Footnotes not yet transferred. see here

https://docs.google.com/document/d/1o-mASDGFNYb-YY8Ujga2NDyqL6DQXGCuVHdQUYlwlkE/edit

Reference List

• Self harm

• longing to suffer 209

• Method

• categories a la Millard 45

• the interpreted body 150, 159

• dialogue with unreason 187

• organizing empiricism, phenomenology 135, 175

• monologue 

• Madness and and the Subject

• original dimensionality, xi

• The sacred circle, exclusion 6-10

• self-relation, self interest, unreason 13, 14, 24, 30

• self-discourse 100, 183, 245

• the human 240

• transitionary moments

• positivist protection 221

• the authority of the doctor 269-278

• liberty

• mercantile liberty 213-215

• co-constitutive liberty and guilt 182, 250, 252

• absolution 216, 247

• paradox of innocence 219-220

• freedoms of madness 234

• justifications of of confinement: social security and usefulness 235

• madness is childhood 252-255

1. The Sacred Circle

“We fill pre-existing forms and when we fill them change them and are changed.”

-Frank Bidart, “Borges and I”

Self harm has not always been understood in terms of mental illness.  

>Victorian context, religious meanings

>DSM-5?

>The current “common sense” understanding of DSH links it—often to the point of tautology—with “mental illness,” a label which by turns conveys pity and unease; treatment and confinement; fear of violence, fear of malingering, fear of being infected with madness oneself. Mental illness qua illness tends to imply that, insofar as the condition can be altered, it requires one to assume that there is something objectively and concretely wrong with the the patient, which must be fixed through the intervention of a doctor or allowed to heal ..

..

> and the necessity to simply accept what is “naturally” wrong with a subject-population, and almost always the open-ended (perhaps even constitutively unanswerable) question of where one’s diagnosis ends and one’s self (with all the baggage of authenticity and responsibility that brings. 

However, this tautology has not always been in place, and the classification of self-harm in particular as symptomatic of an illness in particular is relatively new, unevenly applied, and actively evolving. To understand the meaning of self-harm and mental illness is to go beyond our immediate associations and explore the conditions by which those meanings were produced: in this project, perhaps no text is more indispensible than Michel Foucualt’s  Madness and Civilization: A History of Insanity in the Age of Reason (henceforth M&C).

In the opening chapters of M&C, Foucault begins his history by first discussing an antecedent to the body of the madman. Preceding the insane in the historical development of the medico-juridical apparatus—and therefore in certain ways shaping the space which madness would come to fill and thereby inherit ... (the body of the leper) and a key historical turning point (the disappearance of leprosy):

A strange disappearance, which was doubtless not the long-sought effect of obscure medical practices, but the spontaneous result of segregation and also the consequence, after the Crusades, of the break with the Eastern sources of infection. Leprosy withdrew, leaving derelict these low places and these rites which were intended, not to suppress it, but to keep it at a sacred distance, to fix it in an inverse exaltation. What doubtless remained longer then leprosy, and would persist when the lazar houses had been empty for years, were the values and images attached to the figure of the leper as well as the meaning of his exclusion, the social importance of that insistent and fearful figure which was not driven off without first being inscribed with a sacred circle.

The spaces (both physical and social) thus vacated would come in time to contain other figures, denizens of confinement who likewise had “their salvation [accomplished] in and by their very exclusion” (Foucault 7). These were the nascent subjects of unreason, a dynamic and flexible category which was applied variously “to the poor, to the unemployed, to prisoners, and to the insane.” (Foucault 39). 

The insane in particular had there own winding path of confinement and exclusion, which neither began in the vacated halls of the lepper nor found its final definitions within the contours of his centuries-and-continents-spanning shadow. predated the usurpation of leprosy’s special societal significance by unreason. Frequently they were expelled to the limits of towns and cities with the heterogeneous ranks of the dispossessed who were kept at bay through an informal combination of violence and charity (thereby offering at least an expectation that the necessities of bare life could be found by means other then overrunning the internal boundaries of the community). Later during the Renaissance, municipal authorities contracted with “Ships of Fools” in the hopes (not always realized) that distance and open water would obstruct the madmen from returning to their old haunts. ... Confined to hard labor, without freedom over when (if ever) they would be permitted to disembark nor the heading of the vessel itself...old haunts...At the same time, the medical* (term used loosely) imagination of the day associated water, especially the open and unpredictable water of voyages, with both the causes of madness and its cure*, making the reduction of the ship of fools to mere population control not quite complete. 

