brief note on ‘the asylum state’
by Arran James
Scanning through a paper on Foucault, Baudrillard and the history of madness, I came across the following:
The asylum has been absorbed into the core of the social field, because normality has reached the point of perfection and assumed the characteristics of the asylum, because the virus of confinement has worked its way into every fibre of ‘normal’ existence (Jean Baudrillard, Symbolic exchange and death. p.127).
In this (hyperbolic) claim Baudrillard sounds a lot like the Foucault he commanded his audience to forget. The asylum, supposedly a place of refuge from the conditions that triggered periods of distress, functioned to carve up the sane and the insane by physically isolating those that early psychiatry deemed mad. In so doing, procedures of confinement could allow the production of a normalised sanity: behaviour and belief- conduct– could be regulated efficiently. Of course the uses of the asylum far exceeded even this aim; they were routinely used to house socially undesirable people who would be subjected to the same inhumane treatment as those suffering from distress. WAF Browne, a Victorian physician, stated that “the lunatic” was
‘left to linger out a lifetime of misery, without any rational attempt at treatment, without employment, without a glimpse of happiness, or a hope of liberation.
Conceal, confine, torture, neglect: these were common hallmarks in the early days of psychiatry, hallmarks that remained in many – if more refined- ways until the closure of the asylums. The deinstitutionalisation movement was and continues to be heralded as a great liberation. Baudrillard’s counter-assertion, really a provocation in the style of Foucault’s method of fabrication, puts forward that when the walls came down and the heavy iron doors were locked for the final time it was the asylum itself that was liberated. It seems that for Baudrillard this is a way to speak about deinstitutionalisation and community care, and the author of the paper suggests- in a highly uncritical manner- that attempts to integrate psychiatric patients into collective life are only an intensification of psychiatric power.
I think this style of argument has a lot of truth to it, especially considering the way community mental health teams operate in conjunction with mental health legislation (esp. CTOs) in making sure that the clinic follows the patient from hospital to home (or “the community”). I also think that it misses the importance of having community treatment options for those who need them and that it also fundamentally fails to grasp the potential radicalism of taking seriously the idea of social integration; that is, full social integration would be participation in struggle against capital and the state and would therefore be disruptive of their functioning. Full integration might imply the potential autonomisation of mental health services so that psychiatric workers became administrators beholden to those for whom they are supposed to care. Full integration might also imply the radicalisation of peer-support networks into solidarity unions for survivors of psychiatric mistreatment (not to imply that mistreatment is the only treatment people receive).
However, with rising dependence on psychopharmacology and the spread of the therapeutic model to problems with living minor as well as large, and the increasingly aggressive pathologisation of everyday life, it seems impossible not to conclude that the there is something of the asylum spread through the social field. What would it mean to take this claim seriously? To take up the specificity of the asylum as a functioning metaphor of society? Practices peculiar to asylums include non-remunerated labour designed to foster “moral integrity”- don’t we see this mirrored in workfare practices? They also include intense surveillance. In contemporary psychiatric hospitals, they might also include “rapid tranquillisation”- the practice of forcibly injecting someone deemed dangerous (often with justification) with antipsychotics in order to call them down. Is such a response mirrored in police actions that are justified by reference to “anti-social behaviour”?
In the end this image of an asylum state might not be particularly helpful, and Baudrillard’s treatment of “the mad” may be more intoxicated with images from psychiatry’s history than it is with any actually living subject. Still, we can hardly disagree that WAF Browne’s summation applies all to readily to our own societies.