assumes responsibility for the constraints of power; he makes them play spontaneously upon himself; he inscribes in himself the power relation in which he simultaneously plays both roles; he becomes the
principle
of his own subjection.
Foucault-Key-Concepts
3
As these cases show, sex is important at both levels of biopower, concerning as it does both the individual's use of his or her body and the growth and health of the population. As Foucault notes, "Sexuality exists at the point where body and population meet. And so it is a mat- ter for discipline, but also a matter for regularization" (2003 : 25 1-2).
Sex was a means of access both to the life of the body and the life of the species. It was employed as a standard for the disciplines and as a basis for regulations. This is why in the nineteenth cen- tury sexuality was sought out in the smallest details of individual existences . . . . But one also sees it becoming the theme of politi- cal operations, economic interventions (through incitements to or curbs on procreation), and ideological campaigns for raising standards of morality and responsibility: it was put forward as an index of a society's strength, revealing of both its political energy and its biological vigor. Spread out from one pole to the other of this technology of sex was a whole series of different tactics that combined in varying proportions the object of disciplining the bodyandthatofregulatingpopulations. (1990a: 146)
Far from being something which we have recently liberated (or still struggle to liberate) from an archaic and repressive power, Foucault therefore argues that sex is in fact a privileged site and indeed a product of the workings of modern forms of power.
Death in the age of biopolitics
In contrast to sex, Foucault argues that death has now receded from view, becoming private and hidden. While sovereign power entailed the right to impose death, the aims of biopower are to foster and manage life, and so death becomes a "scandal". Under sovereign power death was ritualized as the moment of passing from one sovereign authority to the next. Death was the ultimate expression of the sovereign's power
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BIOPOWER
and was made into a public spectacle whenever this power needed to be affirmed. In contrast, under biopower, death is the moment in which we escape power (Foucault 2003: 248). Foucault writes of the "disqualification of death" in the biopolitical age, and observes that the "great public ritualization of death gradually began to disappear" (ibid. : 247). For this reason suicide was illegal under sovereign power, perceived as a seizure of the king's power to take life, whereas today it is a medical problem, a shameful secret and a bewildering threat. As an escape from bio-disciplinary power, suicide is described by Foucault as a subversive act of resistance in works such as "I, Pierre Riviere . . . " (1982b) and Herculine Barbin (1980a).
One manifestation of the shift from the sovereign power to kill to the biopolitical interest in fostering life is that capital punishment came to be contested in the modern period and new forms of punishment were invented to replace it, most notably the prison. While the death penalty was abolished in most Western democracies by the 1970s, its practice had long since become rare. In those places where it is still legal and regularly practised today, such as the United States, it is widely criticized as backward and anachronistic. 4 In earlier eras, execution for murder or theft was understood as punishment for having broken the sovereign's law and for undermining his power. Crime was conceived as a personal attack on the sovereign rather than on the individual victims of the crime or on the security of the population as a whole. Punishment was the sovereign's counter-attack, his reaffirmation of power. In contrast, the current view of punishment is a "paying of one's debt to society", while executions, where they are permitted at all, are justified in the name of security. A criminal condemned to death must be perceived as a threat to the population rather than to the ruler's power. For this reason serial killers are executed in the United States today but the president's political opponents are not.
Capital punishment aside, there is little direct control over death under biopower. As Foucault notes, we now have the power to keep people alive when they should be dead and to decide when to "let them die", or to regulate their lives even after, biologically speaking, they should be dead (2003: 248-9). We may thus choose to cease manag- ing an individual's life by letting her die, or to not foster certain lives to begin with, but this is not the same thing as the sovereign right to kill. While a person might be allowed to die or her life may be disal- lowed to the point of death, and while the state monitors the morbidity rate, you can be fairly sure that your death will not be claimed by the state, and that your life will be managed but not seized. This is why death is now privatized - it is, according to Foucault, "outside the
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MICHEL FO U CA U LT: KEY CONCEPTS
power relationship" (ibid. : 248). While we claim that sex is silenced and repressed, Foucault compellingly argues throughout The History ofSexuality that this is not the case and that we in fact talk about sex more than anything else; on the other hand, death today truly is taboo.
Foucault thinks that the irony of this "disqualification of death" is that wars are bloodier than ever but are justified in the name of life. He writes:
Yet wars were never as bloody as they have been since the nine- teenth century, and all things being equal, never before did regimes visit such holocausts on their own populations. But this formida- ble power of death . . . now presents itself as the counterpart of a power that exerts a positive influence on life, that endeavors to administer, optimize, and multiply it . . . Wars are no longer waged in the name of a sovereign who must be defended; they are waged on behalf of the existence of everyone; entire populations are mobilized for the purpose of wholesale slaughter in the name of life necessity: massacres have become vital. (1990a: 137)
The Holocaust of the Jews, along with the extermination of gypsies and the "euthanasia" of the mentally ill and persons with developmental disabilites, were justified under the Nazi regime as "racial hygiene", nec- essary or beneficial to German flourishing. Nazi propaganda depicted Jews as a plague of rats that posed a threat to German well-being, and presented medical care for the mentally ill and disabled as a drain on German resources better used for those fit to survive. Indeed, despite the "disqualification of death" in the modern era, Foucault argues that there will be more genocides under biopower than under sovereign power, because biopower wants to manage the health of populations. When combined with racism, this management becomes cast as a con- cern for the racial purity of a people. In Society Must Be Defended, Foucault argues that biopower is almost necessarily racist, since racism, broadly construed, is an "indispensable precondition" that grants the state the power to kill (2003 : 256). 5 Under such conditions, eradicating sub-groups of that population is perceived as a justifiable form of man- aging and protecting a people. Foucault writes: "If genocide is indeed the dream of modern powers, this is not because of a recent return of the ancient right to kill, it is because power is situated and exercised at the level of life, the species, the race, and the large-scale phenomena of population" (1990a: 13 7).
We can take the example of the recent US-led invasion of Iraq to illustrate the manner in which the modern biopolitical state justifies
50
BIOPOWER
mass killings in the name of life, and both produces and exploits racism in order to do so. The original justifications for the invasion of Iraq involved claims that Iraq had weapons of mass destruction and was affiliated with Al-Qaeda. The Bush and Blair administrations suggested that Iraq would use its weapons of mass destruction to attack the United States and its allies, affiliated as it was with the attacks of 9/11. Anti- Muslim and anti-Arab racism abounded in this period in the US and was exploited in the arguments for invading Iraq. In this way Iraq was pre- sented as a racialized threat to American existence or to the Western way of life, and invasion of this country was deemed necessary to protect life in Western democracies. When no weapons of mass destruction and no link to Al-Qaeda were found, the Bush and Blair administrations shifted tactics, emphasizing the slaughters and massacres that Saddam Hus- sein had committed against his own people, much like the oppression of women and girls in Afghanistan is exploited to justify the military incursions into this country. Over time these wars are recast as charity missions, undertaken not so much to protect lives in the West as to save innocent lives in the East. While critics point out that the alleged desires to save Iraqi lives and to liberate oppressed women are pretences, the important point is that we now need pretences such as these in order to justify war. We no longer pursue military invasions for the overt sake of glory, gain or conquest, or to defend the honour of the sovereign. While the ancient Romans could invade a foreign country for the undisguised purposes of occupying a land, enslaving a people and gaining access to resources, today we must mask our massacres as humanitarian efforts even while bringing about the deaths of thousands of civilians, turning millions more into refugees, and immediately securing the oil fields.
Social Darwinism and eugenics
In the nineteenth century, Europeans and North Americans grappled with the effects of increased urbanization, including the steady growth of slums inhabited by an underclass of paupers, prostitutes and thieves, many of whom were sickly and, the middle class thought, lazy and immoral. Rates of crime, disease, mental illness, alcoholism, promiscu- ity and prostitution were rampant in this segment of the population, which was, moreover, reproducing itself more quickly than the middle classes. The result was a growing fear among the bourgeoisie that the "dregs" of society would eventually overtake them. The middle classes in Western countries began to suspect that their race was degenerating, both because they were not reproducing quickly enough and because
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MI C H EL FOU CAULT: KEY CON CEPTS
the lower class was reproducing too quickly. These fears were exac- erbated in Britain when studies of the records of the height, weight and health of soldiers throughout the nineteenth century suggested "a progressive physical degeneracy of race" (Childs 2001: 1). European exploration of non-Western countries also confronted Europeans with races they deemed inferior, but which, because they must have a com- mon ancestry with Europeans in Adam and Eve, were believed to have degenerated over time, falling from their original nobility (ibid. ) . The possibility of nationwide racial degeneration was thus posed, and anxi- ety mounted that Europeans could descend to the level of these "inferior races" if procreation patterns were not controlled.
In response to these fears, the science of eugenics was born in the late nineteenth century in Britain with the works of the statistician Francis Galton, and reached its height in the first half of the twentieth century throughout the Western world. Galton drew on his cousin Charles Dar- win's theory of natural selection and argued that human societies were preventing natural selection or the "survival of the fittest" by protecting the sick, the poor and the weak through welfare programmes, charity and medicine. He coined the term "eugenics" from the Greek roots eu (good or well) and genes (born), and described the science as "the study of all agencies under human control which can improve or impair the racial quality of future generations" (Black 2004: 18). Social Darwin- ists argued that the "survival of the fittest" human beings would come about naturally if welfare systems were simply withdrawn: although the poor would continue to have more children than the middle classes, this would be compensated for by higher mortality rates resulting from poverty and lack of medical care. As one Social Darwinist, Herbert Spencer, explains:
It seems hard that an unskilfulness . . . should entail hunger upon the artisan. It seems hard that a laborer incapacitated by sickness . . . should have to bear the resulting privations. It seems hard that widows and orphans should be left to struggle for life or death. Nevertheless, when regarded not separately but in connexion with the interests of universal humanity, these harsh fatalities are seen to be full of beneficence. (Childs 2001: 2-3)
Spencer thus suggests that nature be allowed to run its course, eliminat- ing the weak from society. Individuals such as Spencer rejected the argu- ment that improving the environment of the poor might reduce their rates of mental illness, infection, alcoholism, promiscuity and crime. While those advocating environmental reform suggested improvements
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BIOPOWER
in education and health care for the urban poor, and thus argued for biopolitical interventions of a different order (carried out at the level of disciplinary incursions into the lives of disorderly and abnormal members of society), Social Darwinists opposed such methods, argu- ing that they would only exacerbate the problem by helping to sustain those segments of society better left to die.
