about "Abnormal: Lectures at the College de France" by Michel Foucault

Abnormal is largely about the concept and perception of the abnormal person--the pervert or rapist or peeping Tom, for example--from the 19th century to present. In this lecture, Foucault begins by saying that, when an individual has power, he often becomes an object of ridicule (i.e., kings were often portrayed as fools by the peasants, at times). Foucault then explains how psychiatric opinions delivered in court conjure the character of a delinquent alongside the accused--a delinquent doppelganger to the author of the crime. So, it follows, the respected expert psychiatrist on the witness stand is also an oaf because he assesses and prescribes moral instruction as if he were a child, and he describes danger as if he himself was irrationally afraid.

Foucault then embarks on an overview of how power works in this discussion, referring to the phenomenon of how plague patients were partitioned off within society to be watched and studied (as opposed to lepers banished from society). But instead of plague victims, it is the abnormal who are watched and studied. The result of this partitioning and watching is the individualization of people--which is not to be confused with exclusion. All this is done for the preservation and productivity of society's healthy individuals, those whose potential is maximized.

Now, Foucault explains that, until the 16th and 17th century, a crime was conceived of as an offense against the sovereign, and punishment for the crime had to be bigger than the crime because it had to supersede the crime. But, later, crime in general was imagined as having a nature, a criminality, which leads to the question, What is the nature of a criminal? In a penal system that favors this question, the criminal's motive must be matched and nullified by the judicial system, and the medical community took it upon themselves to diagnose motives. Psychology supplies motives for motiveless crimes, and otherwise labels criminals as insane, thereby releasing the penal system from its obligation to punish.

A major development in criminology and psychology was the recognition and exploration of the concept of instinct. "Instinct" allowed for a power mechanism--the penal system with its need for knowledge--to engage with knowledge a mechanism--psychiatry and its need for power. The notion of human instinct helps make motiveless crimes intelligible; it also allows for the medical transformation of motiveless acts into pathological acts.

The notion of instinct came to dominate psychiatry, and allowed the field to expand its domain. Psychiatry soon became a form of family intervention; familial relations were pathologized such that antagonistic relations are deemed pathological. After 1850, a political dimension is introduced; much as history became a tool to politicize the past and present, psychiatry came to help distinguish riots from good revolutions by looking at the minds and motives of the leaders of movements. Madness opposed order, opposed family and personal relationships, and opposed stability; it was a characteristic of social immobility. Healthy behaviors and mentalities had to be conventional and voluntary; deviant behaviors and mentalities consisted of automatic and instinctual responses. All conduct was judged along a contimuum of voluntary vs. involuntary, all relative to the norm. Here, psychology grows beyond madness; psychology could now question all behavior, all people.

About the time that the state formalized support of marriage through policy incentives, homes started being built partitioned, with different rooms for each family member, separating families within a single home, separating kids from parents. This distribution of bodies helps dissuade the development of pathological, antagonistic, and/or incestuous relationships between family members. Foucault discusses the prototypes of the abnormal individual, the monster and the masturbator, and explains how the masturbator enabled psychology to become an authority on family, and link sexuality with illness in terms of masturbation or any other realization of the sexual impulse deemed immoral. Psychology's linking of sexuality with instinct opened a field that allows for masturbators and motiveless murderers to exist in the same conceptual space. Here, the sexual instinct is imagined as fragile, capable of becoming distorted and the cause of degeneracy.

Foucault discusses a rape case set in the 1860's that was referred to psychiatry for explanation. The controversial field outlined the offender's physical traits, and linked these to his deficiencies. He was described as having arrested development, rather than an exaggerated instinct or drive; likewise, his morality was arrested, according to the psychiatric experts.

In the early psychiatric conception of criminality, a patient's development goes wrong, and then the person becomes a criminal. But later psychiatry posits that the seeds of criminality are sown in the person's childhood. Psychiatry faced a dilemma when patients became depathologized because the practice no longer had the backing of medicine, and patients were no longer an suffering illness, per say. Psychiatry identified collections of eccentricities and behaviors and called them "conditions" or "syndromes". These collections of traits were previously considered predispositions, and a person could have a predisposition and still be normal (to the extent such a conception existed). But conditions and syndromes came to describe the abnormal, and any physical or mental illness can be associated with any condition or syndrome. Conditions refer to health but are not illness; they are non-health. Conditions are typically a case of arrested (moral) development or regression.

Foucault explains that a condition's causal background is the patient's heredity. In examining a patient's heredity, anything can cause anything. For example, Your uncle was a drunk? That explains your degeneracy today. Similarly--and this is the lecture's main point--a person's use of the sexual instinct for non-reproductive purposes, a person's having sex or masturbating for pleasure, is thought to point to a condition. This diagnosis is moralizing cloaked in medicine. Degeneracy grew increasingly medicalized. Furthermore, if conditions are a result of heredity, then the idea of finding a cure means nothing in psychiatry. So, this reveals that the field is not so much about the health of the patient, but rather about the protection of society from the effects of degeneracy. The heredity-based form of racism that sprang up at the end of the 19th century and reached its nadir with Nazism stems from psychiatry's social defense aspect.

