**1. Introduction**

A key difficulty encountered by those who first read Michel Foucault's works in the 1960s was not understanding what type of writing his was, to which *order of discourse* it belonged. Foucault's writing is "mad," in the sense that it is outside any scientific and literary genre. Was Foucault a philosopher, an essayist, an epistemologist, a historian of science, or something else [1]? Putting aside these impossible classifications in *Foucault's case*, the issue of language – of writing in general and of literary writing in particular – represented a "space" that the philosopher found hard to define. What type of language did Foucault study? From *Madness and Insanity: A History of Madness in the Classical Age* published in 1961 through his lectures at the Collège de France in the early 1970s, Foucault studied the mad, their discourses, and those delivered by the doctors across five centuries. The mad, the

doctors, and their discourses represent for Foucault an *outside* and an inside of the *orders of* psychiatric *discourse.* The mad is the *other* with respect to the definitions and identities established by scientific knowledge, from Descartes onwards. A certain literature can push the possibility of language beyond recognized semantic limits, *outside* the *orders of discourse* of ordinary language.

Certainly, Foucault's attention to literature is not linked to an interest in writing, which would be a "shelter for subjectivity" – an *existentially* subjective inner place, removed from the dialectic of relationships – because his archaeology is a research that points beyond, outside this same dimension that is itself still much too *subjective* [2]. Foucault's observations on literature disappear in the 1970s. His motivation is not easy to pinpoint, other than Foucault deciding to commit himself to the political and genealogical study of the relations between men, as literary studies simply were not enough for him. It stands that literature, among all the other studies, allowed him to *escape from himself*, from his books and certain aspects of his thought that were too structuralist. Nietzsche, Bataille, Blanchot, Roussel, as well as Sade, Mallarmé, Joyce, Kafka, Pound, and Borges were at the core of Foucault's literary passion, of his break with phenomenology and with a certain Hegelian French academia of the 1950s, and with philosophy in general, perhaps [3]. His literary studies are not only *archaeologies of knowledge* but *genealogies* too, which he attempts, of the historical present, of modernity, of the 1960s.

Alongside this attention to literature, Foucault, already in *Dream and Existence*, *Mental Illness and Psychology*, and *History of Madness*, wanted to start exploring what had historically been considered *different* due to it being pathological, from a psychiatric point of view. Foucault had to understand what the difference of madness, sickness (*The Birth of the Clinic*), criminality, the difference of what and who is *disturbing*, consisted of. For him, in every disciplinary field – not only in psychiatry – there are always attempts at retrieving, identifying, marginalizing all these *differences*. To this day, work is being done to bring them back as an *alterity*, the alterity of the *same prevalent reason*. In his books of the 1960s, Foucault attempts to reconstruct these techniques of *bringing back* and *identification* to understand why some people are inside a madhouse and others are not.

For Foucault, there are those who know how to *speak* about these differences with care, how to tell about and even paint them. They are painters, poets, a handful of philosophers, novelists, some French cultural figures of the 1960s, but also earlier, from the end of the 18th century and throughout the 1800s, all the way to Roussel, Bataille, Klossowski, and Blanchot. There are those who know how to paint the *others*: Bosch, Velasquez, Van Gogh, Manet, Magritte. Classic and contemporary philosophers, sociologists, scientists, doctors, and lawyers have instead, failed. This is how the confrontation − always at a certain distance – between madness, difference, sickness, criminality, and literature unfolded in the pages of Foucault's books from the 1960s. Here, Nietzsche, Sade, Artaud, Roussel, and Blanchot have lived, *speaking* to Foucault about these *differences*. They effected the possibility of *transgression* and *resistance*, of creating a literary and anthropological space, where they are not marginalized – or maybe they are – but without being put in a madhouse, at least in the "sane" phase of their lives. The cost of this operation is certainly high, even at the literary level, because a certain way of writing entails a "tormented" relationship with language and life that can stray toward a "structural esoterism" made of "haughty signs" [4].

