This anthology is a timely and unique collection of essays that should be of interest to anyone with personal experience with, or research interests in, mental difference, psychiatrization and its resistance. This book emerged from the international conference ‘Searching for a Rose Garden: fostering real alternatives to psychiatry,’ held in Berlin in September 2011 and organized by the Association for Protection against Psychiatric Violence, but also diverges from that conference. It contains essays by those who have advocated for mad liberation or against bio-psychiatry for a long time, as well as new voices. Most importantly, it is entirely written by those psychiatrized. In so doing it becomes a pioneering book that does not just highlight mad knowledge and practice but fosters new conversations and movements.
The book is divided into four sections. As the editors’ note, the first section sets the scene for the book, “reminding us why radically different approaches to madness and distress are needed.” The second section, titled ‘Survivor-produced knowledge’, is about what I would call mad epistemologies. The book itself is a form of subaltern knowledge that I found to be the most rewarding and compelling aspect of Searching for a Rose Garden. It is mad knowledge put into action.
I want to highlight a few chapters, although I wish I could summarize all the works in this collections as they all merit a close read. Bhargavi Davar’s chapter “Alternatives or a way of life?” is featured in the first section of the anthology. The chapter is representative of the kind of ‘user knowledge’ or mad epistemology the book aims to promote, but also quite distinct for its discussion of practices outside of the western perspective. It offers a critique of both psychiatry and what we come to call ‘alternatives to psychiatry.’ The author discusses the paradox of India’s hundreds of ‘modern asylums’ coexisting with thousands of faith based healing centers, which are often considered by western medicine and thought of as ‘superstitious’ and dismissed as pre-modern. From in-depth interviews Davar surmises that people do not come to these faith centers to be cured, but to be (spiritually) healed, to get answers to existential questions. Davar also discusses her mother’s institutionalization and how she ended her life living in a Hindu temple, but Davar insists that this was not an alternative to anything but just “her way of life” (p. 14). To characterize these practices as alternatives to psychiatry already accepts the western approach to understanding mental difference. However, the fetishization (or fascination in the author’s words) of the west with these eastern philosophies and ways of life is also a source of concern – both because of possible appropriation but also because of what Davar characterizes as loss of memory and respect for such ways of life in the west. These ways of life are also eroding now in India because of the increased medicalization of mental difference.
A similar critique is found in Colin King’s chapter “Whiteness in psychiatry: the madness of European misdiagnoses” in the second portion of the anthology. In it, King discusses the dissonance between psychiatric diagnosis and the experience of African men since slavery and his own current experience. Since Whiteness defines the black body/mind as inferior and not human (as in slave codes) it is no surprise that DSM and bio-psychiatry is a continuation of such practices, King argues. Although this chapter is of great importance because of its exploration of race/colonialism and psychiatric disability (and is unfortunately only amongst a few who do so here), it also seems to fall into some of the traps it critiques. This is especially evident in the author’s use of the term ‘cultural autism’ (of the author’s invention I assume) to describe “whiteness in its failed attempts to understand the subjective experiences of African men” (p. 74). Although one can say that autism can also be described as a White western construct, this is not explored in the essay as such and is left as a negative metaphor solely. The usage of autism to denote a lack of understanding seems to perpetuate the kinds of racial ableism/sanism that the author critiques and I fear will alienate many autistic folks reading this anthology, especially those of color.
Another interesting facet of Searching for a Rose Garden, in addition to mad epistemology, is its intertextual nature, displayed throughout the book. For example, in the section on user knowledge Clare Shaw writes powerfully about self-injury and the need to broaden, instead of pathologize, what we call self-harm. In her chapter she references David Webb’s book Thinking about Suicide as being influential in her life and work. David Webb himself then writes in the following chapter about the academic discipline of ‘suicidology’ and how it contributes to, rather than diminishes, the suicide toll. Such intertextuality helps the reader make connections and think about one topic from multiple perspectives.
The third and complementary section of the anthology is about ‘Survivor-Controlled Practice’ which puts this user knowledge or mad epistemology into action. Some examples of such practice (what might be termed alternatives to psychiatry) include a discussion of practices like intentional peer support and personal Ombudsman as well as specific projects in several (European) countries such as The Sunrise Project, Kindred Minds and women’s independent alcohol support. In the introduction, the editorial collective states that they decided not to focus on “well-established alternatives to mainstream psychiatric provision, such as Soteria, Windhorse or Open Dialogue, which all have one known professional (non-survivor) figure behind them.” The decision to highlight instead projects created by those psychiatrized is especially useful since, as the editors note, “It is hard to find projects that fulfill this criteria and are still operating.”
