Will Hall on the anti-identity identity politics of madness
by Timothy
Awhile back I posted on emergent tensions in identity politics and self-positioning within the ‘mad movement(s).’ Of course, this issue also affects folks caught up in self definition, psychiatric labeling, and treatment who might not even be aware of a ‘thing’ being referred to as a ‘mad movement.’
A key part of that post–you can find it here–was a section where I quoted–with permission–from a heated dialogue that occurred on the U.S. International Society for Psychosocial Approaches to Psychosis (ISPS) discussion group. I invited Will Hall to respond, because he’s a person that garners significant respect across various groups in the U.S. ‘psychiatric abuse survivor’ or ‘mad’ movement(s). Will missed the original request, but was gracious enough to give permission for his very thought provoking response to be posted on this blog.
Will’s response is posted below, and you can read more about his work here.
I think Will’s response stands on it’s own. Rather than respond here, I plan to extend the discussion in the next month with follow up post’s on two key issues: 1) Identity, psychiatry and madness; 2) Unpacking social justice and the influence of U.S. style libertarianism within the ‘mad movements.’
Also check out a guest post I recently wrote for The Icarus Project addressing related themes here.
….And now here’s Will.
———- Forwarded message ———-
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Hi everyone,
this is a terribly late reply to an email thread that has the subject line of “Important,” and I apologize for the delay!
(I admit that my filter on my emails is set to squirrel away the ISPS list; I just don’t have time read the majority of listserv emails I get, and so wasn’t aware when this one came in. In June.) Timothy is an old friend who recently alerted me to my lack of response to his email asking for a reply, so I searched around and dug it up. I tried to read through the original email thread this refers to, “Antipsychotic Vs. Placebo in ‘Schizophrenia'” but it’s very long and complicated. What I will try to do is respond to the general issues at stake here.
I should say that I know thread writers Ron, Paris, Nev, and Timothy personally — all are thoughtful and dedicated on these matters. My aim isn’t to take sides or slight anyone, but instead to clarify my own point of view in light of what is being discussed (or at least the part of what has been discussed that I read). I’ve known Timothy far longer than any of the others, and trust his own thoughtfulness in bringing this to my attention as important.
I also don’t want to mis-represent anyone’s point of view, or lead to a what-I-really-meant exchange. I acknowledge being out of the loop and not up to speed. I was asked to respond and so I’ll just make some comments that should stand on their own. It’s not a “what you said meant this” response, it’s a “here’s what I think” response.
I had heard third-hand about a conflict around this topic. What I heard — accurate or not – was the controversial claim that “Psychosis, in and of itself, is not harmful, the only harm is from treatments, meds, and social response.” That people with ongoing “psychosis,” that would include myself, were being told their/our suffering is located in system response not psychosis itself; psychosis persists or inflicts suffering because of iatrogenic harm, not the psychosis itself. That somehow psychosis, when iatrogenic harm is removed from the equation, is necessarily and always a natural human cycling that resolves spontaneously or presents gifts spontaneously.
I think that’s true for /some/ people but not all, and we don’t know why. Setting aside the “where and what is psychosis” question for a moment (I’m not inclined to locate it in individuals as I think psychosis itself reveals the being-ness of self prior to socially constructed individuality), and setting aside the complexity of sweeping statements and the idea of system-izing human experience (which to me is always contingent and unique, not reducible to expressions of type – madness is always a unique creative act in my view just as a human personality is always a unique creative act), my position on that statement would be something like this:
Madness has its own suffering independent of the mental health system’s involvement, or negative social response, or anything else. Madness/psychosis does also often include vast, unimaginable, life destroying suffering. Cross cultural research makes this clear. Talking with people and reading accounts makes this clear. (It seems very obvious to me to make this statement. But then again the statement that meds help some people also seems obvious to me. So maybe I am taking a position that will be seen as controversial without realizing it – I’m curious about responses and interested in learning.)
As far as identity, I think we are the anti-identity identity politics movement. Because our oppression is in such a deep way defined by the act of definition itself, identity-as-site-of-contested-power, we are oppressed, perhaps, in a kind of ‘pure’ way beyond other identities, and language becomes key. Language, in a sense, is the very issue here, and so using language definitions against an oppression that operates through language definition is in itself somehow failing to truly overturn the oppression. Who “is” and “isn’t,” what “psychosis” is, are particularly central for these oppression dynamics.
Saying “you’re crazy” is after all the defining moment that utterly disqualifies the Other in their challenge to privilege. Fights often escalate to war when one side decides the other is ‘crazy’ – whatever the content or social identities. The enemy has some irrational stain that will not be removed through regarding them as a friend and discussing, and therefore justifies treating them as object, not subject, and an enemy.
Identity is meaningful though. We can certainly make great kinship with all people who have had distressing altered experiences. I love when I get some knowing solidarity from someone who has never been in a hospital but had a nasty acid trip, or went on a manic bender from pulling all nighters, or had an “uncaught” extreme state that met with some way out other than the hospital. All of these can resonate with me – there is similarity – even some great similarity – with that I’ve been through. My trainings often draw on these similarities to forge bonds across Otherness and to emphasize the unity of human experience against the constructed individuality of Us and Them, the construct that authorizes dehumanization of the Other-as-sick and is carried to such extremes in mental health contexts. The Hearing Voices Movement has made it clear that emphasizing similarities, the idea of normality of madness and continuum of experience, has a great impact in reshaping how madness is constructed and responded to. “Hey, I have some of that in me too” is a good first step towards compassion.
