Towards the Re-politicization of “Mental Illness”


Firstly, I write this in a resolutely affirmative, movement-building, consciousness-raising spirit. I make this disclaimer because I have become fatigued, as I suspect many others have, by what I perceive to be a very rigid, destructive, and ultimately narrow social justice discourse, delivered mainly on the Internet. (So as not to be hypocritical, I own that I have undoubtedly contributed to this stupor in my rasher moments.) Though I intend for this to be an introduction to that discourse, I am worried that, once introduced, the spirit of my request could soon turn bitter and devolve into a circular “us versus them” debate, as often happens online. Which is unfortunate, because it is the primary place where expressions like the one I am making can be made available. And, in turning sour, I worry that it undermines the potential of the good ideas to gain popular traction and enter the mainstream, along with their potential for community building and real world impact. This is the unfortunate conclusion that my experience has brought me to. I’ve witnessed the dark power of “the discourse,” particularly when it is oriented towards shame and shut-down, and I do not take it lightly.

I am going to present some heavy material, and I want to maintain a discipline of collective respect as I speak to some rough and potentially condemnatory points. And I want to be clear that the purpose of writing this is not merely to indict or identify an unjust, limiting order, but to point towards a new order after it, and in so doing invite all people to identify a better life for themselves in it. Despite great reason for despair and consternation, I want to confront the issues presented here from a place of camaraderie and common cause. What I am speaking to is too universal and too important for anything less.

As one who is well-acquainted with mental illness, I am often frustrated by the lack of respect and lack of recognition that I perceive not just towards the severity of this experience, but also towards the complicated and often deeply unjust social and political context in which it resides. And I have been frustrated for years. Despite a fairly ubiquitous conversation about social justice — perhaps more ubiquitous than at any previous time in American history, thanks to the media of the internet — I almost never read anything about this form of oppression, though I am certain it exists and has considerable impact.

There are reasons for invisibility, and I can nod towards a couple of them. For starters, while there have been historical movements against this form of oppression, such as in the psychiatric survivors or antipsychiatry movements (the oppression was then called psychiatric oppression), none of these movements reached the level of mainstream recognition that other social movements have, such as feminism, LGBTQ rights, or the civil rights movement. The story of “mad people” is not yet a part of the elementary school version of US history, nor is there an “Ex-Patients Caucus” in Congress. This is not recognized as a part of the American social fabric in the way that other groups or histories are, though they are very much a vibrant and important part of it.

Furthermore, I suspect that there is something uniquely enduring about the tendency to put experiences of depression, psychosis, or mental illness out of sight and out of mind. Most people I know can identify this tendency in their own lives or in their own families, and very many of them seem powerless to put words to it. The affliction often has deep and widespread impact, yet conversation never comes up. That itself needs its own analysis and its own term.

In addition to that, there are probably countless more explanations for why this issue seems as marginal as it is. Beyond personal conjecture — the makeshift theories I can create out of personal research and observation — I would not know how to analyze this phenomenon as brilliantly as I see my peers take on other forms of oppression. The social, cultural, academic, and political infrastructure required to achieve a comprehensive analysis and reach a critical mass simply does not exist, leaving many who are in need of such thinking more or less helpless to find words. And the places where this infrastructure might exist are relatively small in the whole of things, and therefore the population it reaches is similarly fractional.

To borrow an old phrase, we are dealing with a problem with no name. I’d like to identify that problem in the hopes of developing a more thorough theory on what this nameless oppressor is, and how it operates. If, for example, sexism refers to a social attitude, and patriarchy refers to the social structure that produces and upholds this attitude, then I’d like to promote a working definition of how social attitudes and social structures restrict the freedoms of people with mental illness along similar lines. (Importantly, I use the phrase “mental illness” because it is most predominant in our culture and media, and therefore will communicate to the widest amount of people. I am familiar with and respect the criticisms made about this phrase, and I hope that more people will follow this thinking towards those criticisms). I propose we identify a pervasive but not-yet-politicized attitude known as sanism, and do so alongside its associated structure — for lack of a more adequate phrase, structural sanism.

Sanism, along with its related –isms, more or less connotes a set of prejudicial or discriminatory attitudes. The social construct implicated by the term sanism is “sanity.” This is the concept around which structural sanism is formed, and which influences social experiences based on designations of sanity or insanity — or, more commonly, sanity and mental illness. I have suggested this to people in my life, sometimes to be met with skeptical responses. “Sanity is a construct? Sanity is just common sense. Sanity is being normal,” they might say. But identifying a given attribute as the norm is precisely the action that ignites the process of a social construct. And by making sanity the default normal, it must be signified by an adjacent abnormal quality — in this case, insanity, “crazy” people, mental illness. And what is insanity? I am not entirely sure. That depends on who you ask, and, like other constructs, it is probably a fluid, indefinable concept, albeit one we give much significance to. Insanty could be a diagnosis of mental illness, an extreme psychological or emotional experience, unique thinking, or any number of “strange” behaviors or dispositions we call “crazy.” It is not connoted by fixed definition, but by membership in a broad, open space outside of a mental, behavioral, or emotional norm.

