“No passion so effectually robs the mind of all its powers
of acting and reasoning as fear.”
Edmund Burke, 1757
“Fear exceeds all other disorders in intensity.”
Michel de Montaigne, 16th C.
“It is a sad fact of life that power and fear
are the fountainheads of faith.”
Saul Alinsky, 1971
“We held no one accountable, gave Dick Cheney
a new heart and still got Boston.”
Jack Carney, 2013
“Don’t mourn, organize!”
Joe Hill, 1915, apochryphal
Fear. Omnipresent. Difficult to ward off or ignore. Just to advise readers, this long, somewhat involved article has been written for purely didactic purposes. Frankly, I’d like more folks to learn how to challenge their fears, how to organize and do systems change work. I trust readers will find it useful and that I managed to at least approximate what I intended.
About a month ago, in the aftermath of Newtown, a colleague posted a provocative article on the ISEPP list serve that had originally been published in The Washington Post, “White Men Have Much To Discuss About Mass Shootings”. The authors’ contention is that American white men have apparently overlooked the fact that most mass murders in the U.S. are carried out by other white men. Rather than searching for causes in the persons of crazy people or, after Boston, in immigrants and Muslims, white men need to examine their own culture, their own beliefs, and how these might be contributing to the mayhem.
I’ve written about this at some length in several articles I’ve posted on Mad In America since the Aurora massacre last August and I’ve identified what I consider two key phenomena – the politics of marginalization, i.e., scapegoating, and the culture of fear. The former has been standard operating procedure, largely on the part of white men, since the founding of the republic, when black men and women, native Americans, all women and all men who did not own property were excluded from recognition in the Constitution. No individual member of any of these groups could vote or hold political office and had no voice in the governance of the country. The history of the United States might best be understood as the struggle that has ensued between the political and social marginalization of the many versus the guarantee of political rights and personal liberty for all. That struggle appears integral to our national identity and can be expected to continue for years to come, since today’s scapegoats are tomorrow’s candidates for liberation.
In his newly published Fear Itself … (2013), Ira Katznelson, Columbia University historian, traces the origins of our modern culture of fear to the Great Depression of the 1930’s, when most Americans were gripped by doubt about their own survival and that of the American republic and liberal democracy. Many pundits of the day advocated the adoption in the U.S. of a model of government closer to that of the Fascist and Nazi dictatorships – strong executive; weak legislature and court system beholden to the executive. Single party; full rights of citizenship conveyed only to those persons found eligible to join that party. And while Roosevelt eschewed this as a viable political strategy and is credited with preserving democratic government and free market capitalism, he arrogated to himself and the office of the presidency and to the Federal Government the greatest concentration of power and authority since Lincoln and the Civil War. Gore Vidal, among others, credits Roosevelt with laying the foundations for today’s imperial presidency.
Unfortunately, the end of the Depression, usually understood to coincide with U.S. entry into World War II, did not end public concern with the country’s future. To quote Katznelson …
“… The scope of the era’s fearful concern for democracy soon widened. In 1941, the University of Chicago political scientist Harold Lasswell identified the “garrison state” as a new form of rule, presided over by specialists in violence, that cut across the distinction between democracies and dictatorships…”
Similarly, the end of the War did not bring with it significant change for the better. The peace dividend that had ordinarily accrued at the conclusion of all previous wars did not manifest itself and never has again. Just remember the fall of the Berlin Wall and the end of the Cold War – nada, by way of public funding to address domestic needs. Instead, the end of the war saw a flurry of activity designed to re-align U.S. foreign and domestic policy with post-war, Cold-war fears, i.e., in opposition to an apparently expansionist Soviet Union. Harry Truman, little more than a hack politician, fell under the influence of conservative yellow dog Democrats and speedily adopted an adversarial stance towards the Soviets. In 1947, the Congress passed the National Security Act, establishing the National Security Council and the CIA. Two years later, the Soviets had the bomb and China had been “lost” to the Communists, a refrain heard until Nixon visited China in 1972. We were left with what Gore Vidal termed the “National Security State,” the product of a National Security Council “blueprint for a new kind of country, unlike anything that the United States had known before … [and] the justification for all sorts of secret services that are in no way responsible to the Congress that funds them [or to] the old Constitution…” Vidal concludes;
