Introduction: Why Swain?

Gladys Swain (1945–1993) was a French psychiatrist, and the historian who redrew the coordinates of the historiography of psychiatry after Foucault’s Histoire de la folie. Her working life as a scholar lasted about ten years; she published a single book of her own. Yet on the ground opened by that one book — Le sujet de la folie : naissance de la psychiatrie (1977)[1] — stand today’s empirical history of psychiatry, the political philosophy of her co-author Marcel Gauchet (1946– ), and this bulletin’s own account of the founding of psychiatry by Pinel. Of her life, however, almost nothing has been written: apart from the two prefaces her husband Gauchet set before her posthumous volumes[2] [3], the record — in French no less than in English — is close to silence. Working within this taciturn state of the sources, the present paper puts in order what can now be established, and situates the intellectual climate that surrounded her within the genealogy that runs from Aron through Lefort to Gauchet. It is addressed in the first place to readers in psychiatry, and assumes no prior acquaintance with French political thought.

1. A Life

1.1 A sketch

Swain was born in 1945 at Ablon (the département is not yet established: see the note on the state of research), and died in Paris on 22 September 1993, at forty-eight[2]. The writings she left are these: the single-author book Le sujet de la folie (1977; the actual distribution came in January 1978, in her thirty-third year[3]); La pratique de l’esprit humain — l’institution asilaire et la révolution démocratique, written with Gauchet (1980)[8]; a dozen or so journal articles; and, published after her death under Gauchet’s editorship, the collection Dialogue avec l’insensé (1994)[2] and the co-authored Le vrai Charcot (1997)[20]. The period of writing runs from 1977 to about 1987 — some ten years[2]. Modest in quantity, this work is still consulted, half a century after publication, as one of the most comprehensive alternative accounts we possess of the birth of psychiatry.

Of her family circumstances the published record says little. But it is worth noting that Gauchet himself, in the preface to the posthumous collection, writes that she was a rebellious head and, being a woman, by no means well born into the bargain (une tête rebelle … en tant que femme, de surcroît point bien née), and that nothing, ever, could make her forget the injustices of the old university and asylum order (Rien, jamais, ne put le lui faire oublier)[2]. From origins that could not be called favoured she made her way into medicine, and cut a path through a medical academy still dominated by men — here is the biographical root of the esprit de fronde[4], the spirit of insubordination that marked her thinking to the end.

1.2 1965: Medical school, and another formation

The key to Swain’s intellectual formation is that it did not take place only inside the lecture halls of the faculty of medicine. By Gauchet’s testimony she entered political activity in 1965, in step with her entry into university, joining the Trotskyist Jeunesse communiste révolutionnaire (JCR)[2]. Gauchet calls this background “a relatively rare equipment for a medical student of the period” (un bagage relativement rare pour une étudiante en médecine de l’époque), and stresses the theoretical acculturation in matters of society and history that she gained there[2]. The training of reading and disputation — what is society, how do institutions form human beings — cast the mould of her thought before the medical curriculum could. The shock of May ’68 carried her out of Leninist orthodoxy; but no later disenchantment ever took from her the critical eye she turned on the old order[2].

Only from this fact does the syntax of her doctoral thesis become intelligible: a prose in which main clause and parenthesis fold over one another, moving through concession and reversal toward the conclusion — prose belonging to the tradition of the philosophical essay, of a kind no ordinary medical education produces. Her sentences were not written in medical school. They were forged in the crucible of political activism and theory, and in that “second university,” the philosophical circle around Lefort and Gauchet described in Chapter 2. The intellectual historian Jerrold Seigel, in his foreword to the English translation, testifies to the difficulty of the Gauchet–Swain prose from the other side: its reason, he finds, lies in the authors’ passionate and deeply humanistic engagement with the people about whom they write[10].