But just as I need to emphasize that my own brief stint of homelessness was not the same as living unhoused on cardboard for years, and my own lockup was not the same as being in a state hospital or on guardianship, or that my own number of crises does not add up to three decades and scores of police call ER visits, we do have to recognize a fundamental difference between the ‘never been caught’ folks and the force hospitalized folks. Force hospitalization can be, for many, a unique degradation ritual enforced by the ruling institutions, a violence that creates a branding on the psyche that is utterly extreme.
Speaking as “someone with a schizophrenia diagnosis” it is my ethical responsibility to also embrace the diversity in these experiences, and not claim to speak for /all/ people. I make a huge effort to always answer “how did you change and feel more in control” with “everyone is different and luck has a lot do with it” rather than claiming I am a recovery poster child with a roadmap. At the same time, I believe very strongly that the ‘psychiatric abuse survivor’ identity is extremely significant to not be erased by some broader category of “lived experience” of psychosis – caught and uncaught – and even non-psychotic experiences (again setting aside the problems in that term) such as the new ‘peer’ umbrella.
Politics, though, does mean we need to rely on shared identities and engage in identity politics to have mass in our mass movement. The caught and uncaught, psychotic and unpsychotic together alliance is working really well in many ways for advancing our shared values and gaining some political power (it also doesn’t work well in other contexts – this is a bigger discussion). We have strength when we create a ‘we’ out of the isolation and divide-and-conquer of oppression. So I can speak for shared experience, to some degree, as long as I also create that welcome space for diversity that negates identity for a moment. As long as my relationship to a broader mass of people continually resonates and re-legitimizes the form of identity authority I am taking, this dance works.
One of the keys to my own work as an educator has been to always, always state “I know many people who get support from hospitals, get support from medications…” before I tell my story. That creates an opening for people to not feel pushed away if they don’t ‘identify’ with the ‘identity’ I might be seen as laying out. It’s a dance between the open-ness of human identity and the specificity of experientially constructed identity. We live as humans in both the specificity of irreducible difference and in the imaginal typing of broad social resonance. We all suffer, yes. There is, and there isn’t, a “mental patient experience” or a “psychotic experience.” Just as there is, and there isn’t, a “woman’s” experience or a “black” experience — though we know of course this identity construction is a key oppositional moment in political challenge to the status quo, and individual experience is self-constructed as social identity to our core. Folks claiming ‘psychotic’ as a broader identity — caught and uncaught — must be also ready to drop that identity and embrace the diversity that those who were “caught” present when they present it. It’s real.
If there’s an argument here about psychosis and mental patient experience between the ‘never been caught’ person and the ‘in and out of hospitals’ person, we need to weigh on the side of ‘in and out of hospitals,’ as a rule of thumb, because, believe me, if you haven’t been in there, you have no fucking idea. It does things to you. And at the same time, that can become identity dogma– what it does it not the same for all. But it is I believe something like a general rule of thumb, or else I wouldn’t be engaging in identity politics at all (the alternative is a kind of pluralist relativism that just enforces erasing of oppressed experience and serves the status quo – sort of like a post-racialism.)
I think if there are specific gripes between specific individuals, then people need to respectfully make those gripes directly, rather than displacing the whole thing into a once-removed more abstract/theoretical discussion. I don’t think anyone can claim authority/expertise based on personal experience as an “uncaught” person who went through psychosis over someone who was in the system. People can claim experience with altered states that may or may not share psychosis, but there is a difference between psychosis and psychosis. All psychosis is not psychosis. Being caught or not isn’t just escaping getting caught, it may have to do with severity of the suffering and how the extremeness of the experience makes it more likely to get caught.
This is as a general principle, which may not hold in specifics. At the same time all of us who are school educated need to recognize we can’t speak for those whose psychosis and poverty so affected their lives they can’t manage a complicated email thread. Or folks so massively terrorized / impaired by their psychosis that their best bet is refuge in meds that might similarly make participation in this discussion impossible. Etc etc. But yes we can speak for the general experience in a general way, and the class diversity of our movement and the response to leadership among class diverse participants legitimizes that.
We have to somehow be an anti-identity identity politics movement. The way I believe, is to stay related, personal, and feeling, and watch out for abstractions, typing, and role-projection. When the feelings get lost in the discussion I start to feel less safe.
If there is a consequential disagreement around “psychosis is not harmful in and of itself until there is a social response” I do think it is legitimate to address the speaker who may not have had ‘psychosis’ as relative to one who did have a ‘psychosis’ that is not only caught, but led to catastrophic long term system involvement. It just risks being extraordinarily insensitive when someone who has the privilege of not enduring devastating institutionalization to claim authority to define an experience as less painful in and of itself, based on grounds of sharing the essence of that experience. It risks that the more privileged position – not being caught and not suffering long term – will end up assuming greater power and using it to marginalize the less privileged, institutionalized/caught and long term suffering position. That potentially recreates the misuse of power our movement is working to overcome -the less ‘crazy’ silencing the more ‘crazy’, in this case by erasing the ‘crazy’ as difference in the equation. This potential division parallels conflict in Black politics around skin tone, and conflicts in feminism around sexual orientation.