This is a rich, winding lecture that recalls and elaborates on many of Foucault's major themes. Thoroughly enjoyable read.

about "Psychiatric Power: Lectures at the College de France, 1973-1974" by Michel Foucault

In these lectures, Foucault defines psychiatric power as "that supplement of power by which the real is imposed on madness in the name of a truth possessed once and for all by this power in the name of medical science, of psychiatry". This definition hints at the areas Foucault explores: reality and truth, systems of power, and the disciplines of science and the human sciences. The lectures serve as an important follow up and, in some key respects, an amendment to his early work, Madness and Civilization: A History of Insanity in the Age of Reason. Reading this and staying engaged was a struggle. The reason for that is largely a matter of context: the practice of psychiatry (and administration of asylums) and the schools of thought therein have a complicated and rich history in Europe, particularly in France and Italy. Foucault digs into and entrenches himself in that history, but, as a student, there is no required preliminary reading to reference. Nevertheless, Foucault does impart many insightful points of brilliance:

• The appropriation and use of reality as a form of power

• The medicalization of children, and the creation and expansion of the concept of development as it pertains to rationality and moralizing, retardation, madness, and defining the normal and abnormal

• Foucault's redefining the abnormal, the retarded, etc, as individuals who act on instinct

• How psychiatry changed from a practice that confined, controlled, and sometimes corrected madness to a power that defines, controls, and sometimes corrects the abnormal, thereby expanding its power into the domain of normality

• The role of psychiatry and asylum administration in capitalism and maintenance of the workforce

• How medical science provides justification and grounds for power, but does not inform psychiatric practice

• The history of the concept of truth, and truth's development and role in science

This is not be a good starting read for people interested in Foucault. And people interested in pschiatry (or anti-psychiatry) should probably also not read this without some background in Foucault.

Note

• The edition I have does offer some good historical context on psychiatry.

James Holmes, madman

The New York Times article "Before Gunfire, Hints of ‘Bad News’" unfolds for us the life of James Holmes leading up the massacre. It pins him down, makes him a subject of analysis, takes us down a path that runs parallel to his even while he diverges from his own. We learn how witnesses remember him, forming a cohesive picture of the subject we can use as a collective memory from which we draw out the identity of James Holmes, an identity through which we can say, "That was something James would do" or "That was not like James," until we know when the madman appeared. So it goes: James was normal when he was quiet and shy, attending school, and, at times, acting goofy and awkward; but then he became a loner and, more troubling, unconcerned with school, which is abnormal. Normal James worked, was willing to work, assumed a career, a productive life. And so his divergence was here--not in the movie theater.

On July 20, 2012, James is said to have killed 12 people and wounded 58 at a midnight screening of "Batman: The Dark Knight Rises". The movie depicts the saga of a crime fighter, Batman, and James allegedly referred to himself as The Joker, Batman's nemesis, a powerful and enigmatic villain, a clever perpetrator of crimes. But James likely will not be judged to have committed a crime, and therefore not be labeled a criminal. He will exist outside the binary of law. The judicial system shines a light on the accused, and they are judged innocent or guilty. James performed his violence in the dark, and his mind just may remain beyond the light. His peers and the experts may decide that James was a madman before he entered the theater. A sane man doesn't just shirk off his ambitions, lose all interest and sympathy for civil society, and abandon his social pretensions. Lock him up. Society must be defended.

Abuse your illusions

In addition to events in your personal life, this year's Carrier IQ story and revelations about mental illness and its treatment show that everything that seems good is actually bad. And if not actually, then eventually. But that won't change anything.

(Taking the Carrier IQ story to its logical conclusion, in the not-too-distant future we'll have contact lens computer screens. Soon after that, thoughts can be harvested and stored on Google servers. Then thoughts will be stored on a centralized, searchable database. Scary!)

Happy New Year!

Together at any cost

The New York Times interest piece "Navigating Love and Autism" (1) establishes romantic relationships as a normalizing force and (2) documents an effort to normalize autistic people. The story begins with college-aged Kirsten dating a young man who offers her some much needed coaching in the social graces. She chafes under his direction and is soon drawn to another young man, Jack, who shows no interest in such social conventions. Comforted by the lack of expectations each felt from the other, Jack and Kirsten strike up a relationship. Soon, though, she realizes she needs more affection and understanding than her new beau can give. He has Asperger syndrome, and, turns out, she sort of does, too. They push on together, usually either arguing or just keeping one another company. She starts learning to cope and eventually he lets her get a kitten.

