Madness and democracy : the modern psychiatric universe /

Gauchet, editor of Le Debat, France's influential intellectual journal, and Swain, until her death in 1993 a psychiatrist and historian of psychiatry, collaborated in 1980 on this fertile interpretation on the history of the idea of insanity and on political efforts to cure the insane. The translation reflects the original French's highly complex tone, and thanks to the lucid and suggestive foreword, the patient reader can make headway into this important but difficult work. The origins of modern psychiatric care grew out of the idealistic efforts of Philippe Pinel, who pioneered humane treatment of the mentally ill during the French Revolution, with his plan to cure insanity through wholesome therapeutic conditions. When Pinel failed, optimistic liberals demanded greater efforts and resources, ultimately leading to modern psychiatric medicine. Contrary to Foucault (see his Madness and Civilization, CH, Dec'65), Gauchet and Swain argue that the desire to cure the insane by institutionalized medicalization stemmed from liberalism's compassion, rather than lack of it. Paradoxically, this sensitivity empowers the democratic state to oversee and control its citizenry in the name of sanity. As much philosophy as cultural history, this work deserves a thoughtful audience, especially readers interested in the relationship between history of psychiatry and modern society. Graduate, faculty. D. R. Skopp; SUNY College at Plattsburgh

Gauchet and Swain challenge Foucault's classic analysis in Madness and Civilization that the "great confinement" of the insane represented the psychiatrization of political and social deviants, and that asylum treatment simply tried to inculcate bourgeois values. Instead of a history of subjugation, their analysis of late 18th- and early 19th-century French psychiatry shows how the modern self came to be understood as a complex creature with dangerous, irrational depths. Gauchet and Swain acknowledge the liberal, humanitarian intentions of "alienists" and cast the psychiatric exercise of power as beneficent in intent although no less insidious than Foucault portrayed it. Dr. Philippe Pinel's famous "moral therapy" and the expansion of the asylum system after the French Revolution, they argue, were a product of therapeutic optimism, driven by the conviction that the insane were never so bestial or alienated from their humanity as to be deaf to the voice of reason or self-reflection. This new model of the insane, in turn, prompted the modern understanding of the self. Furthermore, they contend, the asylum system was structured as an ideal community that crystallized the totalitarian exercise of power in postrevolutionary democratic society. Like Foucault, however, they are given to convoluted philosophical language and sweeping generalizations about subjectivity, power and society that are untethered by documentary supports but sure to stimulate much theoretical speculation. (June) (c) Copyright PWxyz, LLC. All rights reserved