Something that came up in class discussion about History of Sexuality Vol. 1 last week was the legitimacy of the label “confession” for scientific discourses about sex, a prime example of which is doctor-patient relationships. Foucault says that confession as a method of producing truth about sex originated in religious confessions, which encouraged people to recount information about their sexual experiences. The features of confessions that Foucault describes are easy to see in the religious confession—the truth comes to light, and there is a power relationship in between the confessor and an authority figure (a priest) who hears the confession, interprets it, and prescribes a solution (penance). As we discussed, the term “confession” also seems to imply that the confessor is guilty, and that this guilt is being confessed in order to figure out how to make up for it. This is especially true if confessional discourses originated in religious confession. But when it comes to discourses like those of doctor-patient relationships, it isn’t immediately apparent that guilt plays a role, which makes it seem like confession isn’t the right term to use.
We might choose to interpret Foucault’s use of “confession” differently, and perhaps get rid of the element of guilt but keep the other implications (e.g. truth-producing, power relation). I think, though, that we can cash out the idea of “guilt” as Foucault might use it in the case of the scientific confession to make a bit more sense. We can do this in light of Foucault’s discussions in Discipline and Punish about how a goal of disciplinary institutions is to normalize individuals. Especially towards the end of Discipline and Punish, Foucault develops the idea that penal institutions have become preoccupied not with punishing guilty actions, but with normalizing the “deviant” person. Calling someone guilty no longer just means that he or she has performed an action that is wrong or immoral; rather, “guilty” means that someone is a delinquent that deviates from the norm. When someone confesses their guilt in a judicial context (a context to which we can easily apply Foucault’s descriptions of confession), they confess their deviation from institutionalized norms. This deviation is manifested in a person’s actions, but it stems from their guilty “soul,” as modern penal institutions try to get at the motivations and such that underlie a person’s actions.
Other disciplinary institutions—including hospitals—share to some extent in the qualities that penal institutions have (since they’re all part of the “carceral archipelago” that extends out from penal institutions). One of these qualities is their goal of conforming individuals to societal norms, which in the case of hospitals are norms of health. When one tells one’s doctor about sexual practices as part of identifying illness, one is thereby revealing deviations from these norms. This is clearly related to how I just described guilt in the case of the penal system—as deviation from the institutionalized norm. The big difference is that this type of “confession” is much less about the “soul” and much more about the physical body. But, Foucault does say that non-penal disciplinary institutions share penal institutions’ qualities, just to a lesser degree. We thus might describe these scientific discourses as a less intense form of confession, which to some extent still preserves the idea of “guilt” in that there is an element of confessing deviation from norms, along with the typical features of confession—truth-revealing, power relation that results in the doctor interpreting and prescribing, etc.