The Enlightenment is a diverse and complex phenomenon. Its historical origins are difficult to locate, and there is no general consensus on how to determine its goals and objectives.1 It is for these reasons that the question of the Enlightenment has stirred so much controversy among thinkers. Broadly associated with an intellectual movement that took place around the eighteenth century, the Enlightenment has been considered as defying tradition, authority and religion, on the basis of rational inquiry and autonomy. Rationality is viewed as central to the efforts of the Enlightenment thinkers to free humanity from myth and superstition. But the importance that rationality has come to occupy in this movement has divided its critics. Many scholars have celebrated the emergence of the Enlightenment’s faith in rationality and progress, which has given rise to the scientific study of man, to the primacy of the subject and to a humanist discourse. Others mistrust the Enlightenment, maintaining that its adherence to reason has generated irrational practices, which have resulted in abuses of power and totalitarian regimes.2
Owing to these diverse and opposing attitudes, Foucault’s own involvement with the Enlightenment has been subject to conflicting interpretations. His work is still the object of an ongoing debate about the position he occupies in relation to the Enlightenment. One trend of thought regards Foucault, along with thinkers such as Derrida, Lyotard and Rorty, as a postmodern thinker.3 Postmodernism is in many ways considered as a counter-movement to the Enlightenment. Whereas the Enlightenment thinkers are generally regarded as proponents of rationality, objective truth and science whose telos, or end, is to liberate mankind from prejudice through the acquisition of ever-more precise knowledge, postmodernism is sceptical of objectivity and truth, thereby distrusting metanarratives, which claim conceptual mastery of the world.4 Foucault, in particular, has been viewed as a postmodern thinker of power and knowledge, whose discourse seeks to undermine the foundations of truth and reason by showing how those foundations are never neutral, being always produced by the power relations of a given historical and cultural context. For these reasons, Foucault’s insistence on the permanence of power and irrationalism is regarded as being fundamentally in conflict with the unremitting belief in objectivity associated with the view of the Enlightenment among certain strands of postmodern thought.5 Other critics adopt the opposite attitude towards Foucault’s enterprise, but reach a very similar conclusion that his work on the Enlightenment marks a discontinuity in his overall body of thought. Drawing on his late essays on Kant, they argue that Foucault actually defended the Enlightenment only when a rupture had taken place with his earlier ‘postmodernism’.6
The present study offers an alternative to these interpretations that will shed new light on Foucault’s relationship with the Enlightenment and the critical-historical aspect of his work. Its aim is to show how Foucault is neither an anti-Enlightenment thinker who rejects reason and truth, nor a defender of the Enlightenment who had come to abandon his earlier preoccupation with the interpenetration of power and knowledge. His project rests precisely on the idea that there is no necessary ‘for’ or ‘against’ the Enlightenment. Foucault’s relationship with the Enlightenment engages at length with the question: ‘What is this Reason that we use?’7 Seeking to explore the roots and the historical development of this question, Foucault sets out to interrogate the nature of reason, its possible applications and its limits. It will be argued that for Foucault reason has a history, which manifests itself in forms of rationality, which constitute the foundation of knowledge and the search for truth. These forms of rationality evolve through time and therefore cannot characterize a specific historical period. For this reason, the notion of the triumph of rationality is a simplistic view of the Enlightenment. For Foucault, the age of the Enlightenment begins when forms of rationality are subjected to a critical reflection on their limits, when reason itself questions the rational foundations of what is accepted as reason. The Enlightenment is marked by this tense interaction between rationality and reason, and can never reach an endpoint. It is an incomplete and open-ended process, representing a critical attitude to the present moment rather than being confined to a particular historical epoch.8
Foucault uses Kant to explore the critical aspect of the Enlightenment, focusing on the reflective powers of reason on the limits of what is known. Foucault draws, in many respects, on Kant’s philosophy, to dismantle the notion of the Enlightenment as a rationalized project of science, ethics and politics. His aim is to open up a field of research that investigates the ways through which reason examines the limits of what is taken as given and true, as well as the effects that this examination produces on the way people think, act and experience reality. It will be argued that the exploration of Kant and the critical dimension of the Enlightenment is not a late preoccupation for Foucault, but a domain of research already evident in his early writings, which informed his entire body of work. While he distances himself from certain aspects of Kant’s thought, Foucault views Kant’s critical philosophy as central for developing his own understanding of the Enlightenment, naming his project a Critical History of Thought.9 Kant’s method of questioning the pretensions of rationality and reflecting on the limits of who we are through reason inspired Foucault to analyse the birth of the human sciences and especially of psychiatry, which will constitute the main focus of this study. This chapter provides an outline of his critical-historical endeavour, highlighting the mutually supportive and subversive interaction of rationality and reason, which will be crucial for interpreting how Foucault constructs his History of Madness and his subsequent reflections on the domains and limits of psychiatric discourse and practice.
