My Favorite Fears and
How They May Serve Us


I have two main fears in my job.  The first is that I won’t be open to changing my beliefs.

A few years ago I was in class and read this from a research methods textbook:
“An ideology is a closed system of beliefs and values that shapes the understanding and behavior of those who believe in it.  Its assumptions are fixed and strong and not open to questioning.  To their believers, who may be called ideologues, ideologies offer absolute certainty and are immune to contradictory evidence.”
To me that seemed like a clearly undesirable way of thinking.  I recognized that many of my religious beliefs were parts of an ideology so I began questioning them, not wanting to be guilty of being an ideologue.  This led me, eventually, to change many of the beliefs that had been very important to me before.  It was painful and scary!
As I’ve worked in the system in a peer support role I’ve become aware that I’m at risk of being ideological in another way.  This became really clear to me at a MindFreedom conference this summer when a friend and I joked that at these kinds of events we often will swap conversion stories, fine-tune the doctrine of new converts, and discuss evangelism strategies. In some ways, being involved in the c/s/x movement has felt like joining a new church.  I don’t actually think there’s anything wrong with this; as was the case in my religious community, we are united around something that we believe in strongly and feel a responsibility to bring to the world.  Being part of a group like this is empowering, inspiring, and hopeful.
But it also scares me.  It scares me because when I talk to other people in the movement about my job I hear things like, “be careful you don’t sell out” or “it’s hard in that setting not to let your values slip” or “how are you being in the system but not of the system?”  It feels a little bit analogous to the message I got from Christian communities that, if someone spent too much time with unbelievers and around a lifestyle we didn’t agree with, the person’s faith would be vulnerable to weakening, whereas if a person stayed connected to regular Christian teaching and surrounded by others living that kind of lifestyle, his/her faith would be stronger and safer.
The open-minded, non-ideologic part of me does not want my beliefs to be safe—I want them to be challenged.  For that reason I’m very glad to be working in a setting where this is happening all the time. I want to be exposed to other ways of thinking — even ways of thinking that I find offensive or dangerous — because my reaction to some of the things I hear tells me a lot about myself.
The second fear I have is that my beliefs will change.
By far the biggest concern I had when I started working in the system was that I would be “co-opted” or “sell out.”  By that I mean I was afraid I would start believing in the idea of mental illness again, that I would become comfortable with locked up forks and cigarettes, that I would not respect people’s right and ability to self-direct their lives, that I would do harm, that I would become more aligned with the clinical staff I work with than with my fellow activists and peer supporters.  I have, in some moments and to varying degrees, done all of these things. My beliefs are changing somewhat.
I think it’s important to look closely at why this would be scary.  For me, it comes down to identity and belonging.  Identity comes into play because, besides just wanting to be someone who is helpful and not harmful, I saw myself primarily as a psychiatric survivor and part of the consumer/survivor/ex-patient movement.  This identity was (and to a lesser extent, still is) very important to me because it replaced my previous identity of being a chronically mentally ill person.  I found being angry and on a mission to be much more preferable.  This identity piece is loosening quite a bit as, while being a psychiatric survivor is definitely still a part of how I frame my life experience, it’s becoming less and less central to my identity.
The need for belonging is a stronger piece of why I still have a lot of anxiety around compromising or changing some beliefs.  I want to be respected and accepted by other people in the movement.  Being open-minded and questioning things sometimes leads me to worry that I won’t be included or that I’ll be judged as somehow defecting.
It’s easy to see how the first fear serves me well but I actually think this second fear is also very useful; it keeps me vigilant.  If I wasn’t concerned about belonging with this larger group of activists I’d really only worry about belonging with my coworkers, and I’d be less inclined to take risks and challenge the status quo.

Sometimes it seems as if I’m running away from one of these fears only to bump into the other. These two fears generally seem to keep me contained to this uncomfortable-but-productive gray zone where I doubt myself, recognize when my reaction is more emotional than rational, use non-definitive language, and pay a lot of attention to when I speak up and when I don’t.  The challenge is to be open-minded (willing to change my beliefs) and at the same time true to my convictions (refusing to change my beliefs just because others want me to).  I find this challenging.

My struggle with this is representative of the fact that we, as a society (or species?), appear to have a hard time embodying both open-mindedness and conviction simultaneously.  It would make sense to me — whether it’s true or not — that this might be even harder for a survivor movement like ours.  As patients, many of us had our needs and perspectives dismissed by providers in power.  As activists, we sometimes see this dynamic play out again — we’re dismissed as bitter ex-patients out of touch with reality.  Harsh rhetoric and unwillingness to compromise seem like natural responses to this treatment.  Despite this challenge, many survivor-activists manage to find a way to be true to their convictions while remaining open-minded (and thus credible) through self-awareness and intellectual humility.