For a communicable example, the colloquial uses of the phrase “crazy” shows us just how much exists within this territory of the insane. A cursory glance at the thesaurus for “crazy” contains the words, “mad, insane, deranged, demented, lunatic, mental, raving, loopy, ditzy, stupid, foolish, idiotic, silly, absurd, ridiculous, farcical, laughable, risible, unworkable, ill-conceived, senseless, daft, passionate, enamored of, infatuated with, amongst other terms.” Anyone who attunes themselves to its uses in daily life will soon find that the word has so many definitions that it actually has no meaning at all. Just as obviously, an idea of “crazy” is being produced and reproduced here — often in very negative terms, though (just as importantly) not exclusively so.

“Very well,” the skeptic might say, “I see what you’re getting at. But if sanism exists, what makes it so bad?” I posit (and this is a working outline) that sanism in action is primarily represented in a double standard of treatment marked by social isolation, exclusion, neglect, control, paternalism (restricting another’s liberty while telling them it is in their best interests), fear, shame, silence, and assumptions of deviancy, ignorance, incompetence, and violence. I believe that the structural form of sanism was most concretely represented by the era of the asylums. Though the asylums were largely shut down, in the absence of a commitment to change the conditions surrounding them, these conditions did not disappear. Rather, they continued to influence American society in more diffuse ways, which brings us to the complicated, unidentifiable place we presently reside in — where the standards of the asylum maintain some social power even if asylums are no longer a fixture of American life.

The skeptic may then say, “Fine theory, but show me what that looks like.” Without annotated studies, all I can point to is my own experience and observation, and hope that it is enough to convince a skeptic. I have seen civilians cower in terror when others identify themselves with mental illness. I’ve seen parents devolve into hysterics over their perceived “failure” in their pained, afflicted child, and the marginalization it has brought them. I’ve seen people go unaware of mental illness in their own family for a near lifetime, only to have a major, hidden chapter of a family history of mental illness revealed to them in their sixth decade of life. I’ve met people with law degrees who were told that they would never work again after a psychiatric break, and I’ve heard people say that it would be inhumane to have children if mental illness is in one’s gene pool. I’ve heard of engagements break apart after the diagnosis of a mental illness. Totally unsuspecting people are blindsided by a friend’s suicide, only to wonder in desperation, “I had no idea anything was happening. My god, what could I have done differently?”

Community mental health services across the country have undergone years of disinvestment, leading a 2003 Presidential report to declare that the mental health system was “in shambles.” Fifteen years of inertia and economic collapse later, things are no better, leaving large swaths of people with mental illness without any supports. Police operate as the default line of response for mental health calls. Too often this results in a shooting, and the victims are subsequently portrayed as disheveled and irrational in the media. Police themselves have some of the highest rates of death by suicide, while institutional norms in policing serve to discourage the recognition of underlying distress. Our prisons and jails bear the shame of being America’s largest mental health providers, and, in Illinois, the “treatment” received there has been declared “cruel and unusual punishment.”

The “mental illness” explanation for acts of grotesque violence is promoted as ordinary common sense. An outraged and aggrieved populace denounces their President elect as “mentally ill,” placing this form of derision well within the bounds of so-called civil discourse. I have friends who have had to cede control of their lives for 72 hours at a time to involuntary commitment, to the detriment of their personal and professional lives, and others who have been drugged against their consent in the name of mental health treatment. Members of every ethnic group tell me, “In the (Asian, Black, Irish, Hispanic) community, we have a problem with stigmatizing this, we don’t really talk about it,” as though this is a local complaint rather than a universal one. Individuals struggling with mental illness believe, “I’m the only one,” as though the complaint is even more specific.

And I could go on and on about the horribly backwards and needlessly repressive ways this reveals itself in the world, and the ineffable torrents of pain and hopelessness people endure as a result. None of this is merely coincidental. These incidents are far too common in theme and in their rates of occurrence for coincidence. No, I believe this is a systematic affair, all related to how we’ve organized society to deal with — or not deal with — the suffering of the mind. This is sanism. The word is currently so foreign to American English that a squiggly red line develops as I write it, so as to say, “This is not in our dictionary.” We are looking at, to paraphrase what lawyer Michael Perlin wrote, the tip of a deep and ominous iceberg — one with wide impact, deep historical roots, and, despite its apparent magnitude, marginal resistance. I believe it constitutes a major burden on human freedom — possibly even one of the largest, once it is exposed in full.

In the models of other social movements, I implore us to advance a multifaceted, structural, cultural, and political analysis of mental illness in America, to illuminate the reality and mechanisms of sanism, and to then envision and implement ways of organizing American life around it that do not limit our potential for flourishing so drastically. I want this movement to recognize the power in numbers I believe it has — millions, at the least — and charge towards the heart of American culture, and take hold of it.

