Schizophrenia through a Foucaultian Lens

"Madness was not what one believed, nor what it believed itself to be; it was infinitely less than itself: a combination of persuasion and mystification...And by a strange reversal, thought leaped back almost two centuries to the era when between madness, false madness, and the simulation of madness, the limit was indistinct - identical symptoms confused to the point where transgression replaced unity; further still, medical thought finally effected an identification over which all Western thought since Greek medicine had hesitated: the identification of madness with madness - that is, of the medical concept with the critical concept of madness" (p. 164, Rabinow, Paul, ed., The Foucault Reader,1984.)

In speaking about the evolutions of the view of madness in Western societies through the 17th to 19th centuries, Foucalt discusses here the idea of madness, delinquency, and the power relation between psychological treatment and the mentally ill; a manifestation of power relations elsewhere in society (family, government, social rules, etc.), as well as the needed confessions of madness on the part of the ill person.

I found this quote especially interesting because of its possible application to the experience of severe mental illness of a close relation(as a 'healthy' person). How does the process of forced realization as the perceived cure to 'madness' (p.165), conceptions of madness as social aberrance, "abnormal psychiatry," fear/shame/guilt relationships surrounding mental illness, shamanistic power plays with doctors and social stigma, as well as concepts of bourgeois factors in classification of dysfunction and madness (not human mental suffering, but 'dysfuntion' and inability to work, delinquency) relate to my own memories of being within daily and hourly contact with a person whose brain functioned differently from mine? And where do notions of responsibility/personal transgression of an ill person come appropriately into play - esp. when they are of legal majority?

In my own journeys into what seemed a dark house of illness, I think I did not know, and still do not know in many ways, how to fully comprehend this "other" who views the world with a mixture of different reasoning, lack of logical thought progression, and constant paradigmatic shifts. I become confused until all symptoms of difference become allotted to a false front of "madness" (not specific mental illness), which is an indelible stain that cannot lift, so the problem can never be excavated, explored, or understood. It becomes an almost magical, chimerical thing that only something equally "magical" can cure - in my parents' eyes, a miracle. In my own, a series of medications I do not fully understand (Foucault talks about the doctor as a pseudo-magical being, the doctor-patient power relationship on p. 165 of Rabinow, which is in part what I am using to help me view this experience).

What about the experience of the ill person? Is it simply subjective differences in viewing the world, and a lack of understanding on the part of the "well" majority, that renders the illness and illness at all? From my own experience, I would say that the encounters with what I did experience - an abnormality-illness-suffering that I will tentatively call schizophrenia for ease of use, were personally almost unbearable. And from what I could ascertain of what the other person was suffering, it seemed she was experience great pain, fear, and anxiety, thoughts of suicide.

Physically, what I believe to be at the heart of this suffering, which for her crosses bounds of mental pain and often enters the physical, is a problem of brain function. However, the suffering itself often seemed caused not by the "abnormal psychology," though this might seem to keep her in a constant state of changing viewpoint, from which it was impossible to grow forward toward mastery of her own life, but from the impossibility of association across two differing states of living. The mutual existence of the two incompatible ways of dealing with the world and others; hers constantly changing from one delusion to the next, versus mine, was too difficult for either of us to handle, but for her seemed especially painful. There could be no world that allowed for both states, one of us must be insane.

In some ways, I think I took on a magical quality for her because I had "abilities" she did not. (Like being able to understand unstated meanings in discussions, or having an understanding of basic social skills in places like the library.) At other times it was the opposite: she could physically withstand hours of insomnia and intense conversation in a way I could not. In her mind, I was almost always without fail the cause of her pain and persecution, either through my own malevolence or through my connection (spiritual/mental/magical/social) with others who were against her. I have come to think perhaps this was not due to an actual inhibition of her success on my part, nor a complete fantasy on hers, but rather the fact that I stood as a comparison, like Foucault's juridicial asylum systems, a mirror that I did not mean to be for her, and mentally I therefore had to become the Madness and she the Sanity, I the Transgression and she the Reason (pp. 152-155, "Recognition by Mirror" and "Perpetual Judgment").

thanks to Nara Hohensee for her insight in recommending this reading