Rationality and Reason – The ‘Blackmail’ of the Enlightenment
From the outset, Foucault makes it clear that the exploration of the limits of reason does not mean that reason is the enemy of critical thought. As he admits, ‘It is not reason in general that I am fighting. I could not fight reason.’10 On the contrary, for Foucault reason is a critical weapon against the excesses of rationalism. Maurice Blanchot notes in an essay on Foucault, ‘Foucault is not calling into question reason itself, but rather the danger of certain rationalities or rationalizations.’11 Thus the crucial distinction on which Foucault’s enterprise rests is that between reason and forms of rationality:
I don’t at all identify reason with the totality of the forms of rationality. The latter could until recently dominate in the types of knowledge, the forms of technology, and the modalities of governance. The application of rationality occurs primarily in these areas […] For me no given form of rationality is reason.12
This distinction is extremely difficult but crucial to elucidate. Forms of rationality are not opposed to reason but, on the contrary, they stem from a basic ‘trust in reason’, as Nietzsche would say.13 They are forms of conduct and a structuring of reality based on reason as a principle of knowledge and action. Forms of rationality constitute the implementation of reason in everyday affairs. They are reason applied. They correspond to Kant’s description of the private use of reason in a community, when rules need to be followed and practical ends to be pursued. It appears when man, as a ‘cog in a machine’, as Kant says, subjects reason ‘to the particular ends in view’.14 By necessity, a form of rationality cannot be free in its use since it is placed at the service of the specific role the individual has to play in a society as a worker, a scientist, a soldier or a taxpayer. By contrast, reason has no practical, but only reflective applicability; its role is to work at the limits of thought. Reasoning as a reasonable being, as a member of a reasonable community and not as a cog in a machine, is a purely critical operation, which is free in its public use in the spirit of the Enlightenment. Kant accepts the necessity of a development of certain modes of rationality to be applied to social affairs, but the core of enlightened thought consists of being capable of critiquing these affairs in an open and public manner. The mode of rationality structures reality by assuming the status of a universal and global way of thinking; reason, by contrast, reflects critically on the values that permeate it, the principles that govern it and the historical conditions from which it arose.
The distinction between forms of rationality and reason should not create the illusion that their opposition is as clear cut as it may seem. It should not generate the naïve optimism that critiquing the contingency of rationality in the name of pure reason as a higher tribunal will settle the question of the Enlightenment once and for all. Rationality and reason constitute two simultaneous operations (practical and critical) of the same faculty (reason) and therefore their mutual exchange and interdependence needs to be taken into account before we begin analysing their critical interaction: ‘if critical thought itself has a function — and, even more specifically, if philosophy has a function within critical thought — it is precisely to accept this sort of spiral, this sort of revolving door of rationality that refers us to its necessity, to its indispensability, and at the same time, to its intrinsic dangers’.15 Rationality is reason as principle of knowledge, necessary for grasping and manipulating reality, which does not cover the entire field of human experience and when it attempts to extend its powers to domains beyond its limits, it undermines itself by falling into arbitrariness and irrationality. The courage to recognize these limits and the rigour to demarcate them belong to the reflective properties of reason itself. This is reason’s critical operation. Kant’s ‘pure reason’ functions as a border of knowledge and not as its foundation. Its ‘purity’, however, does not imply that it can be discovered or recovered in its raw state insofar as it can only function as a horizon of rationality, as a limit to its ‘impurities,’ abuses and irrationalities, not as an essence or a higher ideal to be achieved. Even if ‘pure reason’ could be isolated and rescued, adhering to it would amount to turning it into a practical guide and a principle of action, a new form of rationality. This is precisely the danger of seeking to identify the Enlightenment with the resuscitation of reason. In fact, Foucault warns, any misunderstanding concerning the Enlightenment is a result of this attempt to return to reason and transform it into a supposedly more progressive form of rationality, creating the misconception that the Enlightenment is a movement based on forms of rationality which one must either accept or reject. This misconception is most clearly evidenced in what Foucault terms the ‘blackmail’ of the Enlightenment.16 Being ‘for’ or ‘against’ the Enlightenment presupposes that we either accept or reject the tradition of rationalism which the Enlightenment supposedly represents. It implies either that a trust is placed in reason as a guiding principle in the search for knowledge and a source of liberation from externally imposed authorities, or that one should be suspicious of reason, whilst ignoring the fact that there is always a form of rationality accounting for this suspicion. Therefore, this dilemma is illusory since in both cases one does not escape the sphere of rationality. As long as the question of the Enlightenment is trapped in this dilemma, it is doomed to undermine itself constantly by reproducing its aporias. This is the case with the Frankfurt School and phenomenology, which Foucault criticizes. Despite their association with the Enlightenment, both theories have overlooked the critical kernel of Kantian anthropology. Thus, for Marcuse, Horkheimer and Adorno, the growing perils of rationality stem from the intrinsic mechanisms and techniques, from the oppressive powers endogenous to reason itself which capitalism has inherited from the Enlightenment.17 According to their interpretation, which is a type of humanism, there is an inalienable essence of man which reason has the duty to liberate and to restore to its fundamental rights which are suppressed and denied. Similarly, for Husserl and the phenomenologists, rationality is a distortion of reason produced by western technoscientific society, generating a perpetual crisis involving contradictions and internal conflicts within the field of rationalities and an irrational abuse of reason and of power. Rationality is a sickness of reason for Husserl, a degeneration of reason responsible for the birth of multiple forms of rationality which, by an ironic reversal, annul reason and generate irrationalities.18 Humanist and phenomenological critique have failed to recognize the subtle distinction between rationality as the domain of knowledge and reason as its limit and instead set in motion the dialectical opposition between the two terms.
