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  • Foucault, the Logic of Psychiatric Power, and Its Paradoxes
  • John Iliopoulos (bio)

Psychiatric power, forms of rationality, truth, critique

Developing his theory of power, Foucault sought to break free from certain misconceptions that widely surround the notion. He strongly resisted the view that power is synonymous with domination and the exercise of hegemony. The notion of domination is linked to the idea that power is a thing, an entity to be possessed, and therefore to be exercised as a force of repression against those excluded from it. Akin to this image is the notion of ideology that Foucault also sought to dismantle. Ideology implies the existence of an infrastructure, a basic reality maintained by those whose interest lies in its preservation through coercive, despotic and even violent means, and through the dissemination of false statements which control and manipulate (Foucault 2000a).

For Foucault, power is relations, which in the broad sense of the term denotes the way one human being directs the behavior of another. There is a specific form of rationality that underpins these relations. By “form of rationality,” Foucault does not mean the abstract mode of reasoning which organizes reality, like Kant’s faculty of the transcendental subject or Weber’s anthropological variant (Foucault 2000b), but the very logic that governs the way people relate to each other. This logic is of course not timeless and universal, but contingent and historical. It emerges each time humans are forced to organize their affairs and solve practical problems. It is an answer to the question: How are men, things, and situations to be governed? To what ends and by what means? A form of rationality is thus the logical element behind power that seeks solutions, articulates truth, and produces knowledge, in contrast with the generally held image of an irrational power, which blindly oppresses, excludes, and tells lies.

As a logical analysis of power bearing similarities to the approach of analytic philosophy (Davidson 1997), Foucault’s method shows how the form of rationality beneath power relations not only does not mask the truth, but actually produces it. In the history of the west, there has been a fundamental “will to truth” (Foucault 1981), a desire to legitimate and justify practices, decisions, and discourses on the basis of the articulation of truth claims. This grounding of legitimacy has taken the form of statements that are scientific. The way people are governed, the way justice is distributed and politics is exercised, are permeated by discourses which must lay claim to scientific [End Page 67] truth. The ensemble of practices and discourses which stem from heterogeneous activities such as the arts, science and literature (what Foucault calls an epoch’s episteme), converge in the production of truthful discourse which generates knowledge, giving rise to the human sciences. Such has been the case of psychiatry, which, as Foucault shows, was born under specific historical conditions as a discipline with pretensions to scientificity. It emerged as a body of knowledge that was able for the first time in western history to borrow methods from other, already established forms of truth production, to demonstrate in a rigorous and valid way the existence, diagnosis, and cure of mental illness. Its way of truth telling did not emerge ex nihilo, nor was it handed over to it by other forces, political or otherwise, as a readymade solution. Psychiatry emerged as a response to a question posed by political, legal, and administrative agents and institutions, who inquired into the possible ways of treating certain individuals who broke the law, caused disturbance, or were maladaptive, on account of what was deemed at the time to be irrational and incomprehensible behavior.

Importantly, the types of truthful discourse that sanctioned psychiatry as a scientific discipline and continue to regulate its practice to this day, have been the product of long-standing disputes and controversies. There is a battle over truth, a struggle around the legitimacy that it provides. Foucault shows how from the beginning of the nineteenth century psychiatrists have been actively engaged in an agonistic relationship with political forces, forensic experts, magistrates, and the police, seeking the most valid ways possible to establish the truth about the essence of mental...