) arrives in the most
unlortunate
state (.
Foucault-Psychiatric-Power-1973-74
39 The father is Brierre de Boismont himself, and the mother is his wife.
Everyone lives in the family home, all are brothers, everyone takes their meals together, and all must have family feelings for each other.
The reactivation of family feelings, the investment of every family function in the clinic, will be the effective agency of the cure.
There are some very clear accounts of this in Brierre de Boismont, in his quotation of the correspondence between his patients, after their cure, and himself or his wife. He quotes the letter of an old patient who wrote to Madame Brierre de Boismont: "Far from you, madame, I will often seek the memory so deeply engraved on my heart, in order to enjoy once more that calm filled with affection that you communicate to those who have the good fortune to be received into your home. I will often cast my mind back to your family milieu, so united in all its parts, so affectionate in each of its members, the eldest of whom is as gracious as she is intelligent. If, as is my wish, I return from my own family, you shall be my first visit, for it is a heartfelt debt" (20 May 1847)/'?
I think this letter is interesting. You see that the criterion, the form of the cure itself, is the activation of canonical types of family feelings: grat- itude towards the mother and father. You also see at work here, or rising to the surface at least, the theme of a love which is both validated and
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quasi-incestuous, since the patient is supposed to be Brierre de Boismont's son, and so the brother of the eldest daughter for whom he experiences some feelings. What will be the effect of this reactivation of family feelings, what will he do when he returns to Paris? First of all he will see his family, the true family--that is to say, the family that will get the benefit of the medical process--and, only secondly, he will see Brierre de Boismont's family, this quasi-family, which therefore plays a role of both super- and sub family. It is a super-family inasmuch as it is the ideal family, which functions in the pure state, the family as it should be always; and it is inasmuch as it is the true family that it is attributed an orthopedic function. Second, it is a sub-family inasmuch as its role is to efface itself before the real family, to activate family feelings by means of its internal mechanism only so that the real family benefits from this, and, at that point, it is no more than the kind of schematic support which, discreetly, constantly sustains the functioning of the real family. This super family and sub-family is constructed in these clinics, the social and economic location of which is, as you can see, very different from that of the asylum.
However, if the bourgeois, paying clinic is thus famihalized--functioning on the family model--then the family, in turn, outside the clinic, must play its role. It is not just a question of saying to the family, if you pay me, I will make your madman able to function in the family; the family still has to play its role, that is to say, actually designate those who are mad. It must play a disciplinary role for itself, as it were, that is to say, it must say: Here is our mad, abnormal member, who is a matter for medicine. That is to say, you have familiahzation of the therapeutic milieu for the clinics on one side, and, on the other, disciplinarization of the family, which at that point becomes the agency of the abnormahzation of individuals.
Whereas the question of the abnormal individual did not arise for the sovereign family--which was concerned rather with the hierarchical order of births, the order of inheritance, relationships of allegiance, obedience, and preeminence between them, with the name and all the sub-functions of the name--the disciplinarized family will begin to sub- stitute for this sovereign function of the name the psychological function of the designation of abnormal individuals, of the abnormahzation of individuals.
? What I am saying about the clinics is also valid for the school, and to a certain extent for health in general, and for military service, and so on. What I have wanted to show you is that, however much the family con tinued to conform to a model of sovereignty in the nineteenth century, it may be that, from the middle ol the nineteenth century perhaps, there was a sort ol internal disciplinanzation of the family, that is to say, a kind of transfer of disciplinary forms and schemas, of those techniques of power given by the disciplines, into the very heart of the game of lamily sovereignty.
Just as the family model is transferred into disciplinary systems, dis ciplinary techniques are transplanted into the family. And at that point the family, while retaining the specific heterogeneity of sovereign power, begins to function like a little school: the strange category ol student parents appears, home duties begin to appear, the control of school dis cipline by the lamily; the lamily becomes a micro-clinic which controls the normality or abnormality of the body, of the soul; it becomes a small scale barracks, and maybe it becomes, we will come back to this, the place where sexuality circulates.
I think we can say that, on the basis of disciplinary systems, family sovereignty will be placed under the following obligation: "You must hnd for us the mad, feeble minded, diflicult, and perverse, and you must lind them yourself, through the exercise of disciplinary kinds ol control within lamily sovereignty. And when, through the operation ol this dis- ciplinanzed sovereignty, you have lound your mad, abnormal, feeble minded, and difficult members in your home, we, say the disciplines, will put them through the filter of normalizing apparatuses and restore them to you, the lamily, for your greater functional benefit. We will make them conform to your needs, even if, obviously, we have made our profit on this. "
This is how disciplinary power lives off family sovereignty, requiring the family to play the role of the agency that decides between normal and abnormal, regular and irregular, asking the family to hand over its abnormal, irregular individuals, etcetera, and making a profit from this, which enters into the general system of profit and can be called, if you like, the economic benefit of irregularity. After which, what's more, the lamily is supposed to find again, at the end ol the process, an individual
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who has been disciplined in such a way that he can be effectively subjected to the family's specific schema of sovereignty. Being a good son, a good husband, and so on, is really the outcome offered by all these disciplinary establishments, by schools, hospitals, reformatories, and the rest. This means that they are machines thanks to which it is thought that disciplinary apparatuses will constitute characters who can take their place within the specific morphology of the family's power of sovereignty.