While Spencer's approach is to let the poor and the weak die out through non-intervention, other eugenicists advocated more active tac- tics. These tactics were divided into what were called "negative" and "positive" eugenics. "Negative eugenics", as the philosopher and eugen- ist F. C. S. Schiller puts it, "aims at checking the deterioration to which the human stock is exposed, owing to the rapid proliferation of what may be called human weeds" (ibid. : 3). This strategy entails preventing individuals and groups deemed "degenerate" from procreating through abortions, forced sterilization, incapacitation (such as locking up the mentally ill), "euthanasia" or, as in the case of Nazi Germany, genocide. Such "negative" tactics, however, can only prevent further deteriora- tion; they cannot improve the species and so strategies of "positive eugenics" were simultaneously promoted. "Positive eugenics" involved encouraging or compelling "human flowers" to produce large families, for instance through economic stimuli. Abortion by "fit" women was illegal in Nazi Germany, and middle-class women who attempted to enter the work force were discouraged on the grounds that j obs outside the home were "race-destroying occupations" (ibid. : 7).
Eugenics thus attempts to improve the gene pool; however, what is meant by "improve" is inevitably socioculturally defined and has always been tainted by classism, racism and abilism. Early eugenicists were concerned with increasing the intelligence of the population, for instance, but this concern tended to promote births in the middle class while preventing them among the working classes. Racist eugenicists are opposed to miscegenation. With the Immigration Act of 1924, eugeni- cists successfully argued against allowing "inferior stock" from southern and eastern Europe into the United States. Laws were written in the late 1800s and early 1900s to prohibit the mentally ill from marrying and to allow them to be sterilized in psychiatric institutions. These laws were upheld by the Supreme Court in 1927 and were only abolished in the mid-twentieth century. As a result, 60,000 mentally ill Americans were sterilized in order to prevent them from passing on their genes. This is particularly problematic since what qualifies as "mental illness" is noto- riously unstable and, as Foucault argues in works such as The History of' Madness (2006b) and Psychiatric Power (2006a), has tended to describe social mores and norms rather than genuine medical conditions. 6
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MICHEL FOUCAULT: KEY CONCEPTS
Social Darwinism and eugenics may be described as biopolitical movements since they involve strategies for managing the health and productivity of populations through interventions in natality and mor- tality rates, mental and physical health, and immigration, even if what is taken to be "healthy" is highly problematic, entailing as it does preju- dices ranging from abilism and classism to sexism, nationalism and racism. Following the Second World War, there has been a tendency to repress the fact that other countries besides Germany have histories of eugenics, histories which quietly continued long after the defeat of the Nazis (Childs 2001: 15 ) . Ladelle McWhorter not only traces the exten- sive history of eugenics in the United States, however, but argues that the contemporary and mostly unquestioned pro-family movement in this country is a mere recasting and extension of the eugenics movement (McWhorter 2009). Eugenic uses of science also arguably continue in the cases of pro-family financial, social and political incentives, designer babies, genetic counselling, preemptive abortions, and the creation of "genius sperm banks". Many of these examples entail the use of new scientific technology to improve the genes of individual babies and of the population as a whole while preventing babies deemed "unfit" from ever being born. These biopolitical practices thus further entrench the prejudices of an abilist society while continuing the goals of eugenics in manners which have become increasingly unbounded by the state.
Notes
1. For a Foucauldian study of how biopower and discipline control the care of o n e ' s b o d y, s e e B a r t k y 1 9 8 8 ; f o r h o w d i s c i p l i n a r y p o w e r c o n t r o l s d i e t , s e e B o r d o (2003) and Heyes (2006); for a Foucauldian study of how biopower controls housing choices and opportunities and the raising and education of children, see Feder (1996, 2007).
2. In the second and third lectures of Security, Territory, Population, Foucault contrasts disciplinary mechanisms and security measures aimed at the level of population which, at the beginning of the first lecture, he calls "somewhat vaguely, bio-power" (2007: 1).
3. SeeKukla(2005:chs2,5).
3. For a n extended discussion of biopolitical interventions in the birthrate among
these demographic groups in the United States, see McWhorter (2009).
4. Bedau,"TheCaseAgainsttheDeathPenalty":www. skepticfiles. org/aclu/case_
aga. htm (accessed August 2010).
5. Foucault writes of "racism against the abnormal" in this lecture, and hence is
not limiting himself to racism based on skin colour in making these claims.
6. To take but one example, homosexuality was included in the Diagnostic and
Statistical Manual ofMental Disorders until 1 973 .
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? FOU R
Power/ knowledg
Ellen K. Feder
Foucault explicitly introduces the composite term, "power/knowledge" (pouvoir/savoir) in the middle, "genealogical" period of his work. At the same time, however, the concept of power/knowledge in many ways encompasses the entire corpus, characterizing the implicit project of his "archaeological" works, the explicit focus of the "genealogical", and the working out of the implications for living a good life in the later "ethical" work.
To understand what Foucault means by power/knowledge we first have to engage in a little translation. Notice that when the term is used in philosophy written in English, the original French in which Foucault spoke and wrote often follows it. In French, there are different ways of expressing distinctive categories of knowledge which English speakers mark by qualifications such as "folk knowledge" or "book knowledge". In many of his earlier, archaeological works, Foucault is interested in investigating how a particular kind of implicit knowledge - the savoir - permeating a historical period, that is, the understanding that counts as the "common sense" of that time/place/people, shapes the explicit knowledge ? the connaissance ? that is institutionalized in the disci- plines that make up the human sciences, including natural (e. g. biology) or social (e. g. psychology) science (Foucault 1972: 182-3).
As a noun, pouvoir is most typically translated as "power", but it is also the infinitive form of the verb meaning "to be able to", and is the most common way of saying "can" in Romance languages. In Foucault's work, pouvoir must be understood in this dual sense, as both "power" as English speakers generally take it (which could also be rendered as puissance or force in French), but also as a kind of potentiality,
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MICHEL FOU CAULT: KEY CONCEPTS
capability or capacity. Power, Foucault tells us, must be understood to be more complex than a term like puissance conveys; it has multiple forms and can issue from "anywhere". Foucault urges us not to think of power only in terms of its "old" monarchical form, as something an individual possesses or wields over another or others. For him power works through culture and customs, institutions and individuals. Like- wise, its effects are also multiple, not simply negative or positive, but, as he puts it, "productive" : they are both positive and negative, unstable valuations that can be reversed through history.
The composite "power/knowledge" is also not quite translatable. Lit- erary theorist and translator Gayatri Spivak helpfully calls our attention to what she describes as the "homely verbiness of savoir in savoir-faire [a ready and polished kind of 'know-how', in English], savoir-vivre [an understanding of social life and customs] into pouvoir", and suggests that regarded in this way:
you might come up with something like this: if the lines of making sense of something are laid down in a certain way, then you are able to do only those things with that something that are possible within and by the arrangement of those lines. Pouvoir-savoir - being able to do something - only as you are able to make sense ofit. (1993: 34)
The kind of knowledge to which Foucault directs us with this term, then, is one that has no clear source, but that a genealogical analysis - an examination of the historical conditions of possibility - illuminates, describing the accidents of history that result in particular consolida- tions of what counts as truth or knowledge. It is not the knowledge that is decreed by some authoritative body "from on high", but is more precisely described in the passive voice: it is the kind of knowledge that is "recognized as true", "known to be the case". For Foucault, this knowledge can only exist with the support of arrangements of power, arrangements that likewise have no clear origin, no person or body who can be said to "have" it.
An example illustrates many of the dimensions of power/knowledge as they are taken up in Foucault's work. It will also help to clarify how the concept of power/knowledge is salient throughout the dif- ferent periods into which scholars generally divide Foucault's corpus: the early (archaeological) texts where, Foucault later says, power/ knowledge was present even if unnamed;1 the middle (genealogical) texts where the concept power/knowledge is explicitly introduced; and finally the late (ethical) reflections, where power understood as
56
POWER/ KNOWLEDGE
capacity becomes more central. In what follows, I examine the concept of sexual difference and its enforcement. Despite his famous interest in questions concerning "sexuality", Foucault does not take up the matter of sexual difference directly; nevertheless, Foucault's work has been highly influential among scholars and activists over the past sev- eral decades who have done so, and have compellingly demonstrated how the tools offered by Foucault's analysis can help us to clarify and deepen our understanding of a critical, yet surprisingly under-studied, concept.
Example: dividing the sexes, or boys will be boys
We take for granted sexual difference. It seems obvious that men and women, boys and girls, make up the world's populace. We may rec- ognize that sexual difference can be understood somewhat differently across the globe; some cultures have standards for masculine and femi- nine behaviour that differ from others. But there remains under the blan- ket of social distinctions what we take to be a brute biological or genetic "fact" of sexual difference. Common sense ? a kind of unquestioned knowledge - tells us that this sexual division into male and female is true, how things are. But if this difference is so obvious we might ask why the distinction between the sexes requires enforcement.
Take the example of four-year-old Nathan who is teased by his class- mates because he enjoys playing "like a girl", dressing up in high heels and dresses instead of like a cowboy, enjoying play with baby dolls instead of trucks. Perhaps we could say that the boy suffers the teasing of his preschool classmates because his play violates the other children's common sense. "You can't be a little girl" (Rekers & Varni 1977: 428), the other children tell Nathan.
What happens to Nathan is not unusual among preschoolers. But Nathan's story is distinctive because his is a published case, among the first of a number of cases, of a condition that was first discussed in US psychiatry in the early 1970s. "Gender Identity Disorder", or GID, continues to be actively treated today. In the paper in which Nathan's story is featured, the authors recount how Nathan's diagnosis led to a long period of therapy designed to help him accept that as a boy he was expected to play with "boys' toys". His parents were instructed to observe him and offer positive reinforcement for playing with gender- appropriate toys, and to ignore him when he played with inappropri- ate toys. Eventually, the case study reports, Nathan was given a wrist counter and told to press the counter when he played with boys' toys
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MICHEL FOU CAULT: KE Y CONCEPTS
but not when playing with girls' toys. When he accumulated enough points he received a prize.
Reading the story of Nathan through the theoretical lens of Foucault, it is striking how closely Nathan's treatment regimen corresponds to the levels and character of surveillance Foucault describes in Discipline and Punish, and to the levels of surveillance the Panoptic structure organ- izes. Most accounts of the Panopticon focus on the prisoners (or mad- men, paupers, schoolchildren) in the machine, those who are isolated and are the clear objects of the anonymous gaze signified by the invisible inhabitant(s) of the central tower. The objective of panopticism is the "internalization" of the authoritative gaze, where one:
subjected to a field of visibility . . .
assumes responsibility for the constraints of power; he makes them play spontaneously upon himself; he inscribes in himself the power relation in which he simultaneously plays both roles; he becomes the principle of his own subjection. (Foucault 1979: 202-3)
But among the many lessons of panopticism is that the power that seems focused on one individual is in fact "distributed" throughout the structure, so that every individual is at the same time both "object" and "subject" of this power: the prisoner is "watched", but is being trained to watch himself, to be his own inspector. The inspector is by definition the "watcher", and yet he, too, is the object of a gaze: his performance as watcher is ever under scrutiny. The Panopticon is Foucault's best lesson in unsettling the way we typically conceive power and its operation.