Any addressing the speaker in questioning the argument risks of course ad hominem fallacy, but there is a feeling and relatedness dimension here beyond logic, and it just doesn’t quite feel right for me to 1) hear a claim that psychosis without iatrogenic harm is not in itself harmful being made by those who also 2) a claim that all psychosis is of the same essence, caught or uncaught and they can therefore 3) speak with authority on the subject. You have to be sensitive when bringing in personal experience to broader arguments; logic can’t ever trump personal experience, but personal experience can’t ever authorize general truth claims or underpin logical argument. Yet at the same time, personal experience is what movements are all about.
That paradox is what makes movements movements and mathematics mathematics. That’s why I embrace a non-identity identity politics, and why I think these discussions are crucial and am happy I was invited to respond.
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Malingering Normal 
Reblogged this on Beyond Meds.
Reblogged this on Ruminations on Madness.
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Thank you, for this and previous posts on the issue(s). I’m looking forward to your next ones.
Thanks for stopping by and reading!
Will — I wonder if you agree or disagree with the following?
“What is the difference between a psychotic or LSD experience and a yogic, or a mystical? The plunges are all into the same deep inward sea; of that there can be no doubt. . . . The mystic, endowed with native talents for this sort of thing and following, stage by stage, the instruction of a master, enters the waters and finds he can swim; whereas the schizophrenic, unprepared, unguided, and ungifted, has fallen or has intentionally plunged, and is drowning.” — Joseph Campbell, Myths to Live By
Hi Mary, thanks for stopping by and reading. I obviously can’t speak for Will. For me, I don’t personally think of Joseph Campbell as an authority on psychosis. I think the quote you provide here is problematic, and I’d offer that I think Will’s reflection here gets at most of what I’d say in response.
What do you think about Will’s response here?
Hi Mary, I think whatever framework people find that is useful for their own experience is great. Opening to spiritual and shamanic /possibilities/ is really important, because we need to expand the possibilities of personal identity and self narrative into the full range of what might be useful to each person, including across cultures.
The parallels with LSD and yogic journeys are real and very provocative in what they say about the nature of individuality and the psyche. As Timothy says I think however for someone who has not been through these experiences to make sweeping assessments of how it is for everyone is a questionable political act. People who haven’t really experienced the horrors and devastation of psychosis need to just chill out on the spiritual cosmos gazing and get a lot more humility around the pain and suffering that is going on.
Campbell, Grof, Perry and others are inspiring and fascinating to read. I’ve been personally influenced a lot by Jung and Mindell, but I also bring my own experience in to how I read these thinkers, Many of them and their followers end up imposing their own diagnostic and etiological framework that ironically, in its positive spin, can be very negating to those who ‘drown’ and can’t quite make it to the spiritual elevation from which this outside diagnosticians pronounce. When we celebrate the shamanic heroes of the psychotic return trip we are casting judgment on those who didn’t make it back. The imperative “if you were just spiritual enough you could transform all this into a gift” is frankly insulting to many people. We shouldn’t just upgrade the DSM to become an assessment of people’s pathological karma, which is unfortunately what I think many of the spiritual interpretations of psychosis end up doing.
Again diversity is key here and anyone, especially people who have not been swimming in that “deep inward sea,” who imposes a single identity on the experience, whether their pedigree is medical or religious, risks committing another act of narrative violence by erasing those who do not fit their model.
dear will, i just wish to thank you for this text and all the thinking behind it. you touch here on some central issues (like language definitions or what u say about ‘feelings getting lost in the discussion’) and bring clarity in what i personally find so hard to express. what u have written here feels so true to me. i have nothing clever to add, just wanted to say how much this helps my own struggles with myself and with people around me. you made me overcome my insecurities with english and write my first comment to a blog ever so take this personally.
Thanks for stopping by and reading.
Thanks Jasna, great to see you part of this discussion — and congrats on the first blog comment!
I really appreciated reading this, it’s been an incredibly thought provoking essay. Heads up that this response initially started life as an email exchange, and Will suggested I publicly write here. My comments don’t pertain to the broader issue of claims making regarding the nature of psychosis, rather I’m interested in exploring the dichotomy of caught/uncaught and severity.
I personally started going mad at a very young age. Intense distress was misread throughout my childhood as physical illness (from the age of 4 teachers urged my parents to have me tested for leukaemia), I endured sadistic abuse and I first started developing unusual beliefs, revolving around death and persecution, around the age of 7. Altered states- both pleasant and terrifying- have been an ongoing feature of my life.
Technically, I am ‘uncaught’, and I understand that the reasons for this are multifaceted. I’m privileged in terms of whiteness, the priority my parents accorded my education and the human and cultural capital I’ve accrued as a result. But there are other aspects to this too. I grew up in a working class family in a low SES region of rural Australia. I think ‘harden the fuck up’ was probably the unofficial governing motto of a lot of families struggling like mine. I was my family’s caretaker and I think it would have been profoundly destabilizing for my kin to acknowledge that I was losing the plot. When I acted strange, I was bullied into silence and I occupied a kind of wooden half life.
I don’t have personal insight into the psychic violence of forced hospitalization and I can’t pretend that I do. I really don’t want to fall into the trap of colonising another’s subject position- in terms of either the experience of psychosis or institutionalisation- or of robbing anyone of their experiential wisdom. I do think that when families are particularly wounded/toxic, they function as a kind of total institution. In light of that, I think the distinction between the categories ‘caught’ and ‘uncaught’ is crude in the sense that some of us who are technically *uncaught* have still been *trapped* in ways that resulted in extreme harm. We haven’t exactly enjoyed the liberty suggested by the status ‘uncaught’.