As it is known, in *The Order of Discourse* Foucault explicitly mentions *powers* and *dangers*, an authentic *apprehension* that can seize us, concerning the language that we speak, which most people do not feel because they use it every day. But before reaching 1970, literary studies allowed Foucault to discover that literary writing had, for a long time – at least since Diderot – already subverted the linguistic codes of

*Between Madness and Literature by Michel Foucault from a Philosophical Point of View… DOI: http://dx.doi.org/10.5772/intechopen.100358*

belonging, in a confrontation (which was also political) with the *discourses of science*, and moreover in a confrontation at a distance with the *difference* of madness, a madness that the *discourses of medical knowledge named* and explained*.* Not only that, they *put it in its place*. This is where Foucault draws madness close to literature. Some literature is, in fact, a "disalienated madness," [1] which cannot be confined to a madhouse, since it is made of "doublings of figures" [4]. This literary writing was not just a game and a literary experiment. It was also, and especially, a way to open up the signs and take them beyond their signifying function [4]. This literature was, in the 1960s of Foucault, "the madness of the outside," [5] when things can be said but *cannot be thought of* as they are uttered. An example is Borges' *Chinese Encyclopedia*, which opens *The Order of Things* and makes Foucault *laugh*. But if I speak and cannot think of what I say, what am I? If I move in a literary scene (Roussel, Blanchot, Borges, Artaud, and many others), I am not raving mad. If I am otherwise a *normal* man, then I am *anormaux*. It is worth repeating that we are on neighboring territories, because the two dimensions of mental illness and a certain type of literature are similar only for the discourses that they deliver. They are both *outside* the order of discourse of scientific knowledge, although under different titles.

This is how Foucault studied the history of psychiatric thought, from leper hospitals to Freud's research, following a pace of this history that consisted also of interruptions, jumps, and sudden forward and backward leaps. In parallel, the *non-works* of literature coincided for him with *acts*, *events*/*enunciations*, where what counted was the *gesture*, not the person who made it, not the *author* who made it. Many were the incomprehensible, unnamable, un-assignable (at least temporarily) words in this semiotic horizon. It was almost like the language *twisted against itself* (Joyce). The sign opposed a resistance, and he who knew how to practice it moved to the *edge* and played on the borders of the *outside* (Blanchot) because the signs that he used could not be immediately recognized. In the face of this word, it is even possible that some *dispositifs* of power can change, because *transgression* [6] – even when only literary (Sade, Artaud, Nietzsche) – can cause a general movement of reversal that breaks with the "old." For Foucault, at the basis of these breaks are *events*, a "solitary movement of singular precociousness" [1]. The switch to history, to a collective strategy, is hard, because everything seems temporary, isolated – an *accident*, an *event,* where the bringing back and integration deployed by the dispositifs of power are always right around the corner [1, 7]. It is thus necessary to look *always, again, for* another *outside.* The work of detachment, what Foucault will name *sé deprendre*, has to begin all over again, both in psychiatric studies and in the field of an archeological and genealogical philosophy that knows how to dialog with certain literary forms.

## **2. Notes on reason and madness in** *History of Madness in the Classical Age*

*Madness* has been the object of many *discourses*, which Foucault studies and divides into periods. In his reconstruction in *History of Madness*, Foucault claims that the mad, at least since the 1750s, had to be excluded and their speech controlled. Only *reason* can speak and this is how *madness* is named, identified, and circumscribed. Of course, so pigeonholed, *madness* contributes to define the limits of this same reason: it is the *exteriority*, the *outside*, the *other* of reason. In any case, only one of them *–* reason – *speaks,* speaking also of the other one. And reason speaks about itself, about what it is and what it is not, of what others are and are not, being the only one entitled to do so. In all these cases, *discourse* is already an instrument in the hands of a power: the power of reason, and a psychiatric power too, if only in its early stages.

But how had people spoken until then? According to Foucault, the Middle Ages held together the scientific, allegorical, mythological, and poetic discourse, as well as that of magic and chemistry (alchemy). Again in the Middle Ages, the world had long ceased to be a *cosmogony*, a tapestry where man could read the signs sewn by God, because Babylon and its punished sins had rendered everything "opaque." The men who built the Tower wanted themselves, and not only God, to be able to name things. Then like now, it was not a matter of simply *designating* things, but also of *creating* something, or re-creating something that already existed by designating/ nominating it. We know that God punished the humans from Babylon for their arrogance and for building that Tower that pointed to the sky. And he punished them by making the signs and the traces that He has always left across the world, opaque and not immediately legible. Foucault maintains that the medieval men then tried to put back together a possible interpretation. Ferdinand de Saussure would write about the arbitrary relationship between the concept and the acoustic image. He would note that certain correspondences/transparences cannot be sought anymore, because sign, meaning, and the world refer to are different things, and nothing is transparent in these linguistic relationships. To the contrary, we have leaps of semiotic atmospheres.

