Monday, 23 January 2012

Book Review: Madness and Civilization

Originally posted to my Simple Food Remedies blog, I'm reproducing this book review here as I think it is relevant to this blog as well.

After reading the Madness of Adam and Eve, How Schizophrenia Shaped Humanity (2002) by David Horrobin, I became interested in the theory that homo sapiens have actually become increasingly mentally deficient since the beginning of civilization and so was intrigued to discover a book called Madness and Civilization, A History of Insanity in the Age of Reason (1961) by Michel Foucault (translated from the French by Richard Howard) which proved to be an interesting read. I think few would argue that we live in a mad world; mad in the sense that we are constantly bombarded every day by human actions that harm, destroy and mutilate. We are destroying nature, ourselves, each other and life itself. Only madmen would do that.

So, I think it is only fitting to share some of what I found to be the highlights of this book. Obviously, not everyone is a raving lunatic, although many of us can remember having an episode or two in our own lives. And, some people are actually quite sane. But the tendency is innate in all of us, like the religious concept of original sin; our species seems to have a propensity to, well, madness.

The more we strive for perfection, the more defective we actually are becoming. I really liked David Cooper’s comment in the Introduction that “curing we understand here as a sort of anti-healing – a process not entirely dissimilar to the curing of bacon, and totally opposed to healing in the sense of the making whole of persons.”

And the more we try to “cure” diseases of any sort, the more they proliferate. Raulin is quoted in this book as saying in the nineteenth century that “since the birth of medicine... these illnesses have multiplied, have become more dangerous, more complicated, more problematical and difficult to cure.”

Foucault starts out with a discussion of Stultifera Navis (Ship of Fools) a book of satire published in 1494 in Basel, Switzerland by Sebastian Brant, a conservative German theologian which he uses to discuss the theory that the invention of the arts can be attributed to deranged imaginations. One point I found particularly relevant was that “self-attachment is the first sign of madness, but it is because man is attached to himself that he accepts error as truth, lies as reality, violence and ugliness as beauty and justice.”

Next, Foucault leads the reader into a discussion about Confinement. From the times of when lepers were isolated, to when fools were sent off to sea until the development of the asylum, civilized man has been confining those who do not fit into the mercantile society which is based on a system of labour that supports the elite upper class of wealthy citizens. “The wars of religion multiplied this suspect crowd, which included peasants driven from their farms, disbanded soldiers or deserters, unemployed workers, impoverished students, and the sick.”

From the chapter on the Insane: “The animal in man no longer has any value as the sign of a Beyond; it has become his madness, without relation to anything but itself: his madness in the state of nature.” Foucault then delves into a discussion about Passion and Delirium.

In the chapter on Aspects of Madness, an interesting physiological observation is made: “Thèophile Bonet, in his Sepulchretum anatomicum, declares that the brains of maniacs, insofar as he had been able to observe them, always seemed to be in a state of dryness, of hardness, and of friability. Later, Albrecht von Haller also found that the maniac’s brain was hard, dry, and brittle.” He makes further observations about hypochondrical and hysterical aspects of madness and the physical condition of the brain and body, but also about the personality, such as this comment: “On one hand, nervous sufferers are the most irritable, that is, have the most sensibility: tenuousness of fibre, delicacy of organism; but they also have an easily impressionable soul, an unquiet heart, too strong a sympathy for what happens around them.” Foucault concludes that it was in these “diseases of the nerves” and “hysterias” that
modern psychiatry was born in the nineteenth century.

A continuing theme throughout the book is that madness is caused by a physical weakness in the constitution of the body.

In the chapter on Doctors and Patients, some daft cures were mentioned such as eating soap to clean out impurities and eating iron filings to make one strong. Vinegar rubbed on a shaved head was supposed to draw out harmful humours and liquids, and taking a bath was good except that taking too many hot baths would make one prone to feinting. But a good remedy that was mentioned was this one:

“It was to Jean-Jacques Rouseau that I owed my return to health. I had read, in his immortal writings, among other natural truths, that man is made to work, not to meditate. Until that time I had exercised my soul and rested my body; I changed my ways; I exercised my body and rested my soul. I gave up most books; I turned my eyes to the works of nature, which addressed all my senses in a language that neither time nor nations can corrupt. My history and my newspapers were the plants of the field and forest; it was not my thoughts that struggled to them, as in the system of men, but their thoughts that came to me in a thousand agreeable shapes.” (Bernardin de Saint-Pierre, Prèambule de L’Arcadie. Oeuvres (Paris, 1818), Vol VII, PP. 11-14).

Foucault progresses with his history of madness in the chapter entitled the Great Fear with a discussion of how madness attained medical status. He says this was in fact made possible only by a strange regression and not really progress at all. Nervous diseases “were formerly much less frequent than they are nowadays; and this for two reasons: one, that men were in general more robust, and less frequently ill; there were fewer diseases of any kind; the other that the causes which produce nervous diseases in especial have multiplied in a greater proportion, in recent times, than the other general causes of illness, some of which even seem to have diminished. ... I do not hesitate to say that if they were once the rarest, they are today the most frequent.” (Simon-Andrè Tissot, Traitèedes nerfs et de leurs maladies (Paris 1978-80), Vol I, pp. iii-iv.).

