The New York Review of Books

The following comments by Michel Foucault on Lawrence Stone’s review, “Madness,” in the December 16 issue were sent to the editors but are addressed to Professor Stone.

1) You ascribe to me the thesis that, as from 1650, a new principle emerged according to which “madness is shameful” and “the best treatment is forcible isolation from society under management by professionally trained doctors.” This view is precisely the opposite of that which I have set forth as the main argument of my book and enlarged upon through the full five chapters of the first part. Namely, that the procedures and institutions of confinement evolved throughout the whole of the sixteenth and seventeenth centuries, and did not begin in 1650; that they were essentially extramedical; that the results aimed at were only partially therapeutic. The dates, conditions and regulations of these nonmedical confinements are analyzed on pages 56-123 of my book; the limited space allotted to medical practice is analyzed on pages 124-177. Why do you not take into account these 120 pages which utterly refute the thesis you credit me with? And why do you ascribe to me an untenable thesis, never, to my knowledge, maintained by anyone and certainly not by me?

2) You credit me with the idea that this was merely the result of “a conspiracy of professionals to seize power for themselves to lock people up.” This is, once again, the exact opposite of what I have said. To begin with, I never had recourse to the notion of “conspiracy” to analyze this historical phenomenon, or any other. Moreover—and this forms the subject matter of my book—I have attempted to show the length, the diversity and the complexity of the processes which finally, after a century and a half or more, led to the setting up of a specialized psychiatry and of a body of alienists who were able to claim the exercise of medical authority within the framework of the institutions of confinement. What I wrote is therefore not the description of a conspiracy; I never set down 1650 as the date of a medicalization; and I never considered doctors to be the sole agents of such a medicalization. You are entirely mistaken on all three points. Why?

3) You raise the objection that there is evidence of the confinement of madmen during the Middle Ages, as if I did not know or mention such facts. Now, I refer precisely to such accounts of confinement as can be found and I point out that there existed, in this respect, a very old tradition that assumed, in later years, another dimension; I mention a certain number of examples on pages 20-21 and 125-127; I also point out (pp. 161-162) that, throughout the Middle Ages, madmen were sometimes locked up and displayed like animals. Assuming that you have read my book, could you have copied what I said the better to reproach me with not having said it? Or should I believe that you have not read it?

4) Yet another objection on your part: madmen were not “isolated” since tourists went to see them where they were kept in chains.

Two comments:

a) Do you really believe that locking people up and making an exhibition of them proves that they are not submitted to segregation? Just tell me if, fettered and howling in a yard or writhing behind bars, subject to the jibes of gawking onlookers, you would not feel slightly isolated?

b) Now, it so happens that I have mentioned, with appropriate references for both France and England, these visits to madmen made a show of in this way (pp. 161-163). I consider these facts as an aspect of the complex attitude toward madmen: they were hidden away and at the same time exposed; both attitudes are borne out by my references.

A little more attention would have prevented you both from over-hastily leveling at me an ill-founded reproach, and from supporting the said reproach with such a wondrous strange chain of reasoning.

5) You argue that there are “enormous differences in the degree and organization of incarceration from country to country,” England specializing in private institutions and France in state-supported ones. Now, on pages 67-74 and 483-496, I insist on the pronounced differences between a country like France and a country like England where religious organization, legislation, institutions and attitudes provide much more scope for private initiative; I point out, in particular, the long tradition with which Tuke is in keeping and which evolved throughout the eighteenth century. Nevertheless, you are wrong in thinking that everything in France was state-controlled.

6) When you argue that the incarceration of the indigents occurred mainly in the seventeenth and eighteenth centuries, and that of the insane in the nineteenth century—it is true that I know not what to answer any more than I can guess to which passage of my book you refer, since it is entirely concerned with the slow evolution from one form of confinement, intended mainly for the poor, into a confinement involving medical treatment. You content yourself with repeating my general thesis while twisting it into an objection.

7) Contrary to what you claim, I never compared “the treatment of the mad” to that of lepers. I pointed out that a certain number of disused leprosaria were employed for other purposes and in particular [for] a confinement which was, in the seventeenth and eighteenth centuries, only very partially therapeutic.

