes of power that make different demands on the subject and so open the space for resistance. The triumph over power is exercised not by a subject caught between competing demands of power; nor is it exercised by the (metaphorical) prisoner isolated in his cell; rather, the “victory cry” over psychiatric power comes in the form of the mostly female psychiatric patient in the theatrical space and throes of hysterical simulation. It is hysterical simulation, not panopticism, that captures the features of disciplinary power that go beyond its impersonal quality to its tactical character, the “networks, currents, relays, points of support, differences of potential,” and so on, that figure such power as a game in which the possibility for resistance is realized.
To understand the radical resistance that goes under the name of hysterical simulation for Foucault we have to grasp what the hysteric is being asked to confirm: namely, the authority of the doctor, understood as impersonal and anonymous, and the legitimacy of psychiatric power, its capacity to accurately diagnose and cure mental illness. Above all, this confirmation involves the subject in manifesting her subjectivity, that is, enacting that which she is taken to be. In this sense, the hysteric must be willing to play the game. At the same time, however, it is just her will that, like that of the mad King George III, the game of psychiatric power is supposed to subordinate, and such subordination is absolutely crucial to the demonstration of psychiatric power in the authoritative figure of the doctor. By producing symptoms that conform to hysteria as an illness but are simulated, the hysteric poses a challenge to the authority of the doctor that the manifestation of hysterical symptoms is supposed to secure. It is an authority premised on never posing the question of truth, premised on the claim that psychiatry, as a true science, already contains all the criteria of truth and so closes every outside space for its adjudication. To this the hysteric says, “if you claim to possess the truth once and for all, in terms of an already fully constituted knowledge, well, for my part, I will install falsehood in myself.” (136) I will in effect avow that which you say I am—a hysteric—but you will never know whether such avowal is true. For this reason, disciplinary power has to eliminate the possibility of simulation. And so Charcot and his pupils would develop and employ a range of self-registering instruments to facilitate control over the will of their experimental subjects. The devices were meant to create an objective index for the existence of a hypnotic state that would eliminate the suspicion that a hypnotized subject was simulating.
Crucial here is that psychiatric power cannot settle simply for eliminating the role of the subject’s will; it needs the subject to freely avow its obedience and submission, to will not to will, so to speak. And though this is not really thematized in the early 1970s lectures that make up Psychiatric Power, my argument is that the importance of avowal as it links up with freedom as the very condition of power is prefigured in Foucault’s account of the hysteric, though not properly thought through.
To get at the difference in his understanding of the place of freedom in power relations, consider the story of Dr. Leuret, known for using brutally cold showers to extract the truth of madness from his patients. In his December 19th lecture of 1973, Foucault explains this mostly in terms of the need to establish “an imbalance of power” (146) and a “state of docility” that will make the patient available for psychiatric treatment. In the 1981 inaugural Louvain lecture that was published in Wrong Doing, Truth Telling, however, Foucault describes the same cold shower treatment in different terms: now the emphasis is less on creating docile bodies than it is on extracting the patient’s avowal of madness. On the one hand, the patient is physically constrained to avow: that is the role played by the cold shower. Though not in the chains that bound mad patients in psychiatric power’s prehistory, the patient cannot meaningfully be said to make a free choice. Yet Leuret was assuming that he did. As Foucault asks in 1981 but not in 1973: “Why must an avowal, even when it is obtained through force, be consider free in order to take on its effects?” As Daniel Nichanian astutely parses this scene: “This puzzle could be rephrased as follows: Why does Leuret ask a question at all? The answer is that the economy of this relationship is sustained by the assumption that the patient is manifesting his own subjectivity; that he is avowing freely.” (38) The question is not whether such freedom is a mere ruse, but why presupposing it is absolutely crucial to how power works according to the later Foucault, but also to power’s potential undoing.
Returning to the hysteric, we might say that at issue is not just the manifestation of the truth of herself in a game she is invited to play and so participation in her own subjection. Though this was a crucial aspect of Foucault’s account at the time of how power works, i.e., through subjectivation, it is not the whole of how power works for him, not even in the period prior to his writings on governmentality, with its emphasis on freedom as the very condition of any relation of power. For the later Foucault, “treating the other as free is not a mark that one has exited the domain of strategic relations,” observes Nichanian. The question, however, is whether a particular technology of government and of power thinks this freedom through or not. Technologies that do not think it through but presuppose it incite subjects to act in games whose outcomes may destabilize, rather than secure, the ends of that incitation. That in a nutshell is the subversive power of hysterical simulation.