“The climate of fear has been maintained… by Truman’s successors, with the brief exception of Dwight Eisenhower, who… warned us against the military industrial complex that had, by then, established permanent control over the state…”
By the time Vidal wrote that in 1988, fear – of the bomb; of war with the Soviet Union; of Fidel Castro and Cuba; of black men; of the “other” – had become part of Americans’ self-identity. If you’re my age or close to it, you can remember “Civil Defense” drills at school that required you to crawl under your desks for safety. One of the consequences of this early 1950’s campaign, popularized as “Duck and Cover” and aimed at children, was the development by adults as well as children of a presumed emotional disorder termed nucleomituphobia, or fear of nuclear weapons. It never made the DSM, whose first edition wasn’t published until 1952, but it did afflict a good number of persons, many of whom sought treatment with anti-bomb and anti-war therapists in the 1960’s and 70’s whom I happened to know. The aftermath of the 9/11 murders seemed like history re-cycling, although at a higher level of fear and paranoia. Terrorists were the new entity to be feared – the Cold War’s end and the Soviet Union’s demise had left too big a vacuum – particularly if they were Muslims.
This new fear was exploited by neo-Conservative ideologues eager to pursue an aggressive foreign policy rooted in and rationalized by American “exceptionalism.” This required another political hack in the White house to front the machinations, and the acquiescence of the Congress and the American public. In exchange for our safety and security, we accepted the “war on terror” – I turned to my wife when this new “war” was first announced and said to her, “We’re in for it now!” — wars in Iraq and Afghanistan; abduction and torture by C.I.A. and Defense Department operatives; the Patriot Act and daily and secret intrusions into our private lives. As I stated at the outset, we held no one accountable, gave Dick Cheney a new heart and still got Boston.
We should be fearful. If you watched the cable news shows, you saw the future — 9000 cops and FBI agents in armored vehicles in Watertown to apprehend one seriously wounded 19 year old. We live in a dangerous and deceitful world where danger is omnipresent; unpredictable; random. A matter of good and bad luck. Where the national government and a lame duck president are secretive and withhold information in the name of, what else?, national security. Which only serves to make us more fearful and which begs the question: how do we respond to our fear? More importantly, how do we prevent it from determining who we are? There are, of course, alternatives. We can continue scapegoating the politically marginalized – Muslims, immigrants, the presumed mentally ill, a grand old American tradition; or we can organize for change and social justice, another grand old American tradition that’s easier to romanticize than it is to put into practice.
I learned about organizing in the Peace Corps (1964-7); as a social work grad student at U.C.L.A. under the tutelage of Warren Haggstrom, Alinsky’s lead organizer in the fight against Kodak in Rochester (1967-9); working with a bunch of like-minded radicals in the L.A. County Department of Public Social Services (1969-1971); and as a “grass roots” organizer working in Sunset Park, Brooklyn, out of an outreach storefront attached to Maimonides Community Mental Heath Center (1971-1976). It was there that I embraced and attempted to operationalize the ideology of the community mental health movement – an organized and empowered community is a healthy community. Just to give you some historical benchmarks, this was the time when the National Security State (NSS) came under fierce attack for overreaching in Vietnam and bombing Cambodia; when Nixon ended the War on Poverty and proclaimed the “War on Drugs”, offering Black men as the new scapegoats to the frightened “silent [and largely white] majority” and locking them up in prisons and mental hospitals in record numbers. (Michelle Alexander (2010) and Jonathan Metzl (2010) provide excellent accounts of that era and its present day aftermath.)
