Ethics is defined by the dominant paradigm. Within its positional concepts is the discourse that governs what is perceived as truth, morality and right or wrong. That is, “each society according to Foucault’s view, develops a conception of truth that is determined variously by the forces that are prevalent in that society, the political and ideological influences that prevail” (Oliver: pg 142).
During the late middle ages in Europe a paradigm shift occurred in the discourse and treatment about madness. Foucault uses the Ship of Fools to illustrate this process. Author and scientist, Thomas Kuhn, describes a paradigm shift as an evolution of basic assumptions within the ruling theory, “including that which is compatible to its new growth parameters and excluding that which is incompatible”(Kuhn: 147).
In Europe, during the late middle ages, the Catholic church was the custodian of God’s truth and dispensed their discourse as absolute truth. They were the dominant paradigm of this era. The church considered it their responsibility to define the actions of humanity in a scriptural context. Madness was a dominant topic in the European intellectual circles of that era, resulting in literature and plays being produced because of the effects madness had on society. Society had begun open forums on the concepts and discourse of madness, and the church felt it had a social obligation to weigh in on this discourse. Their duty was to make sure that human understanding would align to the church’s obligation to God's truth. Marie Thompson, author of Mental Illness, illustrates Church doctrine concerning madness:
The late middle ages (1300-1500) was a disastrous era for the mentally ill. They became the victims of persecution and were blamed for their own illness, accused of moral weakness, thought to be possessed by evil spirits, accused of indulging in forbidden associations with evil spirits, and expected to affect their own cure. (Thompson, 11-12)
Many mentally ill, because of their perceived voluntary act of associating with these evil spirits, were burned at the stake, or drowned.
By examining the dominant paradigm and a new paradigm, one can better understand the discourse on both sides of the argument. The Church was resistant to change, and they held the power and truth of the day. They believed they were a direct conduit to God, the ultimate authority in human discourse. They had the positional place as the guardian of truth and human conduct. Behaving contrary to that truth was an act of sedition and heresy towards the church and, ultimately, God. The act of biased interference towards the present paradigm was treated with contemptuous intolerance and it placed those who generated this oppositional interference in danger of exclusions and, possibly, death. Physicians and philosophers of the era risked their lives for this argument; a new ethical treatment for the insane.
In 1526, Juan Luis Vives, began to publish a series of recommendations concerning the concepts of medieval charity. (Shuger: 15) Vives proposed a radical approach to the humane and “christian” treatment of the insane, stating:
Now, let us refer to the insane. Since there is nothing in the world more excellent than man, and nothing more excellent in man than his mind, particular care should be given to its welfare. It should be considered the highest of ministries to restore the mind of others to sanity, or to keep them sane and rational. One ought to feel a compassion before such a great distaste to the noblest of human faculties. He who has suffered so should be treated with such care and delicacy that the cure will not enlarge or increase the condition, such as would result from mocking, exciting, or irritating him, approving, or applauding the foolish things which he says or does and inciting him to act more ridiculously, applying stimulus as it were, to his absurdity and stupidity. What could be more inhuman than to drive a man to insanity just for the sake of laughing at him and entertaining oneself with such a misfortunate (Quoted in Thompson: 10)
The Church’s discourse on madness was interpreted in such a way that allowed it to be understood as sin. This interpretation would ultimately be tied back to God's Creation of the universe and the concepts of providential workings. Using this interpretation of sin or madness, one could understand it as a divine punishment or test that could only be absolved with repentance. The conduit of authority in this paradigm, the Church, was, therefore, the voice of God and could validate one’s penance. The new discourse threatened the power and authority of the Church, and ultimately, God. (Thompson, 11)
What new discourse could be tolerated by the dominant paradigm in regards to Official dogma? Sinful humanity could not be trusted to make decisions that would parallel the agenda of the Church. This dispersal of power and truth to secular humanity would have been viewed by the church as turning over humanity’s manifest destiny to an unenlightened sinful creation. At the Council of Trent in 1563, the Church closed all discourse concerning new treatment of the insane. “The council of Trent signalled the end for the voice of institutional reform, as the counter reformation generally favored an entrenchment of the Catholic orthodoxy, for whom and Vives inspired proposal was branded as pestilential, pernicious, and injurious for the Church” (Shuger: 17).