The institutional sense of that term “doctoral thesis” deserves to be fixed at once, for the full measure of the book’s singularity depends upon it. France has no examination corresponding to the national licensing examinations of Japan or the United States; their place is held by the public defence, at the exit of the medical curriculum, of a doctoral thesis — the thèse d’exercice. The successful candidate receives the title docteur en médecine — a professional degree, corresponding to the M.D. of anglophone usage — and acquires the right to practise by enrolment in the Ordre des médecins; it is, institutionally, a different thing altogether from the academic degree of which the Ph.D. is representative, whose French counterpart, in the humanities of that generation, was the State doctorate (doctorat d’État) — the class of Lefort’s Machiavelli thesis (2.1). The thèse d’exercice is normally defended during or at the close of the internat, the residential hospital training; and its content, in the common run, need not exceed a modest case-study[25]. When this paper calls Le sujet de la folie a “doctoral thesis,” it is in this sense of the thèse d’exercice — not in the sense of a Japanese doctoral dissertation, nor of a Ph.D. thesis. Lacan’s thesis of 1932 and Ey’s early papers are, in the same sense, “work of the interne”; and it is only against this institutional background that the anomaly of Swain’s case can be taken at its true size — a professional thesis that need have been no more than a case-study, published as a book by a specialist house, and taking its place at once in the controversy with Foucault.

1.3 The intellectual climate: Foucault, Lacan, antipsychiatry

The France in which she chose psychiatry — the end of the 1960s and the beginning of the 1970s — was a France in which the discipline’s very reason for existing stood in question. The governing frame had been set by Foucault’s Histoire de la folie (1961); over it lay the protest of antipsychiatry and the promise of a pure psychoanalysis held out by Lacan’s Écrits (1966). The dilemma of the age, in Gauchet’s summary, was L’hôpital ou le divan ? — the hospital or the couch?[2] Swain’s singularity is that, standing in the middle of this climate, she gave herself to none of its currents. She chose the hospital — that is, psychiatry itself as a discipline —, declined the romanticization of madness (the one that flew Hölderlin and Artaud as its colours), and put the dominant frameworks not to abandonment but to strict historical verification. What Gauchet names as her core is “the irreducible concern to think for herself” (l’irréductible souci de penser par elle-même), the union of modesty and tenacity, intransigence and receptivity[2]. For the terminus of that verification — the dismantling that descended to the level of Foucault’s own references — the reader is referred to the author’s paper on the criticisms of Foucault[18] and the paper on Pinel and the founding[17].

Beneath this intellectual climate lies a climate of institutions. As the sixth chapter of Clervoy’s biography of Henri Ey records, France in 1965 possessed four chairs of psychiatry in all (two in Paris, Strasbourg, Marseille) and six of neuropsychiatry (Lille, Lyon, Bordeaux, Toulouse, Montpellier, Nancy); the real power over training lay with neurology[24]. Against this state of things the Livre blanc de la psychiatrie française movement of Henri Ey and the Évolution psychiatrique circle (1965–67) demanded the reform of training and the raising of psychiatry’s standing; and in the torrent of university reform that followed May ’68, psychiatry was separated from neurology and became an autonomous discipline with its own specialty curriculum (the CES de psychiatrie) and its own competitive examination for chairs. It is worth remarking that Ey himself was cautious about the “divorce” — fearing that separation would drain psychiatry out of medicine into psycho-sociology, as he thought had happened in America — and argued instead for an integration with the proportions reversed[24]; but however that may be, Swain, who entered university in 1965 and chose psychiatry at the beginning of the 1970s, belongs literally to the first generation of the autonomous psychiatric curriculum that this reform opened. No document places Ey and Swain in personal contact (for the crossing of their ideas, see the author’s Foucault paper[18], chapter 3, section 5). At the level of institutions, however, she became a psychiatrist inside the course that the battle of Ey and his generation had forced open. One may add that Privat of Toulouse, the house that published her book, was also the house to which Ey had entrusted, in December 1965, the publication of his own plan for the reorganization of the psychiatric field — a publisher with deep ties to the discipline[24].