As a direct consequence of Nixon’s and his successors’ actions to safeguard the NSS, all the government-supplied organizing money dried up. To paraphrase Pogo, we have seen the enemy and it’s those damn’ lefty organizers. The right wing had simply trumped the remnants of the New Deal and Kennedy progressives. One telling illustration: when Nixon dismantled the Office of Economic Opportunity (OEO) in 1973, his special advisor, Pat Moynihan, who had written The Negro Family: The Case For National Action (The Moynihan Report), in 1965, and set up the OEO for LBJ, followed the money, left the White House and won Jim Buckley’s (William F.’s brother) N.Y. Senate seat in 1976. That same year, Maimonides’ Federal funding ran out and all its outreach storefronts, where all the organizers worked, were shut down. I went to work in Maimonides’ in-patient psychiatric unit and began my long and involved training as a psychotherapist. But that’s yet another story.
What remains to be told in this narrative is that the mid-1970’s didn’t mark the end of organizing. There’s some organizing going on right now – our Boycott DSM-5 effort and the work being done by Tina Minkowitz and the Center for the Human Rights of Users and Survivors of Psychiatry (CHRUSP) – that I’ll discuss below. It just means that you have to do it on a shoestring, particularly if you’re part of a politically marginalized group and have very few resources. Which predicament has never seemed to stop anyone determined to get things done.
Let me begin that discussion by outlining a template for organizing, derived from Alinsky’s Rules for Radicals(1971) and my firsthand experience, that might prove useful for aspiring organizers.
- Have a plan. As my old organizing buddy, Mickey Weinberg, would say, you have to have a plan. In other words… what are you trying to achieve and how do you intend to achieve it?
- Provoke conflict with the entity or organization most likely to oppose what you’re attempting. The issues at the root of the conflict have to be made clear.
- Seize the moral highground. There are the good guys and the bad in any conflict. Make sure it’s you that’s seen as the good guy, the one with right and justice on your side.
- Know the environment or system(s) you’ll be operating in. Who are the key stakeholders in the system? Who has the power or leverage to make changes in the system? Make them your ally or, at least, sympathetic to your cause.
- Build your organization as a transparent, inclusive and democratic entity, with all key decisions made by the organization’s elected leaders and by its membership. Identify and bring to the fore individuals who can provide leadership.
- Review regularly the progress made by the organization in pursuit of its objective. Modify its objectives and organizational strategy in accordance with the results it’s achieving and specific conditions/variables in the organizational environment. Learn from your mistakes!
- Keep your eye on the prize, but be flexible and prepared to improvise on the fly.
I’ll add one more proviso — study the past and learn from it. At the top of my list are two iconic organizing campaigns: the Great Flint Sitdown Strike of 1936-7, and the Birmingham Children’s Crusade, May 2-8, 1963, the culmination of a year-long battle to integrate the City of Birmingham. Full accounts can be found in the late Sidney Fine’s Sit-down: The General Motors Strike of 1936-1937 (1969), and in Taylor Branch’s two-volume masterwork, Parting the Waters : America in the King Years 1954-63 (1988) , and Pillar of Fire : America in the King Years 1963-65 (1998).
In the here and now, I’d like to think that our Boycott DSM-5 campaign conforms to my organizing template. Readers can judge for yourselves when I post “Next Steps: More Lessons Learned from the DSM-5 Boycott,” on or about May 20, the date of the new DSM’s scheduled publication. Right now I’d like to focus on the work being done by Tina Minkowitz and her group, which appears to have taken on greater urgency subsequent to the psychiatric profiling that followed on the aftermath of Newtown. They’ve taken on the daunting task of bringing to public attention the political and social consequences of the country’s forced treatment policies for persons caught up in the public mental health system and changing the laws governing them. Her Center for the Human Rights of Users and Survivors of Psychiatry (CHRUSP) launched a campaign almost two years ago, the Campaign to Repeal Mental Health Laws (CRMHL), whose objective, to quote from their position paper, is the “repeal of [all] mental health laws, guardianship, the insanity defense and all other laws that discriminate based on madness and mental health labels/struggles with difficult experiences.” And they have a plan.
First, they made two key strategic decisions:
- To align themselves with the U.S. and international disability community, which is quite extensive and does have some leverage within the U.S.;
- To equate their struggle to overturn psychiatric profiling and all forced psychiatric treatment in this country with the pursuit of universal human rights as embodied in the U.N. Convention on the Rights of Persons with Disabilities (CRPD).
