On Creative Maladjustment and Rethinking Psychiatry


On this day January 16 2012, we commemorate the life and work of Dr. Martin Luther King, Jr.  and as such, many thoughts are running through my mind. Which of his speeches resonate with me and why, how old was I and where was I when he was assassinated, what images from the civil rights movement are etched in my memory?

Last year, I was a presenter at USC Law School’s Saks Institute for Mental Health Law, Policy and Ethics focusing on the use of Mechanical Restraints in Mental Health Care. During that presentation, I showed pictures of police dogs gnashing at their prey and fire hoses exploding with force on its intended targets. The prey and targets were Black Americans marching for their civil and human rights during non-violent protests. Just as those images flashed before the auditorium audience, they flashed before me when as a citizen, I was aggressively approached by police for involuntary commitment and when  hospital staff, “the 4 big men in the white uniforms” and/or the police forcibly restrained me because I was noncompliant with treatment. The experience of restraint is traumatic on its own, yet it was compounded by my memories of violence, hate and lack of power imposed on Black Americans. But now it was happening to me as part of my “care” as a psychiatric patient.

On September 1st 1968, Dr. Martin Luther King gave a keynote address at the American Psychological Association’s annual meeting. In that speech, he called on psychologists, who invented of the term “maladjusted”, to recognize that maladjustment is a normal and “adjusted” response to injustice:

“There are certain technical words in every academic discipline which soon become stereotypes and even clichés. Every academic discipline has its technical nomenclature. You who are in the field of psychology have given us a great word. It is the word maladjusted. This word is probably used more than any other word in psychology. It is a good word; certainly it is good that in dealing with what the word implies you are declaring that destructive maladjustment should be destroyed. You are saying that all must seek the well-adjusted life in order to avoid neurotic and schizophrenic personalities.
But on the other hand, I am sure that we will recognize that there are some things in our society, some things in  our world, to which we should never be adjusted. There are some things concerning which we must always be maladjusted if we are to be people of good will. We must never adjust ourselves to racial discrimination and racial segregation. We must never adjust ourselves to religious bigotry. We must never adjust ourselves to economic conditions that take necessities from the many to give luxuries to the few. We must never adjust ourselves to the madness of militarism, and the self-defeating effects of physical violence.”

I will add that we must never adjust ourselves to inhumane mental health care that discounts the very essence of who we are as humans. And today I am honored to add my voice and opinion to the Mad In America site through this blog, to take this day of remembrance and celebration of the life and work of Dr. Martin Luther King, Jr. to highlight Dr. King’s call for “creative maladjustment” as synonymous to our work here of rethinking psychiatry. Together as consumers, providers, family members, policy makers, advocates, journalists and doctors, we refuse to accept the status quo by standing up against injustices in mental health care. Through “creative maladjustment”, MadinAmerica.com provides a venue for all who share a vision of justice in mental health care to engage in dialogue and action that will ensure that our  care is compassionate, person centered, driven by client choice, and ultimately results in people leading independent and full lives. How are you engaging in acts of creative maladjustment to ensure justice in mental health care?

“Injustice anywhere is a threat to justice everywhere.” MLK


Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.


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  1. Dear Keris – thanks for your blog post and remembering of Dr Martin Luther King.

    I can identify with your experience of restraint when non compliant and am concerned that here in Scotland restraints are still being used in the psychiatric setting. Even yesterday I sent an Email about this to a national organisation, raising awareness of this, concerned about the need to use force on a person with mental distress which I think is an abuse of human rights. I have sent your blog post to the organisation’s leaders.

    Regards, Chrys

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  2. Keris – thanks sp much for your eloquent post. i shared it with a whole bunch of friends. here’s something i wrote a couple years ago, inspired by MLK. these days i’m not as excited about the language and vision of “mad pride” as an organizing principle, but i do have big dreams….mad love and see you around this site, sascha

    “i don’t know about you all but i know i want to be a part of a movement that has language to talk about power and class and race and gender without devolving into fragmenting identity politics, a movement that is full of love and actually prioritizes supporting the people in it, a movement that can collectively learn from its mistakes, a movement that knows its history and tells the stories publicly and loudly and beautifully, a movement that prioritizes community health and community support in ways that capture people’s imaginations and in ways the state and corporations will never be able to, and a movement that has mad respect for wild dreams and true diversity and the ones who–by their very nature–don’t fit into neat boxes and never will under any system.

    a movement of the people that respects the freaks and wild ones.”