1.4 Illness and silence

After the ten years of writing, Gauchet records, “illness and suffering” (la maladie et la souffrance) drew her away from writing[2]. About the name of the illness he has disclosed nothing — not in the prefaces, not in any later recollection — and no published source identifies the cause. What can be stated with certainty is the single fact that, after an illness of some six years, she died on 22 September 1993[26]. After her death Gauchet gathered the dispersed articles into Dialogue avec l’insensé, and completed the unfinished joint research as Le vrai Charcot. Nearly forty years after the work broke off, it has not aged. Rather, as the age of operational diagnosis goes on evading the question of the subject in madness, its timeliness has grown.

2. A Genealogy: From Aron to Swain

2.1 Lefort, the point of junction

At the centre of the intellectual environment that surrounded Swain stands Claude Lefort (1924–2010). For the reader in psychiatry, the political philosopher’s position may be marked briefly. Lefort came to philosophy under Merleau-Ponty, his teacher at the Lycée Carnot; after the war, with Cornelius Castoriadis, he founded the legendary group of the anti-Stalinist left, Socialisme ou Barbarie. From about 1952, on the other hand, he was acquainted with Raymond Aron (1905–1983), through whose support he obtained a post in sociology at the University of Caen (1966–71). His State doctorate, Le travail de l’œuvre Machiavel, was examined at Paris I in 1971 under the supervision of none other than Aron, and published the following year[11] [12]. In the person of Lefort, that is, the lineage of Merleau-Pontian phenomenology and of the anti-totalitarian left crosses the lineage of Aronian liberalism. The critique of totalitarianism, and the theory of democracy as the empty place of power, were born of this crossing.

2.2 From the crossroads at Caen to the first issue of Libre

Gauchet was Lefort’s direct pupil at Caen. Lefort’s tenure there (1966–71) coincides exactly with the years in which Gauchet pursued three parallel courses at the same university — philosophy, history, sociology (1966–71)[12] — and probably overlaps with Swain’s student years as well (see the note on the state of research). Thereafter Gauchet stood at the centre of the review Textures (from 1971), with Lefort, and then of Libre (1977–80, Payot), with Castoriadis, Clastres and Lefort. Swain’s attachment to this circle is a matter of documents, not of conjecture. To the first issue of Libre (1977) she contributed the article “Deux époques de la folie”[6] — none other than the first appearance of the piece later collected in the posthumous volume as “De Kant à Hegel.” To share a table of contents with Lefort, Castoriadis and Clastres in the very year her thesis appeared in print is to have belonged to this circle of political philosophy as one of its writers, not as a bystander at its edge. The following year, jointly with Gauchet, she signed the preface to a re-edition of Esquirol’s doctoral thesis of 1805, Des passions[7]. In 1980 the co-authored La pratique de l’esprit humain was published in Gallimard’s Bibliothèque des Sciences humaines; and in Le Débat, the review Gauchet founded that same year with Pierre Nora, further joint articles followed (1984, 1986)[13].

That Swain herself acknowledged owing the inspiration of her method of analysis to Lefort is on record in the anglophone scholarship[4]. Lefort’s problematic — what relation does a society entertain with itself? — prepared the method of La pratique de l’esprit humain, which reads a single institution, the asylum, as a crystallization of modern democratic society’s relation to itself (the closer examination is left to the author’s paper on that book[19]). And as “De Kant à Hegel” shows, she could move freely inside German idealism. A psychiatrist re-reading Kant’s classification of the maladies of the soul and Hegel’s doctrine of Verrücktheit as the periodization of the history of psychiatry — such analytical breadth is not the product of a medical curriculum. It is the product of the second university.

2.3 This genealogy on the map of French thought: Sartre, Althusser, Foucault

The received map of postwar French thought is, for most readers, a single line: from Sartre’s existentialism to the structuralism of Lévi-Strauss, Althusser and Lacan, and on to the post-structuralism of Foucault, Derrida and Deleuze. In Japan, where the map was drawn by what got translated, “contemporary French thought” has meant almost exclusively this line; in the English-speaking academy the same line has circulated under the name of French Theory. It is, so to speak, the genealogy of the thought of revolution: Marxism and its structuralist renewal at the École normale supérieure (Althusser), then the Nietzschean critique of reason itself. The genealogy that surrounded Swain belongs to another line — one poorly visible, from either shore, on that map.