The former was somewhat controversial, since not all psychiatric service users and survivors agree with being characterized as disabled. But, to borrow a page from the Gay Rights struggle, what difference does it make to you as a person how you might be labeled if your human rights are guaranteed. The label will soon have little meaning for most Americans and might even be your badge of pride. Article 12 of the CRPD calls for “states parties”, i.e., countries that have ratified the Convention, to “recognize that persons with disabilities enjoy legal capacity on an equal basis with others in all aspects of life.” Further, it obliges “states parties [to] take appropriate measures to provide access by persons with disabilities to the support they may require in exercising their legal capacity…” Accordingly, if you have “equal status under the law”, your legal equality cannot be “derrogated” or diminished by a presumed “diminished capacity” due to an hypothesized mental illness. Consequently, you can only receive treatment of any kind if you consent to it; to receive treatment without your consent is to receive “forced’ treatment.
Second, they have established themselves as the “good guys” and currently occupy the moral high ground. The U.S. Senate, it should be remembered, failed to ratify the CRPD back in September. (It should be noted that the U.S. became a signatory to the Convention back in July, 2009, little more than two years after it was enacted by the U.N.) Right wing lobbyists, led by Rick Santorum, made the usual appeal to U.S. exceptionalism, advancing the spurious claim that CRPD ratification would open the door to international meddling in U.S. family life. The Tea Party wing in the Senate embraced that argument; and the Democrats, led by then Senator now Secretary of State Kerry, failed to muster the two-thirds majority needed to ratify the Convention. Even if the Convention had been passed, it had been amended with so many R.U.D.’s – Reservations, Understandings, Declarations – or amendments as to render the CRPD meaningless.
R.U.D.’s are invariably attached to U.S. ratification of many of its international treaties, particularly those emanating from the U.N. and dedicated to promoting human rights. They are usually rooted in two constitutional and legal notions: “federalism,” interpreted to mean that the individual states are each sovereign entities and can’t be obliged to change their existing laws unless they contradict Federal laws; and that Federal law already “fulfills or exceeds its obligations” under the treaty being considered. The CHRUSP and its allies, in a recent letter to the National Committee on Disability, asked the NCD, whose members are appointed by the President and confirmed by the Senate, to push for re-consideration of the CRPD without the invalidating RUD’s. The letter pointedly reminds the NCD “…that human rights are universal, and that no state can declare its own law to be the measure of compliance with the treaty.” This was a reference to Kerry’s statement after the CRPD’s defeat in the Senate “…that ratifying the treaty would not require any change to U.S. law, but would afford the nation a leadership role in the international community on disability rights issues…”
(It should be noted that, to date, seventy-six of the U.N.’s 168 member nations have ratified the Convention.)
Third, CHRUSP has found a powerful ally in the U.N. Human Rights Committee. In late March, Tina Minkowitz and Maxima Kalitventsev took their convictions and commitment to Geneva and met with the UN Committee to present CHRUSP’s case. The U.N.’s Special Rapporteur on Torture, Juan Mendez, had just issued one of his periodic reports (March 4, 2013) focusing “on certain forms of abuse in health care settings that may cross a threshold of mistreatment that is tantamount to torture or cruel, inhuman or degrading treatment or punishment…” He concludes in his report that “…medical treatments of an intrusive and irreversible nature, when lacking a therapeutic purpose or when aimed at correcting or alleviating a disability, may constitute torture (italics mine) …when administered without the free and informed consent (ditto) of the person concerned…”
Mendez’s report served as the backdrop to what Tina and Maxima told the Committee. Informative accounts of what took place can be found in the blogs that Tina and Maxima posted on MIA on April 4. Maxima provided the Committee with the personal anecdotes needed to bring the issue at hand – forced treatment without informed consent – to life, to make it real. Tina detailed the chief outcome: specifically, that hers and Maxima’s testimony appeared to lead the Committee to conclude that the United States government, a signatory of the International Covenant on Civil and Political Rights, albeit with the usual RUD’s, might be in violation of Article 7 of that Covenant, which “prohibits torture and cruel, inhuman or degrading punishment.” As a consequence, the Committee has asked the U.S. to respond to the following question by October: “Please clarify how, in the State party’s [the U.S. government’s] view, the possibilities for non-consensual use of medication in psychiatric institutions and for research and experimentation… are in conformity with the obligations upon a State party under 7 of the Covenant.”