Our common goal, I imagine, is revolutionary cultural change — an overhaul of the way we think and act in response to madness.  I personally think that this is going to happen (and is happening!) slowly over time and will take more patience and tolerance than I always have.  Those of us who have experienced first-hand the dire need for this change absolutely must be speaking up — and we have to do it in a way that will be heard.  We all have different ideas how to make that happen.  In my view, being heard as a member of an oppressed group requires exceeding the usual expectations of maturity, self-control, and critical thought.  It might mean tolerating ignorant comments for the sake of the conversation, forging genuine relationships with people whose actions we find oppressive, or acknowledging the limitations or flaws in our own perspectives.  It also means knowing where you draw the line and taking a principled stand in a thoughtful way at times.  If we fall to either side — being either ideologic or too passive in sharing our convictions — I’m concerned that we may not get the responses that we’re hoping for.
What approaches do you find helpful in the struggle to create change?  What beliefs of yours are being challenged? Do you have beliefs you are not open to questioning? How do you balance (or not) open-mindedness with conviction?


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. Malaika,

    I like many of the points you make here. We need to try and find as much common ground as we can to have dialogue with others and hopefully help move our society in a positive direction…more human rights, less oppression, more trauma informed, humanistic support for those going through emotional struggles…

    I am also acutely aware of the corporate control of medical research and the profit driven industry that defends the status quo in the medical model, mental health industry. This industry, which pays the salaries of those of us working for this system, including paid peer specialists, demands our loyalty to the dominant, disease based paradigm. C/S/X formed groups to recover from or escape this oppressive system and form alternatives. In my mind, we are at very high risk of selling out or being bought out as a group…this is what I fear we stand to lose…our history as a group fighting for our dignity and our rights to self determine. While I agree that working toward common ground by being less reactive and striving toward open-mindedness is laudable, I think we must also stand our ground and continue to push forward. I think we have an uphill battle and that we are in a one down position against huge corporate influences. While we should not be ideological, I also think that our revolution is not being paid for by the corporate elite, but by our ingenuity and our blood, sweat and tears…we should expect a tough road ahead…

    Thanks again for your article. Glad to have such a thoughtful discussion on this process.

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  2. Yes, this is a very thoughtful article. But it also shows one of the main reasons the system is giving us these crumbs. I don’t think of myself as particularly ideological, but I do like to think of myself as having a pretty clear idea of what needs to be done to take away the power of the people who have hurt us. It just doesn’t make sense to me to think that if you help to run this system (even though in truth you have virtually no power at all within this system) you can somehow change it for the better.

    Although the author doesn’t use the word, this is another example of thinking that “dialogue” is somehow going to change things. Does anyone think that if only the Jews had had more dialogue with the Nazis, the Holocaust would never have happened?

    I think one of the main reasons our movement has not gone very far is that we don’t seem to have any sense of moral outrage. If we don’t really think what is done to us is an outrage, if we ourselves don’t clearly see it as morally wrong, why should anyone take us seriously? And so most people don’t.

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    • Regarding Ted’s “moral outrage”.
      When a person is feeling and expressing outrage (anger) they are judged “psychotic” and potentially dangerous, then drugged/medicated for their inappropriate response to receiving “help”.

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      • Oh, I am not talking about people who are right now under the control of the system. Of course, they are not able to speak out and express how they feel. I’m talking about people who are free now, more or less, but who in spite of knowing how badly they have been treated, somehow think if they are “nice,” or whatever word they would use, might be able to change things.

        Look, every other movement for liberation in the last half century, starting with the civil rights movement in the 1960’s, has only made progress when it spoke out forcefully against its oppressors. I am feeling more and more frustrated when people act as if they have never heard of such things. I’m not saying anything very original. The bottom line is that if you don’t fight for your rights, you will lose them.

        I don’t think that is particularly “radical” or “revolutionary”, or even “ideological.” It’s just common sense, and we have the last half century of the experience of other movements to confirm this.

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        • I agree with you, Ted. As a fellow shock survivor, as a former anesthetized mental case of 25 years. I personally refuse to tone down my outrage at the psychiatric establishment for treating me and millions of others like hunks of meat. I am four years drug free and will continue to speak out against psychiatric brutality at every opportunity.

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          • …and more power to you. I have decided to speak up every time I hear someone, especially the member of the system, spreading psychiatric bs. It is not easy and it puts you on the outside as the radical one but it tends to work in the long term. some people actually start to listen and come back with “now I know what you meant”.

