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Tijdschrift voor Psychiatrie 48 (2006) 11, 881 - 888


The unbroken power of psychiatry as seen through the eyes of Michel Foucault

H.F. Kraan

Is the psychiatrist still a powerful force in society? Foucault, a 'historical philosopher' concerned with power relations, would have answered this question in the affirmative. Possibly, however, the psychiatrist's sovereign power is weaker than it was a century ago because some of the psychiatrist's tasks have been re-allocated. Some have been assigned to the growing number of specialist groups in the mental health service, others have been put in the hands of 'health managers' who form part of our country's growing bureaucracy and put a financial and economic burden on our health service. Nevertheless, the procedural power of psychiatrist has not been weakened; psychiatrists are able to deprive patients of their freedom, pronounce them unfit for work and reduce punishments and sentences for serious crime on the grounds of diminished responsibility. This procedural power is accentuated by the increasing influence of psychology in society. The power of psychiatric knowledge has shifted from an archaic to a demonstrative discourse about truth which is rooted in evidence-based medicine and which enhances the power of psychiatrists still further. This may also mean that the 19th century concept of hysteria is perpetuated in psychiatric practice in all kinds of modern clinical forms.


keywords discourse, evidence-based medicine, Foucault, power, truth