Alan Saunders: Hi, I'm Alan Saunders, and this week The Philosopher's Zone is in a heady place: Paris in the late '50s and early '60s.

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Alan Saunders: Quite a philosophical ferment going on in those days. Jean-Paul Sartre was old hat, but there were plenty of Young Turks. There was the Marxist, Louis Althusser, the literary critic Roland Barthes, Jacques Derrida was teaching at the Sorbonne, and so was the historian and philosopher of science, Georges Canguilhem, and it's one of Canguilhem's students that we're talking about this week.

Exactly 50 years ago, the 33-year-old Michel Foucault submitted for his doctoral thesis a work that would become one of the most influential books on the history of psychiatry. It introduced the idea that madness has a history, and that what Foucault called 'the great confinement', the locking-up of the insane from the late 17th century onwards, was the outcome of a particular historical process.

This week, we go back to 1959 and the writing of Folie et deraison: histoire de la folie a l'age classique, or Madness and Civilisation: a history of insanity in the age of reason.

Now it might seem a little strange, but despite the importance of the work, a full-length English translation was not published until three years ago. We'll find out what was cut out, and why, in a moment.

Justin Clemens is a lecturer in English at the University of Melbourne. He's also the Secretary of the Lacan Circle of Melbourne, and an art critic for the magazine The Monthly and he joins us for today's program.

Now Foucault's book is published in 1961, and he becomes as the cliché goes 'an overnight sensation'; the book turned him into a star. But what did it mean in practice to be a French philosophical star in the early 1960s? Justin Clemens.

Justin Clemens: Well the history of French philosophy is very, very different from the history of English philosophy. Since the Enlightenment, characters such as Voltaire or Diderot who were at once philosophers, they're writers and they're activists, all at the same time. And Foucault slips with this book quite neatly into this category of at once a philosopher, at once a committed activist, and also a literary figure.

Alan Saunders: And I mean, how famous was he? I mean did people ask him for his autograph on the street, or was he just famous among a rather small, select group of people?

Justin Clemens: Well it starts as fame among a very small, select group of people. I guess the crème de la crème of French intellectual culture in Paris. But after a couple more books, Foucault becomes a genuine star. He's not only a great writer in a sequence of magnificent books, but he's also integral in the reorganisation of the French university system between the 1960s, too, so he's a major, I guess, administrative, bureaucratic figure as well.

Alan Saunders: Four years after publication, an English translation appeared, but it was a translation of an abridged edition of the original text which ran to some 690 pages. Now we all know that some books could do with a good edit, a bit of cutting back on excess and repetition. Was this the case with Foucault's History of Madness, or have we had important things missing from our English version for the last 40 years?

Justin Clemens: That is probably correct, because the book in its full form is absolutely enormous, and it's quite hard going despite its genius. Foucault in fact did the first sets of cuts himself; the book was re-published in France and then it was the translated version of that that spread across the world. I think only Italy did the full version in the 1960s, everyone else got what turned out in English to be Madness and Civilisation.

Alan Saunders: So what did we miss out on by not having the full text, apart from the rather more prolix and difficult bits?

Justin Clemens: Well we did miss out on prolixity and difficulty, and one of the things I guess about the bits that got cut out were some kind of previewer performances which are like great interpretations of such literary classics as Diderot's Rameau's Nephew for instance. But also some very, very specific detailed analyses of the relationship for instance between institutional incarceration of the mad in the 17th century and at the same time a sort of development in medical theories of madness, which nonetheless seemed to have nothing whatsoever to do with incarceratory mechanics. So some very, very specific historical details and some very, very clear analyses in fact.

Alan Saunders: Well the crucial idea that emerged from the book, and it seeped into popular culture and our understanding of mental illness, whether we agree with it or not, is the idea that madness is culturally constructed. That's to say it's a product of our culture and of our institutions. Madness, in other words, is maintained by powerful institutions like medicine and psychiatry. Is that a fair (it's undoubtedly too simple) but is that a fair summing-up, in your view, Justin?

Justin Clemens: Once again, yes and no. I think Foucault himself is a mercurial figure here who'll later say Nothing in the history of man, nothing in man himself has enough stability over time to ensure any absolute views whatsoever, which means there is a kind of relativisation of what constitutes madness. At the same time, Foucault is also not quite that simple. He's rather interested I think in the ways in which institutional histories and their claims to reason actually necessarily project an 'other 'of some kind, and in this book in particular, he's interested in the ways in which madness was considered 'other' by various forms of state rationality I suppose.