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    • Sascha-
      Beautifully put! When presenting, I love to use the Apple video “Thrink Differently” as it so eloquently captures the spirit of the non- conformists, wild ones, and those that stick out in ways of creative maladjustment – those very things that made each of the people in that video ad great leaders that people quote and emulate today!
      Some how I think the freaks, wild ones and non-conformist have figured it all out yet we are ahead of our time(sometimes) waiting for others to catch up!
      Thanks also for your phenomenal work!

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  3. Wow, Keris. Breathtaking. And made me wonder more about whether schizophrenia and neuroses are not themselves creative maladjustments, albeit not empowering ones. It is incredible what the human brain and psyche can do in response to trauma. Precisely why we should take all precautions to avoid creating more trauma, esp. for those already in pain. Thank you for your eloquent personal testimony and honoring of Dr. King and human rights.

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    • Jennifer-
      You pose the very question I’ve been struggling with to this concept of creative maladjustment. When I was first introduced to the term, it was in the context of equating a person’s experience of “schizophrenia” to creative maladjustment. I had to wonder if that is what MLK intended when he gave this speech which by the way is not the first time he used this term “creative maladjustment”. In order to grapple with MLK’s intent and what I had been told was his intent, I read the entire speech myself (well worth doing and the link is imbedded in the blog post).
      How I have interpreted his words – and I could be isogeting rather than exegeting the text, is that as a result of adjusting oneself to injustice (how in-natural) a person can become mad (maladjusted). King refutes the social psychologists construct that being adjusted prevents madness- when one should be horrified by violence or hatred but adjusts and accepts it anyway- the result is madness. The “ACT” of creative maladjustment then is a deliberate and intentional way of being that stands up against the norm (adjusted) and fights against injustice.
      I guess I don’t think “creative maladjustment” as similar to experiences of “schizophrenia” but rather see “creative maladjustment” as a deliberate response to something awry externally in our world that in fact prevents us from going mad.

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      • Hi Jennifer

        there are psychologists who do see schizophrenia and other ways of expressing distress as creative maladjustments.

        One way of thinking about all forms of extreme mental distress that gets labelled as mental illness is that they are ways of expressing fear and confusion (often moral confusion – often along the lines, “Do I have the right to be angry with people who have mistreated me?”). For example if you are manic (or bipolar as they like to call it now) you might be running around, talking lots etc so that you don’t have to think about the awful things that have happened such as the unfaithful partner, the awful job and the frightening childhood. You might also do things that subtly annoy and disrupt the lives of those who have annoyed you while somewhat sensibly denying responsibility for this. To earn a diagnosis of schizophrenia you might go off into fantasy land because the reality of your life is too painful to bear.

        There is lots of research which says that people in extreme distress, those diagnosed with schizophrenia and mania have had horrible and frightening things happen to them (childhood sexaul assault, family violence, racism, poverty and homophobia are all found in high levels in people with these diagnosis).

        CBT therapists talk about dysfunctional cognitions, which means bad and stupid thoughts, but the psychologist Dorothy Rowe says this is an insult, the ways that people think when they are depressed or psychotic are the best they can come up with in what at the time are extremely difficult situations.

        With time and support and a change of circumstances we can often think things through and no longer need our creative resistance. That is what good therapists and good friends help us do.

        I think it is much more humane to see some, though maybe not all, madness as creative resistance rather than illness.

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        • John-
          I like how you described creative resistance as response rather than illness. At times I’ve wondered if acculturation and traumatic experiences resulted in my experiences of creative resistance and I didn’t have “language” to express the feelings/ experiences other than in the context of illness.
          Thanks for “pushing the mad envelope”.

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