Nineteenth-century French culture had an uneasy preoccupation with madness (la folie) and the new concept of mental illness (l'aliénation mentale). Both were defined in opposition to a normative model of good health, implicitly identified with the perspective of male bourgeois rationality. Yet it remained unclear whether, or how, the normal and the pathological could be definitively separated. Writers and doctors were well aware of an ambiguous intermediary zone encompassing nervous disorders, eccentricity, and ‘perverse’ desires as well as dreams, mystical ecstasy, and intoxication – in short, any deviant or oppositional behaviour, as well as the entire realm now known as the unconscious.

Post-revolutionary French culture has played an important role in research on the histories of madness and psychiatry since the publication of Michel Foucault's Folie et déraison in 1961. His study outlines different stages in the treatment of madness in France from the medieval period, culminating in Philippe Pinel's establishment of the psychiatric profession after the 1789 Revolution. The ostensibly humanitarian aims of Pinel's new ‘moral treatment’ were mythologised in paintings of the era, which portray him removing the chains of the insane in the Bicêtre asylum. Foucault famously proposes, instead, that Pinel's paternalistic and moralising methods merely replaced visible chains with the no less oppressive internalised chains of guilt (pharmacological constraints would follow in the twentieth century). Whilst aspects of Foucault's account are questionable, it powerfully critiques the psychiatric profession's normalising drive, like other works of the period.