It makes total sense to me to claim that severity is a pivotal factor in forced hospitalization. The disorganisation I was experiencing didn’t completely trump the capacity I had for impression management, and I managed to escape with being ‘treated’ as a psych outpatient rather than being trapped as an inpatient. That said, I think severity requires more unpacking. Do we gauge this by the intensity of distress? Chronicity? The extent to which the observing ego is swamped? Our in/ability to convincingly meet the requirements of a social interaction, or fulfill identity commitments? This too is multifaceted and I reject the idea that not being caught implies that your experience wasn’t severe or you haven’t suffered greatly over the long term. One has to be seen to be read as ‘severe’ and then endure the process of being ‘caught’. I was denied visibility, my state of being was misinterpreted (as physical illness), and also recuperated and repackaged by actors more powerful than myself (being positioned as willfully defiant by an abusive parent). I suspect there are others out there with experiences somewhat similar to mine, and I also wonder if these processes of being rendered invisible are in some ways gendered.
I can accept that there is a fundamental divide between myself and someone who has been institutionalised in the system, but I can’t frame my experience as ‘I wasn’t caught because things weren’t bad enough to warrant capture’, and I suppose I wonder what kind of speaking position that leaves me with. These days I’m a PhD student engaging with other mad folk for my thesis and I’m trying to find my voice both as an emerging survivor academic and as a participant in this movement, while also honouring the voices of people I engage with. Like the self and like psychosis, I think that voice somehow emerges in the field of relations between people. That’s both exciting and nerve wracking. I recently found an ally who writes about the need for critical reflection in the process of speaking with authority and ‘truthing a claim’, and that’s what comes to mind for me here. I don’t want to erase differences in degrees of ‘craziness’ but I am asking for awareness of those of us on the periphery, who’ve struggled with silence and invisibility for a very long time, who don’t quite fit into a dichotomy of the uncaught, privileged and less crazy versus the caught, oppressed and more crazy.
Hi Laura,
Thanks for this deeply felt response. In general, I’d say dichotomies get us in trouble—as with systems of classification— the moment we forget their status as heuristics.
I hope you read my earlier post that Will is responding to. There I contrasted a conversation with my mom— with one from US-ISPS. I offered both so readers could see—among other things—my own conflicted/contradictory self-positioning.
Honestly, it’s hard to speak on these matters in simple or concise terms. I’ve lived my whole life grappling with madness, my moms then my own. Plus, like you, I study this stuff. Part of why I don’t believe everything can be said in clear and simple terms is that the more we reduce complexity, the more we risk over-simplification.
I suppose it’s always a matter of degree. The map is not the territory and what not.
Plainspoken explanations are great for selling pharmaceuticals. They work less well for grappling with something as abstruse as madness.
But I’ll try.
My initial reaction to your comment is a felt sense of your compassion, your endurance and survival, and the sense that this discussion risks rendering your experiences ‘invisible,’ repetition, in a way, of earlier wounds.
I agree, caught/uncaught –on it’s own—doesn’t necessarily say much about ‘severity.’ But then, just by acknowledging severity you allow for complexity and humility than many people I’ve talked to don’t.
Let’s not lose sight of folks who can’t even participate in this discussion. A lot of that’s related to other issues. But it’s also because some folks have profound difficulty even using language to communicate. ‘Thought disorder’, ‘word salad’; these terms developed to describe observable behavior. Those who’ve spent much time in a state hospital almost certainly have seen—or experienced it. I’m at a point when I’m losing patience for those who can’t acknowledge the suffering, the ‘reality’ of severe psychosis.
But that’s not my sense of what you’re saying. I point it out to underscore the range of issues my earlier post—and Will’s response—are attempting to grapple with.
A whole other complicating factor is that some of those who are *caught*–are not also ‘mad, nor do they claim to be: as in Being Sane in Insane Places. The gross over-diagnosis in the U.S. further undermines experiential claims of madness. I’ve seen this lead to survivors –in the sense of psychiatric abuse survivors—making the claim that madness doesn’t exist. For this reason I often feel that ‘survivors’ are working against the interests of mad folks.
But then, power/knowledge—or social construction if you like—does both produce—and constrain—how we experience ourselves. Our subjectivity, and our sense of agency, is in many ways illusory. Psychiatry(s) writ large in the cultural imaginary. That is to say in some sense it’s true that one couldn’t be ‘psychotic’ before there was a concept called psychosis with all it’s trappings. Goffman, Hacking and what not.
….And
Like Will, I also believe that “psychosis itself reveals the being-ness of self prior to socially constructed individuality,” though I wouldn’t put it quite like that.
Or rather, *sometimes* this is the case. Other times it’s probably straight up due to trauma, or response to environmental toxins. And the process of diagnosis and ‘treatment’ in many cases deeply damages a person’s identity.
So yeah. Not being ‘caught’ isn’t—in itself—the only indicator of ‘severity.’ Nor is being ‘caught’ for that matter.
But then, there’s also myriad heterogeneities within the constructs we’re talking about just in terms of phenomenology. I’m not sure what psychosis has been for someone until they describe it to me. For me, it’s generally been stuff like believing everyone’s been replaced by demons, or that my life is some kind of experimental scenario, the messages in the tv or the radio are being manipulated to attack me. In the past this used to lead me to get into all kinds of trouble.