[possibly begin with the town limit, ship of fools; then the lepper]

. (7-8, see also the epigraph in the opening pages of this essay). But it is the confinement to the Hôpital Général that Foucualt marks as the decisive (or at least most visible) inauguration of the classical understanding of madness. (Foucualt xii) Often making direct use of the facilities of former lazar houses, the Hôpital and its equivalents in England and Germany would be a site where a variety of socially undesirable populations were brought together and mingled:  “the debauched, the spendthrift fathers, prodigal sons, blashamers, men who ‘seek to undo themselves,’ libertines. And through these parallels, these strange complicites, the age sketched the profile of its own experience of unreason.” (Foucault 65) Part “forced labor camp,” part “semijudicial structure” (but without pretext at medical functions (Foucualt 59 , 40), it was in the Hôpital that the “old rites of excommunication” which had previously ensconced the leper would continue to be practiced, refined, and reformed, only now in the service of the double-master of morality and production. (Foucault 57-58). 

§ 

The identification of unreason with acting against one’s interests had not always been in place—indeed, prior to the classical age the reverse position prevailed. In texts ranging from fables, plays, and parodies to “learned literature” (theology, natural philosophy, etc.) the theme of “Madness or folly was at work,” taking in the late Medieval period precedence over “the sovereignty of the human soul,” arguing against itself and formulating its own paradoxical structure: “it is denounced, and defends itself that it is closer to happiness and truth than reason, that it is closer to reason than reason itself” (Foucault 13-14). Madness in these texts plays a universalizing role, being common to 

every man, since it is man who constitutes madness in the attachment he bears for himself and by the illusions he entertains...self-attachment is the first sign of madness, but it is because man is attached to himself that he accepts error as truth, lies and reality, violence and ugliness as beauty and justice. (Foucault 26) 

Later, under the dawn of confinement, madness is given a unique position within the broad category of unreason, at once quintessential to it and exempted within it, even as unreason itself 

was no longer conceived as the precondition of man’s rationality. (Foucault 77-78, 81). Yet madness never fully conceded its association with this recursive phenomena, variously referred to as “self-attachment,” self-interest, libidinal investment, cathexis, and desire; rather, the attachment subsists but in a profane or twisted form. Madness becomes the name for the simultaneously moral and economic problem of a person who is not interested in pursuing their self-interest, and who must therefore be forced, like a beast of burden, to pursue the natural, objective ends which nature and nature’s God have duly established: to labor, which in the context of the Hôpital always meant to labor for someone else (footnote on the hospitals and primitive accumulation. () even after the classical period of madness comes to an end (footnote: Foucault places this date at the liberation of the Bicetre (xiii) and the Birth of the Assylum, the simultaneous inauguration of the period of positivist (and shortly thereafter, medicalized) madness, which Foucualt considers to still be ongoing () ) the basis on which Madness is abnormalized (and its therapeutics justified) remains largely unchanged: in the wake of the revolution, as prisoners whose only crimes have been “abandon[ing] themselves to the excesses of libertinage, debauchery, and dissipation” are being set free, an exception was made for those “whose minds are deranged and whose imbecility makes them incapable of conducting themselves in a world where their rages would make them dangerous. With respect to these, all that is necessary is to ascertain whether their condition is still the same, and unfortunately it becomes indispensable to continue their detention as long as it is acknowledged that their freedom is harmful to society, or a useless benefit to themselves.’”   (235) 

Thus what would come to be known as mental illness has from the beginning functioned as a constitutive-other to liberal capitalism, both at the material level (being forced to engage in productive, profitable work) and its logic: the double freedom of the worker under capitalism is premised on their ability to engage in self-management, so it is inevitable that those judged incapable or unwilling to work (for the distinction does not yet exist at this stage of history, or is only beginning to become legible) will of course be treated to special confinement and particularly harsh exploitation of labor. If it is impossible to extract from the currently available the sources a total quantity of value extracted during this period, how much more opaque is the long-term value of accumulated through by the state contractors who originally rented the bodies of madmen in their factories, workshops, mills, and from the bodies of those motivated by fear of the Hospital to work and who the capitalized and reinvested the same profits down the centuries to present day. For reason of primacy if not absolute value, the various prisoners at the Hôpital must figure with the enslaved africans, dispossessed and genocided indigeneous peoples, and evicted and executed peasants, especially peasant women, (Caliban and the Witch) in the long list of the victim’s of the processes of primitive accumulation. 