? 1. "Lesjurieux must be placed in a place of salely, but they can only be detained by virtue of
a judgment which must be prompted by the family ( . . . ) . It is to the Tribunals alone that
it [the Civil Code; J. L. | entrusts the care ol establishing iheir condition. " Circular of Portalis, 30 Fructidor Year 12 (17 September 1804) cited in G. Bollotte, "Les malades men- taux de 1789 a 1838 dans I'ceuvre de P. Serieux" Information psychiatrique, vol. 44, no. 10, 1968, p. 916. The Civil Code of 1804 reformulated the old jurisdiction in article 489 (Title XI, ch. 2): "The person who has reached the age of majority and is in a habitual state
of imbecility, dementia, or trenzy, must be interdicted, even when this state has intervals of lucidity. " See, "Interdit" in CJ. de Ferriere, ed. , Dictionnaire de droil el de pratique (Paris: Brunei, 1769) vol. 2, pp. 48-50; H. Legrand du Saulle, Etude medico-legale sur ('interdiction des alienes et sur le conseil judiciaire (Paris: Delahaye el Lecrosnier, 1881); P. Serieux and L. Libert, La Regime des alienes en France au XVIIT siecle (Paris: Masson, 1914); P. Serieux and M. Trenel, "L'inlerdiction des alienes par voie judiciaire (sentence d'interdiction) sous I'Ancien Regime" Revue historique de droit francais el etranger, 4'1' series, 10th year, July September 1931, pp. 450 486; A. Laingui, La Responsabilite penale dans I'ancien droil (XVT- XVIII' siecles) (Paris: Librairie generale de droit et de jurisprudence, 1970) vol. 2, pp. 173 204. Foucault relers to interdiction in Hisloire de la folie, pp. 141-143 (omitted from Madness and Civilisation). He returns to the topic in the lecture of 12 January 1975 ol his course al the College de France, 1974 1975, Les Anormaux, eds. V. Marchetti and
A. Salomoni (Paris: Gallimard/Seuil, 1999) pp. 131-136; English translation, Michel Foucault, Abnormal. Lectures at the College de France 7974-7975, English ed. Arnold I. Davidson, trans. Graham Burchell (New York: Picador, 2O03) pp. 141-145.
2. The law ol 16 24 August 1790 made conhnement a police measure by entrusting "to the vigilance and authority ol municipal bodies . . . the responsibility lor avoiding or remedy
ing unlortunate events which could be occasioned by the insane or thefurieux left in lib erty" (Title XI, article 3) in Legislation sur les alienes et les enjants assisles. Recueil des his, decrels et circulaires (1790-1879)(Paris: Ministere de I'Interieur et des Cukes, 1880 ) vol. 1, p. 3. See, M. Foucault, Hisloire de lajolie, p. 443; Madness and Civilisation, pp. 238 239-
3. F. E. Fodere, Traite du delire, vol. 2, p. 252.
4. P. Berthier, Medecine mentale, vol. 1; De I'isolement (Paris: J. B. Bailliere, 1857) p. 10.
5. The principle is stated by Esquirol in his "Memoire sur I'isolement des alienes" (read at
the Institut on 1 October 1852): "The isolation of the insane (sequestration, confinement) consists in withdrawing him Irom all his habits, in separating him from his lamily, his friends, and his servants; in surrounding him with strangers; in changing his whole way of
life" Des maladies mentales considerees sous les rapports medical, hygienique el medico-legal, vol. 2, p. 745-J. P. Falret, "Du traitement general des alienes" (lecture at Salpetriere, 1854) in Des maladies mentales el des asiles d'alienes (Paris: J. B. Bailliere, 1864) pp. 677-699, see p. 685 sq. ;J. Guislain, Traitesur les phrenopathies, p. 409;J-M. Dupuy, Qulquesconsiderations surla
Jolie. Visite au Castel d'Andorle, etablissemcnl destine aux alienes de la classe riche (Pengueux: Dupont, 1848) pp. 7-8.
6. Francois Leuret states that "whenever one can, one should impose silence on the patient on the subject ol his delirium and occupy him with something else" Du traitement moral de la
Jolie, op. cit. , p. 120. See also his "Memoire sur la revulsion morale dans le traitement de la folie" in Memoires de I'Academic royale de medecine, 1841, p. 658. However, it is J. P. Falret who, in a faithful summary ol Esquirol's conceptions, states the principle most explicitly in an unpublished manuscript: "Isolation is obviously of prime importance . . . But, once the patient has been withdrawn from external influences, should he be left to himself without seeking to destroy the lixity of his unhealthy preoccupations? Obviously not. Not content with having removed the causes which may foment it, one must combat the delir- ium itself, and to this end experience recognizes no more ellective means than, for some, fixing their attention on objects most likely to fascinate them, and, lor others, diverting them from their hxed ideas, distracting them from their preoccupations by constantly pre senting them with objects loreign to their delirium, and by completely directing their attention on every kind ol occupation, so that it is impossible lor them to think of the subject ol their illness. " Quoted by G. Daumezon and P. Koechlin, "La psychotherapie institutionelle
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7.
Iranc. aise contemporaine" AnnaisPortugueses de psiquialria, vol. 4, no. 4, 1952, p. 27/l. See also, J. P. Falret, Des maladies menlales el des asiles d'alienes, p. 687.
"The moral cause of insanity often exists in the bosom of the lamily, and gets its source from sorrows, domestic disputes, setbacks, etcetera (. . . ) the lirst shock to the intellectual
and moral faculties olten takes place in the insane person's own home, amongst his acquaintances, his relatives, and his friends. " J. E. D. Esquirol, Des passions, considerees comme causes, symplomes el moyens curatifs de /'alienation mentale, Paris Medical Thesis no. 574 (Paris: Didot Jeune. 1805), p. 43. SeeJ. Fournet, "Le traitement moral de l'alienation mentale, soit morale, a son principe et son modele dans la famille" (Report read to the Societe medicale d'emulation, 4 March 1854): "A good number ol the insane find in what we call the family
not only the conditions which irritate, aggravate and precipitate these kinds ol alfections, but in virtue ol this, the conditions which give birth to them" Annales medico-psychologiques, 2,KI series, vol. 6, October 1854, pp. 523 524; and A. Brierre de Boismont, "De l'utilite de
la vie de lamille dans le traitement de l'alienation mentale, et plus speciaiement de ses lormes tristes" (Report read to the Academic des sciences, 21 August 1865) Annales medico- psychologiques, 4th series, vol. 7, 1866 (Paris: Martinet, 1866), pp. 40 68.