Alan Saunders: Foucault's work has been criticised by quite a lot of historians, but should we, in fact, see it as a scholarly, historical text, or as a set of philosophical variations on historical themes?

Justin Clemens: It's in many ways a hard question to answer, for a number of reasons, not least the philosophical problems. I think it's both a work of anti-philosophy, and a work of anti-history in some ways, but for all that has the most rigorous and well-informed, intelligent, philosophical theses running through it, as well as an attentiveness to historical detail. It's unprecedented, and really shows that the documents on which he's relying, could have had, in fact must have a different interpretation science than the ones that historians up till Foucault and in fact since Foucault have assigned them.

Alan Saunders: And he did spend a long time in the archives, didn't he?

Justin Clemens: He talks about this filthy habit somewhere of spending most of one's day in the archives, just going through the dreary blah-blah-blah of human history.

Alan Saunders: For people who haven't read the book, we should probably backtrack a little. Where does the history start? At what point in history does he start exploring madness?

Justin Clemens: It's quite interesting. He starts basically with the late mediaeval period, where he talks in a very famous passage about the image of the ship of fools that emerges in this trans-European manner in the 16th century, as well as the great enthusiasm for the late mediaeval, I guess, early Renaissance period for the Dance of the Death, and then he basically moves forward; the classical age of which he speaks is essentially the 17th and into the 18th century, and then the book concludes with the sort of projection forward into the 19th century and beyond.

Alan Saunders: In fact he begins though, not with madness but with leprosy. What's the role of leprosy here?

Justin Clemens: It's fantastic. One of the things that Foucault argues specifically about what happens to madness in the 17th century is that it suffers a 'great confinement' as he calls it, an exclusion and incarceration whereby people who we would now denominate mad are locked up higgeldy-piggeldy with an enormous number of other sorts of types, like beggars, petty criminals, layabouts, prostitutes, and so on. And he wants to ask us to the provenance or historical anticipations of this great confinement.

He finds this in the great leprosaria of the mediaeval period, and he draws that connection first of all in order to show yes there have been these techniques before in the history of the West, certainly, but then that the great confinement that he's talking about vis-à-vis madness in these other forms, it's not quite the repetition, something different is going on, and it's kind of a bravura Foucault performance again. He uses these vignettes, these quite surprising, shocking examples which at once seem to be analogies, and yet at the same time, enabled him to show that actually there's radical differences in what look to be similar sorts of operations.

Alan Saunders: Well let's look at some of the specific examples he uses in Madness and Civilisation. He observed as you say, that the Western imagination became obsessed with madness from about the 15th century onward; that was sort of bodied forth in a fascination with images of madness, and he himself is fascinated by images of madness. His work has a great deal of emphasis on art, and especially visual art, from the Renaissance onwards.

Justin Clemens: Yes, that's right. I mean one of the things that Foucault is superb at is marshalling an incredibly diverse range of evidence in support of his theses, and so in the History of Madness you will find in addition to all the bureaucratic documents, the medical text, quasi-scientific treatises, police reports and so on, you'll also find this insistent attentiveness to images, particularly high art images, and also to the work of great writers as well.

Foucault does a number of things with these. On the one hand to pick up on something I said before, he at once shows the continuity sometimes with the general tenor of the epoch, and at the same time he uses these images to contest as well some of the dominant tendencies too. So people like Goya, for instance, even Hogarth, Durer and so on, to van Gough, all become these kind of quasi images both of complicity and of a radicality whose radicality needs to be re-vivified for today.

Alan Saunders: You mentioned great writers. He's particularly interested in Shakespeare; the depiction of madness notably in King Lear, and also in Cervantes' Don Quixote, what does he draw from them?

Justin Clemens: One of the things he wants to say is this is the last great moment in Europe where European culture shows a continuity of reason with madness, that the mad person is part of the society in which you're in, and that the mad have a reason that reason itself doesn't know, that puts your own position into question, and ought to make you think about the very stability, very rationality of your own procedures. And so for Foucault, Shakespeare and Cervantes become these images of the last great moment before madness is actually confined in the 17th century, excluded, demonised and basically locked up.

Alan Saunders: In fact he distinguishes madness from unreason. What's the difference?

Justin Clemens: Ah. It's a terrible question. It's not entirely clear, but my personal take on this is that he uses the reason/unreason duality as a kind of pincer for picking up historical documents, and madness becomes (to mix metaphors slightly) the red thread that enables you to track the different relationships between reason and unreason in history from the different ways in which madness has been treated; has it been locked up? Has it been celebrated? Has it been put onto boats? Is it re-sequestered within the family? Is it shoved into an asylum? And so on. So reason versus unreason is the great division in which he uses madness in this book in particular, to track the vicissitudes of that relation.

