Comfort in history: Foucault’s guide to mental illness

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“Just want you to fill out this form.”

Disinterested, she passes me a pen and a form with rows of boxes. How I answer these will determine what kind of mad I am. If I get a high enough score, I’m officially depressed! The clinical sweet smell wafts in waves. I can’t blame her apathy. How many ‘me’s’ does she see?

My feelings are squished into boxes, categories, taxonomies, labels.

Labels function to explain an inexplicable world, how we come to terms with life. But it’s disempowering – just part of the bureaucratic quagmire. Question after question. Number after number. Form after form.

One form is replaced with multiple mental health plans and letters of recommendation. She’s looking at the screen now. Her pointer finger is on the mouse, scrolling, body inert. I move to leave and she doesn’t turn around. Outside, the receptionist, with her over-lined lips and clack-y nails, is humming. The fluorescent lighting burns into the white forms in my hand; flames lick at the edges; 1970s carpet lies dirty beneath me.

But it wasn’t always like this. Current perceptions of mental health weren’t inevitable nor are they the best. This is what Foucault argues in Madness and Civilisation (1961). Analysing the twists and turns of the preceding 400 years, Foucault pieces together the past to uncover a mosaic of understandings about mental health. The historical warehouse exhibits better ways of life.

Popular conceptions of mental health are socially constructed and historically contingent. They don’t emerge from truth or neurological inherent defects but from society’s power relations. Scanning texts of the past – whether it’s court documents, police records or literary sources – Foucault uncovers discontinuities. In doing so, he denies teleology. History has not been an upwards progression to our Utopian present, but a discontinuous set of modes. Foucault wards us off surety, telling us to scrutinise the unexceptional. Don’t take this at face value.

“Apologies. Good luck”

It’s taken me three months to reach out again. Now the world has quietened. Only delivery drivers occupy the streets. All interactions are now mediated by an LED screen. Everything’s more red-hued than before. “Mental health,” rings the news. Cluttered with tabs, the laptop lies open in agony. Tears are welling but held back, a wave building against my skull. No one has a spot available for months. I don’t think I can wait.

In this age of mental health awareness, interactions with the health care system are demoralising. The other day was ‘R U OK Day’. But the reality is so many my age struggle with mental illness and can’t access treatment. How has this become ok?

History explains

In the Renaissance, the madman was viewed with ambivalence. He was otherworldly, fool-like, sacred and even trustworthy. Foucault explains he was a ‘wandering figure’. While he stood outside of society, he could communicate truth and divine visions. Society didn’t think there was something innately wrong with him so he was allowed to live.

With the arrival of the classical Age of Reason, the madman became a figure of deviance. No longer existing in the interstices, society contains the man on the margins of the city, in the Hospital. Here, he doesn’t get to participate in the world of ‘reason’. The 17th century was obsessed with confining these non-conformists, fearing their ‘unreason’ would pollute reason. This illness also became linked to laziness: “For the first time, madness was perceived through a condemnation of idleness and in a social immanence guaranteed by the community of labour.”

The madman became a figure of illness in the modern world. He could now be corrected and rehabilitated. The Hospital is now the asylum; it no longer just confines but enacts treatments to bring him into the world of reason. His perceived brokenness, neurological failure, and retarded development can be fixed with a tranquilliser, electric chair, lobotomy or electroshock therapy. Madness became attached to social failure. In the asylum, Foucault tells us, “the madman … must feel morally responsible for everything within him that may disturb morality and society and must hold no one but himself responsible”.

But the late 20th century brought change. Freudian psychological language dominated: the madman is within us all. Control was now about medicating and analysing. Psychology and psychiatry would ‘benevolently’ guide us. But they were really playing that child’s game with the shapes, forcing the round psyche solid in the square hole of Reason. This was normalisation through neutralisation. Somewhat released from the asylum, we were still contained and disciplined.

“Tell me about yourself”

Photo: Pexels, Mikhail Nilov

After months on the waiting list, I finally secured an appointment. I sit here again in front of the screen. She peers out through the dirt. It’s not everything I hoped it would be. The cold bristles through. I’m the patient, wrong, mad. Everything is curable with money. The system laughs in the face of my casual wage; $180 becomes $100 with Medicare. I need it weekly, but can scarcely afford fortnightly.

Foucault doesn’t explain everything. He didn’t live to decipher today. It’s become a cliche to talk about mental illness and its ‘unprecedented high rates’. But it’s true. The burn-and-churn capitalist machine cannot avoid responsibility here, especially because of its profit. Relentlessly individualising discourse places the burden on us to get ourselves better. And everything is conveniently curable with a credit card. The present is not exceptional, not a shining beacon of mental health awareness and care, but instead a capitalistic ‘wellness’ imperative.

Everyone knew when you were going to the counsellor in high school. You would have to walk from the centre to the margins – past the main buildings, through lunch areas, under the carpark and through the kindergarten. Years later it doesn’t feel much different. But months later, after reading Foucault, I know why I still feel so alienated. I know it’s not so different from the past. While Foucault’s work has been relegated to the dark and labyrinthine academic world, we can talk about his work best subjectively, as a guidebook to understanding ourselves. Foucault has laid bare my chains, shown me what’s truly going on. More trapped than ever, I feel free. Foucault has released me from the torturous exceptionalism of the present.

Foucault allows us to step back from demoralising experiences and find comfort in the past. The purpose of history is not just to explain the present, but to save us from it.

Bio: Victoria Gillespie is a third-year Bachelor of Arts student, majoring in Politics and History. She likes to investigate history for explanations for why things are the way they are. She can be contacted at vgil4644@uni.sydney.edu.au.