Foucault, on the contrary, insists that there is no essence, no a priori nature of reason which, in the process of its implementation, supposedly loses its basic design by falling into contradictions and irrationalities.19 Foucault saw and spotted multiple transformations of rationality in his historical analyses, but ‘should one call that the demise of reason?’20 Rationality in its technoscientific and political forms is undoubtedly linked to mechanisms of coercion and excesses of power, but this in no way suggests that reason is the source of irrationality. On the contrary, only reason can critically reflect on rationality to identify its set of values and imperatives as inherently irrational. Reason cannot lose its basic design because, as limit, it is the faculty which makes possible the spotting and diagnosis of the ambiguities and contradictions of rationality in the first place. This is why, for Foucault, the Enlightenment is not an obligation to restore its supposed ‘essential kernel of rationality’, but an act of courage and a political problem of determining the ‘contemporary limits of the necessary’, through the critical interplay between rationality and reason.21 The Enlightenment is not a rational project but a ‘limit-attitude’22 of reason that analyses and reflects upon the limits of rationality; it is the critical work of reason reflecting on the boundaries of our knowledge, on what is accepted as rational, true and real.
Foucault’s Enlightenment and Kant’s Epistemology
For Kant, the dynamic interaction between rationality and reason is first and foremost an epistemological problem, a philosophical question pertaining to the faculties of human cognition and the necessary limitations of knowledge. It is therefore from Kant’s abiding preoccupation with human finitude and the possibility of its transparency to knowledge that this analysis must begin. Foucault had shared this preoccupation and already from the early stages of his work he had set out to implement it to the study of concrete practices and institutions. Closely reading Kant’s texts, Foucault investigated the question of critique and its essential connection to the limits of rationality. With the help of the Kantian Critiques, he demonstrated how the fundamental tension between rationality and reason became an area of philosophical concern since Kant and how it has informed psychiatric practice and theory from the late eighteenth century to the present.
Kant’s basic motto, his instruction to those who seek to put their reason to work is: ‘Aude sapere: have the courage, the audacity, to know.’23 This instruction does not mean the courage to use knowledge against prejudice and superstition. It does not imply the liberation of man through more precise and accurate application of scientific learning which will lead humanity to a more mature state of self-realization. It means questioning knowledge to assess to what extent something can be known and to what extent reason can function as a source of knowledge, without transgressing its limits: limits which can only be located by reason itself. This is why Kant’s critique should not be seen as a manifesto of the Enlightenment. It neither describes a unique moment in history nor prescribes a utopian state of affairs based on reason and progress. Kant’s work is viewed by Foucault as a reflection on the limits of thought, constituting ‘the handbook of reason as it has grown up in the Enlightenment’, rendering the Enlightenment ‘the age of critique’.24 Accepting the challenge to criticize rationality and its dangers requires an idea of our knowledge and its limits, and an act of courage to make these limits manifest.25 Reason does not only produce knowledge but also delineates its boundaries which, when transgressed, generate dogmatism and illusions. Thus, the critical process of the Enlightenment does not amount to expanding or perfecting knowledge, but to ‘know knowledge’.26
In the field of cognition, reason has no end other than itself. In fact Foucault points out that reasoning, as Kant applies the term, räsonieren, is to reason for reasoning’s sake.27 Reason’s function is theoretical, speculative and regulatory, ensuring the correct application of concepts and establishing the limits of possible experience. Reason’s sole object is the understanding (Verstand) and its legitimate use, not objects in the external world. It is responsible for the transcendental conditions of possibility for knowledge, not for its actual contents. Knowledge is governed by the understanding which is applied through a set of conditions set forth by reason, which is itself unconditioned. Cognition is obliged to turn to the a priori postulates of reason in order to seek the foundations of what will count as an object of representation. But reason, which has endowed the understanding with the principles of representation, is not itself responsible for representing. It only safeguards the correct application of comprehension. As Kant points out: ‘all the concepts, nay, all the questions which pure reason presents to us, have their source not in experience, but exclusively in reason itself […] since reason is the sole begetter of these ideas, it is under obligation to give an account of their validity or of their illusory dialectical nature’.28 Reason is transformed into a form of rationality when it ceases to be regulatory and becomes a principle of knowledge when it abandons its transcendental domain in order to become empirical.29 Reason has no end other than itself; therefore, when it is forced to pursue ends foreign to reflection and speculation, it necessarily generates illusions. Reason is sacrificed the moment it is turned into a principle. This is how rationality is born.
Reason carries out its critical enterprise when it questions its own elevation to the status of a principle of knowledge. Reason does not legislate. It ‘purges’ itself of any teleology and assumes its position at the limits of knowledge. In its critical role, therefore, it does not provide the ‘wealth’ of the source of knowledge, but the ‘rigour’ of its limit.30 Contrary to the commonly held assumptions which identify the Enlightenment with the assertion of rationality as a principle of action and the wealth of cognition and knowledge, supposedly endowing the subject with the autonomy and freedom to overcome dogmatism and external authority, Kant shows that it is precisely the illegitimate status of sovereignty accorded to rationality which increases our dependence on the authority of another and reinforces our state of tutelage.31 The attitude of the Enlightenment begins when, by rigorously demarcating the limits of the understanding, reason ensures its legitimate application, rendering the subject autonomous precisely by abolishing the need to appeal to an external authority.
