4/13 | Psychiatric Power

While the previous year’s lectures on The Punitive Society focused in large part on the birth of the penitentiary and were motivated by the question “why the prison one hundred and fifty years ago, and for one hundred and fifty years?” (TPS, p. 226), Foucault turns in November 1973 to the birth of the asylum in a radically anti-institutionalist way. His objects are the psychiatric practices in the earlier period, what he calls “proto-psychiatry”, from 1790 to about 1820 or 1830. And, just as he had added the term “practice” to the title of his 1972 lectures Penal Theories and Institutions in the very first notations on his manuscript pages (T&IP, p. 3 “manque un troisième terme : pratique”), here too the focus is on maneuvers, strategies, and tactics.

From the outset, Foucault corrects his past mistakes.

He was wrong in his History of Madness, he tells us, to focus on representations and images (discourses of truth) or to focus first on institutions; before we begin to think about institutions (the family, the asylum, the state), before we even begin think about discourses of truth, we need to understand the microphysics of power electrifying the relationship between the doctor and patient. That therapeutic relationship is riven with power struggles, and it is only from there that we see begin to understand the production of institutions and discourses.

He was wrong to focus on violence or to place the family model at the heart of the asylum. (PP, p. 14-15). Instead of violence, he says, we need to study “microphysics of power”; instead of institutions, “tactics of how power plays out in these institutionalized forms”; instead of the family or the state, the “strategies of these relations of power and struggles that take place in psychiatric practice.”

His approach, he says, must be radically anti-institutionalist: “Let’s be really anti-institutionalist. What I propose to bring to light this year is, before analysis of the institution, the microphysics of power.” (PP, p. 33) And in this vein, as Jesús R. Velasco points out so insightfully, he immediately turns away from the expression he had been contesting for years—the notion of apparatuses—and deploys a new term: « dispositif » (PP, p. 13).

In Psychiatric Power, Foucault elaborates on his theory of power, which he had begun to set out so precisely and in detail in the last lecture of The Punitive Society on March 28, 1973: “It is now time to talk about this power,” he said there, before launching into a ten page dissertation on his theory of power (TPS, p. 227). Here, on November 7, 1973, he picks up the thread: power is not something that is possessed; it is rather “dispersion, relays, networks, reciprocal supports” (PP, p. 4). It is also rife with struggle, war, tactics, strategies, micro-physics. (PP, p. 16). And this notion of struggle will permeate the relation between psychiatrist and patient, and thread right through the asylum: “before the problem being 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. So what is organized in the asylum is actually a battlefield.” (PP, p. 6-7). We see here again, the theme of civil war, without the wording, but with all the battles, battlefields, and struggles that will recur in the book of 1975.

If we can think of the 1972 lectures, with François Ewald, as a prototype for a repressive model of power, and the 1973 lectures as a prototype for a productive punitive model of power (TPS, p. 279-283), then perhaps we can think of these 1974 lectures as the prototype for the disciplinary model of power. Psychiatric power is struggle, mastery, and direction of others. (PP, p. 173-174). As Foucault emphasizes, the mantra is: “I direct, I praise, reward, reprimand, command, constrain, threaten, and punish every day.” (p. 174).

In these lectures, Foucault revisits and refines themes from 1973: (1) the relation to Marx, supplementing the theory of capital accumulation with the theory of the accumulation of men (p. 71); the theory of the Panopticon, with further elaborations on pp. 41 and 73-80; (3) the use of time-tables, on this occasion for the children at Bicêtre (p. 218); and (4) the discussion of colonialism and slavery (p. 69). We see Foucault return to the critique of Durkheim and the production of individuality: There is no individual beneath power relations who can be freed. The individual is created by disciplinary mechanisms and by the discourse of the human sciences. (PP, p. 57). It is only “from the oscillation between the juridical individual and the disciplinary individual [that is] born the illusion and the reality of what we call Man.” (PP, p. 58).

What would it entail, we might ask ourselves, to take seriously this idea of “the illusion of what we call man?” (PP, p. 58)

Foucault gives us a “little history of truth” (PP, p. 235) that Daniele Lorenzini discusses so insightfully. He foreshadows his interest in “dangerousness” (p. 220), monomania (p. 249), and social defense (250) that he will develop in his 1978 essay on the dangerous individual in 19th century psychiatry and in his final lecture, on May 20, 1981, in Wrong-Doing, Truth-Telling: The Function of Avowal in Justice. He foreshadows as well his interest in avowal throughout these 1974 lectures (see esp. p. 159, 161) as well as in the direction of conscience (“The psychiatrist is someone […] who directs individuals”, p. 174).

Foucault offers a rich revisionist theorization of the family as the agent of disciplinary power (see especially page 115 and the lesson of December 12, 1973 starting on page 123). What is remarkable is the interplay between disciplinary and sovereign power. How imbricated they are. The family, as an instantiation of sovereign power, lodged within disciplinary apparatuses. It is the family, Foucault shows us, who identifies the abnormal for the psychiatric discipline:

On the other hand, in our kind of society, that is to say, in a society in which there is a disciplinary type of microphysics of power, the family has not been dissolved by discipline; it is concentrated, limited, and intensified. Consider the role played by the civil code with regard to the family. There are historians who will tell you that the civil code has given the maximum to the family; others say that it has reduced the power of the family. In fact, the role of the civil code has been to limit the family while, at the same time, defining, concentrating, and intensifying it. Thanks to the civil code the family preserved the schemas of sovereignty: domination, membership, bonds of suzerainty, etcetera, but it limited them to the relationships between men and women and parents and children. The civil code redefined the family around this micro-cell of married couple and parents and children, thus giving it maximum intensity. It constituted an alveolus of sovereignty through the game by which individual singularities are fixed to disciplinary apparatuses. (English 82-83; French 84).

And of course Foucault sets the stage, first, for his next lecture series, the 1974-1975 lectures on Abnormal. Psychiatric power, Foucault tells us, spreads through abnormal children (p. 190), and gets diffused through the very notion of normality (p. 202 and 221)—drawing on Canguilhem, whom he quotes: “’Normal’ is the term used by the nineteenth century to designate the scholastic prototype and the state of organic health.” (PP, p. 202).

And second, for his work on the history of sexuality. These 1974 lectures are where sexuality begins to take shape as an object of study. Of course, Foucault had talked about sexuality before. In L’Ordre du discours for instance, he had rehearsed how his archeological approach would play out on sexuality. In The Punitive Society, he had explored the disciplinary regulation of the sexuality of workers (TPS, p. 133) and of sexuality at school (p. 213). But here, in 1974, the object begins to gel, as Foucault explores how the medical knowledge of hysteria tried to hide sexuality, but how, as psychiatry moved from the asylum to the hospital, as it became not just madness but illness, it became possible to see emerge the medicalization of sexuality.

« En forçant les portes de l’asile, en cessant d’être des folles pour devenir des malades, en entrant enfin chez un vrai médecin, c’est-a-dire chez le neurologue, en lui fournissant des vrais symptômes fonctionnels, les hystériques, pour leur plus grand plaisir, mais sans doute pour notre plus grand malheur, ont donné prise à la médecine sur la sexualité. » (PP, French edition, p. 325)

It is there, with hysteria, that we will begin the conversation in the seminar Foucault 4/13, drawing on the insightful introductory posts of Linda Zerilli and Anna Lvovsky. Welcome to Foucault 4/13!

[Read post here. © Bernard E. Harcourt]