Power in psychiatry. Soviet peer and lay hierarchies in the context of political abuse of psychiatry

Soviet political abuse of psychiatry in the Brezhnevite era offers a rich case study of entanglement between various layers, impact spaces, and actors of power. This article discusses two types of discursive power in Soviet psychiatry. One sprang from the madness-affirmative cultural canon, in which dissidents sought their self-legitimation. More prominently, there was the power of psychiatrists within their own hierarchic system. I analyse how the action scopes for psychiatric power varied, depending on whether the recipient was a patient or fellow professional. Here, the inherent hierarchy structured and regulated the peer community and secured the stability of medical practices – and of the political entanglement of these practices and actors with the state-owned places of power.

Foucault understood critical psychiatry

SUMMARY Critical trends in psychiatry are abundant today. Their impact on how psychiatry is currently practised is considerable. Yet what deserves close examination is the extent to which these modes of critique (anti-psychiatry, liberation movements, activism, existential, narrative or hermeneutic approaches, theories of values, psychoanalysis) inherently belong to or have become part of the very system that they criticise. Despite their political, social or scientific influence, which is undeniable, their critical power is often limited by their inability to radically challenge the deeper anthropological and philosophical presuppositions on which mainstream psychiatry rests. It can be argued that Foucault offers such a challenge. Implementing his historico-philosophical method, Foucault is sceptical of the anti-psychiatric quest for non-oppressive modes of psychiatric power and the humanist and postmodern efforts to moralise or relativise psychiatric truth. All these modes of critique rest on preconceived notions of nature, power and truth and have been integrated by the pluralism of the psychiatric universe. Yet Foucault's critique seeks precisely the opposite: to explore a new anthropological conception of insanity that has the power to challenge the legal, moral or reductionist constraints under which medical truth currently operates.

Foucault and the birth of psychopolitics: Towards a genealogy of crisis governance

The article contributes to the genealogy of current tendencies in crisis governance by reconstructing Michel Foucault’s analysis of the application of the notion of crisis in 19th-century psychiatry. This analysis complements and corrects Reinhart Koselleck’s history that viewed crisis as originally a medical, judicial or theological concept that was transferred to the political domain in the 18th century. In contrast, Foucault highlights how the psychiatric application of the concept of crisis was itself political, conditioned by the disciplinary power of the psychiatrist. Unlike the ancient medical concept of crisis that emphasized the doctor’s judgement in observing the event of truth in the course of the disease, psychiatric crisis is explicitly forced by the doctor in order to elicit the desired symptoms in the patient and convert their power of disciplinary confinement into medical diagnosis. The article argues that this notion of crisis resonates with the tendencies observed in contemporary crisis governance in Western societies. While these tendencies are often addressed in terms of ‘psychopolitics’ that presumably succeeds Foucault’s ‘biopolitics’, we suggest that Foucault’s own work on psychiatric power offers a valuable genealogical perspective on the contemporary governance of crises.

Foucault On Psychoanalysis: Missed Encounter or Gordian Knot?

Foucault’s remarks concerning psychoanalysis are ambivalent and even prima facie contra-dictory, at times lauding Freud and Lacan as anti-humanists, at others being severely criti-cal of their imbrication within psychiatric power. This has allowed a profusion of interpretations of his position, between so-called ‘Freudo-Foucauldians’ at one extreme and Foucauldians who condemn psychoanalysis as such at the other. In this article, I begin by surveying Foucault’s biographical and theoretical relationship to psychoanalysis and the sec-ondary scholarship on this relationship to date. I pay particular attention to the discussion of the relationship in feminist scholarship and queer theory, and that by psychoanalytic thinkers, as well as attending to the particular focus in the secondary literature on Fou-cault’s late work and his relationship to the figure of Jacques Lacan. I conclude that Fou-cault’s attitude to psychoanalysis varies with context, and that some of his criticisms of psychoanalysis in part reflect an ignorance of the variety of psychoanalytic thought, partic-ularly in its Lacanian form. I thus argue that Foucault sometimes tended to overestimate the extent of the incompatibility of his approach with psychoanalytic ones and that there is ultimately no serious incompatibility there. Rather, psychoanalysis represents a substantively different mode of inquiry to Foucault’s work, which is neither straightforwardly ex-clusive nor inclusive of psychoanalytic insights.