The Anthropology
Foucault’s late theoretical analysis of Kant’s critique and the Enlightenment can now shed retrospective light on the way he had tackled the same topics at the early stages of his philosophical career, by way of psychiatry. Foucault’s treatise, Introduction to Kant’s Anthropology from a Pragmatic Point of View constitutes the theoretical background of his writings on mental health, from his famous Mental Illness and Psychology and the History of Madness, up to his recently published lectures on psychiatry. In his Introduction, Foucault argues that Kant’s anthropology is an exemplary form of Enlightenment critique, opening up a field of research where man himself becomes both the object of rational analysis and at the same time an area of perception whose limitations are submitted to strict interrogation by reason. Kant’s anthropological project, Foucault insists, is part and parcel of the three Critiques and must be considered as their continuation and completion: ‘The Anthropology says nothing other than what is said in the Critique: we need only glance through the 1798 text to see that it covers exactly the same ground as the critical enterprise.’32 The Anthropology constitutes Foucault’s first systematic attempt to apply Kant’s analytic of finitude to the concrete investigation of psychiatric theory and practice as it appeared in the west during the period which has been named the Enlightenment.
In his Anthropology, Kant applies the three crucial questions of his Critiques (what can I know? what must I do? and what can I hope for?) to the field of experience, leading to a fourth question that will appear in his Logic – what is man? – which supplements the critical enterprise and takes philosophical reflection ‘to culminate in an interrogation of the questions themselves’.33 As Foucault shows, the anthropology opened up for the first time in the West the possibility of a logical reflection on the nature of the human mind. This is why it broke radically with all previous abstract philosophical theories and empirical psychological approaches, and has remained a singular method with respect to all subsequent modes of research in the field of the human sciences up to the present. Anthropology does not constitute a psychological, sociological or cultural project, but a type of empirical investigation of man which considers and constantly refers itself to its epistemological limitations. It shows how the efforts to offer an objective understanding of human nature are always conditioned and limited by the finitude of man:
When I say ‘anthropology’ I am not referring to the particular science called anthropology, which is the study of cultures exterior to our own; by ‘anthropology’ I mean the strictly philosophical structure responsible for the fact that the problems of philosophy are now lodged within the domain that can be called that of human finitude.34
Kant’s problematic in the Anthropology, already in the spirit of his Critique, was centred on the long-standing tension between psychology and philosophy. He was concerned with the increasing replacement of the metaphysical discourse of finitude by psychology and its positive theses on human nature. For Kant, the clear and lucid methods of empirical psychology had come to fill the space occupied for centuries by the obscure language of philosophy whose failure to reflect positively on the nature of the soul had ‘given rise to the belief that the solutions to its irresolvable problems were hidden in psychological phenomena pertaining to an empirical study of the soul’.35 However, Kant argues, this growing invasion of empirical psychology into the domain of metaphysical reflection – to the point of complete substitution – rested on a logical impasse: empirical psychology attempted to describe the nature of the soul and the rational laws that govern its functioning. It turned the imagination and the understanding, the representations of consciousness and the structure of perception, into objects of empirical knowledge. It could not, however, treat the nature of reason itself as a psychological phenomenon, insofar as it is reason which not only provides the very tools for psychological explanation, but also bars access to whatever type of experience may lie beyond the domain of rationality. The anthropology, then, is the language of logos, reason itself as the outer frontier of empirical psychology designating its condition of impossibility, ‘that inaccessible term that we are always approaching, but never actually go beyond’.36 This is why the anthropology is the very limit of psychology. It studies consciousness in its negative instances and the faculties of the mind in their deviations. Instead of restoring the laws of cohesion and harmony of the faculties, it foregrounds the moments when these faculties come into conflict and contradiction. ‘Anthropology maintains the division of the ‘faculties’ — Vermögen — as in the Critique. However, its privileged domain is not that where the faculties and powers show off their positive attributes but where they show their failings — or at least where they face danger, where they risk being obliterated.’37 The anthropology looks for the limit of the application of the imagination and the understanding, the moments when these faculties transgress their limits and ‘become other than themselves, illegitimate’.38 When this transgression occurs, the rational employment of the faculties disintegrates, leading to phenomena of irrationality, madness. It is the task of the anthropology, in contrast to all psychological enterprises, to reflect on the instances when the harmony of the rational functions of consciousness falls apart and the abyss of unreason threatens the consistency of the mind.
