In his first major work, “Madness and Civilization,” published in 1961, the postmodernist philosopher Michael Foucault examines the humane treatment of individuals considered insane by so-called “enlightened” clinician reformers from the 18th century, including Samuel Tuke and Philippe Pinel. Tuke was a Quaker who institutionalized moral therapy in England. Pinel, considered the father of modern psychiatry, was a French physician who developed moral therapy.
Premodern thinking understood insanity as demonic possession. But Tuke and Pinel sought to normalize and legitimize insanity as a mental illness, reforming the brutal and ignorant treatment of the insane. However, Foucault argues that what appeared to be a neutral, scientific approach was actually a way to force mentally ill people to conform to middle-class moral standards.
Pinel’s asylum established societal middle-class sensibilities as the ethical standard for its inmates. Nonconformity to this middle-class moral standard was defined as insanity. Not surprisingly, insanity appeared prevalent among economic lower-class populations.
Pinel’s asylum became a religious domain without religion. Pure morality and ethical uniformity were the norm.
Social denunciation for trespassing on moral uniformity led to punishment for those who did not conform. This punishment was swift, severe and repetitive until the patient learned to internalize the proper behavior expected and express gratitude for the treatment (punishment) meted out as a cure for their derangement.
At York Retreat, Tuke’s insane asylum, inmates were treated as children who needed to learn how to honor, obey and respect the authority of the father, Tuke himself.
Chains were removed as inmates learned morality, religion, and the Protestant work ethic. Inmates could always be re-shackled if they disobeyed, making them solely responsible for and the cause of their punishment.
Constant surveillance for possible hints of madness taught the inmates to watch and police themselves.
This “neutral” implementation of Tuke’s and Pinel’s “modern” medical treatment of the clinically insane amounted to disciplinary control—power. Foucault argued that this power was maintained through the techniques of hierarchical observation (the gaze), the normalization of judgment, and the examination.
A mere gaze is sufficient to control people. Deviant behavior can be corrected through the power of observation, coercing the one society defines as abnormal toward what society defines as normal. The mere possibility of being gazed upon forces the object of the gaze to internalize the power relation.
Force (power) is closely tied to the establishment of truth. Insanity is cured by combining the gaze with normalizing judgment by deploying the necessary force required to establish “truth.” To exert power is to construct the “truth” and to know the “truth” is to wield power.
Power produces truth. “There is no power relation,” Foucault reminds us, “without the correlative constitution of a field of knowledge, nor any knowledge that does not presuppose and constitute at the same time power relations.”
Once truth is constructed, to question said truth is to question reality. To question reality is a symptom of insanity. Insanity requires a humane response — institutionalization.
To dare to see with one’s own eyes and understand reality from one’s own social location is to be dismissed as insane and locked away in a mental institution.
During the early 1970s in the Soviet Union, political and religious dissidents were interned at maximum-security psychiatric asylums (psikhushkas) without any medical justification. For Soviet rulers, to question or repudiate the legitimized State was a symptom of mental illness.
Similar tactics have been employed in China, from the 1949 Revolution to the more recent treatment of Falun Gong adherents, where critics of the state have been deemed by authorities to be mentally ill.
If those who question and resist authorities are not mad, then they are a perversion, endangering society. As such, to safeguard the well-being of the whole, they must be cut out like a cancer. If not disappeared, then they at least must be silenced or humiliated.
In our current political climate, opposing, questioning or resisting Donald Trump has been given the diagnosis of a mental illness: Trump Derangement Syndrome (TDS). Five Minnesota Republican Senators introduced a bill (SF 2589) to add TDS to the state’s definition of mental illness. Per the bill, TDS is “the acute onset of paranoia in otherwise normal persons that is in reaction to the polices and presidencies of (Trump).”
On a side note, Justin Eichorn, the bill’s primary sponsor, is currently facing child solicitation charges.
I am not saying those who oppose Trump will end up in mental institutions (but then again, they might in some dystopian MAGA future). What I am saying is the construction of “truth” means those who oppose this “truth” can expect to be ridiculed, harassed, humiliated, punished and maybe even lose their livelihood or life.
Like inmates at Tuke’s and Pinel’s asylums, Trump’s gaze is sufficient to self-discipline and conform to white supremacist and Christian nationalist sensibilities. If punished during Trump’s revenge tour, learn to say thank you.
I am mad.
To say Trump lost the 2000 election is to be diagnosed with TDS.
To say no scientific proof exists that vaccines cause autism is to be diagnosed with TDS.
To say dismantling DEI is a white supremacist project is to be diagnosed with TDS.
To say deporting legal residents and U.S. citizens is unlawful is to be diagnosed with TDS.
To say a $400 million plane gift to Trump is graft is to be diagnosed with TDS.
To say Trump is a sexual predator, racist, and anti-Latine is to be diagnosed with TDS.
To say Trump suffers from authoritarian illusions is to be diagnosed with TDS.
Yes, I am mad.
To self-discipline before Trump’s gaze to avoid accusations of mental illness is to become complicit in injustices. Better to be defined mad, regardless of the consequences, by a nation gone insane, constructing truth which justifies oppression, than to fawn for the sake of illusory safety.
What was that line from that 1976 movie? “I’m as mad as hell and I’m not going to take it anymore!”
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Professor of Social Ethics and Latinx Studies at Iliff School of Theology in Denver, Colorado, and a contributing correspondent at Good Faith Media.