CHRUSP anticipates that the U.S. will argue as it customarily does that its current laws and public policies allow it to carry out its obligations under the Covenant. It also expects to have the opportunity to challenge the U.S. reply, and will send a delegation to Geneva in October to meet again with the Human Rights Committee.
Fourth, CHRUSP has succeeded in framing the issues and determining who supports their solution to forced treatment and who opposes it. Nonetheless, formidable obstacles remain to be surmounted, principle among which is the U.S. Government itself. The CHRUSP’s task is to get the Federal Government to do an about-face… to approve the Convention on the Rights of Persons with Disabilities without the disqualifying RUD’s; to take the lead in abolishing all laws, Federal and State, that allow for forced, non-consensual treatment of persons presumed to have mental illnesses and so bring the U.S. into compliance with the Convention. In short, lasting change will depend on the cooperation and agreement of the Federal government.
It is, of course, not likely, that either of the foregoing will be achieved anytime soon. These are endeavors that will take years to accomplish, no matter how much international support, principally that of the U.N., that CHRUSP and its allies can muster. Citing its exceptionalism prerogative , the U.S. will resist what it can be expected to characterize as foreign intrusions into its national sovereignty. This is not to say that CHRUSP is not on the right track – it is, but it is a long and hard one, something which I assume CHRUSP fully understands. Accordingly, it appears to be honing in on the most vulnerable stakeholder in the U.S.’s disability system, the National Council on Disability (NCD), pressing the NCD to enlist the White House and the Senate to re-consider ratifying the CRPD, without RUD’s, if possible. In addition, and perhaps crucially, CHRUSP plans to convince the NCD to recognize persons with psychiatric disabilities as a unique entity within the constellation of disability groups whose interests it presumes to represent to the President and the Congress. Again, it’s not likely that the RUD’s will be dropped, but it’s worthwhile to make an issue of them. More achievable is the demand that the NCD accord “users and survivors of psychiatry” a formal recognition at the national governmental level they currently do not have.
It can be anticipated that CHRUSP will expend a lot of energy and resources to send a solid delegation to Geneva in October. It will need money to get them there and I will make a fund-raising pitch on their behalf at the article’s conclusion.
Fifth, boots on the ground and in the blogosphere. CHRUSP has begun planning a letter-writing/ lobbying campaign aimed at the Congress and State legislators to ratify/support the provisions of the CRPD and to repeal all State laws authorizing non-consensual psychiatric treatment. Its several allies in the U.S. – Voices of the Heart; Mind Freedom International; Law Project for Psychiatric Rights; World Network of Users and Survivors of Psychiatry; and the International Disability Alliance – can be expected to participate in this initiative. Politicians love getting letters. They also respond to Facebook posts and Tweets.
Our Boycott DSM-5 campaign has relied almost exclusively on social media, with some success. The Boycott statement we have posted on ipetitions.com has also attracted a fair amount of attention – almost 1800 signatures to date. One of the advantages of a social media campaign is that the petition website, FB accounts and attached Cause Pages, and Twitter accounts are cost-free. They do require someone who knows how to set up and manage a website, but there is usually someone among campaign supporters who’s sufficiently knowledgeable and who will do the necessary work. (I volunteered my niece, who earns her living as a computer consultant.) Another plus is that the demands placed on supporters to conduct a social media campaign, while not negligible, are certainly manageable. If CHRUSP has not yet considered launching a social media campaign, I suggest that they do. Letters, to remind CHRUSP, can be sent/scanned via computer.
The trick, as always, is to appear to have a larger presence than you might actually have. Numbers and volume are crucial to draw attention to what you’re doing, particularly when you are few in number, relatively powerless and poor.