8. J. E. D. Esquirol, "De la lolie" in Des maladies mentales, vol. 1, p. 120; English translation, J. E. D. Esquirol, Mental Maladies. A Treatise on Insanity, trans. E. K. Hunt (New York and London: Hafner, 1965) p. 74: "The insane man becomes timid and suspicious. He fears
every one that he approaches; and his suspicions extend to those who were most dear to him. The conviction that every one is endeavouring to torment and slander him, to render him miserable, and to ruin him, in body and estate, puts the finishing stroke to this moral perversion. Hence that symptomatic suspicion, which olten grows up without motive. "
9. In 1849, Pierre Berthier (1830 1877) became intern under his uncle, Henri Girard de Cailleux, head doctor and director ol the Auxerre mental asylum. Alter the defense ol his thesis, "De la nature de l'alienation mentale d'apres ses causes el son traitement," at Montpellier in 1857, Berthier returned to Auxerre lor two years belore his appointment as head doctor at Bourg (Ain), before becoming resident doctor at Bicetre in 1865.
10. P. Berthier, Medecine mentale, vol. 1, Observation C, p. 25.
11. Ibid. Observation D, p. 25.
12. Ibid. Obscn'ation B: "M. G. , sullering lrom acute melancholy ( . . .
) arrives in the most unlortunate state (. . . ). After some months of treatment, and not without many ellorls, improvement arrives ( . . . ) . In spile ol the express prohibition of the doctor director, the patient sees his son; he breaks a glass window pane and throws himsell through the opening he has made, with the intention ol joining him. From that moment (. . . ) the hal lucinations reappear with greater intensity, sleep vanishes, the delirium increases; and the patient's situation constantly gets worse" pp. 24-25.
13. In Hisloirc de la folie, pp. 517 519, this principle was considered under the heading "Mirror Recognition"; Madness and Cwili^ation, pp. 262 265.
14. "In a ground floor building, at any moment and without a sound he can arrive close to the patients and servants. " J. E. D. Esquirol, Des elablissements consacres aux alienes en France, p. 36; reprinted in Des maladies mentales, vol. 2, p. 426.
15. P. Pinel, Traile medico-philosophique sur l'alienation mentale, on la Manic, section II, ? xxn: "Habilite dans l'art de diriger les alienes, en paraissant se preter a leurs idees imaginaires," pp. 9 3 9 4 ; A Treatise on Insanity, Section II, "The propriety of appearing to assent to the absurd propositions and fanciful ideas of maniacs" pp. 9 6 97. In lact, Pinel says: "Three insane persons, each ol whom believed himsell to be a king, and each ol whom took the title Louis XVI, quarreled one day over the prerogatives ol royalty, and defended them somewhat too energetically. The keeper approached one ol them, and drawing him aside, asked: 'Why do you argue with these men who are evidently mad? Doesn't everyone know that you should be recognized as Louis XVI? ' Flattered by this homage, the madman immediately with drew, glancing at the others with a disdainlul hauteur. The same trick succeeded with a second, and thus it was that in an instant t here remained no trace ol the dispute. " This pas sage is quoted, with a somewhat dillerent commentary, in Histoire de lajolie, pp. 517 518; Madness and Civilisation, pp. 262 263.
16. J. E. D. Esquirol, "De la folie" in Des maladies mentales, vol. 1, p. 124; Mental Maladies. A Treatise on Insanity, pp. 75 76. Evoking the "strongest objection that can be urged against
? establishments devoted to this kind of treatment," Esquirol counters that "the frightful effects that may result from mingling with companions in misfortune" are compensated for by a cohabitation that "does not injure them,--that it is not an obstacle to a cure--that it is a valuable means of treatment, because it obliges the insane to reflect upon their condition ( . . . ) to occupy their thoughts with what is going on around them,--to forget themselves, as it were, which is, in itself, a means ol cure. " Falret also claims that the asylum makes it possible "to prompt reflection on oneself through the contrast between everything around the patient and his only family circle. " J. P. Falret, "Du traitement general des alienes" (1854) <<n Des maladies mentales el des asiles d'alienes, p. 687.
17. Histoire de la folie evokes the "almost arithmetical obviousness of punishment" p. 521; Madness and Civilisation, p. 267.
18. The roots of the principle of no restraintare found in the reforms undertaken by the Englishmen W Tuke, J. Haslam, and E. Charlesworth, and the Irishman J. Conolly. Following the death at York asylum ol a woman belonging to the Quakers, William Tuke founded on 11 May 1796 an establishment lor the insane lor members of the Society of Friends: the Retreat. Samuel Hike (1784 1857), William's grandson, published Description of the Retreat, an Institution near York jor Insane Persons oj the Society of Friends (York: W Alexander, 1813). See, R. Semalaigne, Alienistes et Philanthropes: les Pinel et les Tuke (Paris: Steinheil, 1912); M. Foucault, Histoire de la folie, pp. 484 487, 492 496, 501-511, Madness and Civilisation, pp. 243 255 (pages 484 501 ol the French edition are omitted Irom the English translation); John Haslam, apothecary at the Bethlehem hospital in London, devoted a work to him: Considerations on the Moral Management of Insane Persons (see also above notes 6 and 13 to the lecture ol 7 November 1973); in 1820, Edward Charlesworth (1783 1853), consultant doctor at the Lincoln Asylum, attacked the coercive methods then much in evidence: Remarks on the Treatment oj the Insane and the Management of Lunatics Asylums (London: Rivington, l825);John Conolly (1794-1866), promoter of no restraint, applied it from 1 June 1839 after his arrival at the Middlesex asylum at Hanwell, near London. He set out his conceptions in, The Construction and GovernmentojLunatics Asylums and Hospitals for the Insane (London: J. Churchill, 1847), and in The Treatment oj the Insane without Mechanical Restraint (London: Smith and Elder, 1856). See also, H. Labatt, An Essay on Use and Abuse of Restraint in the Management of the Insane (London: Hodges and Smith, 1847).
19. Letter ol the Mother Superior of the asylum lor women at Lille to the Mother Superior of the nuns ol Saint Joseph ol Cluny who ministered to the asylum of Saint Yon (Lower Seine)--of which Benedict Augustin Morel (1807-1873) was the head doctor from 23 May 1856--in which she set out the way in she controlled agitated patients: "We set to work . . . taking an agitated woman so as to put her under the supervision of a nun who knew how to impress. " Quoted in B. A. Morel's report, Le Non-Restraint, ou De Vabolition des moyens coercitifs dans le traitement de lajolie (Paris: Masson, i 8 6 0 ) p. 77.