It is at this point that Foucault makes a remarkable observation which has revolutionized the way we interpret the history of psychiatry. He demonstrates that, independently of Kant, in a completely foreign context and institutional setting, the mental health professionals of Kant’s time enacted fully the basic principles of the anthropology. In fact, as Foucault shows, these medical anthropologists created psychiatry as a discipline by unwittingly implementing Kant’s critical method in spite of the general rationalist philosophical framework of the time which determined all psychology and biology. Thus, in stark contrast to the medical treatises of the previous century, there was only a minor contribution to psychological methodology during this period. There was limited use of pathological anatomy as in the rest of medicine. These typical – according to today’s standards – psychiatric practices were subordinated to the more fundamental, basic practice of diagnosing and spotting madness as the dismantling of the faculties, an experience at the limits of rationality, a domain beyond comprehension. The proto-psychiatrists of this period were not psychologists exploring the nature of perception and human cognition on the premise of the infinite or of established truths borrowed from the natural sciences; they were alienists for whom ‘the infinite (was) no longer given’ and for whom ‘there (was) no longer anything but finitude’.39 Theirs was not a rational psychological project investigating the soul, but a reasonable reflection on a radical alterity. Hence the exclusion of the mad subject and the medico-philosophical and sometimes spiritual description of mental pathology during this period. Far from displaying a medical triumph over mental illness, a thorough study of most books of psychopathology of the early nineteenth century displays a deeply ‘tragic confrontation with madness’ which broke with all previous psychology and medical theories concerning mental disorder. In opposition to all previous mental medicine, proto-psychiatry understood that ‘psychology can never tell the truth about madness’, because only the disintegration of the mental faculties can retrospectively shed light on the normal functioning of the mind – it is only ‘madness that holds the truth of psychology’, being both the negative horizon and the condition of possibility for the science of psychology. It was this quest for the inner truth of madness which gave birth to the asylum, to psychiatric nosography, to expert psychiatric opinion – to psychiatry itself.40
Paradox vs Dialectic
Thus, with the help of Kant’s critique, the early Foucault performs an innovative and singular analysis of the birth of psychiatry, challenging the commonplace association of the ‘movement’ of the Enlightenment with the emergence of institutionalized mental health care. Foucault is not the first to underline the close proximity between medicine and philosophy in the Enlightenment, but he is the first thinker to avoid reproducing the view that the Enlightenment supposedly paved the way for a rational psychiatry free of moral, religious or political prejudices. Instead, he advances the notion that the enlightened psychiatry of the late eighteenth century was a reasonable enterprise, exercising the anthropological freedom to confront absurdity without the prejudices of psychologism, and the age-old dilemma between rationalism and empiricism.
However, certain pressing questions immediately arise. Why did the anthropology last only for a few decades? In terms of logic, this phenomenon cannot be explained. If, according to Foucault’s argumentation, proto-psychiatry respected the legitimate uses of reason being therefore logically self-sufficient, there should be no a priori reason why it should be replaced by psychiatric positivism, as it was historically the case. Also, why, despite being the point of origin, the founding act of Western psychiatry, did the anthropology nevertheless remain a remote form of psychiatric practice and theory diametrically opposite to the way it has been practiced throughout the twentieth century up to the present? Was it because the proto-psychiatrists were merely philosophers who, due to lack of scientific sophistication, only posed theoretical problems to which the more advanced scientific thinking of our age has managed to respond concretely? Finally, why is the difference between contemporary psychiatry and its anthropological origins so profound, in spite of their alleged continuity based on shared Enlightenment principles? After all, most contemporary mental health professionals would agree that their rational, experimental, humane and evidenced-based discipline is a more complete and fully realized descendant of eighteenth-century anthropology.
The answer to these questions is not to be found in the study of ‘epistemological breaks’; it can only be traced in the genealogy of the Enlightenment as we briefly outlined it in the second section: since the middle of the nineteenth century, the conception of the Enlightenment has been divorced from Kant’s anthropological reflections and has been imbued with the principles of humanism, liberalism and positivism. The Enlightenment has ceased to be associated with the study of finitude and the limits of rationality, and has gradually been considered a rational epistemological structure attached to the values of progress, liberation and security. Thus, contrary to Kant’s anthropology in which reason alienates man from himself, searching for the inhuman, the humanist and liberal version of the Enlightenment which came to dominate psychiatric thinking saw reason as the probing instrument and the liberating force of man’s inalienable essence.41 While for the anthropology it is reason itself which foregrounds irrational experiences as indispensable for the human sciences, post-anthropological ‘Enlightenment’ grew suspicious and even hostile toward the irrational elements of the human psyche, treating them as a force to be eliminated, a dark region which should be made transparent to the light of rationality.42 This transition from the reasonable to the rational became immediately apparent in clinical practice. The anthropology soon came to be viewed as abstract and primitive and sometimes as cruel and barbaric. Humanists and positivists in the field of mental health agreed that for an ‘enlightened’ medical institution which should be able to include madness calmly into its body of knowledge and its therapeutics, the practice of exclusion and the ‘tragic confrontation with madness’ was an unacceptable reality. Psychiatry should be a valid medical specialty capable of producing positive knowledge based on rationalism and empiricism, a possibility that the anthropological bifurcation of reason had precluded. As a result of this socio-cultural mutation, since the middle of the nineteenth century, post-anthropological psychiatry has established a scientific apparatus which has consistently excluded the anthropology from its epistemological edifice. In fact, it can be argued that Foucault’s entire historico-philosophical project rests on the idea that what appears to be psychiatry’s march towards progress is in actuality a systematic effort to eradicate the anthropological elements that may adulterate the objective and neutral discourse it wants to achieve.