While medieval people were still convinced that the great jigsaw puzzle of opacity could be read through different languages belonging to the same *leggenda* (in the sense of what can be read) [8], the *Âge classique* imposes itself and imposes the singular language of reason, of science, and Cartesian knowledge to everyone. This is how man will start differentiating between scientific, allegorical, and mythological discourses. Based on these rigorous languages, those with the power will be able to start *serializing*, categorizing, *naming*, identifying, and creating taxonomies (maybe we have never stopped doing it) to make other women and men into classifiable phenomena. Given this semiotic premise, the mad of the *Âge classique* are all pigeonholed in a template populated with cases of *abnormality*. According to Foucault, a "tragic awareness" of this madness developed since the very beginning, that is, in the early Renaissance. *Nature* could not be trusted anymore because it was suddenly populated by monsters, including the *mentally ill*, which could come out anywhere. In his reconstruction, Foucault claims that that is when the mad, the beggars, the vagabonds, the libertines, the blasphemers were all gathered at the *Hôpital*: a lager. It was a social problem: *order* had to be made. Undoubtedly, that *Hôpital* was filled with chaos: the homosexuals and debauched laid next to the mad. However, that was the price to pay to the Cartesian method, when a truth must be established that let only the reasonable and rational be free, whereas many and varied persons ended up together in a big hospital. Vagabonds cannot roam the streets, even better if everyone moves to the city from the country, because the country is still too *wild* and we must discipline, build the citizen, and create demography. Individuals must be controlled in order for them to be sent to the factory to work, already *serialized*, from the 1800s onward.

All the *mad*, indiscriminately, are empty, negative, and unreasonable [9]. Their bodies and minds (*spirit*) are too entangled and there is no physical cure that can go with some *moral consolations.* In the early *Âge classique,* this is how one could be innocent and should be cured, but chaos reigns and then the same innocent individual is guilty and must be punished. Thus, takes place the quick shift: reason on one side, madness on the other. Finally, with Pinel and Tuke, madness is *medicalized*, made into a scientific object. The mad are examined as if they were *phenomena*, in the same way *objects* are examined. These *mad objects* (which lack the qualities of the rational and reasonable subject) are our "objects" because they are in our "possession" and, as such, belong to us in every sense. Then, perhaps, we lock them in a drawer, but it is something we decide to do. These prisons/drawers are ours: we built

#### *Between Madness and Literature by Michel Foucault from a Philosophical Point of View… DOI: http://dx.doi.org/10.5772/intechopen.100358*

them to put in our objects, our possessions, our mad, and our physicians. They are the drawers of our desks, on which we compile our *archives* and note that someone is *mentally ill*. In Foucault's reconstruction, at this point this kind of madness is very close to us because it teaches about us, who are the mentally sane. We know ourselves through this madness, that is, through the modalities with which some discourses are made that let us know that someone is mad and maybe we, too, are not so well.

Only Freud will begin claiming that there is something *profoundly true* in the mad, which belongs to all of us. Again, Freud will say that there exist some familiar, *sleeping forms*: the same *voices* for everyone, and strange *lights*. It is as if the mad showed us our youth, being the mirror of the distortions of a civilization that has become modern. The instincts, perversions, pain and violence, the selfishness are ours. They are our mad side. But before reaching Freud, Foucault reminds us that Pinel – who took the important step of declaring that the mad are not monsters but persons in need of a cure – did not free anybody, precisely because he claimed that madness is a *sickness* that must be cured. Pinel, as a phyisician, was a man of power who practiced a discipline that had its own exclusions, "declassifications," and desk drawers. However, Pinel's time is already the time of the *man-madness-truth* tryptic; not the time of the *truth/errors*, *world/ghosts*, *being/not-being*, and *night/day* dichotomies anymore. Foucault identifies a three-partite anthropological articulation that ripens in Pinel's hospitals of the 1800s, on city and country roads, in the literary works of all the authors that we have already mentioned. It may be 1961 and Foucault is speaking of *madness*, but *The Order of Discourse* of 1971 is already ready.

In any case and to stick with our theme, at the time of *The History of Madness*, Foucault attempts straying in the literary field more than once. Diderot's *Le neveu de Rameau* (1891), whose analysis occupies the introduction of the third part of the *History of Madness,* is a lonely man who makes continuous pantomimes. He is vain, *full appearance*, *immediacy.* He is a *raving* man, who interrogates us, even if he represents "all the elements that form a wordless dialogue between day and night […] in the burgeoning transcendence of any act of expression, from the source of language itself […]" [10]. Roussel, Joyce, Foucault: ""He is mad", because that is what people tell him and because he has been treated as such" [10]. *Rameau's nephew* is *lyrical*: he imitates everything, knows all the languages. He is *one and nobody* because he is everyone. He is a man who, in the end, is left on his own, locked up, remaining there with an empty smile on his face that will frighten us. Foucault: "To be oneself that noise, that music, that comedy, to realize oneself as both a thing and an illusory thing, and thus to be not simply a thing but also void and nothingness, to be the absolute emptiness of the absolute plenitude that fascinates from outside, to be the circular, voluble vertigo of that nothingness and that being […]" [10]. In the end, *Rameau's nephew* will be an *object* in the hands of the physicians and his lyricism will be explained and normalized in the *medical discourse*: his will be an *organic problem* and, as such, *medicalized*. And yet, like in a concave mirror, this *monster* of a nephew shows what and, most importantly, who is normal. In a short time, Sade and Baudelaire will be "declassified" too, because their discourses are perplexing. Sade will be classified as a *pornographer.* He will be identified and taxonomized: his work will be considered *obscene*, perverse, and deviant. The danger that he represents must be softened, thus he must be locked up and condemned.