20. An armchair resting on bellows so that "at the slightest movement the insane person is bounced about in every direction, and the unpleasant sensation caused by this movement lorces him to be keep calm. " J. Guislain, Traite sur les phrenopathies, p. 414.
21. Iron handcuffs covered with leather arc recommended by Esquirol as one ol the "many means more gentle than chains," J. E. D. Esquirol, "Des Maisons d'alienes" in Des maladies mentales, vol. 2, p. 533. See also, J. Guislain, Traite sur Valienation mentale et sur les hospices des alienes, vol. 2, book 12, "Institutions for the insane. Means of repression," pp. 271 272.
22. The "strong muffs" are a piece of cloth holding the hands together in front of the body.
23. The straitjacket was invented in 1790 by Guilleret, an upholsterer of Bicetre, and consists of a shirt made of strong cloth or canvas, open at the back, with long sleeves crossing over in Iront and fastened at the back, immobilizing the arms. See, J. Guislain, Traite sur
I'alienation mentale, vol. 2, pp. 269-271; E. Rouhier, De la camisole ou gilet de force (Paris: Pillet, 1871); A. Voisin, "D l'utilite de la camisole de force et des moyens de contention dans
le traitement de la folie" (Communication to the Societe medico psychologiques, 26 July i860) Annales medico-psychologiques, 3rtl series, vol. 6, November i860, pp. 427431; V. Magnan, "Camisole," in Dictionnaire encyclopedique des sciences medicales (Paris: Masson/Asselin, 1880) 1st series, vol. 11, pp. 780 784. Foucault analyses the meaning of its use in Histoire de lafolie, p. 460 (omitted from the English translation).
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24. An instrument of restraint, the wicker casket is a cage, a man's length, in which the patient is laid out on a mattress. It has a lid and is cut oft at the neckline. See, J. Guislain, Traite sur Valienalion mentale, vol. 2, p. 263.
25. The strappado (I'estrapade) hoisted the guilty person, attached by a rope and tied hands and feet, to the top of a bracket, and then let him fall towards the ground several times. On the test of truth in judicial procedure, see Foucault's course at the College de France for 1971-1972, "Penal Theories and Institutions," sixth lecture, and Surveilkr et Punire, pp. 43 46, Discipline and Punish, pp. 39-42.
26. On the public torture and execution of Damien, see Surveilkr et Punir, pp. 9-11 and 36-72; DisciplineandPunish,pp. 3-6and32 69.
27- This is Doctor Gosseret, recounting his having discovered "patients of both sexes fixed to wall by iron chains," quoted by B. A. Morel, Le Non-Restraint, p. 14. Guillaume Ferrus also says that "in some places the unfortunates are fixed to the wall, to which they are attached in an upright position by means of a strap," quoted in R. Semelaigne, Les Pioniers de la psychiatriefrancaise avant et apres Pinel (Paris: Bailliere, 1930) vol. 1, pp. 153-154.
28. F. Leuret, Du traitement moral de lafolie, p. 178.
29. Ibid. p. 179.
30. J. Fournet, "Le traitement moral de Palienation" Annales medico-psychologiques, p. 524. See
also, J. Parigot, Therapeutique naturelle de lafolie. L'air libre et la vie defamille dans la commune de Gheel(Brussels: J. B. Tircher, 1852) p. 13: "We think that the sick man needs the sympa
thy that family life gives birth to right from the start. "
31. J. Fournet, "Le traitement moral de Palienation" pp. 526-527. Joseph Daquin (1732 1815)
was born in Chambery where he was appointed in 1788 to the Incurables where he encountered the conditions imposed on the insane. See J. Daquin, La Philosophic de lajolie,
ou Essaiphilosophique sur le traitement des personnes altaquees defolie (Chambery: Gorin, 1791). A revised and expanded edition appeared in 1804 dedicated to Philippe Pinel: La Philosophic de lafolie, ou Von prouve que cclle maladic doit plutol etre traitee par les secours moraux que les secours physique (Chambery: Cleaz, 1804). See also, J. R. Nylleler, Joseph Daquin und seine "Philosophic de lajolie" (Zurich: Juris, 1961).
32. J. Fournet, "Le traitement moral de Palienation" p. 527. On Mettray, see above note 35 to the lecture of 28 November.
33. Charles Robert Darwin (1809-1882), On the Origins of the Species by means of Natural Selection, or the Preservation of Favoured Races in the Struggle for Life (London: J. Murray, 1859); French translation of the 6 l ' edition, De I'origine des especes au moyen de la selection naturell, ou la Lutte pour I'existence dans la nature, trans. E Barbier (Paris: Reinwald, 1876).
34. Jules Fournet (1811 1885), head of the clinic at the Hotel Dieu, author of, Doctrine organo-psychique de lafolie (Paris: Masson, 1867), and the discourse given at the Congres medico-psychologique in 1878, De I'hereditephysique ou morale (Paris: Imprimerie nationale, 1880).
35- Jean Pierre Casimir Pinel (1800 1866), nephew of Philippe Pinel, worked in 1829 at
76 rue de Chaillot, a clinic devoted to the treatment ol mental illnesses, before transferring
it in 1844 to Neuilly m 1844, in the old Saint-James folly. See his, Du traitement de Palienation mentale en general, et principalement par les bains tiedes prolonges et les arrosemenh continus d'eau
froide su la tete (Paris: J. B. Bailliere, 1853).
36. Alexandre Brierre de Boismont (1798 1881), after being employed in 1825 as doctor to the
Sainte-Colombe clinic, rue de Picpus, took over management of a clinic at 21 rue Neuvc Saint-Genevieve in 1838, which was transferred in 1859 to Saint Mande, where he died on
25 December 1881. See: "Maison de Sante du Docteur Brierre de Boismont, rue Neuve Sainte-Genevieve, no. 21, pres du Pantheon, Prospectus" Observations medico-legales sur la monomanie homicide (Pans: Mme. Auger Mequignon, 1826--taken from the Revue medicale, October and November 1826); and, Des hallucinations, ou Histoire raisonee des apparitions, des visions, des songes ( P a n s : J . B. Bailliere, 1845).