Foucault's analysis points us to ways that power can be exercised from unexpected places. As the study reports the succession of events, it is not Nathan 's distress -- over his desire to play with girls' toys, or the teasing he faces - or worry by his parents or teacher about his behav- iour that brings him to the team of psychologists and researchers who subject him to treatment; it is, rather, the other children's teasing that distresses the teacher, who alerts the parents, who finally bring Nathan to treatment. It may seem obvious that children's interaction with one another is an important dimension of their psychosocial development, but the authority the children's voices command is arresting. We could speculate that the parents, teacher and treatment team see something important, even "natural", about the other children's intolerance of Nathan's behaviour. Viewing children as natural arbiters of gender norms might capture something of the intuitive sense of the adults involved in the case of Nathan, but this perspective calls for analysis of how such authority is vested in Nathan's four-year-old peers.
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POWER/ KNOWLE D GE
In Discipline and Punish, Foucault contrasts disciplinary power with the ordinary understanding of power as something that can be "pos- sessed as a thing" and brandished against another (1979: 177; see also 1990a: 94). Disciplinary power, according to Foucault, is instead an expression of power that is associated with what he calls, in The Archaeology of Knowledge, the "assignment" of subjective positions (1972: 95), whereby individuals are allotted roles in the social world, positions that provide different possibilities for the exercise of power. The power that one can exercise as parent, simply by virtue of being a parent - power that is supported by society and by law - is one good example, but so is the power that is exercised by a bureaucrat in the Department of Motor Vehicles (DMV). It is not that the individual in one or the other of these positions "is" powerful in Foucaultian terms, but that different positions individuals take up or are assigned afford specific arenas for the exercise of power. Once an individual no longer occupies a given position - the parent goes to school to finish his college degree and at least for some part of the day occupies the position of student, or the clerk at the DMV goes home after a day of work - the power associated with that position can no longer be exercised. In the first volume of The History ofSexuality, Foucault clarifies that "power is not an institution, and not a structure; neither is it a certain strength we are endowed with; it is the name that one attributes to a complex strategical situation in a particular society" (1990a: 93). The story of a little boy who is teased in the playground and becomes a psychological case-study illustrates how power relations are distributed widely among young children, teachers and mental health professionals, forming what Foucault described as a "dense web that passes through apparatuses and institutions, without being localized in them" (ibid. : 96). Power is for Foucault inaccurately described as issuing "from above" or "outside"; instead, i t i s more instructive t o understand first the way it "comes from below" (ibid. : 94).
In Bentham's design of the Panopticon, the occupants of the central tower take up positions of surveillance vis-a-vis each of the inmates (and indeed, of one another). Nathan's classmates are similarly enjoined, enlisted in a panoptic apparatus that operates to ensure properly gen- dered subjects. If the exercise of the classmates' gaze is evidenced by their teasing, it should be counted among the "essential techniques" of disciplinary power. Foucault describes such techniques as:
always meticulous, often minute techniques, but they defined a certain mode of detailed political investment of the body, a "new micro-physics of power" [that] had constantly reached out to
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MICHEL FOUCAULT: KEY CONCEPTS
ever broader domains, as if . . . intended to cover the entire social bod? (1979: 139)
Loosed from its discursive field, the children's forthright announce- ment to Nathan that "You can't be a little girl" resists characterization as a subtle expression of power. Conceived within the terms of its field, however, their blunt repudiation is precisely the sort of "capillary intervention" (1990a: 84) that epitomizes a microphysics of power. It is consequential not for its sheer force but for the disciplinary effects it can provoke, that is, for its ability to "reach out to ever broader domains". The children's intervention in the case of Nathan activates a complex machinery of interlocking institutional interests - embodied by his teacher, his parents and an entire team of psychologists, assistants and technicians - functioning to subject Nathan to a "field of visibility" whereby he will learn, as his peers have already learned, to assume "responsibility for the constraints of power . . . [to] become the princi- ple of his own subjection" (1979: 202-3). Located at the extremities of this "productive network of power which runs through the whole social body" (1980d: 119), the children's exposure of Nathan's viola- tion is instrumental in two linked ways: it rouses the apparatus that will therapeutically draft Nathan into his prescribed role and correct the parental missteps that resulted in Nathan's deviation; it also provides an opportunity to produce new knowledge, that is, new "understand- ings", new "truths", not only about Nathan, but about the increasing numbers of children - and their parents2 - who would be identified under this new disorder. 3
Bentham himself understood that "panopticism" functions not only to circulate power, as it clearly does in the example of the prison, but also to produce knowledge. Foucault's formulation of the term "power/ knowledge" is developed from Bentham's own expectation that the Panopticon would serve as a "laboratory . . . [that] could be used as a machine to carry out experiments, to alter behavior, to train and correct individuals" (Foucault 1979: 203). It is a "privileged place for experi- ments on men, and for analyzing with complete certainty the transfor- mations that may be obtained from them" (ibid. : 204) . "Thanks to its mechanisms of observation," Foucault reflects, the Panopticon "gains in efficiency and in the ability to penetrate into men's behavior; knowl- edge follows advances of power, discovering new objects of knowledge over all the surfaces on which power is exercised" (ibid. : 204). But while many would understand in narrow terms the new "object" that is cre- ated to be the "gender disordered" child of the late twentieth century, Foucault's advancement of the analysis of power/knowledge clarifies
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POWER/ KNOWLEDGE
that the objects must be taken to be more widely dispersed, that no one, in fact, escapes the objectification that comes, in the nineteenth century, to be centred around the notion of sexual identity.
Normalizing sex(uality)
Foucault most famously elaborated on this expression of power/ knowledge in the first volume of The History of Sexuality (tellingly titled in French as La Valente de Savoir, "The Will to Knowledge"), the book that immediately follows Discipline and Punish. In The History of Sexuality Foucault makes the remarkable claim that "the 'question' of sex" becomes in the late nineteenth century the most important question "in both senses: as interrogation and problema- tization, and as the need for confession and integration into a field of rationality" (1990a: 69). A whole host of technologies are born to regulate what becomes understood as a person's (sexual) "essence", the truth of an individual, who he or she "really" is. The most sali- ent of these technologies is confession, first religious (as mandated by early Christianity), then psychological (in the nineteenth-century science of psychoanalysis) and finally political, as the mandate to pro- duce information becomes the ground for what became known as population control. 4 What unites these different technologies is the concern with identifying (and so, Foucault explains, what in fact turns out itself to create, as a category, or object of understanding) a whole variety of "perversions" born during this time, different ways to vio- late the multiplying rules governing the important distinction between licit and illicit, normal and abnormal.
Of all the technologies, medicine comes to play the most important role in the development of "the norm", dictating, for example, what constitutes normal marital relations. Children's sexual activity also became an object of keen interest and concern, not only because of a perceived need to "detect" violations of new norms, but, as we saw in the example of the case of Nathan, to be on the alert for problems with parents' rearing of their children:
Wherever there was the chance that [masturbation] might appear, devices of surveillance were installed; traps were laid for compel- ling admissions . . . parents and teachers were alerted, and left with the suspicion that all children were guilty, and with the fear of being themselves at fault if their suspicions were not sufficiently strong . . . [parents'] conduct was prescribed and their pedagogy
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recodified; an entire medical-sexual regime took hold of the fam- ily milieu. (Foucault 1990a: 42)
Further, a whole class of deviant individuals comes to be identified at this time. Among the zoophiles (those who engage in sex with non-human animals), auto-monosexualists (those who are only able to experience erotic pleasure by themselves), gynecomasts (men with atypically large breasts), presbyophiles (those who engage in sex with the elderly) and dysparauenistic women (those for whom sexual intercourse is painful), perhaps the most lasting category of individual is "the homosexual", a new species of individual "born" in 1 8 70 (ibid. : 43 ) . 5
I n the late-twentieth-century diagnosis o f the gender dysphoric child there is embedded a whole history of power/knowledge that involves a complex of elements that come to be designated in Foucault's work by the term "normalization". Normalization, the institutionalization of the norm, of what counts as normal, indicates the pervasive standards that structure and define social meaning. Norms are at once everywhere and nowhere. They are obvious when we are talking about the sorts of standards against which one can be tested with respect to intelligence or body mass, for example. But they are less conspicuous when they are unspoken, what we may even take to be natural or understand as our own (what Foucault would see as their "internalization"), as is often the case with norms concerning gender.
We may think that medicine has always played the role it has in shaping our understanding of the norm, but Foucault's earlier his- tory of medicine, The Birth of the Clinic, suggests otherwise. In the ancient period, conceptions of health were understood not in terms of a single standard against which one should be measured, but rather in terms of the harmonious functioning of the individual. The role of medicine was to provide "techniques for curing ills" (Foucault 1975 : 34). This view of medicine persisted into the eighteenth century, at which time, according to Foucault, medicine begins to fashion a con- cept of "the healthy man, that is, a study of the non-sick man, and a definition of the model man" (ibid. ). At this point, medicine assumes a "normative posture, which authorizes it not only to distribute advice as to healthy life, but also to dictate the standards for physi- cal and moral relations of the individual and the society in which he lives" (ibid. ). This is a crucial change in the understanding of medi- cine, by the profession and by the public at large, paving the way for the shift that will take place from a focus on health understood as qualities specific to an individual, to normality, a standard imposed from without.
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In the example of Nathan, and of his parents, there is an obvious effort to correct the behaviour that is regarded as abnormal. The tech- niques described by the case study enforcing "good" behaviour with reward and punishing bad behaviour with being ignored, asking him to regulate himself with a wrist counter exemplify the sorts of practices Foucault characterized in Discipline and Punish with respect to the operation of the Panopticon. For Foucault it is not accurate to describe the aim of these practices in terms of "repression". Instead, the aim of the panoptic expression of power/knowledge is to enforce a standard that it is at the same time trying to establish by comparing individuals against one another, measuring their differences and then asserting the truth of the standard it "discovers" as the rule (1979: 182-3). Practices such as these exemplify why Foucault makes use of this composite term, power/knowledge: the expression of each term, power and knowledge, are at every point implicated with one another.