This sounds like a wildly grandiose agenda, but there are reasons for optimism. In the last decade, we have witnessed great potential for major consciousness-raising efforts to surge into the mainstream out of seemingly thin air. The first was the Occupy Movement, followed by Black Lives Matter, the Bernie Sanders Campaign, and most recently, MeToo. Each of these efforts took aim at a repressive structural phenomenon, be it a rigged economy, structural racism and policing, the common sense of the American electoral system, or sexual harassment, and each then found a deep and sudden resonance across the American population. Whether or not these efforts have translated into institutional change, or will someday do so, is a separate and much bigger question, and any consciousness-raising effort around sanism and mental illness should be carefully attuned to the fine print of this task, and acknowledge that there is always much more to change than the conversation. Nevertheless, at a baseline level, the capacity to add another layer of social awareness to the American mainstream is enormous. This fact has been demonstrated repeatedly in our times, we should consider ourselves on the cusp of another awakening, and we should urgently pursue a contribution of our own with tactful, concerted efforts.

Given the pervasiveness of common disorders like depression and anxiety, the raw deal dealt to those with disorders such as bipolar disorder or schizophrenia, and the rising incidences of suicide in the United States, I believe there is a vastly wide population of people who would not only respond to such an effort, but who are outright desperate to see one hold influence in our culture. There is a great awakening on the horizon, and we have the power to instigate it. More to the point, if real, substantive change in American society happens when all facets of it work together — faith-based groups, businesses, politics, media, community organizing, advocacy groups — I think you can identify each of these arenas murmuring about the “mental illness problem” in their own way. It would be a shame if this convergence of factors were seized by multinational pharmaceutical corporations, who are well situated to do so, and who plausibly have no stake in the system beyond making drugs the only systemic response available for mental illness. We can seize this opportunity ourselves and present an alternative vision.

Should such a process develop, then there are subsequently deep, profound, beautiful questions to unpack about mental illness in American life. What is suffering, and where does it come from? The world? The brain? The soul? How is it relieved? With relationships? Environment? Drugs? How do social or economic structures induce mental illness? Why are suicide attempts and trauma more common in marginal populations? What if experiences of mental illness are totally natural responses to the issues presented by movements like Black Lives Matter or MeToo? How do we account for the reality that death by suicide in the United States is very heavily a white, middle aged, male, and rural phenomenon, and how might hypothetically deplorable responses to this reality have enabled the politicking of Donald Trump? How is male depression and suicide influenced by gender, how might engagement with feminist thinking relieve these burdens, and what mutually beneficial outcomes could be reached from this? How does one make sense of the paradox of suicide amongst affluent people, and how is that related to systems that produce wealth and poverty? What commonalities can we reach by re-politicizing mental illness?

But all of that must come after the introduction has been written. For now we face a much simpler task: identifying the problem and communicating it to the world. All of this deserves a deeper, more annotated treatment, and I hope the best minds of our time will lend their efforts to it. It needs its history books, its social theory, its great films, great novels, and hordes of organized citizens to be remembered and revered by history. The problem is just that big and just that urgent, and I know that there are millions of people who understand this simply through first-hand experience. I hope you will join me in pursuing this, and I hope we can bring this process to everyone who could benefit from it.

Which, incidentally, includes literally everyone.


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. Why be complicit in your own oppression? I don’t see the “mental health” system as a good thing. You apparently do, and the only reason that I could imagine for your doing so is that you are somehow drawn to the mental patient role. Vocation or avocation, far be it from me to ask.

    I’m a survivor of psychiatric treatment. I’m not, the NAMIfied version, a “mental illness” survivor. I see the truth as outside of the “mental health” system, the “mental health” system being, as it is in so many instances, little more than a trap.

    Your big thing is a much smaller thing tied to the mental health system. Again, why be complicit in your own oppression? Buck your oppressors, and re-enter the “real” world, why doncha? Oh, yeah, because then the playacting would be over. You wanna be a mental patient? Okay, great, or not so great, as the case may be, but count me out.

    Losing your “mental illness” is a pretty easy thing to do. I lost mine, and I encourage others to do the same. Getting caught up in submission to the business interests of those people who profit from other people’ suffering. I’ve got better things to do.

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    • Frank, your criticisms were preempted by the author and largely consist of ad homing insults. What are you doing Btl if as you insist you have better things to be doing and have nothing useful to contribute to the debate? Looking for a rise maybe?

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      • You misconstrued what I said if you thought I was attacking the author’s person. I was saying that the mental patient role is not for me, and that I think we’d be a lot better off if there were more people who felt the same. Is there anything about that that you don’t understand?

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        • Nobody with a wit of sense could think you wanted the patient role Frank, nobody does, it’s rather foisted on people usually these days with vague threats that ‘it will go better for you if you go’ voluntary”!
          It’ s possibly better to suggest that the ‘mental health movement’ could co-opt any ‘sanism’ movement as part of their increasingly successful ‘anti-stigma’ campaigns, which as you know are anything but – psychiatrists/ psychologists continue to stigmatise people by diagnosing these so called pathologies, frequently retraumatising or otherwise compounding the presenting troubles, if there are any!

          In the meantime psychiatry continues to increasingly act as bad pharma marketing executives and dominate the discourse. The fact that you found it easy to walk away from such a fraud is inspirational to many and fair play to you for doing so. Long may it last. Such acts are not always so easy however. Anyone who can free themselves from neurotoxins, stigma, shame, often considerable social pressure, the Katy Bates of the psychiatric world, poor work histories and social isolation. Often improvements are not greeted with joy but resentment, restlessness and others doing the othering beginning to miss the handy scapegoat they’ve come to enjoy. People frequently tapper off mess with little or no support and then are confronted with their original problems of living maybe even less equipped to deal with them than before the great explaining away cover up. If you can do that your something of a hero it can’t often be that easy.