At one of its springs stands Aron. At the ENS, Aron was Sartre’s petit camarade of the same promotion, and passed the philosophy agrégation of 1928 at the head of the list (Sartre, that year, failed). By way of the Sorbonne chair of sociology he reached the Collège de France in 1970; and for thirty years, all the while, he wrote the political columns of Le Figaro — a double activity, academic legitimacy joined to practical commentary, that has few equivalents. At home, however, his position was long that of a minority. Against the Aron of L’Opium des intellectuels (1955), which analysed Marxism as the secular religion of the intellectuals, the temper of the Sartrean years is caught in the saying that it was “better to be wrong with Sartre than right with Aron”[22]. The reversal came in the 1970s. In the anti-totalitarian season opened by the French translation of Solzhenitsyn’s Gulag Archipelago (1974) the valuation turned about, and the Mémoires of his final year (1983) became a bestseller[22].

The other spring is the anti-Stalinist left. Socialisme ou Barbarie, which Lefort founded with Castoriadis (1948/49– ), was the pioneering group that criticized the Soviet bureaucracy from within the left — a criticism begun a quarter of a century before anti-totalitarianism became a fashion. This genealogy, in other words, is not a genealogy of the right. It is the line on which, at the single point of anti-totalitarianism, Aronian liberalism and the non-communist left flowed together. That Aron supervised Lefort’s doctorate (2.1) is the most compact symbol of that confluence. In the later 1970s the confluence took institutional form. François Furet, who led the revision of the historiography of the French Revolution and the restoration of Tocqueville, became president of the École des hautes études en sciences sociales (EHESS) (1977–85); Lefort had moved to the EHESS in 1976. In the reviews, Commentaire (1978– ), around Aron, and the Nora–Gauchet Débat (1980– ) opened a new space to succeed the age of the engaged intellectual of Les Temps modernes. American scholarship has named this turning-point the “antitotalitarian moment”[23].

Gauchet is the child of this confluence. He studied under Lefort at Caen; Lefort introduced him to Furet; and with the backing of Furet and Nora he was called in 1989 to the EHESS — to the Centre de recherches politiques Raymond-Aron[12]. That his institutional address literally bore Aron’s name attests the reality of the Aron–Lefort–Gauchet genealogy more eloquently than any argument could. And when Nora made Gauchet editor of Le Débat in 1980, the choice was read at the time as, among other things, a declaration of distance from Foucault[12].

For the reader in psychiatry, the summary is this. The genealogy in question contested the same themes as the Althusser–Foucault line everyone knows — modernity, power, the subject — and moved to the opposite conclusion: the defence of democracy, and the diagnosis of its internal dangers. It is the “other French thought.” Politically it stands neither on the old right nor on the communist left, but between anti-totalitarian liberalism and a non-communist socialism (Gauchet’s self-description, “philosophical socialist,” names this position). And Swain’s Le sujet de la folie, with the co-authored La pratique de l’esprit humain, is the first work — and still very nearly the only one — to carry the method of this lineage, the Tocquevillian analysis of democracy, into the history of psychiatry. If readers formed on the first map, in Japan or in the English-speaking world, have found this work hard to see, the reason is not its quality. In Japanese, half the map was simply never translated; in English it arrived late, under the counter-label “New French Thought,” and never gained the currency of the other line.

3. The Co-Author Afterwards: Gauchet’s Trajectory and Its Controversies

3.1 From the asylum to religion, and to immigration

Swain’s work is read today, more often than not, together with Gauchet’s name. To know the co-author’s later trajectory, and the controversy that attends it, is therefore indispensable to any reader in psychiatry who would take the measure of her reception as it now stands. Five years after La pratique de l’esprit humain, Gauchet stepped into the first rank of French thought with Le désenchantement du monde — une histoire politique de la religion (1985), and thereafter unfolded his theory of democracy through La démocratie contre elle-même (2002) to the four massive volumes of L’Avènement de la démocratie (2007–17)[14]. Its root theme — after the disappearance of the transcendent instance, society undertakes to include the heterogeneous other within itself rather than expel it to an outside, and the undertaking miscarries — is manifestly the direct extension of the book on the asylum.