37. In 1821, Esprit Sylvestre Blanche (1796-1852) took over management of a clinic founded in 1806 in Montmartre by P.
There are some very clear accounts of this in Brierre de Boismont, in his quotation of the correspondence between his patients, after their cure, and himself or his wife. He quotes the letter of an old patient who wrote to Madame Brierre de Boismont: "Far from you, madame, I will often seek the memory so deeply engraved on my heart, in order to enjoy once more that calm filled with affection that you communicate to those who have the good fortune to be received into your home. I will often cast my mind back to your family milieu, so united in all its parts, so affectionate in each of its members, the eldest of whom is as gracious as she is intelligent. If, as is my wish, I return from my own family, you shall be my first visit, for it is a heartfelt debt" (20 May 1847)/'?
I think this letter is interesting. You see that the criterion, the form of the cure itself, is the activation of canonical types of family feelings: grat- itude towards the mother and father. You also see at work here, or rising to the surface at least, the theme of a love which is both validated and
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quasi-incestuous, since the patient is supposed to be Brierre de Boismont's son, and so the brother of the eldest daughter for whom he experiences some feelings. What will be the effect of this reactivation of family feelings, what will he do when he returns to Paris? First of all he will see his family, the true family--that is to say, the family that will get the benefit of the medical process--and, only secondly, he will see Brierre de Boismont's family, this quasi-family, which therefore plays a role of both super- and sub family. It is a super-family inasmuch as it is the ideal family, which functions in the pure state, the family as it should be always; and it is inasmuch as it is the true family that it is attributed an orthopedic function. Second, it is a sub-family inasmuch as its role is to efface itself before the real family, to activate family feelings by means of its internal mechanism only so that the real family benefits from this, and, at that point, it is no more than the kind of schematic support which, discreetly, constantly sustains the functioning of the real family. This super family and sub-family is constructed in these clinics, the social and economic location of which is, as you can see, very different from that of the asylum.
However, if the bourgeois, paying clinic is thus famihalized--functioning on the family model--then the family, in turn, outside the clinic, must play its role. It is not just a question of saying to the family, if you pay me, I will make your madman able to function in the family; the family still has to play its role, that is to say, actually designate those who are mad. It must play a disciplinary role for itself, as it were, that is to say, it must say: Here is our mad, abnormal member, who is a matter for medicine. That is to say, you have familiahzation of the therapeutic milieu for the clinics on one side, and, on the other, disciplinarization of the family, which at that point becomes the agency of the abnormahzation of individuals.
Whereas the question of the abnormal individual did not arise for the sovereign family--which was concerned rather with the hierarchical order of births, the order of inheritance, relationships of allegiance, obedience, and preeminence between them, with the name and all the sub-functions of the name--the disciplinarized family will begin to sub- stitute for this sovereign function of the name the psychological function of the designation of abnormal individuals, of the abnormahzation of individuals.
? What I am saying about the clinics is also valid for the school, and to a certain extent for health in general, and for military service, and so on. What I have wanted to show you is that, however much the family con tinued to conform to a model of sovereignty in the nineteenth century, it may be that, from the middle ol the nineteenth century perhaps, there was a sort ol internal disciplinanzation of the family, that is to say, a kind of transfer of disciplinary forms and schemas, of those techniques of power given by the disciplines, into the very heart of the game of lamily sovereignty.
Just as the family model is transferred into disciplinary systems, dis ciplinary techniques are transplanted into the family. And at that point the family, while retaining the specific heterogeneity of sovereign power, begins to function like a little school: the strange category ol student parents appears, home duties begin to appear, the control of school dis cipline by the lamily; the lamily becomes a micro-clinic which controls the normality or abnormality of the body, of the soul; it becomes a small scale barracks, and maybe it becomes, we will come back to this, the place where sexuality circulates.
I think we can say that, on the basis of disciplinary systems, family sovereignty will be placed under the following obligation: "You must hnd for us the mad, feeble minded, diflicult, and perverse, and you must lind them yourself, through the exercise of disciplinary kinds ol control within lamily sovereignty. And when, through the operation ol this dis- ciplinanzed sovereignty, you have lound your mad, abnormal, feeble minded, and difficult members in your home, we, say the disciplines, will put them through the filter of normalizing apparatuses and restore them to you, the lamily, for your greater functional benefit. We will make them conform to your needs, even if, obviously, we have made our profit on this. "
This is how disciplinary power lives off family sovereignty, requiring the family to play the role of the agency that decides between normal and abnormal, regular and irregular, asking the family to hand over its abnormal, irregular individuals, etcetera, and making a profit from this, which enters into the general system of profit and can be called, if you like, the economic benefit of irregularity. After which, what's more, the lamily is supposed to find again, at the end ol the process, an individual
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who has been disciplined in such a way that he can be effectively subjected to the family's specific schema of sovereignty. Being a good son, a good husband, and so on, is really the outcome offered by all these disciplinary establishments, by schools, hospitals, reformatories, and the rest. This means that they are machines thanks to which it is thought that disciplinary apparatuses will constitute characters who can take their place within the specific morphology of the family's power of sovereignty.
