When this book came out, I remember it created quite a stir among some circles, which is quite something considering the words printed in this volume are from almost 50 years ago. My psychiatric colleagues grumbled and mumbled about it being "more anti-psychiatry nonsense like those scientology people," so I had to run out to the nearest Borders and buy it for 18 bucks.
Actually, I would not consider the thoughts in this book to be really "anti" anything, as Foucault was a careful and devoted historian and academic. His theories are always well researched and he couches his thoughts in a very detached manner, allowing the reader to come up with their own conclusions. That being said, this book is a translation of actual lectures at the College de France, so it takes on a more conversational tone than his usual books, and as such, he cannot help but throw in some almost subliminal witticisms against the field of psychiatry that poke the kind of gentle but acerbic fun that the French do so well.
The book can be considered a companion piece to his classic "Madness and Civilization," expounding on his analysis of the sources of "power" throughout the history of psychiatric medicine, and here he takes that analysis to the point of the dawn of modern psychotropic meds, during which Foucault was still living when he was giving these lectures in the early 1970s. It would have been fascinating to have been able to read his thoughts on the evolution of psychiatric power during the heyday of Big Pharma and the Prozac-age, but alas, his unfortunate death in the 80s deprived us of a full development of such analysis.
Psychiatric power, for Foucault, was and still is a formidable force, one that has been able to dethrone kings. He gives a fascinating account of how the doctor and his aides handled the mad King George, supplanting sovereign power for disciplinary power. Further on, Foucault reads off many jaw-dropping texts and first-hand accounts from the annals of psychiatry literature and the notes from patient files, shedding light through these documents on the inner workings behind the walls of the old asylums. As a psychiatrist, it makes me appreciate how far we've come from the punitive days of strapping patients to basement floors and dousing their scalps with scalding water, but also how little has changed in some ways. Foucault traces how, though the straps may have come off, power was maintained in the psychiatric world through the simple authority of the Doctors' knowledge of which their certificates, white coats, and commanding manner of speech were testimonials. Power was further maintained as times changed via statutory revisions, judiciary commitments, the isolation of patients from family and visitors, the design of psychiatric hospitals, hypnosis and mesmerism, and finally to the development of neurologic differential diagnosis. These all were adaptations to maintain an unequal balance of power. And he further explores the resistances and attempts by patients to regain power, including the odd but interesting assertion that the epidemic of hysteria in the late 1800s was such an attempt.
Extensive footnotes and citations gave me a plethora of new books to add to my queue, as the quotations of so many works by the greats of early psychiatric practice like Charcot are all so mind-blowing that I simply had to read the source material. I think you'll find this book an absorbing historical exercise if anything else.
My main complaint about this book is that the translators seemed to struggle at times with how to properly convey the French, and we end up with some incomprehensible and sometimes inconsistent phrasing, as well as odd choices of words like "obnubilation." But overall, the final product is a remarkable result of painstaking efforts of scholarship.
Whether or not you agree with Foucault, one cannot help but become engrossed in his work and to never think about power relationships, including those of our own government system, in the same way again.