Alan Saunders: Also important to him, the great philosopher Rene Descartes, what's Descartes' role in Foucault's argument?

Justin Clemens: Well this has become a major controversy, as another great French philosopher of the '60s, Jacques Derrida, who had been at one time one of Foucault's students, in 1963 gave a paper which was published the next year and then re-published again in his own writing Indifference of 1967. This response of Derrida's called Cogito and the History of Madness, focuses on the use that Foucault's makes of Descartes.

Foucault opens the chapter on the great confinement by trying to say that what Descartes does in the first of the Meditations is indeed exclude madness from the purview of reason, at a very, very high level, and yet this philosophical exclusion of madness is consonant with other real acts of the mid-17th century where real mad people are really locked up in real new institutions. And Foucault's point is that the philosophy, which purports to re-found knowledge and be the queen of the sciences, is at the same time continuous with state power in a very nasty way. And Derrida, even though these pages are only a few pages on Descartes through the book, Derrida really picks on this moment and tries to show how Foucault has mis-read the Meditations; that Descartes does not exclude madness, and that philosophy and madness are much more tightly bound than Foucault would have it.

Alan Saunders: What about passion? And philosophers like Descartes saw the passions, our desires and appetites, as what moved us to action in the world. Where do the passions fit into Foucault's account of things?

Justin Clemens: One of the things that Foucault does which I think I mentioned this briefly before, is that with the great confinements of which he speaks where the mad are locked up with all these other types who for us would now be treated relatively separately, for Foucault the theory of the passions is irrelevant, essentially, to that confinement. However, a theory of the passions starts to emerge in medio-philosophical discourse in the 17th century which is very, very different to prior theorisings of the passions. And what he, Foucault, wants to show in this book, is how despite there being a very, very well elaborated theory of passions, they don't really speak to the police and legal treatments of mad people at the time, even though they seemed to be nominally treating the same subject.

Alan Saunders: Now you've mentioned the great confinement, but what happens towards the end of the 18th century, after the great confinement, when I suppose madness becomes much more of a medical issue, doesn't it?

Justin Clemens: That's exactly one of the developments that Foucault wants to track. It's right at the end of the 18th century where instead of the great confinements, he speaks of, he doesn't use these terms, but I guess it's - and he doesn't use these terms for a number of reasons I'm going to go into. It's kind of a great release. There's a famous William Tuke, who's a Quaker tea merchant, sets up a retreat outside of York in England, where he treats mad people in a kind of friendly, welcoming, warm quasi-familial atmosphere, rather than excluding them all, simply demonising them. Whereas in Paris Phillipe Penel famously smashes the chains off, the chained mad inmates in Bicetre and other asylums. And Foucault wants to say, Yes this is a medicalisation of madness. Even in Tuke, who's not a medical figure, and it's also the point at which madness changes again its status. No longer something to be simply excluded, it's something to be treated, to be studied, that becomes part of society again, but part of society under the terms of basically what will become the modern psychiatric profession.

Alan Saunders: It's interesting that looking back to the age of the great confinement, John Locke, the British philosopher says 'The mad do not appear to me to have lost the faculty of reasoning, but having joined together some ideas very wrongly, they mistake them for truths; they err as men do, that argue right from wrong principles.' That's a very, very interesting account of madness.

Justin Clemens: It's an extremely interesting account of madness, and I think one of the things that... Derrida offended Foucault so much Foucault didn't speak to Derrida after, his presentation for about 20 years, and moreover wrote a whole series of very, very nasty, and very, very detailed responses. But Derrida's point which I think you can pick up what you've just been talking about, is simply that philosophy does not exclude madness in the way, and definitely not in the 17th century, in the way that Foucault would like to suggest. Rather, philosophers recognise and great philosophers recognise that there's something about madness that's very, very close to their own enterprise, and it needs to be taken seriously, and can't simply be excluded.

Alan Saunders: At the end of this history, we have somebody who believes that the mad, or at least the mentally disordered, should be spoken to, and should tell their stories. That's Sigmund Freud, where does he come into Foucault's story?