? 1. "Lesjurieux must be placed in a place of salely, but they can only be detained by virtue of
a judgment which must be prompted by the family ( . . . ) . It is to the Tribunals alone that
it [the Civil Code; J. L. | entrusts the care ol establishing iheir condition. " Circular of Portalis, 30 Fructidor Year 12 (17 September 1804) cited in G. Bollotte, "Les malades men- taux de 1789 a 1838 dans I'ceuvre de P. Serieux" Information psychiatrique, vol. 44, no. 10, 1968, p. 916. The Civil Code of 1804 reformulated the old jurisdiction in article 489 (Title XI, ch. 2): "The person who has reached the age of majority and is in a habitual state
of imbecility, dementia, or trenzy, must be interdicted, even when this state has intervals of lucidity. " See, "Interdit" in CJ. de Ferriere, ed. , Dictionnaire de droil el de pratique (Paris: Brunei, 1769) vol. 2, pp. 48-50; H. Legrand du Saulle, Etude medico-legale sur ('interdiction des alienes et sur le conseil judiciaire (Paris: Delahaye el Lecrosnier, 1881); P. Serieux and L. Libert, La Regime des alienes en France au XVIIT siecle (Paris: Masson, 1914); P. Serieux and M. Trenel, "L'inlerdiction des alienes par voie judiciaire (sentence d'interdiction) sous I'Ancien Regime" Revue historique de droit francais el etranger, 4'1' series, 10th year, July September 1931, pp. 450 486; A. Laingui, La Responsabilite penale dans I'ancien droil (XVT- XVIII' siecles) (Paris: Librairie generale de droit et de jurisprudence, 1970) vol. 2, pp. 173 204. Foucault relers to interdiction in Hisloire de la folie, pp. 141-143 (omitted from Madness and Civilisation). He returns to the topic in the lecture of 12 January 1975 ol his course al the College de France, 1974 1975, Les Anormaux, eds. V. Marchetti and
A. Salomoni (Paris: Gallimard/Seuil, 1999) pp. 131-136; English translation, Michel Foucault, Abnormal. Lectures at the College de France 7974-7975, English ed. Arnold I. Davidson, trans. Graham Burchell (New York: Picador, 2O03) pp. 141-145.
2. The law ol 16 24 August 1790 made conhnement a police measure by entrusting "to the vigilance and authority ol municipal bodies . . . the responsibility lor avoiding or remedy
ing unlortunate events which could be occasioned by the insane or thefurieux left in lib erty" (Title XI, article 3) in Legislation sur les alienes et les enjants assisles. Recueil des his, decrels et circulaires (1790-1879)(Paris: Ministere de I'Interieur et des Cukes, 1880 ) vol. 1, p. 3. See, M. Foucault, Hisloire de lajolie, p. 443; Madness and Civilisation, pp. 238 239-
3. F. E. Fodere, Traite du delire, vol. 2, p. 252.
4. P. Berthier, Medecine mentale, vol. 1; De I'isolement (Paris: J. B. Bailliere, 1857) p. 10.
5. The principle is stated by Esquirol in his "Memoire sur I'isolement des alienes" (read at
the Institut on 1 October 1852): "The isolation of the insane (sequestration, confinement) consists in withdrawing him Irom all his habits, in separating him from his lamily, his friends, and his servants; in surrounding him with strangers; in changing his whole way of
life" Des maladies mentales considerees sous les rapports medical, hygienique el medico-legal, vol. 2, p. 745-J. P. Falret, "Du traitement general des alienes" (lecture at Salpetriere, 1854) in Des maladies mentales el des asiles d'alienes (Paris: J. B. Bailliere, 1864) pp. 677-699, see p. 685 sq. ;J. Guislain, Traitesur les phrenopathies, p. 409;J-M. Dupuy, Qulquesconsiderations surla
Jolie. Visite au Castel d'Andorle, etablissemcnl destine aux alienes de la classe riche (Pengueux: Dupont, 1848) pp. 7-8.
6. Francois Leuret states that "whenever one can, one should impose silence on the patient on the subject ol his delirium and occupy him with something else" Du traitement moral de la
Jolie, op. cit. , p. 120. See also his "Memoire sur la revulsion morale dans le traitement de la folie" in Memoires de I'Academic royale de medecine, 1841, p. 658. However, it is J. P. Falret who, in a faithful summary ol Esquirol's conceptions, states the principle most explicitly in an unpublished manuscript: "Isolation is obviously of prime importance . . . But, once the patient has been withdrawn from external influences, should he be left to himself without seeking to destroy the lixity of his unhealthy preoccupations? Obviously not. Not content with having removed the causes which may foment it, one must combat the delir- ium itself, and to this end experience recognizes no more ellective means than, for some, fixing their attention on objects most likely to fascinate them, and, lor others, diverting them from their hxed ideas, distracting them from their preoccupations by constantly pre senting them with objects loreign to their delirium, and by completely directing their attention on every kind ol occupation, so that it is impossible lor them to think of the subject ol their illness. " Quoted by G. Daumezon and P. Koechlin, "La psychotherapie institutionelle
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PSYCHIATRIC POWER
7.
Iranc. aise contemporaine" AnnaisPortugueses de psiquialria, vol. 4, no. 4, 1952, p. 27/l. See also, J. P. Falret, Des maladies menlales el des asiles d'alienes, p. 687.
"The moral cause of insanity often exists in the bosom of the lamily, and gets its source from sorrows, domestic disputes, setbacks, etcetera (. . . ) the lirst shock to the intellectual
and moral faculties olten takes place in the insane person's own home, amongst his acquaintances, his relatives, and his friends. " J. E. D. Esquirol, Des passions, considerees comme causes, symplomes el moyens curatifs de /'alienation mentale, Paris Medical Thesis no. 574 (Paris: Didot Jeune. 1805), p. 43. SeeJ. Fournet, "Le traitement moral de l'alienation mentale, soit morale, a son principe et son modele dans la famille" (Report read to the Societe medicale d'emulation, 4 March 1854): "A good number ol the insane find in what we call the family
not only the conditions which irritate, aggravate and precipitate these kinds ol alfections, but in virtue ol this, the conditions which give birth to them" Annales medico-psychologiques, 2,KI series, vol. 6, October 1854, pp. 523 524; and A. Brierre de Boismont, "De l'utilite de
la vie de lamille dans le traitement de l'alienation mentale, et plus speciaiement de ses lormes tristes" (Report read to the Academic des sciences, 21 August 1865) Annales medico- psychologiques, 4th series, vol. 7, 1866 (Paris: Martinet, 1866), pp. 40 68.
8. J. E. D. Esquirol, "De la lolie" in Des maladies mentales, vol. 1, p. 120; English translation, J. E. D. Esquirol, Mental Maladies. A Treatise on Insanity, trans. E. K. Hunt (New York and London: Hafner, 1965) p. 74: "The insane man becomes timid and suspicious. He fears
every one that he approaches; and his suspicions extend to those who were most dear to him. The conviction that every one is endeavouring to torment and slander him, to render him miserable, and to ruin him, in body and estate, puts the finishing stroke to this moral perversion. Hence that symptomatic suspicion, which olten grows up without motive. "
9. In 1849, Pierre Berthier (1830 1877) became intern under his uncle, Henri Girard de Cailleux, head doctor and director ol the Auxerre mental asylum. Alter the defense ol his thesis, "De la nature de l'alienation mentale d'apres ses causes el son traitement," at Montpellier in 1857, Berthier returned to Auxerre lor two years belore his appointment as head doctor at Bourg (Ain), before becoming resident doctor at Bicetre in 1865.
