(Translated from the French by Richard Howard) First published 1964

Subtitled ‘A history of insanity in the age of reason’, this densely argued and fascinating book shows how madness as a spectacle and disability has fascinated and haunted the history of mankind since the 15th century.

In this meticulously researched, controversial, study Foucault observes how “fear of madness grew at the same time as fear of unreason”. This was represented in Goya’s famous etching ‘The Sleep of reason produces monsters‘. Hieronymus Bosch was another artist who depicted madness to symbolise the fall of man.

This book begins at the end of the Middle Ages after a cure for leprosy had been found. Foucault shows how the role of the leper in society was replaced by the poor, the criminals and the insane.

Madness represents the direct opposite of strength, purpose and reason so is associated with weakness, dreams and illusions.

In this context, idleness was deemed a form of rebellion which is why, in houses of confinement, those denied their liberty were forced into labour “without utility or profit” as an “ethical exercise and moral guarantee”.

Discipline and brutality were the crude tools deployed to prevent deranged minds deteriorating into a state of “unchained animality”.

Madness was conceived as a threat to moral order and signified a fear that, without diligence and self-control man could become no better than beasts : “Madness begins where the relation of man to truth is disturbed and darkened”.

Michel Foucault

Foucault details the main causes of insanity. Passion always contains the possibility of madness wherein reason becomes depraved and dismantled. The simplest (simplified?) classical definition of madness is as a state of “delirium”.

Melancholics are more intelligent yet also more susceptible to insanity whereby sadness and fear is replaced by audacity and fury.

Religion is another cause due to the strong emotions it arouses and the fears of the Beyond; Foucault notes dryly that “Catholicism frequently provokes madness”.

Asylums helped madness to be controlled but not cured as a kind of institutionalised alternatives to the family, a religious domain but with pure morality and not religion.: “Madness will be punished in the asylum even if it is innocent outside of it”.

Freud’s breakthroughs in the field of psychotherapy led to a slightly greater level of compassion for insanity but, even today, medicine and psychology is often used to regulate and punish, not to cure.

Foucault’s work is no light read but worth the effort. It’s a book that  forces you to question accepted notions about how  ‘madness’ and ‘civilisation’ have been defined throughout history..