8) You reproach me with having placed under the same “conceptual umbrella” the treatment of schoolchildren, the poor, criminals and the insane. And you emphasize the fact that the condition of the indigents has greatly improved in the last two hundred years and that children “at least up to the 1960s” are increasingly better educated. Now,

a) I never denied what you put forward in these last two propositions; I never even broached the subject.

b) I did not, in my book on insanity, ever touch upon the question of schoolchildren and their education. Can you quote the passage where I am supposed to have done so?

c) Neither is the presence of criminals (often enjoying a special status) alongside the poor and the insane in the same places of isolation pure invention on my part. It is a fact borne out by documents I quote, more particularly on pages 56-123 and pages 414-421. Are you in a position to deny this fact and to back your denial with convincing documents?

My problem was to understand the logic of a practice which could concern madmen, criminals and the poor. But which in no way concerned children, or the nineteenth and the twentieth centuries, as you would have the reader believe.

9) Finally, harking back once more to this thesis I never upheld (according to which doctors were “behind the great confinement of the insane”), you argue that society was anxious to “pay for incarceration” and that there was, in this respect, an important social demand on the part of the family circle and the entourage; in France, the lettre de cachet, which was one of the means of administrative incarceration, was more often than not demanded by the families, and confinement, even at Bicêtre, had to be paid for, in many cases. Besides, you must not imagine that it was only the “well-to-do families” you mention who made such requests and were willing to pay for the subsequent upkeep.

All in all: nine major errors, spread out over two small columns and a bit; that’s a lot. I am not in the habit of replying to criticisms as I consider the reader quite capable of putting blatant adulterations right all by himself. However, the regard in which you are held prompts me to submit to you these few answers, which could be far more detailed. Indeed, they provide me with an opportunity to ask you a few questions.

1) The “fidelity” you show to my book surprises me. You could have quoted from sources other than those I refer to, mentioned different facts, opened new perspectives. You have done no such thing. Out of the nine reproaches you level at me, four (numbers 3, 4, 5, and 6) consist in repeating what I said while pretending I never said it; three others (1, 2, and 8) consist in turning round, word for word, what I said and ascribing to me the subsequent thesis which has become untenable. As for the ninth reproach, it combines, rhetorically, the two methods used throughout the development.

2) I fear you have taken a considerable risk. Think of those who have read my book; think of those who will read it and want to collate it with your review of it. Is it of no importance to you that people may believe you to be “unconcerned with historical detail of time and place, or with rigorous documentation”?

3) Don’t you agree that the probity essential to any scientific work should rule out such procedures? Don’t you agree that only by respecting the work and the thought of an author can one prevent criticism from falling prey to the bad habits of hurried journalism?

4) I first published my book more than twenty years ago. It was, at the time, a little “solitary” in a field the historians had, perhaps, not fully explored. It is of course necessary that it should be revised, refined, corrected, enlarged upon. Fortunately, since then, the problem has developed, as you justly point out, into a topical question. However, doesn’t the fact that, twenty years later, it gives rise to so many obvious adulterations on the part of someone who should have stayed cool-headed signify that the problems it has attempted to deal with are still charged with passion? All the more reason then for one to be, in discussion, as attentive and as scrupulous as possible. Even when madness is restricted to a subject matter, it has something of a blinding effect on the mind.

It is for this reason I suggest we resume, amicably and in all serenity, the debate on these problems, in as agreeable a manner as possible to both sides. But first, I would appreciate a paragraph-by-paragraph collation of what you have written about my book with what I have actually written. The reader is entitled to know where the truth lies.

Do let us try, together, to provide the means to this end.

Michel Foucault

Paris, France

Lawrence Stone replies:

I am sorry that Professor Foucault is disturbed by my criticism of his ideas. Today he enjoys an almost unparalleled position of intellectual dominance over the interpretation of many key aspects of the evolution of Western civilization since the seventeenth century. We are none of us infallible, and Professor Foucault would surely concede that someone in his well-deserved position of preeminence must expect his ideas to be subjected to reasoned and temperate critical scrutiny. The historian faces several problems in dealing with the writings of Professor Foucault. One is that he is not at all easy to understand, because of what an unkind critic has called “his obscure, arrogant, sensationalist, and opaque form of discourse, which by his own admission is a ‘labyrinth into which I can venture…in which I can lose myself.’ “¹