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          • Perhaps I made escaping the clutches of the mental health authorities sound easier than it actually is. It was certainly not so easy as I may have made it sound to lose my “mental illness”. I was in and out of the mental hospital for a few years, not because I liked the place, but I think because they liked to have me. R. D. Laing came close to defining insanity as a perfectly rational adjustment to an insane world. My insanity was about being stuck in a place that didn’t make sense for anyone, let alone yours truly. As far as that goes, we’ve got better things to be doing with people than putting them in such impossible situations anyway, don’t we? I’ve, as far as my madness goes now, with time become more adept at not getting caught.

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        • Oldhead, Well I can be pretty acerbic myself I suppose. Frank it’s claimed that people end up in impossible situations often by accident but agreed deliberately to do so or indeed keeping people their by artificial means is rank!

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          • I feel that you make a good point about people getting off the drugs and making changes that lead to them regaining their lives, only to have push back from other people because they’ve changed. I think that this is what you are saying but correct me if it’s not.

            Many people don’t want anyone to change because then they’d have to rearrange their thinking about that person and change the way that they react to them. For many this is work that they don’t want to engage in at all. I think it’s much easier to attack people than it is to build them up and support them in their new endeavors.

            I believe that there are families that have deeply rooted emotional and psychological problems and these families often designate a member of the family to be the black sheep, the “mentally ill” family member. And God help that designated person if and when they change or try to change. The other family members refuse to look at their own issues because they conveniently have the scapegoat to point to and unload all the family issues onto. The best thing that the black sheep can do is detach from their sick family and move as far away from them as possible because the family will never change its approach to that person. They are better off with no family at all as to have to deal with the family that they have.

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          • “Frank it’s claimed that people end up in impossible situations often by accident but agreed deliberately to do so or indeed keeping people their by artificial means is rank!”

            Okay. perhaps it was easier for me than all that. Accidentally on purpose and all. Consciously off mark. You tell me. Obviously we have a language (i.e. communication) problem here. I will leave it at that. However rank.

            That said, freedom of choice means a great deal to me, and it is not the kind of thing I would want to forego.

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  2. I lost mine too, Frank! Sort of. May need to relocate AGAIN to get fresh medical records so the doctors will treat me decently and companies will put me on insurance plans without funny looks.

    Through withdrawal though my body’s still adjusting to being drug free after over 25 years of regularly “taking” some drug or other prescribed by a mental illness making quack. Got a part time job. Making plans for the future. Starting over in my mid-forties is bitter sweet. Glad I’m finally free; for a while I thought only death would free me.

    Matt’s right about one thing (at least.) We need a common narrative or story as survivors. But we’re not only heterogeneous as a group, even as individuals our stories are confused.

    I remember reading a book by Szazs ridiculing how writers like Virginia Woolf, Kay Redfield Jamison, and Alice Flaherty couldn’t keep their narratives straight, due to confused ideas about “mental illness” and the human mind as a whole, and self dramatizing behaviors. For example rhapsodizing on “mental illness” experiences for attention–even the negative kind.

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    • hi. I’m so thankful you’re at a point where you can move forward with your life and look to a future outside of Mental Health, Inc. I’m getting there. Getting off the drugs was (surprisingly…) the easy part, possibly because of high dose supplementation. The difficult part that I’m facing now is trying to transition out of labels that have been applied not just “in treatment,” but also in the community. Read: I may end up having to move, also.

      I vaguely remember something Szasz wrote about Woolf…”my madness saved me,” as in she used her “manic depression” to further her own interests, which seems to be fairly common among upper crust “mental patients.”

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    • The Socialist Patients’ Collective (SPK) from Germany wanted to “Turn illness into a weapon”, and thus sabotage capitalism with it.'_Collective

      Perhaps that is happening at this moment, however, I tend to think capitalism is more vulnerable where the illness metaphor is dropped altogether. In this country, it’s money that has short circuited what was once a mental patients’ liberation movement. Think, mafia pay offs, only for mafia substitute government. How does the government crush a liberation movement to overthrow a system of oppression? Why, of course, by giving people jobs in that very same system of oppression.

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      • Even though I’m one of those dreaded peer workers I’m beginning to believe that you’re onto something here.

        I’m seeing it in my own state, which just developed a training program for certified peer workers. But, get this, the people doing the training have no lived experience! And, they’ve set up parameters that are very narrow about how peers function when working with people. I sat on the original committee that began this work and the majority of the members of the committee were people with lived experience. But, we had “advisors” from SAMSHA and people from the state licensing board. We were the preliminary workers setting up what we thought the training should be like. Thrown in among us were people who ran “programs” for the “mentally ill” and people with addictions. Before it was over with many of us with the lived experience were ignored and the people without the lived experience took over and put together the curriculum for the training. Many of us removed ourselves in protest as we could see where things were being pushed by those who had no business pushing.

        All I know is that my training was nothing like the training that this group produced. One of the interesting notes is that the requirement for continuing education requires more than even social workers in the state are required to do. They’ve put so many qualifications on requirements that a person will be spending more time going to continuing ed courses and dealing with more red tape and bureaucracy than they will be actually working with people.