Are *le neveu de Rameau*, Nerval and Hölderlin, Nietzsche and Artaud mad? Absolutely not, not in an important phase of their lives, because they have their own way to tell their experience, which for Foucault is symbolic. It is almost as if they established the sense of how the experience of life is changing in general, between the end of the 1700s and the beginning of the 1900s, thus also the experience of life of those who really experience madness and, especially, of those who watch and

listen to it, deciding whether one is mad, or not. Madness and literature stare at each other from their respective sides, experiencing each its *non-sense*. We are on the outermost edge of "two movements of poetic conversion and psychological evolution" [10], which imply, for Diderot in 1791 and Foucault in 1961, *the inebriation of sensible things*, the enchantment of *immediate things*, a painful irony, a certain loneliness, that of the *neveu de Rameau* and his madness that belongs to us. However, there is not only Diderot. Let us repeat and anticipate a theme that we will return to: Nerval and Hölderlin speak about man's *senseless secret*, about "his first morning," a "young light," a "starting again," an *outdoor* (an *outside*), which is crammed with items that are not mediated by any reason and are very attractive. We will return again to how these literary experiences happen like a tragic and painful "laceration," even if always in the *full light* of the possibility that we might start all over again (Nietzsche). In short, we are dealing with dangerous experiences: "The moment of the *Ja-sagen*, of the embrace of the lure of the sensible, was also the moment they retreated into the shadows of insanity" [11].

*The History of Madness* was not appreciated by some psychiatrists, who deplored that someone could claim that their retreats had an obscure origin in the leper hospitals [12]. We have already recalled that, in spite of their merits, according to Foucault even Tuke and Pinel cannot be ascribed to hagiography of psychiatry. For Foucault, madness is a *cultural product* and, for psychiatry, things went one way, but could have gone another way as well: a *roll of the dice –* as we will see *–* a mode to conceive history marked by unforeseeable *events* and ruptures, which coincided with the birth of the bourgeois society and its ensuing, wide exclusions. At the beginning, psychiatry was, with Pinel and Tuke, one of the positivist forms that corresponded with a sort of apotheosis of the figure of the psychiatrist. In Tuke and Pinel's retreats, a rigorous morality applies, where no *diagnoses* are made, only observations of the *behaviors* of the sectioned patients. For Foucault, here it is all about knowing how to deal with the mad and there is nothing metaphysical in the patient-physician relationship, but rather a full-fledged *political confrontation*. Madness attempts to make its voice heard, but science classifies it like as a sickness, and achieves this by indulging its *moral sensitivity*. Since that time, many steps have certainly been taken, as we at least have tried to rely on the *medicine-verification* model [12]. Is Foucault an anti-psychiatrist? Maybe. Certainly, mental illness is not only a natural occurrence to him; it is also the effect of a specific medical interpretation. Psychiatry advances/imposes such interpretations, which are historically based on a power relation with the patients, is a power that makes institutions – and not only them – work. And yet, if this is how things stand, if psychiatry was and is a power, then its choices can be questioned and subverted [13].

Nevertheless, what *procedures* do men/women undergo to become physicians, as *subjects of conscience*? Simultaneously, on what basis do men/women become patients as *objects of conscience*? For Foucault this question is not only about *repressive systems*, with respect to which we would be *passive*, but about processes of *self-formation*: the mentally ill and the sane self-form with respect to the psychiatric power. The same goes for the physician with respect to the patient. It is a power fight over yielding the power of delivering a certain type of discourse. Is psychiatry willing to ask itself about how its 'truth' has affirmed itself through history, under sometimes violent circumstances? Does it make a genealogy of its historical processes that have led it to, today, deliver certain discourses, which profess the truth about who is mentally ill? To work on one's history effects the *liberation* – albeit partial – of thought, including the psychiatric thought, working silently on what we think, because those who are defined as mentally ill do, indeed, *think silently*, but the same goes also for the physician who observes the patient's behaviors and listens to his/her discourses [10].