Finally, money. If you prefer to send a check to the Center for the Rights of Users and Survivors of Psychiatry (CHRUSP), simply put “UN” in the memo section of the check to indicate that your donation is to be used for CHRUSP’s delegation’s travel to Geneva next October. Mail it to
44 Palmer Pond Road
Chestertown, New York 12817
You can also make an online donation via CHRUSP’s website. At the bottom of the left hand column of the website’s Home page, there’s a “Donate” button which links to “Network for Good”, where credit card donations can be made.
Frankly, CHRUSP’s campaign is one of the few I’m aware of aimed at fundamental systems change. I devoted several pages to its efforts to both highlight what it’s doing and detail how, for purely didactic purposes. As I stated at the outset, I’d like more folks to learn how to do this work and organize. I trust readers found it helpful and informative.
Remember, don’t mourn (or just bitch and moan); organize!
Alexander, M., The New Jim Crow: Mass Incarceration in the Age of Colorblindness, The New Press, New York & London, 2010
Alinsky, S., Rules for Radicals, Vintage Booke, New York, 1971
Branch, T., Parting the Waters : America in the King Years 1954-63,
Simon & Schuster, NY, 1988
Branch, T., Pillar of Fire : America in the King Years 1963-65, Simon & Schuster, NY, 1998
Carney, J., Scapegoating Persons Labelled Mentally Ill: The Politics of Marginalization January 25, 2013
Carney, J., Mass Murder in Newtown: Why and Where Next? December 20, 2012
Carney, J., Remembering the 2003 Fast For Freedom: Time for Another? September 20, 2012
Carney, J., “Aurora: Shrouded in Myths” August 1, 2012
June 23, 2012
Committee for the Human Rights of Users & Survivors of Psychiatry (CHRUSP), http://www.chrusp.org — resource documents to be found on this website:
- Campaign to Repeal Mental Health Laws
- Forced Psychiatry as Torture: A Reflection on the Ongoing Development of Human Rights Norms and Related Conversations
- Principles for Implementation of CRPD Article 12
- Public Comment on NCD’s Engagement with the UN Convention on the Rights of Persons with Disabilities
- Why Mental Health Laws Contravene the CRPD – An Application of Article 14 with Implications for the Obligations of State Parties
Childress, C., Childress, H., “White Men Have Much To Discuss About Mass Shootings,” March 29, 2013,
Diamant, M., “Senate Rejects UN Disability Treatment” Disability Scoop, December 4, 2012,
Fine, S., Sit-down: The General Motors Strike of 1936-1937, (Ann Arbor: University of Michigan Press, 1969).
Katznelson, I., Fear Itself: The New Deal and the Origins of Our Time, Liveright Publishing, New York & London, 2013
Kalitventsev, M., “More Than Surviving: Speaking Up About ‘Life’ in the American ‘Mental Health’ Gulags” April 4, 2013,
Metzl, J., The Protest Psychosis: How Schizophrenia Became a Black Disease, Beacon Press, New York, 2010,
Minkowitz, T., “The U.N. Asks the U.S. to Defend Its Use of Forced Psychiatric Drugging” April 4, 2013,
— resource documents to be found on this website:
- Convention Against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment
- Convention on the Rights of Persons with Disabilities
- International Covenant on Civil and Political Rights
- Special Rapporteur on Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, Juan E. Mendez, March 4, 2103
U.N. Disability Newsletter, Enable, “Convention on the Rights of Persons with Disabilities”
U.S. Senate, Report from the Committee on Foreign Relations, “Convention of the Rights of Persons With Disabilities (Treaty Doc. 112-7)”, submitted by Senator John Kerry, July 31, 2012
Vidal, G., “The National Security State,” (1988), Selected Essays of Gore Vidal, Jay Parini, ed., Vintage Books, New York, 200
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.
Mad in America has made some changes to the commenting process. You no longer need to login or create an account on our site to comment. The only information needed is your name, email and comment text. Comments made with an account prior to this change will remain visible on the site.