Power/knowledge and resistance
In looking at the operation of power/knowledge, it can be difficult to remember that for Foucault power should not be understood solely in the negative terms of repression or constraint. In Discipline and Punish, Foucault insists that:
we must cease once and for all to describe the effects of power in negative terms: it "excludes," it "represses," it "censors," it "abstracts," it "masks," it "conceals. " In fact, power produces; it produces reality; it produces domains of objects and rituals of truth. The individual and the knowledge that may be gained of him belong to this production. (1979: 194)
While many seek to resist the effects of normalizing power that have wrought so much harm (arguably to us all, albeit in different ways, and to different effect), for Foucault the very effort of resistance must be understood itself as an expression of power. In the first volume of The History of Sexuality, Foucault returns to the exemplary case of homosexuality to make this point:
There is no question that the appearance in nineteenth century psychiatry, jurisprudence, and literature of a whole series of dis- courses on the species and subspecies of homosexuality, inver- sion, pederasty, and "psychic hermaphroditism" made possible a
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strong advance of social control . . . but it also made possible the formation of a "reverse" discourse: homosexuality began to speak in its own behalf, to demand that its legitimacy or "naturality" be acknowledged, often in the same vocabulary, using the same categories by which it was medically disqualified.
(1990a: 101)
What does Foucault mean b y "reverse" discourse ? I f the "normali- zation" of the homosexual by nineteenth-century medicine marked the production of a new conception of abnormality, and with it the abnormal individual, twentieth-century resistance to this process must likewise be understood in these terms, but in reverse; as an effort, in other words, to recast normalcy, to understand as normal this new per- son the homosexual. The recasting of normalcy would mean making use of the medical category, not in the sense of the one constricting norm against which all of us should be judged, but to understand homosexual orientation in the "older" sense of the individual standard of health that continues to be active in, and provide validation of, current conceptions of normality. (Even as there are clear standards of health of all kinds, it still makes sense for us to talk about what is healthy " for me" . ) This nor- malizing power that "made up" the "homosexual person" as an object ofpsychiatricmedicinealsoproduced"improbably", "spontaneously", as Foucault puts it (ibid. : 96), the previously unthinkable concept of "gay pride", which led to the depathologization of homosexuality in the United States in 1973 .
The story o f the depathologization of homosexuality, of its removal as a diagnosis from the handbook of psychiatric disorders called The Diagnostic and Statistical Manual ofMental Disorders (DSM), is remark- able in many ways (among them: it was the first, and to date the only, time that a diagnosis was removed from the DSM as a result of a vote by the membership of the American Psychiatric Association) (Bayer 1 9 8 1 ) . But it is also notable because the first edition of the DSM that did not include homosexuality as a diagnosis (DSM III, published in 1 9 8 0) introduced Gender Identity Disorder (GID) of children as a diagnosis. The "risk" of what are characterized as untreated "problems" of gender identity, according to the most influential researcher responsible for the diagnosis, is the eventual assumption of a homosexual identity (Rekers etal. 1977: 4-5). 6
There are at least two lessons to be learned from the replacement of homosexuality with GID. One lesson concerns the role of children in the "society of normalization", something that Foucault addresses in some detail in the first volume of The History ofSexuality. For the
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purposes of understanding the operation of power/knowledge, it is a lesson in how resistance, expressed as a "reverse discourse", can itself be resisted: psychiatry found, in the diagnosis of GID, a new way to pathologize (or maintain the pathologization of) homosexuality, a new way, in other words, to make it known as an object of psychological intervention, to dictate its truth and to manage the treatment of those so labelled, both medically as well as socially.
As a new revision of the DSM is currently in preparation (scheduled for publication in 2012) there has been a great deal of controversy about the diagnosis of GID, with many activists and mental health practitioners, as well as some academics, arguing in favour of remov- ing the diagnosis, just as homosexuality was removed more than two decades ago. And yet, removal of the diagnosis could inhibit those mental health practitioners who have made use of the diagnosis to treat the distress that gender nonconforming, or "gender variant", children may experience as a result of familial or societal intolerance, a form of counter-attack that validates gender variant behaviour. This approach to treatment is itself a form of resistance to the "usual" understanding of the diagnosis of mental disorder, which locates the problem in the indi- vidual so diagnosed. And while many, perhaps even most, practitioners continue to see GID in the terms dictated by the DSM, which perceives mental disorders "in" the individual, there are those who understand the problem to lie instead in the hostile conditions that gender variant children may face. The implicit rationale of those who approach treat- ment of gender variation in this way is similar to that made about a variety of forms of disability (is the problem in the bodies of those with disabilities, or in the material conditions that make mobility or com- munication difficult? )? What some mental health practitioners have done in their practice is turn psychiatric treatment on its head, seeing a child whose gender behaviour does not correspond neatly with her assigned sex as suffering not from a gender identity disorder, but rather as a victim of an intolerance of gender variation that should instead be the focus of intervention.
Seeing the diagnosis in this way would mean, practically speaking, that it should be cast differently (for example, using terms like "Gender Variance" rather than "Gender Identity Disorder", which is an unneces- sary and furthermore misleading term, because it suggests that psycho- logical identity is the problem that needs to be corrected) . Rather than remove the diagnosis, another possibility could be to rename and refor- mulate the diagnosis to better reflect the life goals and distress experi- enced by individuals, and furthermore direct treatment toward the most appropriate means of alleviating distress and promoting flourishing.
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Beyond the change of name, an interesting and promising recom- mendation may be to make use of complementary diagnostic codes known as "V-codes". V-codes are defined in the International Clas- sification of Disorder (ICD, a global handbook with which the DSM is meant to correspond) as "other conditions that may be a focus of clinical attention" (World Health Organization 2004). Some V-codes are diagnoses that have not yet been formally established as diagnoses through appropriate research (and in this sense it would seem that GID as it stands would qualify). Other V-codes are "conditions" that are located outside the individual, but that nevertheless affect the individual's functioning or well-being. An ''Acculturation Problem" (V62. 4), for example, can include a variety of problems adjusting to a new culture, a problem that is cast not as "the individual's" problem; an "Occupational Problem" (V62. 2), which the DSM conservatively describes as "job dissatisfaction", could include distress as a result of working in a hostile environment where again, the problem cannot be understood properly to belong to an individual. With respect to GID in children, probably the most typical problem would be described as a "Parent-Child Relational Problem" (V61. 20), but it could also include a "Phase of Life Problem" (V62. 89). Including V-codes in the very structure of the diagnosis would provide a more accurate picture of the problems that gender variant children face, and furthermore indicate to practitioners that the object of treatment needs to be dif- ferently understood. 8 The use of V-codes in the case of GID could (indeed, would) entail disciplinary effects, but rather than seeking to activate these effects in the life of an individual subjected to treatment, these effects could promote - among therapists and society at large - a different story to tell about sexual difference.
The possibility of making use of V-codes in the diagnosis of GID is one that is consistent with Foucault's analysis of power/knowledge as a pervasive apparatus from which there is no escape, but that can at the same time be resisted or "reversed". Possibilities such as these become the focus of Foucault's attention in his later, "ethical" works.
Conclusion: power/knowledge and technologies ofthe self
After the first volume of The History of Sexuality, Foucault does not explicitly make use of the term "power/knowledge". Yet the focus on "technologies of the self " in Foucault's ethics provides what could well be understood as an elaboration of the concept of power/knowledge in the "positive" terms that are only suggested in the middle work.
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He is still interested in the notion of subjectivity (assujettissement), both in the sense of "making a subject" and "making subject to". He is also concerned with disciplinary practices. Rather than focusing, as he does in Discipline and Punish, on how disciplinary practices pro- mote normalization, he is far more concerned with how these practices can be put to work to resist normalization. At this point in Foucault's analysis he turns to the subject's relationship to her self, that is, her own subjectivity.
One of the most important ways that knowledge is constituted is through the asking of questions. Investigation of the kinds of questions that can be asked within a given historical period was arguably the focus of Foucault's earlier, archaeological works, and the use to which particular questions could be put and to what effect, the focus of the genealogical works. In the later, ethical works, Foucault turns to the kind of knowledge resulting from reflection, "an exercise of oneself in the activity of thought", or askesis (1990a: 9). Practices of thought that could be promoted in gender variant children, their parents and the mental health workers charged with their care could include a reframing of the questions posed. Interrogating "the problem" of gen- der variance, for example, could provide an opportunity, as Foucault recounts, to "learn to what extent the effort to think one's own history can free thought from what it silently thinks, and so enable it to think differently" (ibid. ). Seeing the diagnosis of Gender Identity Disorder not as a disorder located in the individual, but as a larger problem of intolerance and the suffering it causes would indeed exemplify how this exercise of thought could, as Foucault remarked in an interview, "show people that they are much freer than they feel, that people accept as truth, as evidence, some themes which have been built up at a certain moment during history, and that this so-called evidence can be criticized and destroyed" (1988: 10).
Our understanding of madness, standards of "health", "normal" sexuality: all of these, Foucault finally argues, are consequences of a complex operation of power/knowledge of which his own works are also a part. His aim, in narrating the histories that make up his work, is not to uncover "the timeless and essential secret . . . behind things" but rather to expose the greater secret: the "secret that they have no essence or that their essence was fabricated in piecemeal fashion" (1977: 142). With his own projects, he is interested, as he put it in an interview, in exploring "the possibility of a discourse that would be both true and strategically effective, the possibility of an historical truth which could have political effect" (1980f: 64).
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Notes
1. One way power/knowledge manifests itself in Foucault's early work is in the closely related concept of the episteme, elaborated in The Order of Things (1973). An episteme, the prevailing order of knowledge particular to a histori? ?
cal period, accounts for the understanding of how things are connected in the overall "field" of understanding or knowledge; it describes the conditions under which what is taken to be knowledge is possible.
2. Parents of children with GID have themselves been diagnosed with different psychopathologies, and become themselves "cases" for further investigation (see e. g. Coates 1990).
3. The incidence of the disorder has ranged over the years. At the outset it was understood as very rare, affecting perhaps 1 in 100,000 children (Rekers et al. 1977: 4-5); by 1990 clinicians had concluded that it "may occur in two percent to five percent of the general population" (Bradley & Zucker 1990: 478), a finding revised by these same authors nine years later, who liken its frequency to a disorder such as autism, itself a diagnosis with an estimated incidence rate that has steadily increased over the past decades (Zucker & Bradley 1999: 24). For Foucault these differences would indicate changing historical needs t o justify diagnosis and treatment.
4. Interventions by the state in matters such as population control are an example of what Foucault called "biopower". For discussion of this distinctive form of power, which must also be seen as an expression of power/knowledge, see Chapter 3 on biopower in this volume.
5. For a detailed treatment of the history of the "invention" of homosexuality, see Katz (1995).
6. Laterinthedevelopmentofthediagnosis,perhapsevengreaterriskofuntreated GID is the assumption of a transsexual identity (Bradley & Zucker 1990: 482).
7. See, for example, Fine & Asch (1988).
8. This could also be seen in light of the idea of "exteriorizing" a problem faced
by an individual or a family, a process that allows the emergence of a different meaning, "the development of an alternative story", as the psychologist Michael White, himself a close reader of Foucault, has put it (see e. g. White & Epston 1990: 39).
