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Earlier
this week, one of the headlines of the Irish Times
was “Mentally ill much more likely to be detained
in certain areas” (Monday 26 May 2003). Every
year 2600 people are interned in psychiatric hospitals
against their will. International comparisons show
that the 26 counties’s overall rate of involuntary
detention is high, twice that of England and four
times higher than Italy. Mentally ill patients are
almost three times more likely to be detained in a
psychiatric hospital against their will depending
on the health board area where they live. The founder
of the Irish Advocacy Network declared to the Irish
Times:
A
prisoner has more rights than a mentally ill patient
under (the current) legislation. A detained patient
is deprived of the most basic rights, yet a prisoner
can be released on bail or have temporary release.
I can’t understand why the rates of detention
vary so much from area to area. Why some health
boar areas seem to be more open to denying someone
their liberty than others is mind boggling.
Indeed.
On what grounds are individuals defined as "mentally
ill”, and on what basis are some “mentally
ill” people interned and others not? If there
is some “objective basis” for this, how
is it that some areas are more likely to intern people
than others? The fact is that people are left at the
mercy of the unaccountable power of psychiatry. However,
psychiatry cannot avoid major controversies. In the
case of “paedophiles” and other “sexual
deviants” for instance the discourse and categories
of psychiatry clash with those of criminology for
example. In a court of law, psychiatrists and jurists
will fight each other to determine whether the accused
was “insane” or “responsible”,
etc. They will also clash as to whether the accused
should be sent to prison or in a psychiatric hospital
and also on what grounds can the accused be considered
fit for release. Michel Foucault (1926-1984) was a
very original French thinker who came up with brilliant
insights on how the categories of discourses like
psychiatry or genealogy developed. His writings have
been and still are extremely influential. Foucault
shows how what we consider to be “true”
or how human beings understand themselves are related
to determinate forms of power.
During
the 1970s, Michel Foucault adopted a “genealogical”
method to examine the conditions of production of
certain theoretical discourses like psychiatry or
criminology. Genealogy is a method of historical analysis
which unmasks the will to power at the root of history.
Applied to the history of ideas for example, genealogy
points that the different sciences’s quest for
“truth” or “objectivity” is in
fact a quest for “power”, to dominate. Specifically,
Foucault was interested in showing the intrinsic links
between power, knowledge and the human subject. The
conditions of possibility of a science are to be found
in relations of power. Psychiatry, criminology, as
discursive practices, become only possible with the
emergence of a certain form of power: asylums, prisons,
hospitals. In its turn, this knowledge enables a class
of people (doctors, judges, social workers etc) to
exercise power over another class of people (the insane,
the prisoners). Knowledge is an effect of power, and
in its turn creates more power. Doctors and judges,
with the latest results of psychiatry or penology
are able to lock people up for ever. They have the
power to decide who is “mentally ill”, a
“pervert”, or a “criminal”.
Think
of what this means in practice. Joan, a former involuntary
patient told the Irish Times: It meant being forced
to take medication, undergo electroconvulsive therapy
against her will and being searched after any contact
with a visitor. ‘There was nothing to live for.
We were just treated like wild animals, there was
no future, everyday was the same. It could have been
January or June, you had no way of knowing.' For Foucault
there is not power and knowledge, but just “power-knowledge”.
There
is no power relation without the correlative constitution
of a field of knowledge, nor any knowledge that
does not presuppose or constitute at the same time
power relations. These power-knowledge relations
are to be analysed, therefore, not on the basis
of a subject of knowledge who is or is not free
in relation to the power system, but, on the contrary,
the subject who knows, the objects to be known and
the modalities of knowledge must be regarded as
so many effects of these fundamental implications
of power-knowledge and their historical transformations.
(SP, 32)
Finally,
the category of the “subject”, that is the
categories through which human beings define themselves
as individuals (for example how individuals are defined
as “mad”, “prisoner”, “homosexual”)
is constituted by constellations of power-knowledge.
“The individual is not a pre-given entity which
is seized on by the exercise of power. The individual,
with his identity and characteristics, is the product
of a relation of power exercised over bodies, multiplicities,
movements, desires, forces.” A good illustration
of Foucault’s theories is ethnology. Ethnology
was made possible by a form of power: colonialism.
Ethnological theories in turn helped shaping colonial
policies (for example how Belgian authorities dealt
with Hutus and Tutsis in Rwanda). The manner in which
indigenous populations came to be “interpelled”
as subjects (as “Hutus” or “Tutsis”,
“European” or “Indigenous) was shaped
by a constellation of power-knowledge. As a subject
“interpelled” (Althusser) by psychiatry,
Joan says: “It’s like you’ve a stamp
on your forehead for life. There are countries which
I can never travel to because I won’t get a visa.
If there is a job vacancy and two people are going
for it, chances are they won’t give it to the
person who was mentally ill.” Ex-prisoners will
also identify with that.
For
Foucault, “the history of the present” (SP,
35) is characterized by an exponential growth of more
domination and power. Modernity’s “progress”
is simply the progress of domination. His book “Discipline
and Punish: The Birth of the Prison” for example
argued that the transition from one form of punishment
to another (from physical punishment to modern methods
of imprisonment and rehabilitation) was not a result
of greater humanity or increase in knowledge, but
simply a strategy of power (cfr, SP, 81 and pp.83-84).