The first most urgent and immediate task that psychiatry set for itself in the middle of the nineteenth century was the dialecticization of the paradoxes around which the anthropological model was built. If the notion of paradox in Foucault’s work implies an irreducible tension between heteroclite elements (reason/madness, empiricism/transcendence) then, in keeping with his terminology, dialectics denotes their reconciliation and sublation.43 Thus, whereas in the anthropology reason is a barrier against the excesses of rationality, in the psychiatric rationality of the late nineteenth century this barrier was lifted, creating a continuum with the irrational. Psychiatric rationality gradually began to give itself the right, the privilege and the power to use empirical means to capture and comprehend the transcendence of madness and to continue its progress toward an ever more complete knowledge of the unknown, in a process which Virilio would name ‘philofolly’.44
Through dialectics, psychiatric discourse sought to restore the foundations of rational psychology which had been in existence at least since the Renaissance, and were so unexpectedly and radically interrupted with the anthropology. For Foucault, however, this progress merely gives the impression of continuity. What it has actually accomplished is to attenuate the paradoxes of the problematic field of anthropology by smoothing out its deep-seated tensions and conflicts. Thus, by establishing a teleological process of psychological understanding, psychiatric rationality has produced ‘surreptitiously and in advance, the confusion of the empirical and the transcendental, even though Kant had demonstrated the division between them’.45 It is exactly this development which Foucault records in his History of Madness. While psychiatry originally defined itself as a discipline on the basis of its anthropological relation to the other, the exterior, foreign and excluded madman, its theoretical edifice reintegrated psychology, empiricism and a discourse of sameness and inclusion. In the middle of the nineteenth century the idea of madness was inserted into positive medical knowledge, it was transformed into mental illness through a system of psychological explanation and medical aetiology, and was removed from its limit position and finitude of knowledge, to become an object of empirical investigation. The truth of madness became transparent to medical positivism, the mad lost their radical foreignness and positivism became dominant.46
In the History of Madness Foucault concludes with the chapter ‘The Anthropological Circle’,47 where he shows how, in the nineteenth century, dialectical psychiatric anthropology cancelled madness as the outside of reason and sublated it, turning it into the mere opposite of rationality that could be studied empirically. Its efforts focused on the reduction of reason to an organizing principle that would not delineate and recognize madness as a wholly foreign realm of truth, but that could presumably measure and analyse that truth in terms of its somatic, instinctual and psychological components. For Foucault, this reduction launched the empirical study of man on the basis of his finitude while simultaneously denying that finitude, paving the way for the linear progression of positivism, an all-encompassing form of medical rationality, which seeks to rationalize madness. Psychiatry was sanctioned as a strictly medical speciality without frontiers, the moment when medical rationality was allowed to penetrate into the depths of insanity, locating its organic substratum, understanding its underlying psychic processes, or liberating its voice and its silenced nature.
The Critique of Psychiatric Anti-anthropology
Another, crucial question is: does this dialectization of the anthropology constitute an epistemological step forward in relation to the anthropological theories and practices which today seem outmoded and unscientific? As it should be expected by now, for Foucault this transformation merits scepticism, insofar as it disregards the limit-position of pure reason and identifies the Enlightenment with a set of rationalist values and principles totally foreign to the spirit of the anthropology. In fact, this is exactly the type of critique which Foucault performs, not only on a theoretical, but also on a clinical level. This does not mean that he chooses sides. It must always be kept in mind that Foucault is not ‘for’ or ‘against’ the Enlightenment. Although he clearly treats the anthropology as the epistemic expression of the Enlightenment and the very foundation of psychiatric theory and practice, he does not favour its promotion as a scientific model that should guide all research in mental health. What he defends is the paradoxical relationship, that is the simultaneous incommensurability, correlation and antagonism between medicine and philosophy as it was practiced during the early years of psychiatry. He then disputes the dialectical dismissal of this paradoxical relationship as a type of obscurantism in the name of a higher form of rationality, which has led exactly to those illusions and aporias which Kant had so accurately predicted in his Critiques.
Nowhere in his writings does Foucault propose the anthropology as an epistemic paradigm to be followed. The anthropology is not a rational project, but a form of critique of rationality: therefore it cannot exist as a form of science in its own right, if we take science to mean a rational practice with specific rules of formation, a claim to objectivity and a specific type of institutional support. It cannot be a strictly medical science either, if we take medicine to be the science of the body, seeking to capture the natural language of illness in the laboratory or the corpse. However, studying its forms of application and theoretical constructions in the early nineteenth century, Foucault does favourably outline psychiatric anthropology as a sound medical activity with its strict phenomenological diagnostic and nosological discourse, its unique institutional context and its own body of knowledge. He simply highlights the duality inherent to its epistemological system, which demarcates a boundary between scientific perception and the experience of irrationality which goes beyond it. This duality is reflected in the practice of exclusion of the mad in the early asylum, which, far from constituting a morally condemnable phenomenon for Foucault, indicates an epistemological necessity for a quasi-medical psychiatry, which deemed madness not exactly an illness, but nonetheless as an existent in the real world which could be inserted into a valid medical discourse.