I mean, if you really believed that someone was a demon, what would you do?
I’m also someone willing to make the somehow controversial statement that I’ve experienced forced treatment that saved my life, literally, and probably made other people safer to boot. I’ve also been abused in institutions. It’s a complicated world.
Thanks for stopping by and sharing your thoughts and experiences. I’m especially thrilled to hear from other folks who are trying to survive in the academic world.
Hopefully this conversation can deepen understanding for all of us.
Hi Laura, thanks for this very thoughtful and heartfelt response. This discussion engages us all personally and your openness helps bring us to the feeling and relational significance of these topics. You help me to see how I risk being in the position of inadvertently doing what I cautioned against in the post — marginalizing and erasing the experience of another on grounds of my own personal experiential authority position, this time as a ‘caught’ person staking claim to greater severity.
So we run against the peril of identity politics, which is based on me-not me dichotomies. How to establish a political presence and leverage against entrenched power arrangements without an identity politics? How to simultaneously undermine the narrative violence of identity itself, a violence so intimately felt in the mental health context?
You underscore the importance of dropping that identity and welcoming the diversity. It is wrong for me or anyone to set up “caught” and “uncaught” as based on an identity equation of “severe” and “less severe.” I would even go farther, and to encourage us to imagine empowerment in any position we identify as oppressed, and oppression in any position we identify as oppressor. There will be exceptional cases where it is true. Language fails as a positivistic identity of essence – we can’t really assume everyone always ____, as some new equation context will undermine that stability, Language, and identity, are radically contingent.
Knowledge production in the academy embodies colonial values and enacts narrative violence in part because of the exclusion of survivor voices from the research and scholarship sites of generation. That’s the identity politics part, we need more ‘people with lived experience’ (another super problematic term that erases diversity) as a political imperative to break up this hegemony. To some extent that is beginning to happen, as Nev and Timothy have written about. Opportunities are emerging for survivor research. Yet the failure of identity politics is revealed when those meeting the “criteria” of survivor are included but only as tokens, in the double bind of affirmative action Nev wrote recently about (though I don’t follow Rodriguez’s race politics on this), as junior partners, as window dressing, as lesser paid lower status. The values are recapitulated and the politics reestablished as the identity is assimilated. Systematic misuse of power continues.
That I think is the dilemma of anti-identity identity politics. In pinning a meaning to identity, for example as you point out assuming more severe to be caught, we might gain some political expediency in this movement struggle (this after all arose in a debate in an email exchange with political implications). But instead of seeking an ever receding horizon of definition for shared experience in order to ensure there is moving happening in our movement, we might need to – and here is the anti-identity – question the positivistic framework of the epistemology underpinning the strategy,
The “is”-ness of language is going to be in the use and context, not in the ‘meaning.’ It can’t be fixed or identified, only situated in context and relation. We’ve seen this again and again in the history of what we loosely call the survivor movement, which indicates to me as I wrote that what is at stake here is not another iteration of oppressed identity, but the oppressiveness of identity itself.
One of the many things that has inspired me about Open Dialogue is the Bakhtin critique of both abstraction and positivism, and the refocus on lived dialogical encounters between subjects and within subjects. Caught and not caught can be a liberating dichotomy, another erasing marginalization, or anything inbetween, considered in varying contingent contexts. Timothy illuminated this in his referring to the email exchange prior where the crux was the leverage that seemed to apply of “uncaught” and “caught” having no significance because both are under the umbrella of ‘experiencing psychosis.’That’s the same political move that has us referring to ‘peers’ and ‘people with lived experience’ etc etc as a political erasure of the violence of forced psych treatment.
Reformulated in the context of your post, ‘psychosis’ can yes be shared among the ‘caught’ and the ‘uncaught,’ but the political valence of ‘caught’ could be reversed. Your point about the visibility of severity isap, as we know the asylum is a policing of shared public representation not just a responding to the inner experience. Visibility could be a negotiated result of greater ‘impression management’ skills, indicating less ‘severity,’ or — just the opposite. An invisibility enacted by a captivity where the institution might, again to recontextualize and reverse the valence, become an escape /from/ oppression, not descent into it.
(After all, these reversals are what the ‘pro-forced treatment’ crowd evoke, and I want to affirm there is truth in those equations. Lack of treatment, any treatment, is for some a worse violence than iatrogenic harm, as the interest group pushing force right now evidences. I don’t refer to this to suggest an equalization of the reversed context – I am firmly anti-force – just to make a point that we are engaging with a very significant field of implication in this discussion.)
What you raise is to me the most significant dilemma which underscores the anti-identity identity question. In the end, I need a politics that will welcome, care for, and make hospitable the emergence of /all/ voices previously unheard or unwelcomed that defy existing narrative frames. A limitless horizon of inclusion, impossible to reach perhaps, but the universe does bend that way in my view. You have done this, and point me to my own compassion not for the mental patients, or the ones with a psychosis diagnosis, or whatever the blank might be filled with, but my compassion for those who endure the misuse of power. This is where our movement needs to go I believe, a way to articulate and stand for, as a movement, some kind of liberation of the human experience from the violent misuse of power. That is what I aspire to and what motivates me.