        Something is fishy here.

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        • Mental patients and ex-mental patients are simply not competent enough to recognize what they should find supportive and helpful. If peers are not properly trained there is the imminent danger that their clients might respond to something they do or say in a positive way when such a response is clearly unjustified and not in their best interest.

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          • Let’s be honest, the system’s biggest fear of “peers” is that they will talk about the possibility of not following orders, especially as regards “medication.” Their second biggest fear is that the “peers” will call them out on their lack of knowledge regarding how to help, or will show them up in some way that embarrasses them. Both very “patient centered” reasons to be worried, eh? It’s all about control, and those who fear “peers” fear losing control, usually because they have no idea how to establish any kind of helpful relationship with anyone.

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  3. Thanks for this essay. I’m not sure if it’s just me and how I am at present (not too good) but over and over, and here is no exception, the responses so far read to me as toxic and dismissive. In a peculiarly self-serving way, which is as hard to pin down as sanism.

    But basically there is an undercurrent of resentment against anyone that has the (seeming) audacity to suggest that they have mental problems, that are severe, ongoing, and life-limiting, causing tremendous suffering and loss, and which follow a strange course that is akin to an illness.

    Which is to suggest that to be afflicted in such a way is shameful, and to identify one’s struggles as illness-like (or illness-lite, or fully fledged illness and no mistake) is somehow betraying a larger and more meaningful struggle, which is to completely destroy whole institutions of mental health, and/or psychiatry, so that a few individuals can act out their lifelong burning need for revenge…

    Is it just me?

    But anyway, thanks for writing this and good luck with your novel. I agree we need more art — there really can never be enough — that shines a light on sanism, and that help us collectively, in and out of these systems, to better understand the torments we get put through and which are wholly born of prejudice and discrimination against our struggles and our difference.

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    • OK I read it. What strikes me as curious, and somewhat frustrating, is the degree to which the author raises issues which have been under intense discussion for years as though it’s the first time anyone ever thought of them. In doing so he ignores much which he needs to know to have an informed perspective. Moreover in embracing “mental illness” as an acceptable term he demonstrates how far he needs to come himself before he can be educational to others. The silver lining is his ability to see some connections which should eventually lead to an anti-psychiatry analysis. There’s so much to take issue with here. albeit in a friendly way, that I guess I’ll go a chunk at a time:

      while there have been historical movements against this form of oppression, such as in the psychiatric survivors or antipsychiatry movements (the oppression was then called psychiatric oppression), none of these movements reached the level of mainstream recognition that other social movements have, such as feminism, LGBTQ rights, or the civil rights movement

      Oh my. First, you are talking to some of the people who were and are involved in this “historical” movement. Psychiatric oppression has always been called psychiatric oppression and continues to be called psychiatric oppression because that’s what it is.

      Do you want a revolutionary transformation of the sociopolitical conditions which make people crazy (my preferred term)? Or do you want to impress the (non-existent) “mainstream”? If the latter, you sound like you’re ready for your “critical psychiatry” phase, often a prerequisite for developing a genuine anti-psychiatry analysis, which is based not on popularity but on rational thought.

      The story of “mad people” is not yet a part of the elementary school version of US history, nor is there an “Ex-Patients Caucus” in Congress.

      One because we are not “mad people,” we are humans who have been saddled with pseudo-scientific labels which insult our humanity. One of these is “patients.” (Why not ask why there isn’t a “Negro Caucus” in Congress?) Two, because there’s nothing much to teach school children because no ultimately successful anti-psychiatry resistance efforts have yet been mounted; indeed even the need for such is understood by a relative few at this point. But to paraphrase Jerry Rubin, “Nothing in history has ever happened UNTIL IT HAPPENED.

      I would not know how to analyze this phenomenon as brilliantly as I see my peers take on other forms of oppression. The social, cultural, academic, and political infrastructure required to achieve a comprehensive analysis and reach a critical mass simply does not exist

      How brilliantly your so-called peers take on other forms of oppression is questionable. But there is an ongoing anti-psychiatry analysis which has been developing for a while; apparently you haven’t looked in the right places.

      In the last decade, we have witnessed great potential for major consciousness-raising efforts to surge into the mainstream out of seemingly thin air. The first was the Occupy Movement, followed by Black Lives Matter, the Bernie Sanders Campaign, and most recently, MeToo. Each of these efforts took aim at a repressive structural phenomenon, be it a rigged economy, structural racism and policing, the common sense of the American electoral system, or sexual harassment, and each then found a deep and sudden resonance across the American population. Whether or not these efforts have translated into institutional change, or will someday do so, is a separate and much bigger question,

      Except, arguably, for Occupy, these efforts are basically liberal ones which do not challenge capitalism, so yes, whether or not they will end in “institutional change” is a separate question (with a predictable answer). The function of liberalism is to draw idealistic people into intense whirlwinds of activity which can by definition never succeed, other than to disillusion the participants from participating in political activity in the future, which is the purpose. When we have a unified message we will have no trouble communicating it. Right now however we have nothing but confusion.

      More on this later. I’m posting this now before it disappears from my screen again and I totally freak out.