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? PART II
m
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uca It's nee
Todd May
The concept of freedom is an elusive one in philosophy. It lies at the centre of at least two very different sets of philosophical problems. One concerns the metaphysical status of human beings. The other concerns their political status. And, to make matters more complicated, Michel Foucault's perspective on freedom lies within neither set of problems.
As these cases show, sex is important at both levels of biopower, concerning as it does both the individual's use of his or her body and the growth and health of the population. As Foucault notes, "Sexuality exists at the point where body and population meet. And so it is a mat- ter for discipline, but also a matter for regularization" (2003 : 25 1-2).
Sex was a means of access both to the life of the body and the life of the species. It was employed as a standard for the disciplines and as a basis for regulations. This is why in the nineteenth cen- tury sexuality was sought out in the smallest details of individual existences . . . . But one also sees it becoming the theme of politi- cal operations, economic interventions (through incitements to or curbs on procreation), and ideological campaigns for raising standards of morality and responsibility: it was put forward as an index of a society's strength, revealing of both its political energy and its biological vigor. Spread out from one pole to the other of this technology of sex was a whole series of different tactics that combined in varying proportions the object of disciplining the bodyandthatofregulatingpopulations. (1990a: 146)
Far from being something which we have recently liberated (or still struggle to liberate) from an archaic and repressive power, Foucault therefore argues that sex is in fact a privileged site and indeed a product of the workings of modern forms of power.
Death in the age of biopolitics
In contrast to sex, Foucault argues that death has now receded from view, becoming private and hidden. While sovereign power entailed the right to impose death, the aims of biopower are to foster and manage life, and so death becomes a "scandal". Under sovereign power death was ritualized as the moment of passing from one sovereign authority to the next. Death was the ultimate expression of the sovereign's power
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and was made into a public spectacle whenever this power needed to be affirmed. In contrast, under biopower, death is the moment in which we escape power (Foucault 2003: 248). Foucault writes of the "disqualification of death" in the biopolitical age, and observes that the "great public ritualization of death gradually began to disappear" (ibid. : 247). For this reason suicide was illegal under sovereign power, perceived as a seizure of the king's power to take life, whereas today it is a medical problem, a shameful secret and a bewildering threat. As an escape from bio-disciplinary power, suicide is described by Foucault as a subversive act of resistance in works such as "I, Pierre Riviere . . . " (1982b) and Herculine Barbin (1980a).
One manifestation of the shift from the sovereign power to kill to the biopolitical interest in fostering life is that capital punishment came to be contested in the modern period and new forms of punishment were invented to replace it, most notably the prison. While the death penalty was abolished in most Western democracies by the 1970s, its practice had long since become rare. In those places where it is still legal and regularly practised today, such as the United States, it is widely criticized as backward and anachronistic. 4 In earlier eras, execution for murder or theft was understood as punishment for having broken the sovereign's law and for undermining his power. Crime was conceived as a personal attack on the sovereign rather than on the individual victims of the crime or on the security of the population as a whole. Punishment was the sovereign's counter-attack, his reaffirmation of power. In contrast, the current view of punishment is a "paying of one's debt to society", while executions, where they are permitted at all, are justified in the name of security. A criminal condemned to death must be perceived as a threat to the population rather than to the ruler's power. For this reason serial killers are executed in the United States today but the president's political opponents are not.
Capital punishment aside, there is little direct control over death under biopower. As Foucault notes, we now have the power to keep people alive when they should be dead and to decide when to "let them die", or to regulate their lives even after, biologically speaking, they should be dead (2003: 248-9). We may thus choose to cease manag- ing an individual's life by letting her die, or to not foster certain lives to begin with, but this is not the same thing as the sovereign right to kill. While a person might be allowed to die or her life may be disal- lowed to the point of death, and while the state monitors the morbidity rate, you can be fairly sure that your death will not be claimed by the state, and that your life will be managed but not seized. This is why death is now privatized - it is, according to Foucault, "outside the
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power relationship" (ibid. : 248). While we claim that sex is silenced and repressed, Foucault compellingly argues throughout The History ofSexuality that this is not the case and that we in fact talk about sex more than anything else; on the other hand, death today truly is taboo.
Foucault thinks that the irony of this "disqualification of death" is that wars are bloodier than ever but are justified in the name of life. He writes:
Yet wars were never as bloody as they have been since the nine- teenth century, and all things being equal, never before did regimes visit such holocausts on their own populations. But this formida- ble power of death . . . now presents itself as the counterpart of a power that exerts a positive influence on life, that endeavors to administer, optimize, and multiply it . . . Wars are no longer waged in the name of a sovereign who must be defended; they are waged on behalf of the existence of everyone; entire populations are mobilized for the purpose of wholesale slaughter in the name of life necessity: massacres have become vital. (1990a: 137)
The Holocaust of the Jews, along with the extermination of gypsies and the "euthanasia" of the mentally ill and persons with developmental disabilites, were justified under the Nazi regime as "racial hygiene", nec- essary or beneficial to German flourishing. Nazi propaganda depicted Jews as a plague of rats that posed a threat to German well-being, and presented medical care for the mentally ill and disabled as a drain on German resources better used for those fit to survive. Indeed, despite the "disqualification of death" in the modern era, Foucault argues that there will be more genocides under biopower than under sovereign power, because biopower wants to manage the health of populations. When combined with racism, this management becomes cast as a con- cern for the racial purity of a people. In Society Must Be Defended, Foucault argues that biopower is almost necessarily racist, since racism, broadly construed, is an "indispensable precondition" that grants the state the power to kill (2003 : 256). 5 Under such conditions, eradicating sub-groups of that population is perceived as a justifiable form of man- aging and protecting a people. Foucault writes: "If genocide is indeed the dream of modern powers, this is not because of a recent return of the ancient right to kill, it is because power is situated and exercised at the level of life, the species, the race, and the large-scale phenomena of population" (1990a: 13 7).
We can take the example of the recent US-led invasion of Iraq to illustrate the manner in which the modern biopolitical state justifies
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mass killings in the name of life, and both produces and exploits racism in order to do so. The original justifications for the invasion of Iraq involved claims that Iraq had weapons of mass destruction and was affiliated with Al-Qaeda. The Bush and Blair administrations suggested that Iraq would use its weapons of mass destruction to attack the United States and its allies, affiliated as it was with the attacks of 9/11. Anti- Muslim and anti-Arab racism abounded in this period in the US and was exploited in the arguments for invading Iraq. In this way Iraq was pre- sented as a racialized threat to American existence or to the Western way of life, and invasion of this country was deemed necessary to protect life in Western democracies. When no weapons of mass destruction and no link to Al-Qaeda were found, the Bush and Blair administrations shifted tactics, emphasizing the slaughters and massacres that Saddam Hus- sein had committed against his own people, much like the oppression of women and girls in Afghanistan is exploited to justify the military incursions into this country. Over time these wars are recast as charity missions, undertaken not so much to protect lives in the West as to save innocent lives in the East. While critics point out that the alleged desires to save Iraqi lives and to liberate oppressed women are pretences, the important point is that we now need pretences such as these in order to justify war. We no longer pursue military invasions for the overt sake of glory, gain or conquest, or to defend the honour of the sovereign. While the ancient Romans could invade a foreign country for the undisguised purposes of occupying a land, enslaving a people and gaining access to resources, today we must mask our massacres as humanitarian efforts even while bringing about the deaths of thousands of civilians, turning millions more into refugees, and immediately securing the oil fields.
Social Darwinism and eugenics
In the nineteenth century, Europeans and North Americans grappled with the effects of increased urbanization, including the steady growth of slums inhabited by an underclass of paupers, prostitutes and thieves, many of whom were sickly and, the middle class thought, lazy and immoral. Rates of crime, disease, mental illness, alcoholism, promiscu- ity and prostitution were rampant in this segment of the population, which was, moreover, reproducing itself more quickly than the middle classes. The result was a growing fear among the bourgeoisie that the "dregs" of society would eventually overtake them. The middle classes in Western countries began to suspect that their race was degenerating, both because they were not reproducing quickly enough and because
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the lower class was reproducing too quickly. These fears were exac- erbated in Britain when studies of the records of the height, weight and health of soldiers throughout the nineteenth century suggested "a progressive physical degeneracy of race" (Childs 2001: 1). European exploration of non-Western countries also confronted Europeans with races they deemed inferior, but which, because they must have a com- mon ancestry with Europeans in Adam and Eve, were believed to have degenerated over time, falling from their original nobility (ibid. ) . The possibility of nationwide racial degeneration was thus posed, and anxi- ety mounted that Europeans could descend to the level of these "inferior races" if procreation patterns were not controlled.
In response to these fears, the science of eugenics was born in the late nineteenth century in Britain with the works of the statistician Francis Galton, and reached its height in the first half of the twentieth century throughout the Western world. Galton drew on his cousin Charles Dar- win's theory of natural selection and argued that human societies were preventing natural selection or the "survival of the fittest" by protecting the sick, the poor and the weak through welfare programmes, charity and medicine. He coined the term "eugenics" from the Greek roots eu (good or well) and genes (born), and described the science as "the study of all agencies under human control which can improve or impair the racial quality of future generations" (Black 2004: 18). Social Darwin- ists argued that the "survival of the fittest" human beings would come about naturally if welfare systems were simply withdrawn: although the poor would continue to have more children than the middle classes, this would be compensated for by higher mortality rates resulting from poverty and lack of medical care. As one Social Darwinist, Herbert Spencer, explains:
It seems hard that an unskilfulness . . . should entail hunger upon the artisan. It seems hard that a laborer incapacitated by sickness . . . should have to bear the resulting privations. It seems hard that widows and orphans should be left to struggle for life or death. Nevertheless, when regarded not separately but in connexion with the interests of universal humanity, these harsh fatalities are seen to be full of beneficence. (Childs 2001: 2-3)
Spencer thus suggests that nature be allowed to run its course, eliminat- ing the weak from society. Individuals such as Spencer rejected the argu- ment that improving the environment of the poor might reduce their rates of mental illness, infection, alcoholism, promiscuity and crime. While those advocating environmental reform suggested improvements
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in education and health care for the urban poor, and thus argued for biopolitical interventions of a different order (carried out at the level of disciplinary incursions into the lives of disorderly and abnormal members of society), Social Darwinists opposed such methods, argu- ing that they would only exacerbate the problem by helping to sustain those segments of society better left to die.
