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 ———-

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.