In Madness and Civilization’s preface, Foucault briefly quotes Blaise Pascal, a French mathematician, writer, and Christian philosopher and Fyodor Dostoevsky, a Russian novelist, and philosopher. These two philosophers, of the 17th and 19th century, give credibility to his writings that focus primarily on French, English, and Russian history. Foucault uses writings by Miguel Cervantes, a Spanish novelist of the 1500’s, to help illustrate the amount of literary attention given to madness in that era. Strangely, Foucault is silent about Spain's dealings with the Catholic Church and the treatment of madness. Foucault, ignores the Spanish dealings with madness almost completely. Instead, his focus is on the French and English dealings with madness, citing his first historical reference of mass confinement in 1656, at the founding of Hospital General in Paris (Foucault 1965: 39).
Foucault was a passionate philosopher. By illuminating specific regions in Europe, he was able to beautifully illustrate his concept on the process of madness in the 1600’s. Ignoring the Spanish dealings with madness was not an oversight, but a choice of the author’s discretion. The information from that period was voluminous and vacillated from multiple theories. Foucault refused to use the singularity of ethical responsibility of right or wrong in a corporate reference such as the Church. Abdicating the Church and focusing on the personal responsibility to truth and enlightenment was more his philosophical style. “Enlightenment is man's release from his self incurred tutelage” (Foucault, 2007: pg 31). In other words, a person who was enlightened did not need someone else to reason for them, or define their personal truths. His book Madness and Civilization is an account of suffering and torture in the 1600s. He uses the Ship of Fools to illuminate this process.
In the symbolic voyage of the ship of fools, a transformation would occur, not for the mad, but for society and its discourse and treatment of the mad. Those deemed to be socially unacceptable would be taken from the Ship of Fools, and deposited into a cataclysmic abyss, where few returned. Language and professions would develop from this paradigm shift, new discourse that would be used to ratify the agenda of those who wielded the power of truth. Society would begin to look at madness in a different way and those concepts, cultivated in that era, would sinuously work their way throughout the framework of civilization’s future.
1656, Hospital General, Paris France, Foucault uses this historical shift, in reference to his timeline on the treatment of society's undesirables. Though Foucault never shifts the blame to the Church of that era, ignoring the obvious culpability the Church played in the dominant paradigm of that time is difficult. The mass confinement that occurred was the paradigm shift. The Church and society agreed upon new ethics in the treatment of the mad. They would confine them for an indefinite period of time. Foucault references the Edict of 1656, which gave the administrators of the Hospital a type of sovereignty over those who were confined. Being that as it may, the hospitals were primarily used for confinement, and, secondarily, for work. “Labor being an infallible panacea, a remedy to all forms of poverty”(Foucault 1965: 45).
The edict was simply a way to remove the problem from the public purview, thus removing the social debate on madness. Confinement was the way to end public debate on madness. It allowed control to be exercise in the arena of social discourse and, once this control was exercised, the sun set for those deemed mad. Now, the mad and undesirables could be removed from public view and, once again, could be treated as the church dictated through their societal influence. In other words, those who were in charge of these hospitals were, typically, upstanding, God fearing citizens, who would enforce suffering and torture upon those confined at these asylums, with the hope that the mad could affect their own wellness (Thompson: 12). It would be more than a century before the glimmer of hope would rise for those confined in these asylums. Despite the transformation of the Churches paradigm towards undesirables, their hands were still throttled around the discourse that governed the treatment of those confined. Those confined at these hospitals, whether through poverty or madness, all were expected to work. Foucault defines a major shift in the paradigm toward the mad, claiming that the creation of these hospitals marked a decisive event in European history.(Foucault 1965: 34) The moment when madness was perceived as the same as poverty is when it became a social issue. A major shift for the social intellectual perception, madness was now treated as something that had to be confined, where the mad or undesirable would congeal in the dark recesses of the asylums. No longer would the mad be permitted any measure of freedom; now madness was to be confined to the madhouse. The question is, who was more insane, those who were confined or the society that confined them?
Foucault, Michel. Madness and Civilization. NY: Random House, 1965.
---. The Politics Of Truth. Los Angeles, CA, Semiotext(e): 2007.
---. Society Must Be Defended. Lectures at the Collège de France. 1975-1976. NY: Picador, 2003.
Kuhn, Thomas. The Structure of Scientific Revolutions. Chicago, IL: University of Chicago Press, 1962.
Oliver, Paul. Foucault, The Key Ideas. New York, NY, McGraw-Hill: 2010.
Shuger, Dale. Don Quixote in the Archives: Madness and Literature in Early Modern Spain UK: CPI Group, 2012.
Thompson, Marie. Mental Illness, Greenwood Press, Westport, CT: 2007