While Spencer's approach is to let the poor and the weak die out through non-intervention, other eugenicists advocated more active tac- tics. These tactics were divided into what were called "negative" and "positive" eugenics. "Negative eugenics", as the philosopher and eugen- ist F. C. S. Schiller puts it, "aims at checking the deterioration to which the human stock is exposed, owing to the rapid proliferation of what may be called human weeds" (ibid. : 3). This strategy entails preventing individuals and groups deemed "degenerate" from procreating through abortions, forced sterilization, incapacitation (such as locking up the mentally ill), "euthanasia" or, as in the case of Nazi Germany, genocide. Such "negative" tactics, however, can only prevent further deteriora- tion; they cannot improve the species and so strategies of "positive eugenics" were simultaneously promoted. "Positive eugenics" involved encouraging or compelling "human flowers" to produce large families, for instance through economic stimuli. Abortion by "fit" women was illegal in Nazi Germany, and middle-class women who attempted to enter the work force were discouraged on the grounds that j obs outside the home were "race-destroying occupations" (ibid. : 7).
Eugenics thus attempts to improve the gene pool; however, what is meant by "improve" is inevitably socioculturally defined and has always been tainted by classism, racism and abilism. Early eugenicists were concerned with increasing the intelligence of the population, for instance, but this concern tended to promote births in the middle class while preventing them among the working classes. Racist eugenicists are opposed to miscegenation. With the Immigration Act of 1924, eugeni- cists successfully argued against allowing "inferior stock" from southern and eastern Europe into the United States. Laws were written in the late 1800s and early 1900s to prohibit the mentally ill from marrying and to allow them to be sterilized in psychiatric institutions. These laws were upheld by the Supreme Court in 1927 and were only abolished in the mid-twentieth century. As a result, 60,000 mentally ill Americans were sterilized in order to prevent them from passing on their genes. This is particularly problematic since what qualifies as "mental illness" is noto- riously unstable and, as Foucault argues in works such as The History of' Madness (2006b) and Psychiatric Power (2006a), has tended to describe social mores and norms rather than genuine medical conditions. 6
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Social Darwinism and eugenics may be described as biopolitical movements since they involve strategies for managing the health and productivity of populations through interventions in natality and mor- tality rates, mental and physical health, and immigration, even if what is taken to be "healthy" is highly problematic, entailing as it does preju- dices ranging from abilism and classism to sexism, nationalism and racism. Following the Second World War, there has been a tendency to repress the fact that other countries besides Germany have histories of eugenics, histories which quietly continued long after the defeat of the Nazis (Childs 2001: 15 ) . Ladelle McWhorter not only traces the exten- sive history of eugenics in the United States, however, but argues that the contemporary and mostly unquestioned pro-family movement in this country is a mere recasting and extension of the eugenics movement (McWhorter 2009). Eugenic uses of science also arguably continue in the cases of pro-family financial, social and political incentives, designer babies, genetic counselling, preemptive abortions, and the creation of "genius sperm banks". Many of these examples entail the use of new scientific technology to improve the genes of individual babies and of the population as a whole while preventing babies deemed "unfit" from ever being born. These biopolitical practices thus further entrench the prejudices of an abilist society while continuing the goals of eugenics in manners which have become increasingly unbounded by the state.
Notes
1. For a Foucauldian study of how biopower and discipline control the care of o n e ' s b o d y, s e e B a r t k y 1 9 8 8 ; f o r h o w d i s c i p l i n a r y p o w e r c o n t r o l s d i e t , s e e B o r d o (2003) and Heyes (2006); for a Foucauldian study of how biopower controls housing choices and opportunities and the raising and education of children, see Feder (1996, 2007).
2. In the second and third lectures of Security, Territory, Population, Foucault contrasts disciplinary mechanisms and security measures aimed at the level of population which, at the beginning of the first lecture, he calls "somewhat vaguely, bio-power" (2007: 1).
3. SeeKukla(2005:chs2,5).
3. For a n extended discussion of biopolitical interventions in the birthrate among
these demographic groups in the United States, see McWhorter (2009).
4. Bedau,"TheCaseAgainsttheDeathPenalty":www. skepticfiles. org/aclu/case_
aga. htm (accessed August 2010).
5. Foucault writes of "racism against the abnormal" in this lecture, and hence is
not limiting himself to racism based on skin colour in making these claims.
6. To take but one example, homosexuality was included in the Diagnostic and
Statistical Manual ofMental Disorders until 1 973 .
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? FOU R
Power/ knowledg
Ellen K. Feder
Foucault explicitly introduces the composite term, "power/knowledge" (pouvoir/savoir) in the middle, "genealogical" period of his work. At the same time, however, the concept of power/knowledge in many ways encompasses the entire corpus, characterizing the implicit project of his "archaeological" works, the explicit focus of the "genealogical", and the working out of the implications for living a good life in the later "ethical" work.
To understand what Foucault means by power/knowledge we first have to engage in a little translation. Notice that when the term is used in philosophy written in English, the original French in which Foucault spoke and wrote often follows it. In French, there are different ways of expressing distinctive categories of knowledge which English speakers mark by qualifications such as "folk knowledge" or "book knowledge". In many of his earlier, archaeological works, Foucault is interested in investigating how a particular kind of implicit knowledge - the savoir - permeating a historical period, that is, the understanding that counts as the "common sense" of that time/place/people, shapes the explicit knowledge ? the connaissance ? that is institutionalized in the disci- plines that make up the human sciences, including natural (e. g. biology) or social (e. g. psychology) science (Foucault 1972: 182-3).
As a noun, pouvoir is most typically translated as "power", but it is also the infinitive form of the verb meaning "to be able to", and is the most common way of saying "can" in Romance languages. In Foucault's work, pouvoir must be understood in this dual sense, as both "power" as English speakers generally take it (which could also be rendered as puissance or force in French), but also as a kind of potentiality,
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capability or capacity. Power, Foucault tells us, must be understood to be more complex than a term like puissance conveys; it has multiple forms and can issue from "anywhere". Foucault urges us not to think of power only in terms of its "old" monarchical form, as something an individual possesses or wields over another or others. For him power works through culture and customs, institutions and individuals. Like- wise, its effects are also multiple, not simply negative or positive, but, as he puts it, "productive" : they are both positive and negative, unstable valuations that can be reversed through history.
The composite "power/knowledge" is also not quite translatable. Lit- erary theorist and translator Gayatri Spivak helpfully calls our attention to what she describes as the "homely verbiness of savoir in savoir-faire [a ready and polished kind of 'know-how', in English], savoir-vivre [an understanding of social life and customs] into pouvoir", and suggests that regarded in this way:
you might come up with something like this: if the lines of making sense of something are laid down in a certain way, then you are able to do only those things with that something that are possible within and by the arrangement of those lines. Pouvoir-savoir - being able to do something - only as you are able to make sense ofit. (1993: 34)
The kind of knowledge to which Foucault directs us with this term, then, is one that has no clear source, but that a genealogical analysis - an examination of the historical conditions of possibility - illuminates, describing the accidents of history that result in particular consolida- tions of what counts as truth or knowledge. It is not the knowledge that is decreed by some authoritative body "from on high", but is more precisely described in the passive voice: it is the kind of knowledge that is "recognized as true", "known to be the case". For Foucault, this knowledge can only exist with the support of arrangements of power, arrangements that likewise have no clear origin, no person or body who can be said to "have" it.
An example illustrates many of the dimensions of power/knowledge as they are taken up in Foucault's work. It will also help to clarify how the concept of power/knowledge is salient throughout the dif- ferent periods into which scholars generally divide Foucault's corpus: the early (archaeological) texts where, Foucault later says, power/ knowledge was present even if unnamed;1 the middle (genealogical) texts where the concept power/knowledge is explicitly introduced; and finally the late (ethical) reflections, where power understood as
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capacity becomes more central. In what follows, I examine the concept of sexual difference and its enforcement. Despite his famous interest in questions concerning "sexuality", Foucault does not take up the matter of sexual difference directly; nevertheless, Foucault's work has been highly influential among scholars and activists over the past sev- eral decades who have done so, and have compellingly demonstrated how the tools offered by Foucault's analysis can help us to clarify and deepen our understanding of a critical, yet surprisingly under-studied, concept.
Example: dividing the sexes, or boys will be boys
We take for granted sexual difference. It seems obvious that men and women, boys and girls, make up the world's populace. We may rec- ognize that sexual difference can be understood somewhat differently across the globe; some cultures have standards for masculine and femi- nine behaviour that differ from others. But there remains under the blan- ket of social distinctions what we take to be a brute biological or genetic "fact" of sexual difference. Common sense ? a kind of unquestioned knowledge - tells us that this sexual division into male and female is true, how things are. But if this difference is so obvious we might ask why the distinction between the sexes requires enforcement.
Take the example of four-year-old Nathan who is teased by his class- mates because he enjoys playing "like a girl", dressing up in high heels and dresses instead of like a cowboy, enjoying play with baby dolls instead of trucks. Perhaps we could say that the boy suffers the teasing of his preschool classmates because his play violates the other children's common sense. "You can't be a little girl" (Rekers & Varni 1977: 428), the other children tell Nathan.
What happens to Nathan is not unusual among preschoolers. But Nathan's story is distinctive because his is a published case, among the first of a number of cases, of a condition that was first discussed in US psychiatry in the early 1970s. "Gender Identity Disorder", or GID, continues to be actively treated today. In the paper in which Nathan's story is featured, the authors recount how Nathan's diagnosis led to a long period of therapy designed to help him accept that as a boy he was expected to play with "boys' toys". His parents were instructed to observe him and offer positive reinforcement for playing with gender- appropriate toys, and to ignore him when he played with inappropri- ate toys. Eventually, the case study reports, Nathan was given a wrist counter and told to press the counter when he played with boys' toys
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but not when playing with girls' toys. When he accumulated enough points he received a prize.
Reading the story of Nathan through the theoretical lens of Foucault, it is striking how closely Nathan's treatment regimen corresponds to the levels and character of surveillance Foucault describes in Discipline and Punish, and to the levels of surveillance the Panoptic structure organ- izes. Most accounts of the Panopticon focus on the prisoners (or mad- men, paupers, schoolchildren) in the machine, those who are isolated and are the clear objects of the anonymous gaze signified by the invisible inhabitant(s) of the central tower. The objective of panopticism is the "internalization" of the authoritative gaze, where one:
subjected to a field of visibility . . .
assumes responsibility for the constraints of power; he makes them play spontaneously upon himself; he inscribes in himself the power relation in which he simultaneously plays both roles; he becomes the principle of his own subjection. (Foucault 1979: 202-3)
But among the many lessons of panopticism is that the power that seems focused on one individual is in fact "distributed" throughout the structure, so that every individual is at the same time both "object" and "subject" of this power: the prisoner is "watched", but is being trained to watch himself, to be his own inspector. The inspector is by definition the "watcher", and yet he, too, is the object of a gaze: his performance as watcher is ever under scrutiny. The Panopticon is Foucault's best lesson in unsettling the way we typically conceive power and its operation.