3.2 The charge of a turn to the right

From the 2010s onward, Gauchet’s interventions on immigration, laïcité and populism drew strong criticism from the left — the verdicts ran from conservatism to reaction. His own self-description is “philosophical socialist”[15]. The essentials are these. Already in a Débat article of 1990 he had argued that what was needed was not a halt to immigration but a maîtrise — a mastery reinserting the process of immigration into the domain of social sovereignty. In an interview of 2017, however, he spoke of a change in the very nature of immigration, and used the vocabulary of a peuple de souche — a people of old stock — coexisting with newly arrived peoples differently tied to national unity; the choice of words was criticized as an approach to the language of the far right. In 2014 his nomination as opening lecturer of the Rendez-vous de l’histoire at Blois had already provoked a call for boycott[27].

From the standpoint of this paper, two points matter. First, these interventions read not as topical aberrations but as consistent consequences of a single problematic — the inclusion of the other, and its limits — pursued without interruption from the mad, through religion, to the immigrant. Second, and for that very reason, they suggest that an operation which the author’s study of La pratique de l’esprit humain[19] criticized apropos of that book’s image of the insane — the construction of the included other according to the needs of the theory — may be repeating itself upon a new object. The reader of Swain can thus understand the controversy around Gauchet not as background noise to her reception, but as the later history of a tension her joint book already carried within it.

3.3 Reappraisal in English, and the end of Le Débat

In the English-speaking world, meanwhile, the recent movement runs rather toward consolidation. In the reaction against post-structuralism, the “other French thought” has been rediscovered as a theory of democracy with historical and anthropological foundations, and a volume of critical essays has been devoted to Gauchet[16]. That his anglophone critics re-frame his diagnosis of the present as a problem not of the excess of autonomy but of its blindness shows a range quite different from the verdict of simple conservative reaction. The closing of Le Débat in 2020, after the forty years of the Nora–Gauchet editorship[13], marked the end of an era; that his classicization abroad has proceeded in the same years is the paradox in which the ambiguity of his present position is well caught.

4. Reception: Empirical History, the English-Speaking World, the Classroom

4.1 Empirical history: Postel

How Swain’s work was received on the side of empirical history of psychiatry is best shown by the medical historian Jacques Postel (1927–2022). It was Postel who, in 1968, first pointed out Foucault’s defective reference to Pinel’s Traité — the declared citation of the first edition resting in fact upon the second; Swain inherited the observation and radicalized it into a question about the entire structure of interpretation[17]. Postel’s debt in the other direction runs deeper still. In the essay on the founding myth of French psychiatry in his late collection (2007), he names Swain as one “to whom we owe much for this study” (à qui nous devons beaucoup pour cette étude), takes Le sujet de la folie as his authority at nearly twenty places, and repeats the formula comme l’a montré G. Swain. The philosophical frame of his Pinel studies, moreover — the fault-line from Kant to Hegel, and the discovery of a remainder of reason — he draws from her article in the first issue of Libre, writing “as the late Gladys Swain so rightly showed in 1977” (comme l’a montré si justement la regrettée Gladys Swain)[5]. Yet Postel was no unconditional follower: he kept the empirical historian’s reservation that the Pinelian rupture “is not so total as Swain would have us believe”[28]. Precisely this balance of debt and reservation is the proof that her work was received in earnest on the empirical side.