And yet even that isn’t quite formulated right. Perhaps somewhere in the dialogical encounter Bakhtin evokes, the radical unfinished project of bringing in more voices, some kind of space can be opened to engage such a vision. Maybe in that space those who have “Other” identities even beyond this can also find hospitality. I know many people in the position of “family member” who have endured violence at the hands of captivity by people who might have that caught or uncaught identity – your own story parallels this. I also hear people in the position of “staff” who have also endured violence. As a movement driven by political necessity by identity and opposition, such voices are very difficult to welcome. I haven’t held back from activism and flag-raising because of the unreachability of that aspiration, but the aspiration remains and I bring it to all my work, which so often includes mixed groups of learners from family, professional, and survivor positions. If I didn’t welcome all, and approach that horizon to some degree, there would be no viability to that work. I always preface myself with acknowledging the many people who do feel helped by force treatment, by their medications, by the diagnosis. That has become key to what I do. So I want us to somehow do that, to create spaces where people such as yourself who don’t find themselves at home with a place to stand in the deployed positions can step in and speak up, and find a home.
I think we have the heart and the vision to do this, as a kind of anti-identity identity politics, and I have a hope that Bakthinian dialogue is one pathway forward. A social justice and identity politics stance is missing from that dialogue — Bakhtin finds use as a clinical alternative not as a configuration of social movements. We can’t just adopt dialogue, we need activism. Maybe we can somehow develop the imperative beyond the identity in our activism, because in trying to work out our politics, we keep coming up against the limitations of positivism and abstract descriptivism as we try to get at the oppression so many of us have felt, so intimately, from different standpoints. Thanks again for deepening the discussion and inspiring me to look more closely at all this.
As far as demons, I have lived with several and worked with many, but there are demons and there are demons. I want to be careful about an identity politics for demons and essentializing demons — or establishing the position of people-with-lived-experience-of-demons as an expression of severity, or marginalizing the demon voice, or marginalizing the need to get away from demons, or marginalizing the need to destroy demons. My demons don’t allow me to speak for all people who have demons, or to speak for all demons. There is demon diversity. Come to think of it, there are some pretty hellish people out there and some demons I’ve met who have turned out to be ok, so I guess that means the demon-human dichotomy itself would appear to be contingent. So I have hospitality towards the whole demon trope, let me leave it at that, but I wouldn’t want to valorize my own hospitality and erase those whose severity means they exclude demons, or to romanticize or discount demons-as-suffering, because maybe I have the privilege of not having met those demons, though my demons have been pretty bad.
🙂
– Will
Thanks Will, for your generosity in furthering the dialogue. I suspect what’ll be most useful to take away from this discussion, including voices from ISPS and my mom, will not be the points any of us offer up, but our failure to construct any ‘essential’ truth. What’ll be most useful is emergent in the fissures between these partial, contingent ‘truths.’
Context. Yes.
This is a privileged discussion. The language is (necessarily) difficult. We assume familiarity with canonical folk, with Open Dialogue, and survivor politics. And it is a rich discussion.
But one could read what’s written as support for the Joseph Campbell quote, for someone telling my mother, or Nev’s mother that they are too ‘ungifted,’ that they’ve not worked hard enough and that’s why the suffering. It’s a reminder that the nuance we’re engaged with here is all too often invisible out there where stark dichotomy rules the day.
A consequence, I think, of your own earned position ‘out there’ is that you may not often be confronted with this. You are, after all, Will Hall.
You brought up post-racialism. It’s a useful parallel. Race, I’m told, is socially constructed. Yet, the notion that “we’re all the same” in a conversation about racism risks potentiating oppression. There are people who wear dreadlocks that think only certain others should wear dreadlocks. They speak from particular contexts that aren’t *merely* embodied relations between social actors, but locations riddled with vectors of historical force.
The utterance “we’re all the same” in the service of erasure.
Lets go ahead and coin it: post-sanism.
‘Out there’ is not post-sanist. ‘Out there’ is not a place where what’s mainstream can be tidily summed up as the ‘biomedical paradigm.’ As Laura brought up, Calvinist notions of ‘toughening up’ and ‘work ethic’ inflect discussion of mental health, and situate people in discourses in which their suffering is imbued with moral implication.
Notions quite friendly with the Szaszian ‘myth,’ no?
Let’s keep it real. What we’re discussing is the genealogy of the college counseling center where I work in which I have to argue for the ‘reality’ of my student’s need for academic accommodations on the basis of a psychiatric diagnosis. I encounter folks quite happy to agree with the Szazian myth in the service of their belief that my student doesn’t have a disability, that they’re just lazy. It’s a whole ‘nother mainstream.
Identity politics matter. It has implications for folks gaining access to everything from housing to education to representation.
Does it really matter who ‘gets’ to wear dreadlocks? It depends on who you ask.
Anti-force? It’s a convenient and politically expedient position to take, Will. But not very dialectical. You leave out the majority of folks who’ve experienced it who later said they needed it. Myself included. It’s a simple fact that without force, we wouldn’t be having this conversation at all. You can go all Kantian and suggest that the person who initiated that particular police call did something ‘wrong,’ but it gets pretty paradoxical if you’re argument is that it’s wrong because it was against my autonomy or self-determination. You see what I mean?
No doubt I’ll be misconstrued for that statement. I might even get vicious right wing ‘survivor’ hate mail filled with cruelty and personal slights like Nev has for her conflicted and deeply personal and vulnerable post about her mom.