Foucault's analysis points us to ways that power can be exercised from unexpected places. As the study reports the succession of events, it is not Nathan 's distress -- over his desire to play with girls' toys, or the teasing he faces - or worry by his parents or teacher about his behav- iour that brings him to the team of psychologists and researchers who subject him to treatment; it is, rather, the other children's teasing that distresses the teacher, who alerts the parents, who finally bring Nathan to treatment. It may seem obvious that children's interaction with one another is an important dimension of their psychosocial development, but the authority the children's voices command is arresting. We could speculate that the parents, teacher and treatment team see something important, even "natural", about the other children's intolerance of Nathan's behaviour. Viewing children as natural arbiters of gender norms might capture something of the intuitive sense of the adults involved in the case of Nathan, but this perspective calls for analysis of how such authority is vested in Nathan's four-year-old peers.
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In Discipline and Punish, Foucault contrasts disciplinary power with the ordinary understanding of power as something that can be "pos- sessed as a thing" and brandished against another (1979: 177; see also 1990a: 94). Disciplinary power, according to Foucault, is instead an expression of power that is associated with what he calls, in The Archaeology of Knowledge, the "assignment" of subjective positions (1972: 95), whereby individuals are allotted roles in the social world, positions that provide different possibilities for the exercise of power. The power that one can exercise as parent, simply by virtue of being a parent - power that is supported by society and by law - is one good example, but so is the power that is exercised by a bureaucrat in the Department of Motor Vehicles (DMV). It is not that the individual in one or the other of these positions "is" powerful in Foucaultian terms, but that different positions individuals take up or are assigned afford specific arenas for the exercise of power. Once an individual no longer occupies a given position - the parent goes to school to finish his college degree and at least for some part of the day occupies the position of student, or the clerk at the DMV goes home after a day of work - the power associated with that position can no longer be exercised. In the first volume of The History ofSexuality, Foucault clarifies that "power is not an institution, and not a structure; neither is it a certain strength we are endowed with; it is the name that one attributes to a complex strategical situation in a particular society" (1990a: 93). The story of a little boy who is teased in the playground and becomes a psychological case-study illustrates how power relations are distributed widely among young children, teachers and mental health professionals, forming what Foucault described as a "dense web that passes through apparatuses and institutions, without being localized in them" (ibid. : 96). Power is for Foucault inaccurately described as issuing "from above" or "outside"; instead, i t i s more instructive t o understand first the way it "comes from below" (ibid. : 94).
In Bentham's design of the Panopticon, the occupants of the central tower take up positions of surveillance vis-a-vis each of the inmates (and indeed, of one another). Nathan's classmates are similarly enjoined, enlisted in a panoptic apparatus that operates to ensure properly gen- dered subjects. If the exercise of the classmates' gaze is evidenced by their teasing, it should be counted among the "essential techniques" of disciplinary power. Foucault describes such techniques as:
always meticulous, often minute techniques, but they defined a certain mode of detailed political investment of the body, a "new micro-physics of power" [that] had constantly reached out to
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ever broader domains, as if . . . intended to cover the entire social bod? (1979: 139)
Loosed from its discursive field, the children's forthright announce- ment to Nathan that "You can't be a little girl" resists characterization as a subtle expression of power. Conceived within the terms of its field, however, their blunt repudiation is precisely the sort of "capillary intervention" (1990a: 84) that epitomizes a microphysics of power. It is consequential not for its sheer force but for the disciplinary effects it can provoke, that is, for its ability to "reach out to ever broader domains". The children's intervention in the case of Nathan activates a complex machinery of interlocking institutional interests - embodied by his teacher, his parents and an entire team of psychologists, assistants and technicians - functioning to subject Nathan to a "field of visibility" whereby he will learn, as his peers have already learned, to assume "responsibility for the constraints of power . . . [to] become the princi- ple of his own subjection" (1979: 202-3). Located at the extremities of this "productive network of power which runs through the whole social body" (1980d: 119), the children's exposure of Nathan's viola- tion is instrumental in two linked ways: it rouses the apparatus that will therapeutically draft Nathan into his prescribed role and correct the parental missteps that resulted in Nathan's deviation; it also provides an opportunity to produce new knowledge, that is, new "understand- ings", new "truths", not only about Nathan, but about the increasing numbers of children - and their parents2 - who would be identified under this new disorder. 3
Bentham himself understood that "panopticism" functions not only to circulate power, as it clearly does in the example of the prison, but also to produce knowledge. Foucault's formulation of the term "power/ knowledge" is developed from Bentham's own expectation that the Panopticon would serve as a "laboratory . . . [that] could be used as a machine to carry out experiments, to alter behavior, to train and correct individuals" (Foucault 1979: 203). It is a "privileged place for experi- ments on men, and for analyzing with complete certainty the transfor- mations that may be obtained from them" (ibid. : 204) . "Thanks to its mechanisms of observation," Foucault reflects, the Panopticon "gains in efficiency and in the ability to penetrate into men's behavior; knowl- edge follows advances of power, discovering new objects of knowledge over all the surfaces on which power is exercised" (ibid. : 204). But while many would understand in narrow terms the new "object" that is cre- ated to be the "gender disordered" child of the late twentieth century, Foucault's advancement of the analysis of power/knowledge clarifies
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that the objects must be taken to be more widely dispersed, that no one, in fact, escapes the objectification that comes, in the nineteenth century, to be centred around the notion of sexual identity.
Normalizing sex(uality)
Foucault most famously elaborated on this expression of power/ knowledge in the first volume of The History of Sexuality (tellingly titled in French as La Valente de Savoir, "The Will to Knowledge"), the book that immediately follows Discipline and Punish. In The History of Sexuality Foucault makes the remarkable claim that "the 'question' of sex" becomes in the late nineteenth century the most important question "in both senses: as interrogation and problema- tization, and as the need for confession and integration into a field of rationality" (1990a: 69). A whole host of technologies are born to regulate what becomes understood as a person's (sexual) "essence", the truth of an individual, who he or she "really" is. The most sali- ent of these technologies is confession, first religious (as mandated by early Christianity), then psychological (in the nineteenth-century science of psychoanalysis) and finally political, as the mandate to pro- duce information becomes the ground for what became known as population control. 4 What unites these different technologies is the concern with identifying (and so, Foucault explains, what in fact turns out itself to create, as a category, or object of understanding) a whole variety of "perversions" born during this time, different ways to vio- late the multiplying rules governing the important distinction between licit and illicit, normal and abnormal.
Of all the technologies, medicine comes to play the most important role in the development of "the norm", dictating, for example, what constitutes normal marital relations. Children's sexual activity also became an object of keen interest and concern, not only because of a perceived need to "detect" violations of new norms, but, as we saw in the example of the case of Nathan, to be on the alert for problems with parents' rearing of their children:
Wherever there was the chance that [masturbation] might appear, devices of surveillance were installed; traps were laid for compel- ling admissions . . . parents and teachers were alerted, and left with the suspicion that all children were guilty, and with the fear of being themselves at fault if their suspicions were not sufficiently strong . . . [parents'] conduct was prescribed and their pedagogy
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recodified; an entire medical-sexual regime took hold of the fam- ily milieu. (Foucault 1990a: 42)
Further, a whole class of deviant individuals comes to be identified at this time. Among the zoophiles (those who engage in sex with non-human animals), auto-monosexualists (those who are only able to experience erotic pleasure by themselves), gynecomasts (men with atypically large breasts), presbyophiles (those who engage in sex with the elderly) and dysparauenistic women (those for whom sexual intercourse is painful), perhaps the most lasting category of individual is "the homosexual", a new species of individual "born" in 1 8 70 (ibid. : 43 ) . 5
I n the late-twentieth-century diagnosis o f the gender dysphoric child there is embedded a whole history of power/knowledge that involves a complex of elements that come to be designated in Foucault's work by the term "normalization". Normalization, the institutionalization of the norm, of what counts as normal, indicates the pervasive standards that structure and define social meaning. Norms are at once everywhere and nowhere. They are obvious when we are talking about the sorts of standards against which one can be tested with respect to intelligence or body mass, for example. But they are less conspicuous when they are unspoken, what we may even take to be natural or understand as our own (what Foucault would see as their "internalization"), as is often the case with norms concerning gender.
We may think that medicine has always played the role it has in shaping our understanding of the norm, but Foucault's earlier his- tory of medicine, The Birth of the Clinic, suggests otherwise. In the ancient period, conceptions of health were understood not in terms of a single standard against which one should be measured, but rather in terms of the harmonious functioning of the individual. The role of medicine was to provide "techniques for curing ills" (Foucault 1975 : 34). This view of medicine persisted into the eighteenth century, at which time, according to Foucault, medicine begins to fashion a con- cept of "the healthy man, that is, a study of the non-sick man, and a definition of the model man" (ibid. ). At this point, medicine assumes a "normative posture, which authorizes it not only to distribute advice as to healthy life, but also to dictate the standards for physi- cal and moral relations of the individual and the society in which he lives" (ibid. ). This is a crucial change in the understanding of medi- cine, by the profession and by the public at large, paving the way for the shift that will take place from a focus on health understood as qualities specific to an individual, to normality, a standard imposed from without.
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In the example of Nathan, and of his parents, there is an obvious effort to correct the behaviour that is regarded as abnormal. The tech- niques described by the case study enforcing "good" behaviour with reward and punishing bad behaviour with being ignored, asking him to regulate himself with a wrist counter exemplify the sorts of practices Foucault characterized in Discipline and Punish with respect to the operation of the Panopticon. For Foucault it is not accurate to describe the aim of these practices in terms of "repression". Instead, the aim of the panoptic expression of power/knowledge is to enforce a standard that it is at the same time trying to establish by comparing individuals against one another, measuring their differences and then asserting the truth of the standard it "discovers" as the rule (1979: 182-3). Practices such as these exemplify why Foucault makes use of this composite term, power/knowledge: the expression of each term, power and knowledge, are at every point implicated with one another.
Power/knowledge and resistance
In looking at the operation of power/knowledge, it can be difficult to remember that for Foucault power should not be understood solely in the negative terms of repression or constraint. In Discipline and Punish, Foucault insists that:
we must cease once and for all to describe the effects of power in negative terms: it "excludes," it "represses," it "censors," it "abstracts," it "masks," it "conceals. " In fact, power produces; it produces reality; it produces domains of objects and rituals of truth. The individual and the knowledge that may be gained of him belong to this production. (1979: 194)
While many seek to resist the effects of normalizing power that have wrought so much harm (arguably to us all, albeit in different ways, and to different effect), for Foucault the very effort of resistance must be understood itself as an expression of power. In the first volume of The History of Sexuality, Foucault returns to the exemplary case of homosexuality to make this point:
There is no question that the appearance in nineteenth century psychiatry, jurisprudence, and literature of a whole series of dis- courses on the species and subspecies of homosexuality, inver- sion, pederasty, and "psychic hermaphroditism" made possible a
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strong advance of social control . . . but it also made possible the formation of a "reverse" discourse: homosexuality began to speak in its own behalf, to demand that its legitimacy or "naturality" be acknowledged, often in the same vocabulary, using the same categories by which it was medically disqualified.