10. P. Berthier, Medecine mentale, vol. 1, Observation C, p. 25.
11. Ibid. Observation D, p. 25.
12. Ibid. Obscn'ation B: "M. G. , sullering lrom acute melancholy ( . . .
) arrives in the most unlortunate state (. . . ). After some months of treatment, and not without many ellorls, improvement arrives ( . . . ) . In spile ol the express prohibition of the doctor director, the patient sees his son; he breaks a glass window pane and throws himsell through the opening he has made, with the intention ol joining him. From that moment (. . . ) the hal lucinations reappear with greater intensity, sleep vanishes, the delirium increases; and the patient's situation constantly gets worse" pp. 24-25.
13. In Hisloirc de la folie, pp. 517 519, this principle was considered under the heading "Mirror Recognition"; Madness and Cwili^ation, pp. 262 265.
14. "In a ground floor building, at any moment and without a sound he can arrive close to the patients and servants. " J. E. D. Esquirol, Des elablissements consacres aux alienes en France, p. 36; reprinted in Des maladies mentales, vol. 2, p. 426.
15. P. Pinel, Traile medico-philosophique sur l'alienation mentale, on la Manic, section II, ? xxn: "Habilite dans l'art de diriger les alienes, en paraissant se preter a leurs idees imaginaires," pp. 9 3 9 4 ; A Treatise on Insanity, Section II, "The propriety of appearing to assent to the absurd propositions and fanciful ideas of maniacs" pp. 9 6 97. In lact, Pinel says: "Three insane persons, each ol whom believed himsell to be a king, and each ol whom took the title Louis XVI, quarreled one day over the prerogatives ol royalty, and defended them somewhat too energetically. The keeper approached one ol them, and drawing him aside, asked: 'Why do you argue with these men who are evidently mad? Doesn't everyone know that you should be recognized as Louis XVI? ' Flattered by this homage, the madman immediately with drew, glancing at the others with a disdainlul hauteur. The same trick succeeded with a second, and thus it was that in an instant t here remained no trace ol the dispute. " This pas sage is quoted, with a somewhat dillerent commentary, in Histoire de lajolie, pp. 517 518; Madness and Civilisation, pp. 262 263.
16. J. E. D. Esquirol, "De la folie" in Des maladies mentales, vol. 1, p. 124; Mental Maladies. A Treatise on Insanity, pp. 75 76. Evoking the "strongest objection that can be urged against
? establishments devoted to this kind of treatment," Esquirol counters that "the frightful effects that may result from mingling with companions in misfortune" are compensated for by a cohabitation that "does not injure them,--that it is not an obstacle to a cure--that it is a valuable means of treatment, because it obliges the insane to reflect upon their condition ( . . . ) to occupy their thoughts with what is going on around them,--to forget themselves, as it were, which is, in itself, a means ol cure. " Falret also claims that the asylum makes it possible "to prompt reflection on oneself through the contrast between everything around the patient and his only family circle. " J. P. Falret, "Du traitement general des alienes" (1854) <<n Des maladies mentales el des asiles d'alienes, p. 687.
17. Histoire de la folie evokes the "almost arithmetical obviousness of punishment" p. 521; Madness and Civilisation, p. 267.
18. The roots of the principle of no restraintare found in the reforms undertaken by the Englishmen W Tuke, J. Haslam, and E. Charlesworth, and the Irishman J. Conolly. Following the death at York asylum ol a woman belonging to the Quakers, William Tuke founded on 11 May 1796 an establishment lor the insane lor members of the Society of Friends: the Retreat. Samuel Hike (1784 1857), William's grandson, published Description of the Retreat, an Institution near York jor Insane Persons oj the Society of Friends (York: W Alexander, 1813). See, R. Semalaigne, Alienistes et Philanthropes: les Pinel et les Tuke (Paris: Steinheil, 1912); M. Foucault, Histoire de la folie, pp. 484 487, 492 496, 501-511, Madness and Civilisation, pp. 243 255 (pages 484 501 ol the French edition are omitted Irom the English translation); John Haslam, apothecary at the Bethlehem hospital in London, devoted a work to him: Considerations on the Moral Management of Insane Persons (see also above notes 6 and 13 to the lecture ol 7 November 1973); in 1820, Edward Charlesworth (1783 1853), consultant doctor at the Lincoln Asylum, attacked the coercive methods then much in evidence: Remarks on the Treatment oj the Insane and the Management of Lunatics Asylums (London: Rivington, l825);John Conolly (1794-1866), promoter of no restraint, applied it from 1 June 1839 after his arrival at the Middlesex asylum at Hanwell, near London. He set out his conceptions in, The Construction and GovernmentojLunatics Asylums and Hospitals for the Insane (London: J. Churchill, 1847), and in The Treatment oj the Insane without Mechanical Restraint (London: Smith and Elder, 1856). See also, H. Labatt, An Essay on Use and Abuse of Restraint in the Management of the Insane (London: Hodges and Smith, 1847).
19. Letter ol the Mother Superior of the asylum lor women at Lille to the Mother Superior of the nuns ol Saint Joseph ol Cluny who ministered to the asylum of Saint Yon (Lower Seine)--of which Benedict Augustin Morel (1807-1873) was the head doctor from 23 May 1856--in which she set out the way in she controlled agitated patients: "We set to work . . . taking an agitated woman so as to put her under the supervision of a nun who knew how to impress. " Quoted in B. A. Morel's report, Le Non-Restraint, ou De Vabolition des moyens coercitifs dans le traitement de lajolie (Paris: Masson, i 8 6 0 ) p. 77.
20. An armchair resting on bellows so that "at the slightest movement the insane person is bounced about in every direction, and the unpleasant sensation caused by this movement lorces him to be keep calm. " J. Guislain, Traite sur les phrenopathies, p. 414.