If I do, hopefully it won’t be behind so much cowardice as to anonymize an ISP address. I want to talk to them for real’s.
I’m not pro-force. I generally emphasize arguments against it, actually (also true of medication). But again, it depends on the context. The context of this blog is folks who are already very critical and educated. Here I think we need to think more thoroughly about the question of “capacity”, perhaps in the sense of Amartya Sen: our capacities are in reference to the context in which we find ourselves, not the idyllic world that we desire.
Demons. I like what you said about them. I didn’t bring them up to substantiate my own claims of severity. I brought them up with reference to heterogeneity. That is, what’s called psychosis is categorically and phenomenologically diverse. Robert Bentall is pretty good on the categorical part, Louis Sass on the phenomenology. But I’d say Nev is even better.
But yes, it’s a complex matter.
After all, the only reason my life works is because I know demons are real and not real. Both. Neither.
This is great Timothy; what keeps me going in this work is to continue to learn and develop so this whole discussion is much appreciated. Your points are well taken.
Not to swerve into a discussion about force, but here is a thumbnail of what I am thinking these days. Force has usefulness for some, but hurts others and always risks harm, sometimes extreme harm. So on those grounds force is too much of a gamble, even if we acknowledge, as we must, that it is not universally harmful. The harm it does cause is too great to risk even if there is efficacy for some. Second, force reflects a double standard in our legal system where a second class not-quite-fully-human status is established when madness is present or considered present by a medical authority. That dual standard reflects the whole of our social bigotry towards madness and needs to be abolished. Abolition would drive alternatives to force, of which there are an unused abundance. The equation would then be reversed – the risks of a no-force approach would be accepted, while the standard would be protecting people from force, rather than the other way around. Finally force is widely used in association with medical interventions e.g. drugging/confinement to protect from suicide that have only limited justification based on outcome. Preventive hospitalization for suicidality has no utilitarian justification- the research just doesn’t support it. So when my friend was in a coma there was a clear need to use restraints in the bed to prevent her from tearing out the tubes that were keeping her alive; we don’t have that clear efficacy with the medical treatments associated with force. I am not a civil libertarian and don’t support an anti-force legal position without also a pro-services position. The two go hand in hand, and I think one of the big problems with the survivor movement is we’ve been too in the Szaszian anti-state frame when we need instead, as frought and problematic as it is, to be in the what-kind-of-services-and-social-responses-do-we-need-to-best-help-people frame. – Will
We may not disagree on the “force” issue. Much.
Lets unpack a bit further.
1. I wholeheartedly agree that the primary concern is lack of services. Ironically, this is TAC’s position also. Clearly you and I would part ways with TAC—almost certainly—when it comes to which services we’d like to see.
2. The empirical literature on the question of “force” is much more complex, the findings much more ambiguous than either the “pro” or the “anti” crowds are willing to acknowledge. Based on my reading of the literature, “the research just doesn’t support it” isn’t quite right. Either side can spin studies to support their conclusions.
3. Risk assessment—understood as determining whether someone will be “dangerous” to themselves or others beyond imminent threat—doesn’t work any better than guessing. It’s a practice that is not supported by evidence. But it’s important to distinguish between “risk assessment” and responding to “imminent threat.” Risk assessment is about more futural circumstances. “Imminent threat” is about judgment in the present moment concerning potential for immediate danger. It can’t really be investigated experimentally for obvious ethical reasons. We still have to make decisions about what to do when our friend has intentionally overdosed, and within a narrow time horizon.
4. Thought experiment: if I told someone I was just now on my way to go jump off a bridge, would it be wrong for someone to call the police if no other option was available? The fundamentalism of some ‘survivor’ folks forces them into saying, yes it’s wrong. Typically they make arguments grounded in individualist notions of ‘autonomy’ and ‘self-determination.’ Lots of problems with this. 1) It treats a culturally specific value set as if it were universal. I personally think American culture could use a strong dose of more collectivist notions. For instance, it privileges “harm” to the individual, over the well documented collective harm of a suicide. 2) It’s naïve with regard to ‘autonomy.’ It individualizes a persons suffering and presumes that ‘choice’ is equal across individuals. Simply not the case. Not everyone has the same options available. Autonomy is limited by—among other things— You see how these sort of arguments quickly become very aligned with a “right” politic?
5. I think ‘real life’ is much messier than can be accounted for by a hard and fast fundamentalism. This is why some in the TAC and NAMI crowd get so angry at c/s/x. The simple appeal to “autonomy” doesn’t fit the messiness of their lives when loved ones are in danger of dying because they ‘re refusing to eat because they believe their food is being poisoned by John the Baptist etc. I agree that if we had robust programs and services—and real options—to a large extent this would become a moot point because we could find the right fit for almost everyone, and without coercion or force. Unfortunately, we don’t live in that world.
Again, I typically emphasize the case against force, because I agree it can be very harmful, is ethically extremely fraught etc. My main purpose in raising this issue—again, in the context of this blog, which is read by already politicized in movement folks and critical academics—is because it’s an issue we have to get more nuanced about. Otherwise our positions just won’t be credible.