(1990a: 101)
What does Foucault mean b y "reverse" discourse ? I f the "normali- zation" of the homosexual by nineteenth-century medicine marked the production of a new conception of abnormality, and with it the abnormal individual, twentieth-century resistance to this process must likewise be understood in these terms, but in reverse; as an effort, in other words, to recast normalcy, to understand as normal this new per- son the homosexual. The recasting of normalcy would mean making use of the medical category, not in the sense of the one constricting norm against which all of us should be judged, but to understand homosexual orientation in the "older" sense of the individual standard of health that continues to be active in, and provide validation of, current conceptions of normality. (Even as there are clear standards of health of all kinds, it still makes sense for us to talk about what is healthy " for me" . ) This nor- malizing power that "made up" the "homosexual person" as an object ofpsychiatricmedicinealsoproduced"improbably", "spontaneously", as Foucault puts it (ibid. : 96), the previously unthinkable concept of "gay pride", which led to the depathologization of homosexuality in the United States in 1973 .
The story o f the depathologization of homosexuality, of its removal as a diagnosis from the handbook of psychiatric disorders called The Diagnostic and Statistical Manual ofMental Disorders (DSM), is remark- able in many ways (among them: it was the first, and to date the only, time that a diagnosis was removed from the DSM as a result of a vote by the membership of the American Psychiatric Association) (Bayer 1 9 8 1 ) . But it is also notable because the first edition of the DSM that did not include homosexuality as a diagnosis (DSM III, published in 1 9 8 0) introduced Gender Identity Disorder (GID) of children as a diagnosis. The "risk" of what are characterized as untreated "problems" of gender identity, according to the most influential researcher responsible for the diagnosis, is the eventual assumption of a homosexual identity (Rekers etal. 1977: 4-5). 6
There are at least two lessons to be learned from the replacement of homosexuality with GID. One lesson concerns the role of children in the "society of normalization", something that Foucault addresses in some detail in the first volume of The History ofSexuality. For the
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purposes of understanding the operation of power/knowledge, it is a lesson in how resistance, expressed as a "reverse discourse", can itself be resisted: psychiatry found, in the diagnosis of GID, a new way to pathologize (or maintain the pathologization of) homosexuality, a new way, in other words, to make it known as an object of psychological intervention, to dictate its truth and to manage the treatment of those so labelled, both medically as well as socially.
As a new revision of the DSM is currently in preparation (scheduled for publication in 2012) there has been a great deal of controversy about the diagnosis of GID, with many activists and mental health practitioners, as well as some academics, arguing in favour of remov- ing the diagnosis, just as homosexuality was removed more than two decades ago. And yet, removal of the diagnosis could inhibit those mental health practitioners who have made use of the diagnosis to treat the distress that gender nonconforming, or "gender variant", children may experience as a result of familial or societal intolerance, a form of counter-attack that validates gender variant behaviour. This approach to treatment is itself a form of resistance to the "usual" understanding of the diagnosis of mental disorder, which locates the problem in the indi- vidual so diagnosed. And while many, perhaps even most, practitioners continue to see GID in the terms dictated by the DSM, which perceives mental disorders "in" the individual, there are those who understand the problem to lie instead in the hostile conditions that gender variant children may face. The implicit rationale of those who approach treat- ment of gender variation in this way is similar to that made about a variety of forms of disability (is the problem in the bodies of those with disabilities, or in the material conditions that make mobility or com- munication difficult? )? What some mental health practitioners have done in their practice is turn psychiatric treatment on its head, seeing a child whose gender behaviour does not correspond neatly with her assigned sex as suffering not from a gender identity disorder, but rather as a victim of an intolerance of gender variation that should instead be the focus of intervention.
Seeing the diagnosis in this way would mean, practically speaking, that it should be cast differently (for example, using terms like "Gender Variance" rather than "Gender Identity Disorder", which is an unneces- sary and furthermore misleading term, because it suggests that psycho- logical identity is the problem that needs to be corrected) . Rather than remove the diagnosis, another possibility could be to rename and refor- mulate the diagnosis to better reflect the life goals and distress experi- enced by individuals, and furthermore direct treatment toward the most appropriate means of alleviating distress and promoting flourishing.
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Beyond the change of name, an interesting and promising recom- mendation may be to make use of complementary diagnostic codes known as "V-codes". V-codes are defined in the International Clas- sification of Disorder (ICD, a global handbook with which the DSM is meant to correspond) as "other conditions that may be a focus of clinical attention" (World Health Organization 2004). Some V-codes are diagnoses that have not yet been formally established as diagnoses through appropriate research (and in this sense it would seem that GID as it stands would qualify). Other V-codes are "conditions" that are located outside the individual, but that nevertheless affect the individual's functioning or well-being. An ''Acculturation Problem" (V62. 4), for example, can include a variety of problems adjusting to a new culture, a problem that is cast not as "the individual's" problem; an "Occupational Problem" (V62. 2), which the DSM conservatively describes as "job dissatisfaction", could include distress as a result of working in a hostile environment where again, the problem cannot be understood properly to belong to an individual. With respect to GID in children, probably the most typical problem would be described as a "Parent-Child Relational Problem" (V61. 20), but it could also include a "Phase of Life Problem" (V62. 89). Including V-codes in the very structure of the diagnosis would provide a more accurate picture of the problems that gender variant children face, and furthermore indicate to practitioners that the object of treatment needs to be dif- ferently understood. 8 The use of V-codes in the case of GID could (indeed, would) entail disciplinary effects, but rather than seeking to activate these effects in the life of an individual subjected to treatment, these effects could promote - among therapists and society at large - a different story to tell about sexual difference.
The possibility of making use of V-codes in the diagnosis of GID is one that is consistent with Foucault's analysis of power/knowledge as a pervasive apparatus from which there is no escape, but that can at the same time be resisted or "reversed". Possibilities such as these become the focus of Foucault's attention in his later, "ethical" works.
Conclusion: power/knowledge and technologies ofthe self
After the first volume of The History of Sexuality, Foucault does not explicitly make use of the term "power/knowledge". Yet the focus on "technologies of the self " in Foucault's ethics provides what could well be understood as an elaboration of the concept of power/knowledge in the "positive" terms that are only suggested in the middle work.
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He is still interested in the notion of subjectivity (assujettissement), both in the sense of "making a subject" and "making subject to". He is also concerned with disciplinary practices. Rather than focusing, as he does in Discipline and Punish, on how disciplinary practices pro- mote normalization, he is far more concerned with how these practices can be put to work to resist normalization. At this point in Foucault's analysis he turns to the subject's relationship to her self, that is, her own subjectivity.
One of the most important ways that knowledge is constituted is through the asking of questions. Investigation of the kinds of questions that can be asked within a given historical period was arguably the focus of Foucault's earlier, archaeological works, and the use to which particular questions could be put and to what effect, the focus of the genealogical works. In the later, ethical works, Foucault turns to the kind of knowledge resulting from reflection, "an exercise of oneself in the activity of thought", or askesis (1990a: 9). Practices of thought that could be promoted in gender variant children, their parents and the mental health workers charged with their care could include a reframing of the questions posed. Interrogating "the problem" of gen- der variance, for example, could provide an opportunity, as Foucault recounts, to "learn to what extent the effort to think one's own history can free thought from what it silently thinks, and so enable it to think differently" (ibid. ). Seeing the diagnosis of Gender Identity Disorder not as a disorder located in the individual, but as a larger problem of intolerance and the suffering it causes would indeed exemplify how this exercise of thought could, as Foucault remarked in an interview, "show people that they are much freer than they feel, that people accept as truth, as evidence, some themes which have been built up at a certain moment during history, and that this so-called evidence can be criticized and destroyed" (1988: 10).
Our understanding of madness, standards of "health", "normal" sexuality: all of these, Foucault finally argues, are consequences of a complex operation of power/knowledge of which his own works are also a part. His aim, in narrating the histories that make up his work, is not to uncover "the timeless and essential secret . . . behind things" but rather to expose the greater secret: the "secret that they have no essence or that their essence was fabricated in piecemeal fashion" (1977: 142). With his own projects, he is interested, as he put it in an interview, in exploring "the possibility of a discourse that would be both true and strategically effective, the possibility of an historical truth which could have political effect" (1980f: 64).
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MICHEL FOUCAULT: KEY CON C EPTS
Notes
1. One way power/knowledge manifests itself in Foucault's early work is in the closely related concept of the episteme, elaborated in The Order of Things (1973). An episteme, the prevailing order of knowledge particular to a histori? ?
cal period, accounts for the understanding of how things are connected in the overall "field" of understanding or knowledge; it describes the conditions under which what is taken to be knowledge is possible.
2. Parents of children with GID have themselves been diagnosed with different psychopathologies, and become themselves "cases" for further investigation (see e. g. Coates 1990).
3. The incidence of the disorder has ranged over the years. At the outset it was understood as very rare, affecting perhaps 1 in 100,000 children (Rekers et al. 1977: 4-5); by 1990 clinicians had concluded that it "may occur in two percent to five percent of the general population" (Bradley & Zucker 1990: 478), a finding revised by these same authors nine years later, who liken its frequency to a disorder such as autism, itself a diagnosis with an estimated incidence rate that has steadily increased over the past decades (Zucker & Bradley 1999: 24). For Foucault these differences would indicate changing historical needs t o justify diagnosis and treatment.
4. Interventions by the state in matters such as population control are an example of what Foucault called "biopower". For discussion of this distinctive form of power, which must also be seen as an expression of power/knowledge, see Chapter 3 on biopower in this volume.
5. For a detailed treatment of the history of the "invention" of homosexuality, see Katz (1995).
6. Laterinthedevelopmentofthediagnosis,perhapsevengreaterriskofuntreated GID is the assumption of a transsexual identity (Bradley & Zucker 1990: 482).
7. See, for example, Fine & Asch (1988).
8. This could also be seen in light of the idea of "exteriorizing" a problem faced
by an individual or a family, a process that allows the emergence of a different meaning, "the development of an alternative story", as the psychologist Michael White, himself a close reader of Foucault, has put it (see e. g. White & Epston 1990: 39).
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? PART II
m
? ? FIVE
uca It's nee
Todd May
The concept of freedom is an elusive one in philosophy. It lies at the centre of at least two very different sets of philosophical problems. One concerns the metaphysical status of human beings. The other concerns their political status. And, to make matters more complicated, Michel Foucault's perspective on freedom lies within neither set of problems.
