Essay Foucault

8/2/2019 Essay Foucault

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Goldsmiths Anthropology Department

Cover Sheet

StudentNumber

33145855 Claude Jousselin

College

Email

[email protected]

Degree

Programme

MA in Anthropology of Health

and the body in the 21st

century

Year ofCourse

2008-2010

Course

code and

name

AN71021A Psychology and

anthropology

Essay

Deadline

26/02/10

SubmissionDate 26/02/10

Are you

dyslexic?

No

Essay or Assignment Title

The subject is simply an effect ofpower/knowledge relation. What did Foucault

mean by this?

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The introduction of CTOs finally went ahead in October despite years of

angry opposition from patients, mental health charities, psychiatrists and

the civil rights lobby. The stated aim is to help "revolving door" patients -

people with schizophrenia or psychosis - who are discharged from

hospital, stop taking their medication, suffer a relapse, and face

sometimes distressing forceful readmission to hospital because they

become a danger to themselves or others.

If patients refuse to take medication, they can be returned to hospital and

treated for 72 hours. If they still refuse, the CTO is revoked and they are

detained.

The government expected about 450 people in England and Wales to be

released on CTOs in the first 12 months, but the figure is already closer to

1,600.

(The Guardian 13/05/09)

Psychiatry and its institutions were of special interest to Foucault, it

provided him with an analytical platform to develop concepts and tools in

order to describe the objectification of subjects; he would move his

inquiry to other institutions such as the prison but his focus remained on

revealing different mechanisms in place by which, in our culture, human

beings are made subjects (Foucault, in Rabinow & Dreyfus 1982: 208).Following Foucaults method of creating a history of the present and

the necessity to study systems of power in their historical and localised

details, I propose to illustrate the place of the subject in the concept of

power/knowledge through the recent development in psychiatric care in

the UK.

The introduction of the Supervised Community Treatment Order (SCTO)

as an amendment to the Mental Health Act of 1983 needs to be seen in

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light of 30 years of reprovision of psychiatric care in the community, a

development that has occurred since Foucaults death in 1984. In the

1980s, the advancement of psychotropic medications provided

institutions an opportunity to reconsider the appropriateness of the

asylum for the mentally ill both on the ground of improved treatment for

and economically advantageous for the state. However applying

Foucaults power/knowledge analysis gives a different picture, where

new treatment knowledge created opportunities for new mechanisms of

control to develop which I will suggest were incorporated in a context

wider than psychiatry, in the everyday life of human beings. I will argue

that this process has subjected people to new micro-mechanism of power,

and in agreement with Foucault I will propose that individuals are not

simply or only the effect of knowledge/power, since resistance and

struggles are necessary counterpoints to power relations.

In the first instance I will review some of the themes developed by

Foucault on his concept of power/knowledge and will argue that Foucault

did not mean that the subject was simply an effect of

power/knowledge; on the contrary he attempted to portray the complex

relations between power and knowledge which assume an active subject

that is not fixed and is prone to historical change. Finally I will return to

my inquiry, or rather my limited sketch of an ascending analysis of

power (Foucault in Gordon 1980: 99), into the technique of SCTO toillustrate my interpretation of Foucaults concept of power/knowledge

and its effect on the subject.

Foucaults Madness and Civilisation ( 1961), and Discipline and Punish

(1975) were concerned directly with the knowledge created by a new

surveillance and medical gaze in the 18th and 19th century which produced

technologies leading to new forms of social control. Through detailed

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historical studies of the development of the prison and the asylum, he

depicts power as being exercised through transparency (Foucault in

Gordon 1980: 154), making visible all aspects of peoples lives right

through the details of their body, observations and the medical records.

Just as the objective existence of the body was questioned in The Birth of

the Clinic (1973), where the localisation of the disease and the

development of anatomy were described as creating a new concept of the

body, Foucault suggests that the subject was also conjured up in new

ways through the knowledge produced by disciplinary strategies. A

subject that is no longer autonomous but the result of external controlling

actions, subjected to disciplinary power and constituted as peripheral

subjects as a results of the effects of power (Foucault in Gordon 1980:

98).