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        • Thanks for your comments, Ted. I agree with you that direct action has been hugely important in all civil rights movements that I’m aware of, include ours. I’m not arguing against that at all. I’m arguing for that and other efforts being done with intentionality, intellectual humility, and respect. I feel justified in my rage but I don’t know if people listen to me very well when I direct that rage towards them. I think it can have the effect of actually making people more rigid in their thinking because when we cast someone as our enemy they are likely to construct an enemy image of us as well. On the other hand, I do think yelling and fighting and picketing are effective strategies at times!

          I realize a lot of people will not agree with me about this but I’m currently questioning whether it’s helpful to consider people whose actions I find oppressive as “oppressors,” or if, instead, it might be more helpful for me to think of them as victims of the same ideas and systems as I am but in a different way. I just read this fascinating article about public concerns about wrongful confinement in 19th century England: It’s incredibly relevant. In particular these sentences:

          “The greatest danger to civil liberty arose not from an unlikely collection of evildoers, but from ignorance, arrogance. and narrow-rnindedness…Someone had to make such a division [between the sane and insane]: the system of involuntary confinement demanded it. Winslow and his colleagues [“mad-doctors”] were the agents of a society determined to banish the. mentally disturbed from its midst. The doctors made the immediate decision to confine, but ultimately the responsibility rested with the society which gave them the power to do so. The Victorian public tended to overlook its responsibility by treating the asylum as something apart. at once indispensable and disreputable…The outbursts retlected the anguish of a society convinced of the need for a system of involuntary confine- ment yet uncomfortable with the implications of its existence. and suspicious of
          the abilities and intentions of those charged with its operation. The attacks on the doctors and others connected with the system were often irrational, hysterical, and misdirected.”

          In other words, railing against individuals who are carrying out the acts we find oppressive may not be most efficient use of our energy if our goal is to change the societial thinking that necessitates that people fill these roles. If that’s the case our efforts may be better spent on changing public opinion and modeling the change we want to see (ex: not “othering” those who we think have “othered” us). I don’t really know the best way to help make this happen but I’m very interested in learning and this article articulates the approach I’m trying to use now based my current understanding.

          Thanks again for your comments and for hearing me out. I genuinly look forward to learning more from you!

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          • “I don’t know if people listen to me very well when I direct that rage towards them”
            Well, that’s only right if you are after the enforcers of the current system. And I think that their minds either cannot be changes (mainly for the conflict of interest) or they anyway don’t mean anything.
            “people whose actions I find oppressive as “oppressors,” or if, instead, it might be more helpful for me to think of them as victims of the same ideas”
            That is an old idea and it is probably right to an extent. Nonetheless if you had a choice would you rather be rich or poor, a slave or a slave owner? Even if you’re the oppressor and don’t like it you have certain power which makes it easier for you to change things. Being a victim comes with helplessness that is difficult to overcome. So even if being an oppressor may be seem as damaging and mentally impoverishing it’s still different from being the oppressed.

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          • Malaika

            I don’t mean to be disrespectful but, I’m sure that there were many slave owners in the South who were humane and kind people but they were still oppressors by the fact that they continued to own human beings as slaves. They may have been enlightened people in all senses of the word, but very few of them set their slaves free.

            As a peer worker who works for the very state hospital where I was once held and oppressed, I’m not so sure that my presence is making any difference at all in the attitudes and actions of the system. It is business as usual even after three years of my being a part of the staff. All questions and discussions that make the administration and psychiatrists uncomfortable are buried and absolutely nothing gets done. When the drugs are mentioned as being part of the problem for the people who are forced to take them, I am met with total silence and downcast eyes. I’ve not been told to quit asking the questions and stop starting the discussions, not yet anyway, but I’m met with a total wall of silence and people won’t even look at me. It’s as if I never said anything at all. It’s somewhat like being in the Twilight Zone.

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    • “It just doesn’t make sense to me to think that if you help to run this system (even though in truth you have virtually no power at all within this system) you can somehow change it for the better.”

      I’ve been just watching the Wire ( and this series brilliantly illustrates how little good intentions and good people with convictions mean in a fundamentally broken system riddled with wrong incentives. Psychiatry is not any different. With all respect for the author of the article I think that her approach is very naive and doomed to leave her deeply frustrated in the long term. I can only hope I am wrong…

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      • One of the big problems that peer workers have who go back into traditional settings to work, rather than for an alternative organization, is that they are co-opted very badly. It is very difficult to do what you are trained to do in these settings. The staff in these traditional settings do not understand, or choose not to understand, that those of us who come back to work “in the system” are in it but not of it.