Foucault provides further proof of the epistemological validity of the anthropology in his historical analyses in which he demonstrates that, by overcoming the anthropology, psychiatry has not achieved the desired degree of progress and sophistication. As he argues, it may be that the opposite is in fact the case. In its anthropological conception psychiatry displayed philosophical rigour and epistemological soundness. While on the fringes of medicine, proto-psychiatry maintained a strict isomorphism with medical discourse and a respect for logical argumentation and careful clinical observation. Curiously, it was later, when psychiatry attempted to establish equivalence with the rest of medicine, incorporating the tenets of positivism and the values of demonstration and proof, that it lost its scientific rigour and its validity. The bizarre early nineteenth-century notion of partial insanity may constitute a more valid diagnostic category than today’s schizophrenia and the definition of monomania in the early years of psychiatry can be shown to contain a stricter medical reasoning than the concept of dangerousness in contemporary forensic psychiatry. This epistemological regression rather than advancement is for Foucault the direct result of psychiatry’s dialecticized anthropology. Overstepping the boundaries of reason, psychiatric rationalism generates effects opposite to the ends it has set out to accomplish. Its will for a neutral, objective and value-free medical knowledge ends up contaminating psychiatric discourse with normative, moral and pedagogical propositions, attaching psychiatric power to extra-scientific factors. As long as the discourse of the anthropology was on a formally equal level with all medical knowledge, the proto-psychiatrists enjoyed a degree of autonomy and their relationship with legal, administrative and pedagogical authorities was based on agonistics and parity. From the moment post-anthropological psychiatric discourse was disconnected from this normative structure, and exceeded the medical domains of intervention, psychiatric power has weakened and its dependence on complex social and political forces has increased. In other words, history proves Kant right, displaying the actual processes through which the dependence and tutelage of psychiatrists on power relations foreign to their discipline is reinforced the more psychiatric knowledge falls prey to the transcendental illusion of mastering fields outside its comprehension.
Thus, the anthropology is a core, constitutive element of psychiatric epistemology and the more psychiatric rationality overlooks its indispensability, the more it is deprived of its scientificity. The recognition of this fact, however, somehow does not seem sufficient. The flagrant inconsistencies and illusions of contemporary psychiatry have not curbed the irresistible desire to transgress the limits of cognition; the colonizing force of today’s globalizing, all-encompassing psychiatric rationality seems irreversible. The ever-expanding field of positivism and psychology rules unchallenged and it stands as the most widely accepted scientific solution to the philosophical problems of the human mind and behaviour. There exists a vast interdisciplinary field, which is permeated and guided by rational psychology and neurobiology. Competing scientific paradigms, epistemological obstacles or conflicting psychological theories pose only minor and temporary deadlocks that the system generally removes as internal errors or statistical abnormalities. Even the challenge once posed by anti-psychiatric movements has been absorbed by the system’s increasing capacity for integration of oppositions into its own logic.
In this all-embracing mental health network which imposes the illusory image of infinite progress and total positivity, the anthropology, which ‘can in fact speak only the language of limit and negativity’,48 reemerges as the most groundbreaking and unsettling form of critique. While its logic remains radically anti-dialectical and paradoxical, its scope of action now changes in order to meet the new challenges of our times. As anti-dialectical, the anthropology cannot merely defend the negative side of current morality and epistemology, which the hegemonic logic of globalization has already absorbed. For example, the anthropology can no longer attack psychiatric rationality for its illegitimacy and irrationality; current rationality is immune to this type of critique, since it makes no claims to absolute truth, but to credibility and reliability. There can be no anthropological tribunal unmasking false scientific statements – global rationality only asserts statistical approximations. The anthropology is also not another type of humanism, protecting madness against the structures of domination – current systems of subjugation involve uniformity and control, not repression.
As a paradoxical form of critique, the anthropology carries the hegemonic logic of psychiatric rationality to its extreme. It poses the question: what happens when global rationality reaches its limit-point of saturation and full realization? The answer is indeed paradoxical: strange and unexpected phenomena of reversal seem to occur. The seemingly irreversible movement of homogenization and inclusion inside the ideal milieu of our post-asylum, community psychiatry produces forces of distance, alterity and exclusion. The pacifying and security-orientated field of forensic psychiatry generates phenomena of terror. The prevalent ideal of free democratic exchange and universal consensus brings about instances of repression, policing and prohibition. The high level of modern techno-scientific sophistication allows excluded forms of medical reasoning, forms long rejected as magical or religious, to resurface in all their force. These phenomena of reversal are not part of a metaphysical or historical necessity; they do not occur at the level of abstract philosophical speculation. The anthropology spots them in those real and concrete occasions, inside those invisible and local struggles between patients and doctors where madness appears once again as inhuman and resistant to medical understanding. Exactly at the moment when psychiatric rationality forces madness into its universe of moral and positive discourse, it is the mad who, indifferent to their own rights and provocative to those speaking in their name, draw lines of division, separation and duality, where there once was abstract difference and multiplicity.