4.2 An abridged translation and the series “New French Thought”

The anglophone reception begins in 1999, with Madness and Democracy, the Princeton translation of La pratique de l’esprit humain[9]. It is an abridgement — some chapters are omitted — but one through which the substance carries. What matters is that the translation appeared in the series New French Thought (edited by Thomas Pavel and Mark Lilla), a series conceived expressly as a counter to post-structuralist French Theory: Swain’s English debut was thus placed, from the first, in the context of the “other French thought.” The long foreword contributed by the intellectual historian Jerrold Seigel — which values the book as a work whose humanity and analytic power compel re-engagement with the great questions it raises, while directing three lucid criticisms at its Freud–totalitarianism judgment, its thesis of the democratic origin of psychological knowledge, and its state-centrism — remains a document of the first rank for the level of the anglophone reception[10]. In 2009 there followed, in a journal of intellectual history, a full-scale study placing the Gauchet–Swain theory of the subject in its post-1968 context[4].

4.3 The present: the classroom, and the remaining absences

In France, Swain remains in the curriculum: “De Kant à Hegel,” from the posthumous collection, serves to this day as a commented text in psychiatric teaching[21], and the single-author book was reissued in 1997 with Gauchet’s new preface “De Pinel à Freud”; the chain of reference has never broken. In Japanese, by contrast, there exists — so far as the author has been able to determine — no translation of Swain and no extended introduction; the Japanese original of the present paper was written, alongside this bulletin’s examinations of her doctrine[17] [18] [19], as a first step toward filling that absence. In English the absence is only partly relieved: one abridged translation, one foreword, one article — and, until now, no biographical introduction at all. The present English edition is offered to that gap.

5. The Writings, with Brief Annotations

Swain’s writings are listed here in order of publication, with the books as the axis. The greater part of her journal articles was gathered after her death into Dialogue avec l’insensé, whose table of contents thus doubles as the effective list of her papers.

Le sujet de la folie : naissance de la psychiatrie, Toulouse, Privat, coll. « Rhadamanthe », 1977 (distributed January 1978). — The single-author book, founded on the thesis. Reissued: Paris, Calmann-Lévy, coll. « Liberté de l’esprit » (the series founded by Raymond Aron in 1947), 1997, with Gauchet’s preface “De Pinel à Freud.”

« Deux époques de la folie », Libre, n° 1, Paris, Payot, 1977. — The article that introduced the Kant/Hegel fault-line; published in the first issue of the Lefort–Castoriadis Libre. Later collected in Dialogue avec l’insensé under the title “De Kant à Hegel.”

Preface (jointly with Gauchet) to the re-edition of Esquirol, Des passions considérées comme causes, symptômes et moyens curatifs de l’aliénation mentale (1805), Paris, Librairie des Deux Mondes (the year of publication is given as 1978 by one source and 1980 by another: see the note on the state of research).

La pratique de l’esprit humain : l’institution asilaire et la révolution démocratique (with Gauchet), Paris, Gallimard, Bibliothèque des Sciences humaines, 1980. — English translation (abridged): Madness and Democracy : The Modern Psychiatric Universe, trans. C. Porter, foreword by J. Seigel, Princeton U. P., coll. « New French Thought », 1999.

Joint articles with Gauchet, Le Débat, 1984 and 1986 (titles and issue numbers to be confirmed: see the note on the state of research).

Dialogue avec l’insensé : essais d’histoire de la psychiatrie, préface de M. Gauchet (« À la recherche d’une autre histoire de la folie »), Paris, Gallimard, Bibliothèque des Sciences humaines, 1994. — The posthumous collection of the articles.

Le vrai Charcot : les chemins imprévus de l’inconscient (with Gauchet), Paris, Calmann-Lévy, 1997. — The unfinished joint research, completed by Gauchet.

Conclusion

A psychiatrist who wrote for ten years, was ill for six, and died at forty-eight prepared the most radical criticism yet made of the enormous construction that is Foucault’s, supplied the empirical historians with their framework, and crossed one of the living genealogies of political philosophy. The record of that life is meagre, and this portrait keeps its own list of open questions (see the note on the state of research). But the meagreness itself seems not unrelated to the character of her work — which does not speak of itself, but makes its object speak. The substance of the doctrine is treated, and will continue to be treated, by the studies of this bulletin[17] [18] [19]. The present paper is their small portrait of the author.