Foucault relies heavily on contrast and contradiction. From the contrasting images of leprosy and the Ship of Fools at the beginning of the work onwards, Madness and Civilization is structured around a series of conceits and paradoxes. The experience of madness and unreason is complex, Foucault suggests, and this complexity is echoed in his work.

Some academics have criticized Foucault for what they see as his chronic obscurity, but at least part of the issue stems from his attitude to language and discourse. Those who are labeled as mad can become “trapped” within their own delirious discourse and within the structures designed to confine them. (Perhaps the experience of being trapped inside some of Foucault's more difficult sentences is meant to echo this.)