21. Iron handcuffs covered with leather arc recommended by Esquirol as one ol the "many means more gentle than chains," J. E. D. Esquirol, "Des Maisons d'alienes" in Des maladies mentales, vol. 2, p. 533. See also, J. Guislain, Traite sur Valienation mentale et sur les hospices des alienes, vol. 2, book 12, "Institutions for the insane. Means of repression," pp. 271 272.
22. The "strong muffs" are a piece of cloth holding the hands together in front of the body.
23. The straitjacket was invented in 1790 by Guilleret, an upholsterer of Bicetre, and consists of a shirt made of strong cloth or canvas, open at the back, with long sleeves crossing over in Iront and fastened at the back, immobilizing the arms. See, J. Guislain, Traite sur
I'alienation mentale, vol. 2, pp. 269-271; E. Rouhier, De la camisole ou gilet de force (Paris: Pillet, 1871); A. Voisin, "D l'utilite de la camisole de force et des moyens de contention dans
le traitement de la folie" (Communication to the Societe medico psychologiques, 26 July i860) Annales medico-psychologiques, 3rtl series, vol. 6, November i860, pp. 427431; V. Magnan, "Camisole," in Dictionnaire encyclopedique des sciences medicales (Paris: Masson/Asselin, 1880) 1st series, vol. 11, pp. 780 784. Foucault analyses the meaning of its use in Histoire de lafolie, p. 460 (omitted from the English translation).
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24. An instrument of restraint, the wicker casket is a cage, a man's length, in which the patient is laid out on a mattress. It has a lid and is cut oft at the neckline. See, J. Guislain, Traite sur Valienalion mentale, vol. 2, p. 263.
25. The strappado (I'estrapade) hoisted the guilty person, attached by a rope and tied hands and feet, to the top of a bracket, and then let him fall towards the ground several times. On the test of truth in judicial procedure, see Foucault's course at the College de France for 1971-1972, "Penal Theories and Institutions," sixth lecture, and Surveilkr et Punire, pp. 43 46, Discipline and Punish, pp. 39-42.
26. On the public torture and execution of Damien, see Surveilkr et Punir, pp. 9-11 and 36-72; DisciplineandPunish,pp. 3-6and32 69.
27- This is Doctor Gosseret, recounting his having discovered "patients of both sexes fixed to wall by iron chains," quoted by B. A. Morel, Le Non-Restraint, p. 14. Guillaume Ferrus also says that "in some places the unfortunates are fixed to the wall, to which they are attached in an upright position by means of a strap," quoted in R. Semelaigne, Les Pioniers de la psychiatriefrancaise avant et apres Pinel (Paris: Bailliere, 1930) vol. 1, pp. 153-154.
28. F. Leuret, Du traitement moral de lafolie, p. 178.
29. Ibid. p. 179.
30. J. Fournet, "Le traitement moral de Palienation" Annales medico-psychologiques, p. 524. See
also, J. Parigot, Therapeutique naturelle de lafolie. L'air libre et la vie defamille dans la commune de Gheel(Brussels: J. B. Tircher, 1852) p. 13: "We think that the sick man needs the sympa
thy that family life gives birth to right from the start. "
31. J. Fournet, "Le traitement moral de Palienation" pp. 526-527. Joseph Daquin (1732 1815)
was born in Chambery where he was appointed in 1788 to the Incurables where he encountered the conditions imposed on the insane. See J. Daquin, La Philosophic de lajolie,
ou Essaiphilosophique sur le traitement des personnes altaquees defolie (Chambery: Gorin, 1791). A revised and expanded edition appeared in 1804 dedicated to Philippe Pinel: La Philosophic de lafolie, ou Von prouve que cclle maladic doit plutol etre traitee par les secours moraux que les secours physique (Chambery: Cleaz, 1804). See also, J. R. Nylleler, Joseph Daquin und seine "Philosophic de lajolie" (Zurich: Juris, 1961).
32. J. Fournet, "Le traitement moral de Palienation" p. 527. On Mettray, see above note 35 to the lecture of 28 November.
33. Charles Robert Darwin (1809-1882), On the Origins of the Species by means of Natural Selection, or the Preservation of Favoured Races in the Struggle for Life (London: J. Murray, 1859); French translation of the 6 l ' edition, De I'origine des especes au moyen de la selection naturell, ou la Lutte pour I'existence dans la nature, trans. E Barbier (Paris: Reinwald, 1876).
34. Jules Fournet (1811 1885), head of the clinic at the Hotel Dieu, author of, Doctrine organo-psychique de lafolie (Paris: Masson, 1867), and the discourse given at the Congres medico-psychologique in 1878, De I'hereditephysique ou morale (Paris: Imprimerie nationale, 1880).
35- Jean Pierre Casimir Pinel (1800 1866), nephew of Philippe Pinel, worked in 1829 at
76 rue de Chaillot, a clinic devoted to the treatment ol mental illnesses, before transferring
it in 1844 to Neuilly m 1844, in the old Saint-James folly. See his, Du traitement de Palienation mentale en general, et principalement par les bains tiedes prolonges et les arrosemenh continus d'eau
froide su la tete (Paris: J. B. Bailliere, 1853).
36. Alexandre Brierre de Boismont (1798 1881), after being employed in 1825 as doctor to the
Sainte-Colombe clinic, rue de Picpus, took over management of a clinic at 21 rue Neuvc Saint-Genevieve in 1838, which was transferred in 1859 to Saint Mande, where he died on
25 December 1881. See: "Maison de Sante du Docteur Brierre de Boismont, rue Neuve Sainte-Genevieve, no. 21, pres du Pantheon, Prospectus" Observations medico-legales sur la monomanie homicide (Pans: Mme. Auger Mequignon, 1826--taken from the Revue medicale, October and November 1826); and, Des hallucinations, ou Histoire raisonee des apparitions, des visions, des songes ( P a n s : J . B. Bailliere, 1845).
37. In 1821, Esprit Sylvestre Blanche (1796-1852) took over management of a clinic founded in 1806 in Montmartre by P.