We're supposed to assume that being in a troubled relationship is preferable to being alone, and that this couple is to be congratulated even though their partnership is fraught with difficulties. From the article:

The months that followed Jack and Kirsten’s first night together show how daunting it can be for the mindblind to achieve the kind of mutual understanding that so often eludes even nonautistic couples.

The story continues: After establishing a presence on an advice web site for Autistic people, Jack and Kirsten are somehow invited to speak publicly about relationships. Kirsten is quoted as saying  “Parents always ask, ‘Who would like to marry my kid? They’re so weird.' But, like, another weird person, that’s who." The people who approached them for advice feel anxiety about their own relationship prospects.

The message: They may not be happy but at least these autistic people can try to be normal by having a relationship.

Since the earliest diagnoses, the prevailing wisdom has said that people with Aspergers were mostly unable to have meaningful personal relationships. So, now, the general narrative spawning this article and Jack and Kirsten's efforts is supposed to be that "the overarching quest of many (new adults) in this first generation to be identified with Asperger syndrome is the same as many of their nonautistic peers: to find someone to love who will love them back." Before establishing this narrative we might first check whether we share a common definition of love and value the same things in relationships. What we consider a traditional relationship may not be the shoe that fits Kirsten or Jack.

Where does this "quest" come from? Why the anxiety about being alone?

Notes:

• I heard Asperger syndrome won't appear in the next Diagnostic and Statistical Manual of Mental Disorders (this would be volume five). Instead the diagnosis will fall under the general Autism spectrum.

• The best part of the article comes when the question is put to Jack: Did you ever fear being alone? He answers, “I have no doubt if I wasn’t dating Kirsten I would have a very hard time acquiring a girlfriend that was worthwhile.”

On Foucault's The Will to Knowledge

In the first volume of The History of Sexuality, The Will To Knowledge, Foucault dissolves the conventional wisdom that says sexuality has been repressed since the Victorian age. He argues instead that it began to flourish in the 18th century through discourse. Conceptually, sexuality came into being then as a social construct that has since permeated our lives. This flourishing began with the rite of confession and from there evolved and spread through the newly powerful institutions of science, medicine, and education. A general example: What was a simple debauchery before came to be identified as a specific perversion--and only one of many possible perversions--that evidenced any number of other sexual issues to be uncovered in the recesses of childhood memory and untangled in the psychiatrist's office and later echoed in the medical texts. Sexuality is a secret we tirelessly mine for truths about ourselves. Foucault doesn't deal in conspiracies. Rather, his are institutional analyses, demystifications of the larger issues and forces at play anytime we and our managers attempt reform and understanding.

This volume--or, at least this translation--feels less inspired than Foucault's earlier works, gifting us with fewer flourishes and specific citations. But the overall concepts are more accessible; for example, the recent history of family medicine and psychiatry are less foreign to casual readers than, say, the innards of the asylum. But my main criticism is this: Madness and Civilization excelled at painting a picture of what madness meant before the modern age took hold of it; The Will To Knowledge, on the other hand, gives us little idea of what sex meant to society prior to the Victorian era. Nevertheless, like any Foucault work, this is to be studied and enjoyed for its originality, insight, thoroughness, style, and potential. And I enjoyed this volume far more than I did the third volume, The Care of the Self.

Alienation to alienated

When reading Madness & Civilization, know that a lot of people considered normal today would have been diagnosed mad in previous centuries. For example, Foucault spends a great deal of time discussing melancholics, known today as people suffering from depression.

Anyway, finished reading Madness & Civilization. The closing of chapter IX, "The Birth of the Asylum", includes this wonderful sentence--the parentheticals are mine:

He (Freud) did deliver the patient from the existence of the asylum within which his "liberators" had alienated him; but he did not deliver him from what was essential in this existence; he regrouped its (the asylum's) powers, extended them to the maximum by uniting them in the doctor's hands; he created the psychoanalytical situation where, by an inspired short-circuit, alienation becomes disalienating because, in the doctor, it becomes a subject.1

Here, I think Foucault is saying something like this: The structures and practices of the asylum gave doctors moral authority over the mad; doctors objectified the mad in those asylums, thereby alienating them, making them outsiders in the real world of reason. But once patient care fell to psychiatry--most notably with Sigmund Freud--doctors' authority transferred from those structures to the personage of the doctor. The doctor then exercised his authority in the psychiatrist's office. There, the alienation that was, in the asylum, only a side effect of being the anomaly became itself a neurosis to be studied and speculated on.

Pure rad.

His arguments probably don't play well when taken in pieces like this, but one can see how rich the content of his writing is. I could spend three days unpacking this one sentence and still not feel the thing fully fleshed out.

I think the prevailing opinion is that Foucault was not much of a writer. I disagree, although I have only translations to judge by.

1"Madness & Civilization" by Michel Foucault