Histoire de la Folie (1961) by the French philosopher Michel Foucault has profoundly influenced the general public's conception of the history of psychiatry, but the book is relatively seldom discussed among psychiatrists. Foucault views the core characteristics of psychiatry in the light of what he terms "the great confinement" of the mad and other outsiders. He maintains that the confinement took place all over central Europe from 1650 until 1800, and that the psychiatric asylum was designed on the basis of the confinement house. This paper discusses whether this great confinement actually took place and critically examines Foucault's interpretational model. There is a further discussion of the main reasons why the humanistic and creative spirit characteristic of the early nineteenth century asylum was replaced by stagnation and disillusionment 150 years later.