This new militant anthropology is a radical, post-Kantian and neo-alienist form of critique inevitably leading to Nietzsche. It is the ‘Kantian Nietzsche’ whom Foucault discovers, the Nietzsche who renews the anthropology not by demonstrating the system’s inconsistencies and transcendental illusions, but by critiquing the system’s self-deluding omnipotence and unconditional truth and perfection. In an age when all-inclusive rationality universalizes meaning and positivity, Nietzsche traces all the forces of nonsense and duality, which, arising from within the system’s own totalizing logic, resist integration and rational control. Through Nietzsche’s genealogy, Foucault will not look for medical flaws or epistemological obstacles, but for anthropological mutations, crises, ruptures, discontinuities and radical breaks in the history of psychiatry, emerging from the spontaneous, incomprehensible and subversive acts of patients, which reverse positivity and reproblematize the lost object of madness. Foucault will focus on those historical events when psychiatry will enjoy the certainty that it has dispensed entirely with the alterity of madness, only to discover that its hegemony is a simulacrum and that it is alterity itself which secretly controls the truth of medical discourse. When all appears settled and psychiatry seems to have imposed unequivocally its unified theories and universal models (biopsychosocial model, the DSM, genetics, neuroscience), it is the patients themselves who make a parody of its meaning and its truth models, and defy the rational programming of the institution. Remnants of the anthropological age of psychiatry, monstrosity, hysteria and other forms of mental illness will arise from the limits of the diagnostic field as agents of a forgotten otherness who have the potential to set the pretension of truth against the psychiatric rationality that aspires to integrate and incorporate them. These unmarked terms, these blind spots of the psychiatric diagnostic system, will make the diagnostic game more complex and enigmatic, they will unsettle psychiatry’s deep-seated rationality, they will derealize its constituted practices and objects of knowledge and will exclude themselves from the nexus of total socialization and therapeutics.49
Conclusion
The Enlightenment is not a state of affairs but an event. It is not an epoch belonging to a historical totality but an attitude towards the present which acknowledges the difference of the present from the past and future. It is a diagnosis which uses reason as a tool for locating mutations, points of transition and ruptures: ‘Diagnosis in this sense does not establish the recognition of our identity through the play of distinctions. It establishes that we are difference, that our reason is the difference between discourses, our history is the difference between times, our self the difference between masks.’50 A diagnosis of our present condition contains an essential relationship with otherness, which is the very function of truth itself.51 It consists of reflecting on what is other in relation to our present rationality, and how our ontology, that is, our practices, modes of being and existence, differs from other cultures and other societies.
Kant’s Anthropology offers Foucault the opportunity to explore the relationship that western rationality has established with otherness. From The History of Madness onwards, on the grounds of the anthropological enterprise of the late eighteenth century, Foucault will analyse in a critical fashion the birth of psychiatry during the Enlightenment as a result of a reflection on human finitude and the limits of rationality. This will enable him to dispel the commonly held view of Enlightenment’s preoccupation with reason and progress that supposedly made psychiatry possible. He will show how in the late eighteenth century it was not rationality that viewed madness as its imperfection, but pure reason that conceived the madman as its other.
However, historically the anthropology proved to be short lived. Foucault shows how a few decades after its appearance, the anthropological survey mutated into a type of positivism and naturalism, into a rigid method of analysing detectable and measurable phenomena that can be fitted into an unproblematic understanding of nature. Psychiatry has adopted only those aspects of Kant and his conception of the anthropology which concern the abstract individual and the universal laws underlying human cognition and behaviour, seeking only to develop causal, hermeneutic and explanatory accounts of how these laws operate. It has left out his subtle reflections on the limits of possible experience which undermine the laws of cognition, the moment these take on the value of universality and absolute truth: ‘In fact, the moment we think we can give critical thought the value of positive knowledge, we will have forgotten the essential point of Kant’s lesson. The difficulty we encountered in situating the Anthropology in relation to the critical ensemble ought to have been indication that the lesson is not simple.’52 This is in fact one of the most widely studied and difficult lessons, whose misconstrual has led to the illusions that Foucault sets out to combat: the illusion of psychologism, which arbitrarily reduces concepts to natural and psychological mechanisms, the transcendental illusion when rationality aspires to colonize domains which a priori lie beyond its grasp and the anthropological illusion, when the anthropology itself attempts to pacify and reconcile its own intrinsic conflicts.53 To the extent that they have not escaped this triple illusion, most medico-philosophical trends dominating psychiatric discourse today – positivism, phenomenology, psychoanalysis, anti-psychiatry – have been absorbed by the same forms of rationality that they claim to criticize.
All these theories and disciplines will be studied thoroughly in this book in order to illustrate more clearly how Foucault’s critical endeavour differs by reproblematizing the anthropology and the indispensable core of human finitude for psychiatric epistemology. This reproblematization will amount to recurrently questioning the self-evident solutions of psychologism, which mask the inescapable philosophical tensions of the anthropology behind the appearance of objectivity and scientific progress. The very aim of the anthropological critique is ‘the destruction of psychology itself’, not because psychology is a pseudo-science, but because by reviving and reactivating ‘that essential, non-psychological because nonmemorizable […] relation between Reason and Unreason’,54 it will touch the roots of psychology and will shake its foundations, opening the possibility for radical renewal and transformation.