*Between Madness and Literature by Michel Foucault from a Philosophical Point of View… DOI: http://dx.doi.org/10.5772/intechopen.100358*

Let us be clear on this: Foucault's whole operation in 1961 and then in 1972 with the new edition of *The History of Madness* and then with the two courses at Collège de France, *Le pouvoir psychiatrique* (1973–1974) and *Les Anormaux* (1975), was not easy, because Pinel is not at all bad. He is a physician who stands before the mad and tells his assistants that these people are not criminals, nor possessed by the devil, nor wild beasts to chain and lock up, but sick people, and it is necessary to treat them with care and humanity. But we have seen that for Foucault, Pinel's progress still carries within itself the discursive mesh of a series of passages that reduce the *other* to nothing, but a *sick person* to cure and, in a positivist sense, a scientific object to analyze like any other phenomenon. We will have to wait for Foucault to read Freud and even he will not be enough for the philosopher because his psychoanalyses are induced *self-confessions*. In any case, madness remains the result/discard of the Cartesian cultural gesture of separating *reason* from *non-reason*, being mentally sane from being mentally insane. For Foucault, psychiatry does not liberate, it excludes. Lepers were too excluded by means of specific rituals of purification. They were only one step ahead of the beginning of psychiatry's history, which was grafted onto their historical branch via an event, an *Hôpital*, a Cartesian distinction between *being* and *not being*.

Is Foucault's reconstruction of the *history of madness* perhaps too ideological? Does it wink to *Surrealism*? Is it too not historical enough, *anti-psychiatrist*, anti-Cartesian, and anti-Enlightenment (these are the accusations that were leveled at him and that he took in serious consideration) [14]? Maybe, but this is not what matters today. What matter are his observations on the discourses of psychiatry, *powerful* discourses that forced many *different ones* into a silence that stretched to Freud's time, even if, to Foucault, certain tales of the self (the dialog and the psychoanalytic encounter) look a lot like *self-surveillance*. In any case and at every moment in history, psychiatric time needs its own *microphysics*, which is only possible starting from the discourses that the psychiatrists make and let others make, or not: from a psychiatric point of view [15], *society*, *power*, and *normality* are important stakes. Is Foucault anti-psychiatrist, *post-romanticist*, and an idealist? Foucault signaled a discursive shift: the mad's discourse, which was silence, was replaced with the medical discourse, a kind of "transcription" of *madness* in the language of *mental illness.* This affects us, if nothing else, for all the times we speak of *medicalization,* a concept that touches us throughout our lives, from the moment of birth to that of death.

We know that in the 1970s and 1980s Foucault sought a return to the *Aufklärung* beyond its historical limits: a *critical*, *archeological*, and *genealogical* return to the time of the *Luminares*, because a different life is possible, because, if anything, the Greeks and the Romans, at least some of them, before the Christians, led lives that were ethically different from our present ones. But what kind of shift did Foucault attempt? Are not his *Aufklärung* and his *critical detachment* themselves constitutive of a new *scene*, with all the limitations that it entails [16]? Regardless of how we want to answer this question, already by 1961 Foucault had described a "madness of not madness," in the *non-sense* of a reason, a knowledge, and a medicine that impose themselves as *dispositifs of power* with catch-all pretenses. Then, next to it, we are left with the impression that the *sense* that we attach to things derives from a *non-sense*, which is of the world and of the same men and women that attempt to give *meaning* to themselves, walking on an *abyss*, the abyss of the *non-sense* that they find themselves facing.

For Foucault, let us repeat it, *power and knowledge* can constitute themselves in a *moment*, and therefore at the beginning of any time there is a *roll of a dice*, an *empirical* dimension that is necessary and not transcendental. There has never been, for Foucault, a *transcendental subject.* There was never a man, a woman, that had

been always made in a certain way and would be like this forever. There has always been and there will always be a man and a woman of knowledge and power, who change at each historical passage and some passages are, as we were saying, a *roll of the dice*. This is where we run along the edge of the abyss, that is also connected with what might happen: Nazism, Fascism, the lagers, the atomic bomb, the "madness of not madness" taken to their limits. And yet, *they* are the mad ones, the people whom we cure, medicalize, and confine in the madhouses. In Italy, Basaglia, first in Gorizia and later in Trieste, began opening some psychiatric hospital in the same years that Foucault was conducting his studies, from the end of the 1960s through the 1970s. Basaglia's operation was not easy, especially for the families of the liberated *mad*, who were again hit by their relatives' *non-sense of the sense*.