The development of disciplinary practices in the 18th and 19th century

created this pervasive, omnipresent power, a machine in which everyone

is caught, those who exercise power just as much as those over whom it is

exercised" (Foucault in Gordon 1980: 156).

Foucault describes this when he writes of the confinement of the insane

with other prisoners and goes on to discuss how this new controlling

system of confinement created the opportunities for new knowledge a

century later for the emergent psychiatry of the 19th century who located

the insane within these institutions, effectively the precursors of theasylum. Whilst the insane were hidden from the rest of society in these

establishments, to some extent it highlighted their presence and

abnormality which facilitated their study by interested doctors. It is this

process where power is creating a space for new knowledge, in itself

creating new means of domination that defines Foucaults concept of

power/knowledge; by highlighting the knowledge thus created, his

analysis provides a more complex understanding of power than its

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reduction to repression. Power is elusive yet omnipresent, it circulates

[...] it is never localised here or there, never in anybodys hand (Foucault

in Gordon 1980: 98). Foucaults concept of power is productive, better

assimilated to an energy source that fuels society; it is also inter-

dependant with knowledge in an intricate network of connections where

there is no power relation without the correlative constitution of a field

of knowledge, nor any knowledge that does not presuppose and constitute

at the same time power relations (Foucault in Rabinow 1984: 175)

What of the individual in this web of interactions? Foucault has

consistently viewed with a critical mind an enlightenment vision of

knowledge as a liberating enterprise and with his concept of

power/knowledge argued that individuals are in fact constituted into

subjects through subjugating practices. Is this the death of the subject as

described by many critics of Foucault? These techniques of control that

subjugate the subject are localised in space and time, thus individuals are

the changing product of their power relations environment rather then

being universal and permanent. But whilst this argument keeps the

subject alive, it seemed reduced to a malleable concept dependant on

external forces for its construction.

Foucault in a latter text the subject and power (1982), provides more

detailed insight to reconcile this seemingly lack of agency andsubjectivity in individuals with his suggestion that we must constitute

ourselves as subjects acting on others- as agents, that is not as victims

(Hacking in Hoy 1986: 235).

Foucault suggests that to analyse power/knowledge it is more productive

to look at the space between different forms of power, rather than ask

who holds the power ask how is it being exercised and proposes a method

of analysis of power relations through points of resistance; how does

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struggles against power take shape? In this questioning Foucault also

starts from the premise that where there is power there is resistance, that

every power relationship implies, at least in potentiala strategy of

struggle []( Foucault, in Rabinow & Dreyfus 1982: 225). The subject is

constantly engaged and active in these power relations with individuals

exercising power on themselves and others, producing, inventing and re

inventing themselves in these relations. Instead of suggesting the

eradication of the subject as his critics put it (see Allen 2000), I would

argue that this is what Foucault meant when he said:

The individual is an effect of power, and at the same time, or precisely

to the extent to which it is that effect, it is the element of its articulation.

(Foucault in Gordon 1980: 98)

In one of his last interviews (Lotringer 1989) Foucault illustrated this by

describing how the insane subject can be construed as passive and docile

to coercive powers but that he is also active in constituting himself as a

psychiatric patient in his relation to the doctor treating him, including

through the various means of resistance that he may express such as non

compliance.

To accept this we need to agree first with Foucaults vision of power as a

productive force rather than as repressive and oppressive and secondly

that the subject has no permanent essence, nor is it fixed through history.

We also need to recognize that Foucaults modes of exploration aredetached, non-judgmental and more interested in the process, the how

rather than the causation.

When faced with the outcome of everyday oppression or structural

violence, this detachment is counter intuitive to the active and free subject

that I am, but I would suggest that Foucaults analytical methodology of

power relations provides a mean of disrupting accepted understandings as

I will now attempt to illustrate.

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community care depicted above hides a number of techniques that have

reorganised the experience and understanding of mental illness.

Normalisation, according to Foucault, is the process by which a society

encourages its people to self regulate and conform to established rules

and this I would propose took a particular form in the early 1990s through

a convergence of technical developments, the internet, the mobile phones,

and CCTV providing new means of surveillance.