        As a peer worker in the state hospital where I was once held I always remember what a former marine once told me. He asked me if I knew the first rule of the battlefield and when I told him that I had no idea he stated that you never leave your wounded behind. This is why I remain where I am, when people who are being held there often think that I’ve gone over to the dark side because I work for the very system that once oppressed me, and which is now oppressing them.

        You are correct when you say that it’s very frustrating but at least I don’t think that I’m naïve about it all. At least I hope I’m not.

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  3. this topic is interesting – the idea of holding on to your values as you work within an oppressive system. The problem with the article, which is the same as the systems’ problem – is that what the client wants or thinks is not in the equation. The greatest strength of the writer is that they are conscious of this dilemma. It is important to remain vigilant and have relevant supervision – both peer group as well as clinical.

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    • Thank you! Good point about supervision–it’s so important! I think I could be doing a better job of making sure that I get supervision/consultation from outside of my workplace because I want to be accountable to and guided by more than just the agency I work for

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  4. Thanks for sharing so transparently your internal paradoxes around making changes from within the system. Very courageous.

    “Being open-minded and questioning things sometimes leads me to worry that I won’t be included or that I’ll be judged as somehow defecting.”

    Very powerful statement. When that happens, then you are creating change. If not, then nothing is changing. Change occurs when we are not afraid to test the boundaries of the status quo. Of course it’s going to shake things up, that’s the point.

    Revolutionary change occurs not when we make the choice (with conviction) to speak, embody, and live our truth over appeasing others to simply “be accepted.” I don’t see how it could be otherwise. (Although I’m open to hearing if anyone knows how to create meaningful change in an oppressive system without making waves and risking backlash. Hard to imagine how this would be…).

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  5. Working within the system to create change can still be done and is, in my opinion, extremely challenging and courageous. We must never forget who we are, and what we have survived. We must not reenact this trauma on others. Yet we must also forge ahead into a system that is starting to learn about us, and teach them, and change their perspectives. That’s why Whitaker gives talks with psychiatrists in the room. That’s why Martin Luther King, Jr. talked to whites as well as blacks. We can’t all be on the sidelines, protesting outside of the APA convention. Some of us must enter the APA convention, and give presentations on who we are, as a community, a cause, and a civil rights movement.

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  6. Of course, talk to anyone who will listen. But I just can’t understand how anyone who has been abused by psychiatry can think that changing the minds of psychiatrists (which is rarely possible) is more important than changing the mind of the general public.

    I think that a lot of the people who have this position have had terrible experiences at the hands of psychiatrists, yet you somehow believe that if only you keep talking to them they will see the error of their ways.

    It wasn’t a mistake. It wasn’t an error. Surely they have to know what they are doing. When people die from the drugs that are forced on them, when people in great emotional need are treated with utter disrespect, surely the people who do this should be held accountable. And when we refuse to confront them, when we make excuses for them, when we continue to let them define who we are, we are accepting that what they did to us was justified and right.

    What psychiatry does to people is just as bad as lynch mobs and rapists and anti-gay thugs. The problem is that we seem to be afraid to say so. There’s a quote from the Talmud that I have used sometimes: “Who can protest an injustice but does not is an accomplice to the act.” I think it is very true.

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    • “But I just can’t understand how anyone who has been abused by psychiatry can think that changing the minds of psychiatrists (which is rarely possible) is more important than changing the mind of the general public.”

      Thanks for bringing that up! I agree with you 100% that changing the minds of general public is what matters. As I mentioned in my comment above, it’s the opinion of the general public that allows psychiatry to maintain it’s power (and, conversely, it’s psychiatry’s power that maintains public opinion….)

      Just to clarify, I spend about 1% of my time (or less) talking to psychiatrists so that’s not where a lot of my time and energy happens to be going at this time, though I do believe in engaging psychiatrists or anyone else in the same honest, respectful way.

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  7. When I first began to study law, I was afraid that it would also change my personal beliefs. I am not religious, but I rather enjoy my almost childlike view of the world, and I won’t lie to you,,,, it did. I had to choose to place my own idealist views of the law up on a shelf and learn to accept the more limited and realistic views of American Law. I refuse to give them up though. I think it says something about a person to imagine an idealistic view of the law for everyone and not just themselves.

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    • Paraphrasing some old saying: “Who was not idealist in his youth is bound to become an old a***hole”… I’d say this does not end with “youth” ;). One can be an idealist and a realist in the same time. Being a realist only makes you eventually a cynic.

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