These are really good insights Timothy; you help me deepen my own understanding. Once we recognize that the TAC/NAMI folks are reacting to the simplifications of survivor positions, we can improve our standing politically by developing those positions into greater nuance and honesty. It is interesting to me to talk with former staff of Soteria and I-Ward and folks who were at Kingsley; the ‘force or no force’ distinction itself starts to become fuzzier in real life practice. And of course the powers we concede the state are different than those we would take ourselves: anyone knows this who has stolen a drunk friend’s car keys. Thanks for inviting me to post and making this opportunity for dialogue possible; I hope it continues to generate thoughtful comments. – Will
Hey Will & Timothy, I just wanted to write briefly and say thanks very much for your detailed responses to my reply, I appreciate your insights. I’m gaining a lot from reading through this discussion as it unfolds– cheers
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what I really struggle with is the pressure to be ‘recovered’, or ‘a recovered X’ and how this is wielded within psych survivor activism and MH services, it can end up being no less prescriptive than a medical model.
Joanna,
Thanks for reading! Yes, I agree. “Full recovery” narratives, and the tendency for them to become prescriptive, can be very problematic, even while inspiring hope for some. I always try to emphasize that, for me, the struggle and experience is “ongoing…”
I feel crushed by them because I can’t live up to them, and it’s like it’s your personal failure if you can’t
Joanna I’m glad you brought this up. I have the same feeling about the pressure to not take psychiatric medication or to no longer have suicidal feelings. I often talk about living with altered states and emotional extremes and consider myself “recovered” from the diagnosis by rejecting it, but don’t think the ‘recovery’ language is always helpful. The difficult experiences, that could be called ‘psychosis,’ I am still struggling with in different ways, and still affect me. And I am lucky to be able to work etc. I know for many people these experiences are devastating and there can be no single standard of pressure to recover because everyone is different, for some people they are a greater impairment and disability than for me, it took me many years to find a way to work off disability in part because of luck and resources I have. I don’t see recovery as about personal failure – it is often just some people have more extreme or severe altered states, maybe related to trauma, economic class, mystery, many possible factors.
I was an activist for many years Will and I am sickened by activism now which is excluding, intolerant, divisory, has no interest in social justice and frankly betrays many of us with no solidarity. It sometimes feels like the flip side of psychiatry, I never envisaged that in my youth it’s my greatest sadness. A high profile activist said in her story how she was diagnosed/given medication by her psychiatrist and told she could then have disability benefits and a bus pass (like this was some kind of prize and no it doesn’t happen quite like that), it gives a terrible message in the current neoliberal climate when the very few people who do still possess a bus pass (they are being cut) are being heckled by transport staff “you’re not disabled”, and interrogated as though public property.
Those who sneer at people who don’t identify themselves as ‘recovered’ for ‘rotting on disability’, ‘sitting in their sick role’ are not helpful. Nor is saying to someone who speaks of positive experiences of services “how many people have to die for your OK experience of our services?” effectively blaming anyone who’s had an ok experience for the existence of poor and forced treatment. What does that achieve? I have few positive experiences of services and are not promoter of them but I refuse to denigrate anyone’s personal experience I don’t have that right.
Turning on anyone who; uses services, doesn’t reject their diagnosis, takes medication, is in receipt of benefits, is not in paid employment, is pointless.
For one of the most well known critical thinking professionals to state “you learn more from people who are recovered than those who are still in all the problems” sounds like saying there is nothing to be learnt from people struggling or with enduring difficulties when most activism originated from people “still in it”, so anyone not ‘recovered’ is worth nothing?
People go on and on and on about diagnosis but what doesn’t come into the equation is that fact that services are paid according to diagnosis, and all social supports and benefits require diagnosis – and that includes where people design their own non-medical support. There’s a great testimony of that in one of Peter Lehman’s books, but who would respect that now when ‘recovery’ means nothing unless you’re not in receipt of state support and are in paid employment no matter what the conditions. We only ever hear ‘recovery stories’ of a certain kind, recovery not involving higher education or paid employment is airbrushed out like an embarrassment and anyone with longer term needs/on-going difficulties are like dirty words. Voluntary work is no longer valued as an outcome, and now social policies don’t allow for it. Vol work must only be a ‘stepping stone’ to paid work. In the UK 70% of people who have used psych services/with a psych diagnosis are unemployed, we have high levels of unemployment anyhow with many people chasing each vacancy and there are less jobs available than the total number of unemployed. People massive gaps in their cv have no chance, and yet psych survivors have the highest levels of vol work of all disabled groups. People can feel/be disabled by society, policies, attitudes, and distress – which doesn’t automatically make a person some weak medical model sop sitting in their sick role. WNUSP do refer to people with psychosocial disability, but I believe in self-definition. I defend anyone’s right to describe themselves however they choose no matter whether I agree with it or not.
If were going to talk about classification systems then we have to address the thorny issues which embarrass recovery movements – how do we support people who cannot fit traditional working patterns, work consistently enough to support themselves, need an on/off system, or maybe something like the European Citizen’s Income, or to do vol work, or not at all? How would we devise social support systems which do not require diagnosis? Some US states make ‘welfare’ (we have adopted that term but in the UK it used to be social security) contingent on treatment compliance with housing/income used as leverage. That is horrific, and there are suspicions the UK system could go down a route of linking compliance to welfare (and Workfare). Physical disability and poverty activists in the UK and Canada have done some great work and campaigning, but mental health groups are glaringly absent. Some will even say that social justice is not worth bothering with that somehow getting rid of MH legislation and diagnosis (overlooking it’s ties to many systems), will somehow be everyone’s recovery and the answer to everything.