The last section of the book is titled ‘Working in Partnership’ and comprises discussion of different projects, models and musings (as well as critiques) of research/teaching and practice partnerships between those psychiatrized and those who are not. This is the only section that is written by those psychiatrized and those who were not but see themselves as having a stake in the struggle.
The philosophy at the heart of the third section on alternatives to psychiatry (which are based on mad epistemology) and the fourth section on partnerships characterizes the book as a whole, in my opinion. The approach that guides most of the chapters is that there are no easy universal prescriptions as to “what to do” to combat psychiatrization of people experiencing mad gifts or crisis. One solution does not fit all, and this is exactly the problem with psychiatry and bio approaches to mental difference; that they are monolithic and all encompassing. Instead, the authors throughout this collection offer us varied approaches, as well as their own honest reflections and critiques of said approaches. It is a process of constant trial and error; of becoming instead of being.
Another unique and important aspect of this anthology is not only the centering of mad epistemologies but also its engagement with disability studies and politics. Taking a cue from disability studies and movements, especially in the UK, a number of authors point to a need for a social model of madness. This, of course, alludes to the social model of disability which locates disability not in the body or mind of those with impairments but in the social, cultural and economic barriers they face that create their disablement (lack of physical accessibility, ableist policies and attitudes etc.).
This engagement with disability politics can also facilitate a broader coalition of activism, knowledge and practice in relation to both disability and madness. I am not personally convinced that madness and disability are separate entities though, although in the UK context and within the formulations of the social model that are espoused herein I can see how these two movements would be separate and perhaps at odds. But disablement is not just about bodily difference. At least in the American context people refer to psychiatric disabilities in the same way they would refer to sensory, cognitive or physical disabilities. In this sense madness can be perceived of as a disability in terms of theorizing, critically engaging with its complexity as well as celebrating its radical potential.
The connection between disability politics and mad politics and studies is importantly explored by Peter Beresford in his chapter “The role of survivor knowledge in creating alternatives to psychiatry.” In it, he discusses the potential of the social model of disability, as well as mad studies, to help gain a new and unified perspective on mental difference. However, the chapter sets aside any discussion of the possible tensions between mad studies and survivor movements and disability studies. As Beresford himself notes,“Big questions have been raised about the applicability of the social model of disability to mental health service users/survivors, but that is not the issue under consideration here.” This is fine for this specific chapter but I do wish it was the topic of consideration somewhere in this anthology.
Searching for a Rose Garden is true to its subtitle of “fostering mad studies,” a title added, as the editors reveal, after the conference had already taken place and mad studies was becoming better known. I found the engagement with the emergent field of mad studies to be the most rewarding and promising, especially as a way to develop a mad epistemology that is guided by, and hopefully also expands, mad movements. The transference (if you will) of mad epistemologies that have created the, perhaps academic, field of mad studies is front and center here, and their infiltration across settings and geographical locales leads one to believe in and be optimistic about the possibility of mad movements and studies on a more global scale.
Several authors in Searching for a Rose Garden discuss how mad studies can breathe new life and cohesion into survivor movements and user research as well as what I would call mad epistemology. Sweeney notes that in addition to its intersectional nature, mad studies can provide a counter discourse to bio-psychiatry as well as theorization beyond “consumerist service user involvement arguments” (p. 51), especially since nearly all such attempts end in co-optation, as the fourth part of the book clearly demonstrates. But as Sweeney and others also note, mad studies also has a lot to gain from user/survivor research and knowledge. It is this synergy that holds the most promise in my mind and what would make the book an indispensable collection.
This translation of mad studies across projects and contexts is not without challenges. Specifically, the absence or insistence of intersectionality was something I found to be quite uneven in this anthology. For example, Beresford highlights in his discussion of the social model of disability how important it was that it was created by disabled people from their own experiential knowledge. But it is as important to note that it was specifically conjured up mostly by White physically disabled men. As several authors highlight, especially notable in the overview by Sweeney on “the transformative potential of survivor research,” the field of mad studies, especially as was conceived in Canada, at least attempts to grasp with the intersectional nature of psychiatrization and the mad experience, certainly in relation to variation in relation to race, gender, sexuality, nationality, etc. This is in contrast, as Sweeney and Beresford note, to survivor research in its current form, especially in Europe (although the same can certainly be said about the U.S. as well). As the field moves forward one hopes that an emphasis on intersectional activism and analysis will indeed be at the center.
Since the book is so accessibly written and wide ranging it should appeal to those without any academic expertise, but I would especially urge those who are academics or professionals in the mental health arena not to dismiss it (and several chapters discuss this very dismissal at great length) and instead embrace it as experiential knowledge that should be the core of all disciplines engaged with mental health, psychiatry and its critique.