Foucault 4/13 Epilogue: Psychiatric Subjects, Political Subjects, Maneuvers and Counter-Maneuvers

By Bernard E. Harcourt

The presentations by Linda Zerilli, Alondra Nelson, and Anna Lvovsky at Foucault 4/13 raised challenging questions concerning the political dimensions of Psychiatric Power. Linda Zerilli started us off by questioning whether the disempowered hysteric patient—predominantly middle-class women trapped in coercive family relations—could really act as the agents of resistance to psychiatric power. Alondra Nelson challenged the elision of the primary brute violence of the colonizer and drew our attention to the writings of Frantz Fanon, who wrote on similar questions of psychiatric power. Anna Lvovsky turned our attention to the question of sexuality, asking “to what extent is scientia sexualis responsible for designating sexuality as a unique truth of the self?”

It was within this context that John Rajchman offered an alternative reading of the 1974 lectures, emphasizing the way in which Lacan himself had felt it necessary to rework his psychoanalytic theories as a result of the resistance of feminists in the 1960s. This, John Rajchman suggested, casts a different light on the role of the hysterics in Foucault’s work. Linda Zerilli nevertheless questioned whether the focus should have been on the hysterical female patients only, or rather on the persons outside the mental hospital putting pressure on psychiatric power.

Nadia Urbinati reminded us of the political stakes of the lectures in the early 1970s, while Stathis Gourgouris underscored the deeply political nature of an analysis of disciplinary forms of power, and of relations of power more generally. Antonio Pele joined us virtually from Rio and reemphasized the political struggles that were at play during the time of the lectures. Adam Tooze focused the conversation on the second and third lectures, where Foucault develops disciplinary power as opposed to sovereign power—suggesting that those were the most political lectures, and tying those to the later dissection, in January 1974, of the “microphysics of power” by means of the analysis of the various maneuvers, strategies, and tactics of the psychiatrists. In a conversation with Noa Ben-Asher, Rosalind Morris, and Dana Polan, the seminar discussion turned to Nietzsche, psychoanalysis, and the emerging notion of the dispositif.

The seminar left me rethinking Foucault’s minute and intricate analysis of the “maneuvers” (p. 146) and “counter-maneuver” (p. 318) that constituted those new form of disciplinary power in the nineteenth century. The relationship between the strategies of the psychiatrists, the subject formation of the patients, and the resistance of other patients (hysteric or not) is utterly fascinating, and reflects a certain dynamic that I feel needs to be schematized. It is a movement in three parts, with a cadence and rythm:

(Doctors) Inform themselves about everything, obtain total information about the patients, get all the background on family and friends—know everything. (PP, p. 184: “you should know why he is there, what the complaint is against him, his biography; you should have questioned his family or circle”). The maneuver is “Creating an imbalance of power” (p. 146): “right from the start or, anyways, as quickly as possible, making power flow in one and only one direction, that is to say, from the doctor” (p. 146). To show the doctor’s “reality and omnipotence” (p. 148).

(Patients) Made to feel that doctors know more about them than they do themselves, more than anyone could possibly imagine anyone would know. Made to feel that doctors can catch their lies and their deliriums.

(Hysterics) Some patients resist by means of the excesses of the “functional mannequin” (p. 311). Some patients display more symptoms than the doctors know about, thereby injecting the question of truth into the situation. This is the “second maneuver”: “At the end of the second maneuver, the doctor is therefore once again newly dependent on the hysteric….” (p. 316)

(Doctors) The technique of psychiatric questioning: minute, detailed strategy of questioning, like a sword fight, not about extracting information, but about placing the patient under the doctor’s mastery. (PP p. 185: “interrupt him with questions”; “follow a certain order”). Here, the maneuver is: “the reuse of language” (p. 149): require the patient to “read and recite verse” (p. 150).

(Patients) Made to feel there is “an interplay of meanings which give the doctor a hold on the patient.” (p. 185)

(Hysterics) Sexual avowals that disrupt: Charcot does not want to talk about sexuality (p. 318). MF: “the hysterics, for the third time, take back power over the psychiatrist, for these discourses, scenes, and postures.” (p. 320).

(Doctors) Maintain a constant file, and constantly supervise the patient—permanent surveillance. (PP, p. 185: “a complete system of statements and notes on the asylum patient.”) Here the maneuver is: Creating regularity and order: the asylum becomes therapeutic “because it obliged people to submit to regulation, to a use of time, it forced them to obey orders, to line up, to submit to the regularitiey of certain actions and habits, to submit to work.” (p. 151). The quest is for order, PP p. 152.

(Patients) Feel completely known, everything the patient has done, “what he said the day before, what faults he committed, and what punishment he received.” (PP, p. 185)

(Hysterics) Challenges the system of surveillance by showing more symptoms than expected.

(Doctors) To get the patient to “tell the truth”: to avow that he is mad, or was mad, that those were only hallucinations. The maneuver here: “the patient must be got to tell the truth.” (p. 157).

(P) Patient must avow, must confess (p. 159). He must recognize certain biographical episodes.

(H) Sexual avowal as “the hysteric’s victory cry.” (p. 322).

These dynamics capture the central elements of disciplinary power. Recall from the lecture of November 21, 1973: first, getting a total hold and “exhaustive capture of the individual’s body, actions, time, and behavior” (p. 46); second, implementing a process of continuous control (p. 47); third, imposing isotopic forms of classification, ranking, hierarchies through examinations and competitions (p. 52); fourth, producing an unclassifiable residue who requires even more disciplinary mechanisms, a super-discipline (p. 53).

From the perspective of the doctors, the efficacy of the asylum is due to “uninterrupted disciplinary training; the dissymmetry of power inherent in this; the game of need, money, and work; statutory pinning to an administrative identity in which one must recognize oneself through a language of truth.” (PP, p. 161)

From the perspective of the patients, this is “the truth of a madness agreeing to first person recognition of itself in a particular administrative and medical reality constituted by asylum power.” (PP, p. 161).

From the perspective of the strategic hysteric, the avowal of madness is a strategic way to avoid being deemed demented, and provides a privileged position in the asylum. (p. 254). As Foucault emphasized, “the only way not to be demented in a nineteenth century hospital was to be a hysteric.” (PP, 254)

This recurring interplay of doctor, patient, and resistant is what forms, it seems, the very  backbone of disciplinary interactions. It is all a game of strategy and counter-strategy, reinforcing and undermining authority in the total institution.