Madness and Civilization Summary

The perception of mental illness has changed across time. And this change has more to do with social and economic needs, than any humanitarian feelings towards the mentally ill.

From the discovery of that necessity which inevitably reduces man to nothing, we have shifted to the scornful contemplation of that nothing which is existence. p.13

Before the 15th century, there was an obsession with death, the totality of it, the limit it placed on our lives — and then in the last years of the century, this fixation was replaced with the mockery of madness. Madness itself was a form of death, a head that will become a skull is already empty.

Fear in the face of the absolute limit of death turns inward in a continuous irony; man disarms it in advance, making it an object of derision by giving it an everyday, tamed form, by constantly renewing it in the spectacle of life, by scattering it throughout the vices, the difficulties, and the absurdities of all men. Death’s annihilation is no longer anything because it was already everything, because life itself was only futility, vain words, a squabble of cap and bells. p.13

Throughout the book, Foucault describes the evolution of mental illness, and how society has dealt with it, at each stage. To describe this idea, he recalls the leper, who in the past, because of his physical illness, was driven out of society. In fact, lepers were confined until leprosy no longer existed. The same would later to happen to the mad. But madness was not always seen in the same way, in fact, it was never seen in the same way at any epoch in the past.

They must be punished according to law and placed in houses of correction; as for those with wives and children, investigation must be made as to whether they were married and their children baptized, “for these people live like savages without being married, nor buried, nor baptized; and it is this licentious liberty which causes so many to rejoice in vagabondage.” p.31

There was a time when the mad were mobile, where they interacted with society, and people heard them speak. There was a time when it was those who knew too much that went mad — Don Quixote went mad because of too much reading, so his priest burnt a selection of his books to cure him. There was a time when to be mad meant to be unproductive, thus the vagabonds, the idle, and the youth who had squandered the family fortune were labelled as mad. There was a time when the remedies to curing the mad was in throwing cold water at them. But confinement was the most popular tool.

Ultimately, confinement did seek to suppress madness, to eliminate from the social order a figure which did not find its place within it; the essence of confinement was not the exorcism of a danger. Confinement merely manifested what madness, in its essence, was: a manifestation of non-being; and by providing this manifestation, confinement thereby suppressed it, since it restored it to its truth as nothingness. Confinement is the practice which corresponds most exactly to madness experienced as unreason, that is, as the empty negativity of reason; by confinement, madness is acknowledged to be nothing. p.64

Madness was recognized as non-reason, or the negation of reason — that is, non-being — insofar as it is cut off from external stimuli. In fact, doctors prescribed travel and ocean waves to restore movement, and thus the correct flow of thoughts in the mind. To cure madness, by language, for example, was to follow the madman in their illusion, or to force them to come out of their condition out of necessity (the need to work and survive).

Eventually, the mad were no longer allowed to be mobile and were locked up in prisons to make sure they were productive and not just a drag on society, they were forced to work. Ironically, this had the effect of displacing “normal” people in society from jobs, and then those people were labelled as “mad” and the cycle continued.

Then in the 19 thcentury, it was only the unproductive mad people that were considered “mad” — this marked the beginning of the asylum.

If it is true that labor is not inscribed among the laws of nature, it is enveloped in the order of the fallen world. This is why idleness is rebellion-the worst form of all, in a sense: it waits for nature to be generous as in the innocence of Eden, and seeks to constrain a Goodness to which man cannot lay claim since Adam. Pride was the sin of man before the Fall; but the sin of idleness is the supreme pride of man once he has fallen, the absurd pride of poverty. p.34

But they were also forced to work, not for any productive reasons but for religious reasons. The madman was forced to accept that they were not being productive out of their own free will, and that there was nothing physically wrong with them. This induced feelings of guilt in the madman, first for recognizing that they were mad, and second, from being shamed by an authority figure whether priest or guard.

Labor in the houses of confinement thus assumed its ethical meaning: since sloth had become the absolute form of rebellion, the idle would be forced to work, in the endless leisure of a labor without utility or profit. p.34

They were forced to work so that they did not violate one of God’s commandments. The work was a way to fix their soul, and consequently, absolve them of guilt. But that wasn’t the only rationale — there was an idea, that work was a way to cure man from his suffering. When man escapes the law of labor that nature imposes on him, he seeks into a world of anti-nature, and artifice, and his madness becomes only one manifestation of such a world. In describing how he succeeded, by industrious activity in being cured, Bernadin de-Saint Pierre said:

It was to Jean-Jacques Rousseau 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. p.104

The next stage, psychiatry, is when the analyst takes the role of the priest. The patient, or the madman, confesses to them their sins. In a sense, the madman is like a child while the analyst/therapist is the adult. Merely by virtue of rationality vs non-rationality, the therapist had the upper hand and did not need to use any physical force.

Madness and Civilization: A History of Insanity in the Age of Reason

That was Foucault’s contention against Freud, that one did not need to archive mountains of data on a patient to analyse them. it was sufficient to merely be the rational person in the room, and in that sense, you could hold up a mirror to the madman or the patient, and they would be able to see the errors in their thinking for themselves.

Originally published at



Get the Medium app

A button that says 'Download on the App Store', and if clicked it will lead you to the iOS App store
A button that says 'Get it on, Google Play', and if clicked it will lead you to the Google Play store
Sud Alogu

Sud Alogu

I write about ideas that matter to me. In other words, revolutionary.