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 (Department of History, Queen's University, Kingston)
Published on H-SAfrica (August, 2007)
Foucault's Re-Examination of Disciplinary Power in Psychiatry
The vast number of studies that have been influenced by Michel Foucault's writings and the plethora of books about his work are testimony to its importance. Yet, many, including himself, have questioned his initial analysis of psychiatry in his book, Folie et Deraison: Histoire de la Folie a l'Age Classique (or Madness and Civilization), first published in 1961, and some have doubted its applicability and even its accuracy. Thus, when a new collection of Foucault's public lectures about psychiatric power is published, one could mistakenly relegate it to the historical backburner. What is significant about these lectures, however, is that they reveal Foucault's changing insight into the nuances of what he calls "disciplinary power" that supplement and, in some cases, supplant those in Folie et Deraison. Foucault delivered these lectures after he published The Birth of the Clinic (1963), The Order of Things (1966), and The Archaeology of Knowledge (1969), but before his final works Discipline and Punish (1975) and The History of Sexuality (1976-1984). Thus, twelve years after he published his first book on the history of madness, these lectures reveal a significant reformulation of his notions of psychiatric power that produce a more in depth discussion of the "apparatus" ("dispositif"), rather than "representations," of power that were prevalent in his earlier work (p. 13). His lectures delve more into the history of psychiatry instead of the history of madness and briefly discuss the spread of what he calls the "Psy-function" to other arenas, such as schools, prisons, and the military. In his course summary, he also conceptualizes the rise of the "depsychiatrization" movement, what is commonly known as antipsychiatry (p. 342). With these reflections, the collection serves as an important addition to his existing publications.
As an African historian who works on the history of madness, I was interested in the applicability of Foucault's revised arguments to my own research. For those not working on psychiatric history, these lectures offer little to the debates about colonial power that are not already in his other works. Foucault's comments on colonization are limited to a few pages (pp. 68-73, 108-109), and he is more concerned with what he calls "internal" colonization in Europe than the "external" in its colonies (p. 71). Nevertheless, for those of us working on the medical history of Africa, the question remains as to whether these lectures offer any new ideas about psychiatric or medical power that could facilitate a fresh approach. The answer to this is a somewhat nebulous yes and no, partly because of the pre-existing debates that exist among scholars about the relevance of Foucault's work to Africa in general. Megan Vaughan, for example, has shown how Foucault's notion of subjective power as described in Europe was not fully applicable to colonial African medicine. She argues that the colonist had no need to construct a deviant "other" as it already had the "other" in the form of the "African." Alex Butchart, on the other hand, argues that Foucault's descriptions of power can be easily applied to medical views and practices in colonial Africa, particularly in South Africa. Butchart, along with others, argue that psychiatric projects in South Africa during the twentieth century were part of a larger means to control violent resistances to colonial and apartheid policies and were used specifically as a form of a disciplinary hegemony. Thus, there is in African historical studies a divergence among scholars as to the validity and applicability of Foucault's arguments.
We can see disagreement in western histories of psychiatry as well. Edward Shorter's History of Psychiatry: From the Era of the Asylum to the Age of Prozac (1997), for example, specifically denounces Foucaultian-influenced and antipsychiatric arguments and promotes a progressive linear trajectory of psychiatric development in the western world, one that suggests that psychiatry's history was simply the advancement of scientific innovations and psychoanalysis was merely a blip on the larger somatic history of psychiatry. While pervasive, this view is not accepted by the majority of those studying psychiatric history. Power structures certainly played a role in the development of psychiatry and Foucault's arguments cannot and should not be simply dismissed. As psychiatric practices in colonial societies were highly influenced by those in Europe, even if colonial psychiatry manifested itself differently in Africa than in Europe, Foucault's arguments are nonetheless valuable in that they directly assess how power was shaped and constructed among practitioners in Europe. This, at the very least, offers a comparative framework upon which scholars working on various societies can reflect.