Well that was said in Tissot’s time, 1728 -1797. Now, over 200 years later, things look much worse indeed. For some further information, please see my article which includes the amount of prescriptions taken for anxiety and depression in the UK during 2010 (nearly one for every person living here).

Foucault also explains Tissot’s finding that physical labour is good for the human body leading to health and longevity, but “among men of letters, the brain hardens; often they become incapable of connecting their ideas, and so are doomed to dementia.” I know several people who were very smart in their youth and in old age had dementia, one of whom was my grandfather. Foucault concludes that “the more abstract or complex knowledge becomes, the greater the risk of madness.” This is truly scary indeed when we consider the height of complex scientific research that is being undertaken today and especially that being applied to medicine and food.

“Madness became possible in that milieu where man’s relations with his feelings, with time, with others, are altered; madness was possible because of everything which, in man’s life and development, is a break with the immediate.”

Foucault further says that by the nineteenth century, physicians and philosophers became alienated and all trace or semblance of truth was lost.

In the chapter entitled The New Division, Foucault touches upon the need for paupers in a society bent on attaining riches and how it was difficult to fit in madness in the social sphere that was developing before the Birth of the Asylum which is the final chapter. Some might say that we have come a long way since then because we use drugs to treat madness.  At the very least, we have created lucrative markets surrounding the care of disabled people including those with mental disabilities.  However, my view is that madness prevails in the so-called civilized Western society today and the use of drugs is exasperating the situation.

Foucault describes how asylums were places of correction, where moral standards were imposed and how religion was used as a standard of cure.

“... religion can play the double role of nature and of rule, since it has assumed the depth of nature in ancestral habit, in education, in everyday exercise, and since it is at the same time a constant principle of coercion. It is both spontaneity and constraints, and to this degree it controls the only forces that can, in reason’s eclipse counterbalance the measureless violence of madness, its precepts, “where these have been strongly imbued in early life ... become little less than principles of our nature; and their restraining power is frequently felt, even under the delirious excitement of insanity. To encourage the influence of religious principles over the mind of the insane is considered of great consequence, as a means of cure.”” (Samuel Tuke, Description of the Retreat, and Institution near York for Insane Persons of the Society of Friends (York, 1813), p. 50.)

What follows is a long quote because Foucault puts it so well about how doctors take on surreal roles of authority which is still common today. Just because a person becomes a doctor and has a piece of paper that says he did a formal spell of education, people allow him to prescribe chemicals that they know nothing about, cut them open and explore around, poke with needles, remove blood, stick tubes in various places, cut off bits, etc etc, Its all quite shocking really. Meanwhile, I’ve been called an Evangelist for explaining that the GAPS diet could benefit those with certain illnesses when it’s simply based on whole foods!

“In authority he has borrowed from order, morality, and the family now seems to derive from himself; it is because he is a doctor that he is believed to possess these powers, and while Pinel, with Tuke, strongly asserted that his moral action was not necessarily linked to any scientific competence, it was thought, and by the patient first of all that it was in the esotericism of his knowledge, in some almost daemonic secret of knowledge, that the doctor had found the power to unravel insanity; and increasingly the patient would accept this self-surrender to a doctor both divine and satanic, beyond human measure in any case; increasingly he would alienate himself in the physician, accepting entirely and in advance all his prestige, submitting from the very first to a will he experienced as magic, and to a science he regarded as prescience and divination, thus becoming the ideal and perfect correlative of those powers he projected upon the doctor, pure object without any resistance except his own inertia, quite ready to become precisely that hysteric in whom Charcot exalted the doctor’s marvellous powers. If we wanted to analyze the profound structures of objectivity in the knowledge and practice of nineteenth century psychiatry from Pinel to Freud, we should have to show in fact that such objectivity was from the start a rectification of a magical nature, which could only be accomplished with the complicity of the patient himself, and beginning from a transparent and clear moral, practice gradually forgotten as positivism imposed its myths of scientific objectivity; a practice forgotten in its origins and its meaning, but always used and always present. What we call psychiatric practice is a certain moral tactic contemporary with the end of the eighteenth century, preserved in the rites of asylum life, and overlaid by the myths of positivism.

These cures without basis, which must be recognized as not being false cures, would soon become the true cures of false illness. Madness was not what one believed, nor what it believed itself to be; it was infinitely less than itself: a combination of persuasion and mystification.”

In Conclusion, “the night of madness is thus limitless; what might have been supposed to be man’s violent nature was only the infinity of non-nature.”

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Available online in pdf format

PS I took this book out of the local library which was the version first published in Great Britain in 1967 by Tavistock Publications Limited, London.