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2 The Domestication of Difference: The Classification, Segregation, and Institutionalization of Unreason It must be admitted that the normal man knows that he is so only in a world where every man is not normal. . . . In order for the normal man to believe himself so, and call himself so, he needs not the foretaste of disease but its projected shadow. —Canguilhem 1988b, 286 By the eighteenth century, “reason” and science stood triumphant, and madness was marginalized and confined. People who were mad came to be seen as pitiful rather than dangerous and as in need of help. Madness was viewed as a form of chaos and degradation that must be contained. It was no longer the source of wisdom; rather, the antithesis of reason. When St. Luke’s was opened in England in 1751, it was called an “asylum ,” not a madhouse, and casual sightseeing was banned from the outset (Porter 1987, 130). The orientation toward madness was shifting from confinement to treatment, treatment based on increasingly complex diagnosis. Central to the development of diagnostic procedures was the development of concepts of normality and pathology. 36 ch02_GUPress_193022 3/21/02 9:18 AM Page 36 The Cultural Construction of Pathological Humanity: From Order versus Chaos to Normality versus Pathology The father of scientific sociology, Auguste Comte (1798–1857), spearheaded the ideology of normality. The most important effect of this ideology on the construction of “the disabled” was the fact that he concentrated on normality as being equivalent to “the order of things,” as a “normative order,” and defined the pathology as “deficiency” or “excess .” In Comte’s positivism, the normative order was not simply a quality of social or natural phenomena to be discovered but a highly valued condition (see Canguilhem 1988b, 56–57). The concept of normality entered not only the language of science but also the language of everyday life, especially that of the middle classes for whom the distinction between normality and pathology became a vital source of social control. Canguilhem wrote of the extension of “normal” into everyday life in France: Between 1759, when the word “normal” appeared, and 1834 when the word “normalized” appeared, a normative class had won the power to identify—a beautiful example of an ideological illusion—the function of social norms, whose content it determined, with the use that that class made of them. (Canguilhem 1988b, 246) In England, the process occurred a little later, with the concepts being adopted from France. Thus, the term normal with its normative meaning of “not deviating or differing from a type or standard; regular, usual” is listed in the Oxford English Dictionary as having first appeared in 1828 and normalize, in 1868, both vital ideological components of the nineteenth -century worldview. The dialectic between scientific measurement and sociocultural evaluation was well under way as the etymology of “normality” moved toward the effective exclusion of the noncompliant as well as the effective marginalization and exclusion of the nonconformist , the different. “A norm draws its meaning, function and value from the fact of the existence, outside itself, of what does not meet the requirement it serves” (Canguilhem 1988b, 239). Marginalized, hidden, excluded, cast beyond the pale, damned to silence and to pseudo nonexistence , those diagnosed as the embodiment of the pathological were the essential foil to the arrogant “normality” of the definers and their fellow travelers. The concept of normality remained and remains at all times insecure , dependent on its opposite and in constant need of reaffirmation. The Domestication of Difference 37 ch02_GUPress_193022 3/21/02 9:18 AM Page 37 A view of a diverse humanity that was imbued with almost infinite difference gave way to a view of an essentially uniform humanity that was surrounded on its edges, on its margins, by the pathological foils to that uniformity or “normality.” But no “pathological” population could exist until one was culturally constructed. And so, we turn to the processes of diagnosis, the ideological practice by which “the pathological” were separated from the former flux of humanity, the process by which normality was constructed and reconstructed through each diagnosis. The Diagnosis of the Pathological Diagnosis involves the interpretation and evaluation of characteristics and behaviors in terms of preconceived conceptualizations and classifications of the world. It is the taxonomic ordering of “reality.” The medical classification, interpretation, and evaluation of human characteristics and behavior were developed through the transformation of concepts of health and illness that were based on the concepts of normality and pathology. How these diagnoses...


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