In these lectures, Foucault ardently denounces the pervasive scientific trajectories of the history of psychiatry that remained popular, i.e. those histories that promoted a linear, progressive, and scientific developmental approach to the origins and development of psychiatry. For example, he inverts the customary view of Philippe Pinel's great nineteenth-century liberation of psychiatric patients within the institution, which is often cited as the origins of modern psychiatry, with the story of the madness of King George the III. It is with this story, amongst others, that Foucault relates how what he tentatively calls "the power of sovereignty" was gradually dominated from the sixteenth to the eighteenth century by a de-individualized opposite, i.e. disciplinary power (p. 42). He relates how this anonymous disciplinary power was shaped within society and institutions, and how a "battle" ensued against the old hierarchy of feudal power within the structures of what he calls a Panopticon-like hospital (p. 7). Sovereign power was not necessarily substituted with disciplinary power, but sovereign power continued in family structures which, when they failed, were meant to be supplanted by institutional structures where the so-called "truth" of the "disease" was shaped and manipulated (pp. 79-87, 340). These arguments noticeably incorporate many of his ideas from his previous works, while they also foreshadow arguments that would be raised in forthcoming publications and reveal his precursory thoughts about the construction of disciplinary power relationships in numerous other institutions, such as the military, prison, and school system and even the family in modern society. Yet, these lectures stand alone in that they are not merely duplicates of his arguments in later works, and reveal some of Foucault's continued suppositions and re-analysis concerning psychiatry and power.
This collection of Foucault's lectures will, no doubt, supplement and infrequently replace many of the arguments raised in his 1961 work, Folie et Deraison, to which many scholars who write on the history of psychiatry refer, and it will serve as an important reference when discussing power apparatus in any context. Combining transcriptions from tape recordings of lectures and annotations from lecture notes, Psychiatric Power allows readers the opportunity to attend Michel Foucault's 1973-74 public lectures at the College de France without having actually been there. Foucault's lectures were always popular and the editors of this English translation offer a valuable anthology of his lectures from the early 1970s. Arnold I. Davidson's introduction to the text and Jacques Lagrange's comments on the context of the course offer valuable background for the lectures. Moreover, the useful point summaries at the beginning of each lecture, and the thorough index, enables easy reference. In general, the collection offers a much more in depth application of Foucault's analysis of power in a mental hospital setting and will no doubt become essential reading for any scholar studying the history of psychiatry in the west and elsewhere.
. Michel Foucault, Folie et Deraison: Histoire de la Folie a l'Age Classique (Paris: Plon, 1961), trans. Richard Howard as Madness and Civilization: A History of Insanity in the Age of Reason (New York: Pantheon, 1965).
. Michel Foucault, Naissance de la clinique: Une archeologie du regard medical (1963), trans. Alan Sheridan as The Birth of the Clinic: An Archaeology of Medical Perception (New York: Pantheon, 1973); Les Mots et les choses: Une archeologie des sciences humaines (1966), trans. Alan Sheridan as The Order of Things: An Archaeology of the Human Sciences (New York: Vintage, 1970); L'Archeologie du savoir (1969), trans. Alan Sheridan as The Archaeology of Knowledge (New York: Pantheon, 1972); Surveiller et punir: Naissance de la prison (1975), trans. Alan Sheridan as Discipline and Punish: The Birth of the Prison (New York: Pantheon, 1977); La Volonte de savoir: Volume 1, Histoire de la sexualite (1976), trans. Robert Hurley as The History of Sexuality: Volume 1, An Introduction (New York: Pantheon, 1978); Histoire de la sexualite 2: L'usage des plaisirs (1984), trans. Robert Hurley as The Use of Pleasure: Volume 2, The History of Sexuality (New York: Random House, 1985); and Histoire de la sexualite 3: Le souci de soi (1984), trans. Robert Hurley as The Care of the Self: Volume 3, The History of Sexuality (New York: Random House, 1986).
. Megan Vaughan, Curing Their Ills: Colonial Power and African Illness (Stanford, Calif.: Stanford University Press, 1991), 101.
. Alex Butchart, The Anatomy of Power: European Constructions of the African Body (London and New York: Zed Books, 1998).
. Alex Butchart, Brandon Hamber, Martin Terre Blanche, and Mohamed Seedat, "Violence, Power, and Mental Health Policy in Twentieth-Century South Africa," in Mental Health Policy Issues for South Africa, ed. Don Foster, Melvyn Freeman, and Yogan Pillay (Pinelands: Medical Association of South Africa, 1997), 236.
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Tiffany Jones. Review of Foucault, Michel, Psychiatric Power: Lectures at the College de France, 1973-1974.
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