§  

In the Hôpital the understanding of madman-as-beast was affirmed even as its unproductive effects were suppressed through the logic of domestication. Counterintuitively (at least when judged from our own associations) “[t]he therepeutics of madness did not function in the hospital, whose chief concern was to sever or to ‘correct.’ And yet in the non-hospital domain, treatment continued to develop throughout the classical period: long cures for madness were elaborated whose aim was not so much to care for the soul as to cure the entire individual…” (159). However, the differences between the corrective and “philanthropic” approaches should not be overstated. While the hospital aimed to suppress and break his animal behavior (and in so doing tacitly acknowledged something like agency existed in him, albite in a corrupted form), the therapeutic approach was inclined to to forget or erase any kind of mad agency or willed, directed effort to begin with. For this reason both regiments understood the madman as being outside the reach of any mode of discourse but that of brute force and therapeutic development reflects this. Take for example the tactic of immersion, which in the mideval period was meant to simultaneously purify the madman of his ailment and imbue him with the positive qualities of water, and which later under the classical period took on new significance as a means to penetrate the madman’s stupor (166-168), and whichwas discovered, supposedly, from

“the fortunate result of chance: a heavily chained madman was being transported on an open wagon; he managed, however, to free himself from his chains and jumped into a lake, tried to swim, fainted; when he was rescued, everyone thought he was dead, but he quickly recovered his spirits, which were abruptly restored to their natural order, and he ‘lived a long time without experiencing any further attack of madness.’” This anecdote supposedly enlightened Van Helmont, who began to plunge the insane indiscriminately into the sea or into fresh water; “the only care that must be taken, is to plunge the sufferers into the water suddenly and unawares, and to keep them there for a long time. One need have no fear for their lives.” 168

There is no room in such a therapeutics for a reading of an insane agency, not even one to be broken. The motivations of the madman (the unnamed, uncredited, and (arguably) unwilling inventor of Van Helmont’s method)—why he was attempting to escape, what it was like to free himself only to be confined, as generations of madmen had been before him, in the throws of water—these questions do not only fail to interest the classical therapists: they cannot be either asked or explored within the terms of their analysis. They are rendered impossible, meaningless. But not for much longer. [see 182, “physical therapeutics tend to become, in the first half of the nineteenth century, a cure devised by innocent determinism, and moral treatment a cure wrong by culpable freedom.”]

Foucault marks the end of the classical period of the history of madness with “the liberation of the chained inmates of Bicêtre” by Pinel in 1794 (xii, 

now the Hôpital and classical therapeutics alike would give way to the asylum. 

-culpable freedom

-self-discipline

 however, held that the mad were for the moment at least outside of the normal order of humanity, agency, and reason. 

 In this regard, the cures were as de-humanizing but that is not to say that they recogonized 

In both  cures ranged in their forms and rationals, from 

>“The hospital was not a medical institution 159

>but in the non-hospital spaces, cures attempted to be developed

>distinguished between body and soul, but in the sense of different aspects of machinery; “cure for the entire individual” 

>these cures (echo?) animality— “one need have no fear for their lives 168)

>animality also shown to have a complex relationship with agency. the goal in the hospital was not to return human agency, but to domesticate the beast. in cases of cures, agency was no longer suppressed so much as ignored as a factor. see the example of a madman leaping into a lake: what was extracted from this was the water.

maybe have a break here, discuss reason, unreason, self-interest, and agency?

>>>under Pinel the madmen were liberated, and agency takes center place: self-discipline

(The assylum, Pinel and T. Madness changes from a beast of burden to a self-disciplining subject)

///

Then Millard, post-asylum, production of self harm 

Notes

[split first section on general history of madness from unreason as the constitution of (self-)interest generally]

[shifting to self harm specifically]

[next task: working in Milliard?