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      • It’s discussed in Mad in America, but not in many other places.

        It was meant for sharing and promotion amongst an outside community, a wide majority of whom have no concept of these conversations (even in the disability rights part of Illinois, much of this is out of the picture). They can then browse the rest of MIA, if they so choose.

        There was no suggestion that anything here was being said for the first time or with any specific authority. I was mirroring the “call-to-arms’” that one finds in other political areas, because that sort of thing in high currency right now amongst the rest of the country – who, again, is not thinking of these issues in that way, despite a time of mass political awakening and conversation.

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        • The point is to try to spark some consciousness in an exponentially larger yet unpoliticized population. Such a population exists, such a population does not yet have words for any of this, such a population could be won. I was trying to write in ways that might speak to them.

          If you disagree that the MIA style conversations are not taking hold outside of the internet, I would gladly be corrected.

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  4. Rossa Forbes uses “mental” illness. I would use mental “illness.” It’s mental enough (imagination, feelings, and social constructs are mental.) The illness suggests brain disease. Things like traumatic brain injury, brain cancer, Alzheimers are brain diseases.

    Yes, I’m aware no one can see what causes Alzheimers all you hecklers. Scientists are still very ignorant about the human brain. The idea that they can fix chemical imbalances–even if they exist–is therefore ludicrous. Like a 10 year old messing with his chemistry set in hopes of curing cancer. And it’s well known that drugs don’t restore cognitive function to dementia patients. They don’t help or heal–just destroy.

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    • Not sure who Rossa Forbes is or what it has to do with whether or not such a term should ever be used. I’m sort of surprised, Rachel — I thought you were very clear about the fact that accusing someone of “mental illness” is akin to hate speech.

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    • “Things like traumatic brain injury, brain cancer, Alzheimers are brain diseases.”

      A traumatic brain injury is not a disease.

      From wikipedia:

      “A disease is any condition which results in the disorder of a structure or function in a living organism that is not due to any external injury.”

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        • I’ve never read the DSM5 and it doesn’t have any bearing on my life. That’s a personal level.

          Psychiatry as you know is on a growth-binge, and is attempting to infiltrate every area of life, even those areas in which it really should just bugger off.

          But TMI can bring about many of the symptoms of classic so-called mental illnesses, especially depression, and so opening up access to drugs that might alleviate those symptoms might be helpful to some people, and while personally I would resist such approaches (fundamentally because they don’t help me) I wouldn’t be so bold as to demand that no-one should be free to experiment with these substances to alleviate their suffering, if, and only if, that is what they choose to do.

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          • I’ve just had a quick look at DSM5’s categorisation of traumatic brain injury and you are incorrect. It does not categorise traumatic brain injury as an illness. DSM5 categorises traumatic brain injury as a traumatic brain injury.

            I also did a quick search and discovered that the major critique of DSM5’s categorisation of traumatic brain injury amongst neurologists was that it was too optimistic about recovery.

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          • RR, okay. I didn’t realize the DSM5 listed things that weren’t classified as “mental illnesses.” An uncle of mine became an insufferable jerk after his head injury.

            My aunt wanted to put him on SSRI’s. I talked her out of it. Uncle B’s nasty behaviors stem from a lack of “filters” or inhibition. The last thing he (or his wife) need are to break down what inhibitions he still has.

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          • I agree with you. I myself will never put another one of those drugs into my body ever again but if other people feel that they are helpful to them then I say more power to them to take the damned things.

            I don’t want them but if others want to take them then I support their choice. It makes me sad but I support it. One of the huge things that the “mental health” system rips away from people is freedom of choice and self determination. I don’t want to do to others what the system always does.

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          • This isn’t “choice.” Choice would be if there had been a demand for such drugs by people in distress who recognized instinctively and independently that this was what they needed. When something is developed to control you and stop your complaining, shoved in your face with a “take it or leave it, that’s all we got” I don’t know what you call it, but certainly not “choice.”

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    • DSM is a billing guide.
      What it lists in one category in one edition, it will list in another in the next.
      Wait a few years and, under DSM 6, you will all be “wrong”.
      It is not used to determine the reality or interpret the nature of human experience.
      It’s used for insurance.
      edit: this comment was meant as a reply to the previous string of comments.

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      • Unfortunately, it IS used to interpret the nature of human experience, even though it is a billing document. It takes a special kind of idiot to use a billing guide to make determinations about human experience, but apparently, there are a lot of idiots out there pretending to provide medical advice.

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  5. Thank you all for your comments.

    I’m running on a couple of assumptions here that I was not able to express . Firstly, I believe there are a great amount of people who, by virtue of their depression or their proximity to suicide, or any other nameless complaint, would potentially resonate with a critique of psychiatry, of the concept of “mental illness,” and then later take on a more radical point of view. Given the fact that there is almost no discernible mainstream presence of these ideas, however, I have made a strategic compromise and used the phrase “mental illness.” I am aware of objections to this. The point is not to endorse the underlying concept of “mental illness”, but rather to create a point of entry for a broader population to start thinking about them critically. Unfortunately, “mental illness” logic and language permeates every part of the mainstream, and therefore this is the only way a lot of people know how to conceptualize suffering, or at least express it in words. If you have something that introduces the conversation as effectively, I am open to hearing it.