Whilst further detailed research and analysis of the power/knowledge

mechanisms involved would be required I would tentatively suggest that

the process of re-locating the mentally ill within the society a decade

earlier created in that particular time, a space for developing new means

of control which were then integrated and extended to the society as a

whole. In turn this provided the technology to extend the legal detention

of psychiatric patient into their own homes through the SCTO with its

extensive monitoring techniques such as blood or urine tests or electronic

records updated daily.

As the means of surveillance have spread to ensure that the whole

population is monitored, for its own good and the safety of others, one

could ask with Szasz (2005) if this is the breaking of the asylum walls or

its extension to the whole of society.

But this is no conspiracy, no states master plan to control its population,

rather these tactics take shape in piecemeal fashion, prior to any classstrategy designed to wield them into vast, coherent ensembles. (Foucault

in Gordon 1980: 159).

Forming concepts is a way of living not a way of killing life. (Foucault

in Faubion 1985: 45)

This attempt at a genealogy of community care is maybe lacking

hindsight due to the short span of time elapsed; in particular it remains to

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be seen how the way people will be resisting this new development and

what struggles may cause further shifts in power/knowledge relation. Yet

patients and psychiatrists already have to reconsider who they are in the

light of the SCTO; the latter can no longer see themselves as involved

with treatment only since they are now using coercive methods beyond

the hospital and some are actively expressing their concerns (see Critical

Psychiatry); the former are likely to find it easier to develop strategies

from home that will impede the implementation of their monitoring.

Already, statistics show a greater numbers of SCTO in use than expected

yet there is no reduction in the number of hospital readmissions,

suggesting that people are not totally coerced to comply with their

treatment orders when at home. (Kisely & Campbell 2007)

In this brief attempt to analyse the genealogy of knowledge that led to the

implementation of Supervised Community Treatment Orders, I am

presenting a potential reading of the power relations between a series of

powers held in different institutions; psychiatric, social care agencies,

families. I believe that this use of the power/knowledge concept as an

explanatory tool can reveal different understandings of our present

individual and collective experiences.

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Bibliography

Books

Foucault, (1961) Madness and civilization London: Routledge

(1966) Maladie Mentale et psychologie Paris: Presses

Universitaires de France

(1973) The birth of the clinic London: Routledge

(1975) Discipline and punishNew York: Vintage books

(1985) 'Life: experience and science'. In J. Faubion (ed.). Tr.Robert Hurley and others.Aesthetics, method and

epistemology. The Essential Works of Michel Foucault 1954-

1984. Volume Two Harmondsworth, Middlesex: Penguin

Gordon, (1980) power/knowledge; London: Harvester Wheatsheaf

Hoy, (1986) Foucault: a critical reader Basil: Blackwell

Lotringer, (1989) Foucault live; New York: Semiotext(e)

Rabinow, (1984) The Foucault reader; London: Penguin Books

Rabinow & Dreyfus ( 1982) Beyond Structuralism and Hermeneutics:

Chicago: University of Chicago Press

Journal Articles

Allen, A (2000) The anti-Subjective Hypothesis The

Philosophical Forum, Vol 31 (2) 113-130

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Kisely & Campbell ( 2007) Does compulsory or supervised community

treatment reduce revolving door care? British

Journal of Psychiatry, Vol 191, 373-374

Szasz, (2005) Idiots, infants, and the insane: mental illness and

legal incompetence; Journal of medical ethics, Vol 31(2), 78-

81

Online Resources

The Guardian Hazards of a health safeguard

http://www.guardian.co.uk/society/2009/may/13/supervised-community-

treatment-order

Critical Psychiatry Network statement on the use of community

treatment orders http://www.soteria.freeuk.com/CTOs_1.htm

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http://www.guardian.co.uk/society/2009/may/13/supervised-community-treatment-orderhttp://www.guardian.co.uk/society/2009/may/13/supervised-community-treatment-orderhttp://www.soteria.freeuk.com/CTOs_1.htmhttp://www.guardian.co.uk/society/2009/may/13/supervised-community-treatment-orderhttp://www.guardian.co.uk/society/2009/may/13/supervised-community-treatment-orderhttp://www.soteria.freeuk.com/CTOs_1.htm


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