Throughout Madness and Civilization, Foucault insists that madness is not a natural, unchanging thing, but rather depends on the society in which it exists. Various cultural, intellectual and economic structures determine how madness is known and experienced within a given society. In this way, society constructs its experience of madness. The history of madness cannot be an account of changing attitudes to a particular disease or state of being that remains constant. Madness in the Renaissance was an experience that was integrated into the rest of the world, whereas by the nineteenth century it had become known as a moral and mental disease. In a sense, they are two very different types of madness. Ultimately, Foucault sees madness as being located in a certain cultural "space" within society; the shape of this space, and its effects on the madman, depend on society itself.
His central argument [about madness and art], however, rests on the idea that modern medicine and psychiatry fail to listen to the voice of the mad, or to unreason. According to Foucault, neither medicine nor psychoanalysis offers a chance of understanding unreason. To do this, we need to look to the work of "mad" authors such as Nietzsche, Nerval and Artaud. Unreason exists below the surface of modern society, only occasionally breaking through in such works. But within works of art inspired by madness, complex processes operate. Madness is linked to creativity, but yet destroys the work of art. The work of art can reveal the presence of unreason, but yet unreason is the end of the work of art. This idea partly derives from Foucault's love of contradiction, but he feels that it reveals much about modern creativity.
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