The question for us now, however, is whether the capacity to act otherwise is captured in the account of hysterical simulation. The issue, it seems to me, concerns the question of whether subversive actions are here being restricted to certain games that seem to foreclose ways of acting otherwise that are not already given in the scripts and the intersubjective relations of the games themselves.
To get at this problem we need to see that hysterical simulation is not just an example of a rebellious act in which a subject refuses to play by the rules of the game. Such refusal can be taken as a sign that one is not properly manifesting one’s subjectivity. This is especially the case when the improper subject is a woman: the rebellious actions of a wife who is not manifesting her feminine subjectivity properly can be assimilated into, rather than challenge, the regime of power: her actions can be traced back to her husband’s mismanagement of her. It is he not she who is free to act differently.
For Foucault, hysterical simulation amounts to much more than breaking the rules of the game; it is fundamentally corrosive of the game of psychiatric power itself. Corrosive, because it a response that is not external but internal to the game itself; a response that is given in the very logic of the game itself. And though this insight about how taking seriously the rules of a game of power could undermine it would not be clearly articulated until later, when Foucault develops his idea of government, it is implicit in his claim that hysterical simulation undid psychiatric power. Indeed, this is the only way that I can make sense of that incredible assertion, whether or not I agree with it. I say incredible because the drive to root out simulation as a serious threat to medical authority gave rise not to a weakened game, let alone to recognition of the hysteric’s freedom, but, as mentioned earlier, to increasingly complex and elaborate systems of verification designed to root out the possibility of deception. In response to critics who claimed that the Salpêtriére hysterics were “the absolute worst subjects in the world on whom to base scientific conclusions,” Charcot defined the key task of the “truly informed physician” as tracking down deception everywhere it appears, and separating from the real symptoms, which are a fundamental part of the illness, the simulated symptoms that the artifice of the patient would like to add to them.” And surely these techniques of ever more vigilant surveillance were known to Foucault.
In Foucault’s account, however, the hysteric’s simulation owes its destabilizing effects to the demonstration that she is taking the system’s rules very seriously in the very act of provoking it: “The hysteric constitutes herself as the blazon of genuine illness; she models herself as a body and site bearing genuine symptoms” (252). But though this demonstration, well within the rules of the game, ought to underwrite the doctor’s “power-knowledge,” his sole authority “to arbitrate on the question of the reality or nonreality of madness” (252), it actually undermines that authority: “respond[ing] with the most precise and well-determined symptoms; and while doing this she pursues a game that wants to fix her illness in reality, one can never manage to do so, since, when her symptom should refer to an organic substratum she shows that that there is no substratum, so that she cannot be fixed at the level of the reality of her illness at the very moment she displays the most spectacular symptoms” (252). There is no substratum, we might say, because there is only symptom, the symptom is the reality created by hysterical simulation. The symptom is the sole reality that undoes the reality of the physiological substratum, the demonstration of whose existence was intended to confirm psychiatric power. This inversion operates by means not of refusing to play the game of hysteria but by playing it all too well, by taking its indications and signs all too seriously. Thus in strictly conforming to the game’s rules hysterical simulation undoes them. The doctor is failing to acknowledge what he is asking the hysteric to do: to freely manifest her illness. The possibility of doing this takes for granted that she is free to act otherwise.
We do well to recall that, on the one hand, as a technology of governance that does not think through freedom, psychiatric power finds itself in the case of hysterical simulation in the throes of performative contradictions: it needs the subject to freely avow itself as ill while also denying that such freedom is possible because she is ill. On the other hand, I am not convinced that an account of freedom that operates in what Nichanian describes as an ontological register of relations of reciprocity, is the best way to understand resistance. By locating resistance in the intersubjective entanglements that Foucault will later describe as relations of government premised on the subject’s freedom, we risk overlooking the extent to which resistance involves playing different games, engaging in different practices other than those in which one is already incited to manifest one’s subjectivity in certain ways, even if that is accompanied with the recognition that one is free. Both the subject’s refusal or inadequate execution of the need for avowal and a hyper form of avowal like hysterical simulation may produce what Foucault calls “blockages and derailments” for a technology of power. But it is not clear as to how it would transform power. For that I think we need to look at how subjects break with the knowledge/power games in which their freedom is both presupposed and denied by founding new ones. It would be the difference, to conclude, between the women who may well have developed hysterical symptoms out of protest against their confinement in the 19th century patriarchal family, but who remained for the most part caught in the technologies of power that included the psychiatric hospital and its patriarchal structure, and the women who expressed their form of protest through the development of new forms of association, including the forms that made up first wave feminism.