Justin Clemens: Well since I've already started on this: Derrida also writes after Foucault's death, another response to the History of Madness, in which he picks up on Foucault's very strange treatment of Freud. The essay is called To Do Justice to Freud, itself a quote from The History of Madness, where Foucault on the one hand wants to praise Freud for returning to madness, the power of its discourse; by listening to the sequence of patients who Freud has on his couches, and taking their speech incredibly seriously.

On the one hand, Foucault likes that, he likes this return that Freud allegedly made to madness (its discourse) and at the same time he also, Foucault, wants to make Freud yet another agent of knowledge power, of the kind of mute form of incarceration and of repression too. Derrida's point is, when you look at the way Foucault treats Freud he can't quite treat him right, he can't affirm him, he can't deny him, Freud remains a kind of insistent symptom, a problem for Foucault himself.

Alan Saunders: How did Foucault's interest in madness and indeed in the history of medicine, fit into the broader philosophical questions that he spent his life working on?

Justin Clemens: I think that Foucault was actually desperately trying to de-philosophise. One of his critiques of Derrida is that Derrida is just a kind of part of a well-determined little pedagoguery of a very exclusive, prestigious, small, small-minded, philosophical discourse that actually in its obsession with the great texts of the masters, fails to recognise its links to society and actually what happens in society is registered in philosophy, in its dissimulating way. And so much of Foucalt's life it seems to me, is desperately trying to not be a philosopher in a classical model, but to try and be (to use a word he didn't mind himself) a real intellectual, to question philosophy, history, psychiatry, medicine, prisons and so on, sexuality, in a way that returns them a kind of deranging and alienated force and makes you think about them again in ways that either historians wouldn't have made you think about again, and/or philosophers wouldn't have made you think again. So Foucault's I think tries to make you think again.

Alan Saunders: Ah, to be a real intellectual; that's the sort of ambition you can have in France. Foucault himself did undergo depression, and was said to have attempted suicide in his early 20s. Is it too simplistic to see a link between his own experience and his ideas about madness?

Justin Clemens: I don't think so. I mean one of Foucault's own heroes, Nietzsche, the German philosopher, Freidrich Niezsche, says quite explicitly about the history of philosophy: up till now philosophy has just been an unconscious sort of confession on the part of its own author, and one of the things I think that Foucault does by using his own experience, although not in a direct or naked way, is actually to use that experience to help giving the force to question the alleged verities that surround expertise and various institutions.

Alan Saunders: Well you mention Nietzsche. Foucault didn't want to romanticise madness, but nor did he play up the common popular association between madness and creativity or genius, but he was certainly interested in insanity, in the work of Neitzsche, in the work of van Gough, and in Antonin Artaud the French playwright-actor who devised the Theatre of Cruelty.

Justin Clemens: That's right, it's been one of the recurrent critiques of this book that Foucault does in fact romanticise madness, and at the same time he also romanticises the great mad writers of modernity. To some extent I think this is true, but as you just said, it's also not true. What Foucault really finds and drags out of these great artists and writers, are the resources for critique, for ways in which a great form of writing forces you to think again about the received inherited verities and arguments that are allegedly the ones that should constrain our thoughts now.

Alan Saunders: I suppose the view that he romanticised madness was possibly what endeared him to the anti-psychiatry movement which took him on in the '60s.

Justin Clemens: Absolutely. Laing and Cooper was very, very enamoured of Foucault and saw his project I think as essentially continuous with theirs. However, I don't think it is, I think there is definitely that element to it, as you mentioned at the beginning of the program, the kind of cultural relativism of the history of madness. There's something of that there, but there's also something else there in Foucault, which is you can't simply get outside of institutions, you can't simply pretend to not believe in what everyone else believes in, there are real historical and situational constraints, and they're the ones that need to be taken account of. And you do as a committed intellectual, you have to start from where you are, you can't simply romanticise a kind of outside which will somehow give you the truth of your situation. Nor can you de-institutionalise too radically.

Alan Saunders: Fifty years after its first publication in French, do you think that Madness and Civilisation has held up well?

Justin Clemens: Personally I think it has. I think most of the criticisms I've seen of it are details and fiddling with ornamentation. The actual account, its massive sweep, its interpretative brilliance, and the sorts of possibilities that it opens up a further thought; I think it's still as live as it ever was

Alan Saunders: Justin Clemens, thank you very much indeed for joining us.

Justin Clemens: Thank you.

Alan Saunders: Justin Clemens, is lecturer in English at the University of Melbourne. For more on him and on Foucault's Madness and Civilisation, check out our website.

The show is produced by Kyla Slaven, the sound engineer is Charlie McKune, I'm Alan Saunders, and I'll be back next week.