    I share your concerns about “mental illness,” and I hope that more can be brought to understand them. I stated as much in the article, very clearly. Again, there is virtually no mainstream presence for these ideas. The primary point of entry for a vast majority of the population is going to come through the internet. In my personal life, I’ve attracted people into new thinking simply through my personal social media activity, and they have all started from a status-quo place of thinking. I’ve then seen very good people approach these issues in very good faith, only to be turned away with their hands in their faces because the only language they knew – the problematic illness language – was deemed unacceptable by certain members online peanut gallery, and they were subsequently rebuked, and now only know how to approach these issues with a great deal of shame and fear. That is not my personal preference for consciousness-raising or movement-building, and I don’t think that we can make some effort to communicate these ideas to a broader public (and build numbers) if we don’t make some effort to meet them where they are at and allow for them to move towards deeper thinking and action.

    That is my tactic, at least. You are free to have yours. Thank you for responding. I appreciate it.

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    • Matt, ‘Mental illness’ is a part of a whole lexicon of confusion surrounding human distress. It has the direct effect of medicalising distress and compounding our confusion, diagnosis explaining away any context and a helpless need for ‘expertise’ rarely if ever to be found.

      I agree it’s a bit mean spirited to argue the point but I’ve never bought into the concept and using the term as a metaphor, which most people, in these parts anyway, still do, only serves to confuse matters further as different people take a different read on it.

      The notion of ‘sanism’ might help pinpoint the othering which takes place and the legitimising for people to project their fears unto sufferers maybe an alternative to ‘mental illness’ or a recognition of its fraudulent qualities is more pressing?

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      • Popping my nose in here.

        “Matt, ‘Mental illness’ is a part of a whole lexicon of confusion surrounding human distress.”

        Are you using the term “distress” as a metaphor or a literal and universal signifier?

        If the latter then it’s inaccurate and presumptious, given that an experience such as mania definitely fulfills a metaphorical description of illness, but is often as far from being distressing as a whole-body orgasm.

        Unless of course a whole-body orgasm would be something you’d imagine to be unpleasant.

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      • Interesting article, Matt, thank you for your thoughts and ideas. I have a very difficult time with using language that is more empowering, dignified, not medicalized and not stigmatizing. I always ask how would I want to be identified. My years of practice in this insane “mental health” system at various levels has mostly shown me that there are “societal illnesses”. I would love to see a more unified movement that more people can identify with like the “me too”, LGBT and other social movements.

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        • Thank you for your response!

          Part of my concession comes from the realization that, in the absence of a catch-all term, it is not clear what terms would speak to a critical mass of people. Once self-identification comes into play, then they are countless ways that people would like to identify with outside of the “mental illness” metaphor. See, for example, how many different gender identifications have emerged lately once the breakdown of the male/female binary has been introduced.

          I would also like to see people use more empowering language for themselves and for others. That is a welcome development. Bur I think that before that can happen, there needs to be a mainstreamed analysis as to why this is so. Why “mental illness” is a bad concept is self-evident to most people here, as most of these comments demonstrate. I also think that this populace is exponentially outnumbered by people who don’t know that. My hope is to contribute to creating the cultural and political institutions necessary to meet this mass of people and bring the winnable subset of them into new consciousness.

          Hence, “The re-politicization of mental illness.”

          Though I trust you understand that 🙂

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          • So you plan to “educate” people by using language which supports psychiatric oppression?

            Bur I think that before that can happen, there needs to be a mainstreamed analysis as to why this is so.

            Why do you need the approval of the so-called “mainstream” to do what’s right?

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          • It’s good to see someone realising the politics of psychiatry. But ‘re-politisiation’ mental health is always nothing if not political. The absence of discourse about power dynamics therein hides the fact that it usually operates like other disciplines with a peculiar silence on power (economics/ psychology etc.) in the interests of power. So congratulations on opening a debate……

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          • no matter how many new “gender identifications” have sprung up lately, there still exists an epidemic of male violence against women and girls. Funnily enough “gender” language games have had no effect on this. What if futzing around with the language is just a surface measure that can’t change the underlying reality? I dont think this terminology issue is about “choosing the right words.” It’s more about avoidin the wrong ones, the ones which are actually promoting lies. In my book, “mental illness” definitely promotes a lie. However, we should not seek to institute any specific “replacement” word. We should strive to use normal, non-jargon language freely to describe what the eff we are talking about, just like we do with most things in life that aren’t lies or items of interest to dogma.

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          • I agree – it appears to me that the very choice to identify “mental illness” as anything at all immediately creates “otherness” and invites prejudice and discrimination. Instead of saying, “She has depression,” why not say, “She is sad a lot of the time and struggles to find anything positive to look forward to in her life.” The latter formulation affirms the person’s individuality and implies a possibility of change and development over time. The former simply slots a person as belonging to some group of afflicted people whom we can readily decide are not like us, so we can feel pity for them while at the same time not really bother to care, since they have a “disease” and it’s now the doctors’ problem.