In particular, he links modernity to the emergence
of a “disciplinary society” (SP, 211) at
the turn of the 19th century with a system of prisons,
hospitals, asylums and workhouses. Modernity is inseparable
from the exclusion of the mad, the ill, the criminal,
the pervert, the poor … Society as a whole has
become a large prison with no outside (SP, 228 and
301) “Is it surprising if prisons look like factories,
schools, barracks, hospitals, who in turn all look
like prisons?” (SP, 229) No wonder that Joan
can declare: 'To me being in a locked ward was worse
than being in prison. If you break the law and commit
a crime, you go to prison. Yet you can be locked up
in a hospital if you’re ill and have done nothing
wrong. No one should have a right to do that to someone.'
(Irish Times, 26 May 2003)
It
is important to note that for Foucault, power is not
the property of a particular social actor (the ruling
class for example) or located in a particular institution
(the state for example). Power is diffused all over
society, everywhere where there is a relationship
of force.
Power
must be understood in the first instance as the
multiplicity of force relations immanent in the
sphere in which they operate and which constitute
their own organisation … Power’s condition
of possibility … must not be sought in the
primary existence of a central point, in a unique
source of sovereignty from which secondary and descendent
forms could emanate … Power is everywhere;
not because it embraces everything, but because
it comes from everywhere. (VS, 121-122)
That
is when Foucault’s analysis starts to become
problematic and begins to loose its strength. Power
becomes neither differentiated, delimited and defined.
Power is everywhere, there is nothing outside power,
thus power can only appear as unconditioned. So power
can only be explained by … power! Foucault moves
away from an explanation of power to an explanation
by power. Power is not the effect of a particular
form of social organisation, but rather its cause.
Power becomes the secret essence of things, it is
constitutive of reality. The supposed “historical
complexity” of power ends up in ahistorical ontological
simplicity. Everything is just power and nothing else.
Nowhere is that more evident than in his analysis
of resistance (think of revolts in the prisons, anti-psychiatry
etc). “Where there is power, there is resistance,
and that however, or rather equally, the latter is
never in a position of exteriority in relation to
power.” (VS, 126-127) Foucault is unable to conceptually
distinguish resistance from power and thus specify
the conditions of possibility of resistance. If resistance
is never in a position of exteriority to power (given
that power is everywhere), how can resistance be anything
other than a form of power? Since it is a power itself,
it can never really be subversive, it is merely the
counterpart of the power that generated it. If resistance
triumphs over power, it will just become another form
of domination, perhaps even worse than the old. Foucault’s
conclusions cannot but breed a deep scepticism about
the possibilities of historical transformation.
The
same goes with knowledge. Foucault denies knowledge
any identity of its own, reducing it to an effect
of power. Is knowledge only power and nothing more
? It is true that theoretical discourses are produced
and reproduced within definite relations of power,
and these relations have an effect on the constitution
of discourses. However, theoretical discourses should
not be reduced to the social conditions in which they
were produced. Theoretical discourses have at least
two distinct determinations: the context of discovery
and context of justification. Theoretical discourses
have their own rhythms, which cannot be reduced to
those of power. A simple reduction of theoretical
discourses to power is unable to account for objectivity
and epistemic progress. Foucault’s history of
madness, for example, reveals no progress in the theoretical
and practical understanding of an illness; distinctions
between sanity and madness, health and sickness are
not related to the progress of knowledge, but only
to changes in relations of power. Finally, Foucault
is unable to provide a conceptual framework that accounts
for both the internal complexity of subjectivity as
well as the external forces that over-determine it.
The subject is reduced to an effect of the operations
of power. Therefore there is no human nature (the
free individual, sexuality, etc) to be liberated from
power, for that “nature” is already the
effect of the operations of power. So on what grounds
can social practices be deemed “inhuman”
or oppressive of the individual?
Partly
because of the difficulties raised by his collapsing
of truth, resistance and the human subject into “power”,
Foucault came to abandon in the early 1980s his genealogy
of power/knowledge for a totally new project: a genealogy
of ethics. He embarked on a study of Greek, Roman
and early Christian’s attitudes to sexuality
and how individuals shape themselves as ethical subjects.
Foucault seeks to find in obscure classical texts
“the elaboration of a form of relation to self
that enables an individual to fashion himself into
a subject of ethical conduct” (SS, 274). That
Foucault never returned to his genealogy of power/knowledge
was a recognition that his theory of power had finished
into a dead end. However, the vast amount of work
on or influenced by Foucault (that has been increasing
every year since his death from an AIDS related disease
in 1984) are a clear indication that whatever the
weaknesses of his theories, he remains a crucial thinker.
Books
Quoted:
Surveiller
et Punir: naissance de la prison (Paris: Gallimard),
1975 (SP)
Histoire de la Sexualite 1: La Volonte de Savoir
(Paris: Gallimard), 1976 (VS)
Histoire de la Sexualite 3: Le Souci de Soi
(Paris: Gallimard), 1984 (SS)
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