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          • Black holes are physical phenomena, and that’s the term used to describe them, so while it may be simplistic it is not a metaphor. I believe a linguist would concur. Though you might have a response to this as well I think the important thing for Matt to grasp is that “mental illness” is indeed a figurative term and does not refer to anything which actually exists; hence to use it plays into the hands of those who wish to maintain such confusion to serve their own ends.

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          • An old fashioned term for a bad guy was “black hearted” man. Useful as a metaphor. But if a doctor pointed to a man and said, “That man is black hearted. Help me inject bleach into his upper left chest cavity to cure him and make him good” the doc would be taking the metaphor too literally.

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      • “The notion of ‘sanism’ might help pinpoint the othering which takes place and the legitimising for people to project their fears unto sufferers maybe an alternative to ‘mental illness’…”

        Yep, it’s all based on projections. What is real vs. what is illusion is up for grabs. It’s an entire culture based on gaslighting–which is inherently confusing and crazy-making. That’s the idea.

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          • I highlighted this because, to me, it is the grand paradox here to ascend. How can clarity occur where there is chronic deceit happening? Whether or not it is intentional deceit or simply unconscious from habit because this is what the culture requires in order to survive, it still amounts to smoke and mirrors. I’d call it “the program,” or dominant paradigm.

            We’re talking about a population in which so many are justifiably distrustful due to severe betrayal issues. Lots of wounding here, and then re-wounding when one goes through these “systems” (“mental health” system, “disability” system, “social services,” etc.). I am speaking from my own experience and what I’ve heard and read online and off from others over the years.

            And yes, I totally agree with what you say about this being a huge universal issue at the core of it all. We do live in a corrupt and unjust world at present; but to me, for a system of so-called “health care” of any kind–or some kind of social support, in any case–to be such a powerful arm of that oppression would, indeed, point toward perhaps it being the core of it, given the obvious irony.

            That is gaslighting en masse, and it has created absolute chaos because it affects the brain, how we think and perceive, and even how we strategize our lives. It’s caused us to live in a great deal of anxiety, because it is so hard to know who and what to trust.

            Shifting away from gaslighting is an entire paradigm shift, imo, toward integrity. That, alone, will instigate a lot of changes, I believe, because it will generate clarity.

            I hope this speaks to you, Matt, because I appreciate the work you are doing and I do like how you are addressing these issues. It speaks to me.

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    • I have made a strategic compromise and used the phrase “mental illness.”

      And in doing so you surrender to the narrative of the system you profess to oppose; your whole approach reflects a predisposition to surrender before you’ve even started.

      You need to more clearly define the enemy and better understand the functions psychiatry serves as a tool of social control in the guise of medicine. Playing to the “mainstream,” again, is something people looking for approval do; what we need is a working analysis which resonates with those who are actively working to dismantle the psychiatric system. As with any genuine movement, the “mainstream” will catch on once they see it on Dr. Phil. Until then we have work to do.

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        • Are you seriously suggesting that using self-denigrating language is a viable tactic for winning over the “mainstream”?

          “Negro” is considered an insult by most Black people today, and is generally directed at other Black people whom they see as being complicit with racism. It was once considered acceptable, just like “mentally ill” is today, until the advent of the Black power movement and a more radical consciousness led to it being “discredited and abandoned” (Garvey). Are you saying the psychiatrized should remain in the shadows and be satisfied with our former labels?

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          • I’m suggesting that most of the population understands MIA issues in terms of mental illness, and may not be able to take part in a conversation otherwise.

            Whether or not using language one finds denigrating or problematic is incompatible with advancing a deeper movement, again: the Civil Rights Movement, Negro. Problematic language, strategic victory.

            (I don’t know who claimed that white intellectuals made the gains of that era, or who dismissed the work of activists, but it definitely wasn’t me)

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        • A long time ago, the term Negro was considered a polite, respectful term for those of African ancestry. Like the word Black in the 70’s and now the word African American.

          Let me play devil’s advocate though, Oldhead, since the opposition will probably bring this up. The Black rights advocates never argued that Africa did not exist. For that reason the survivors’movement will need different strategies from theirs.

          I like the narratives on the site “I Got Better.”

          Simple messages the sheeple who believe Big Pharma commercials and everything else on TV can grasp are what we need.

          “Psych drugs don’t work.”
          “Recovery is possible.”
          “Psychiatry ruins all hopes of recovery.”
          “Psychiatrize your kid; you’ll have a kid forever.”
          “Psychiatry eats dreams.”
          “A drug is a drug is a drug.”

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    • I think when the mental patient role became the mental health consumer role a lot of people got confused. Once upon a time, “mental illness” was something you were supposed to get cured of. Now a days, “mental health” is what you are expected to buy if some shrink says you’ve got a “mental illness”. There is no expectation that you would cease to do so. After all, if you ever did, en masse, it would throw all those little much more essential mental health goons out of work.

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  6. Conditions such as schizophrenia, bipolar, depression, autism, aspergers, myalgic encephalomyelitis, anxiety, dementia, schizoaffective and so on, are functional disorders.

    Functional disorders are disorders for which there is no known organic basis.

    Are all manifestations of the above list always one and the same thing? No.

    Does that mean that if some do not, in all probablity, have a functional disorder, then no-one does? No.

    Is it pointless to try and find an organic basis for a functional disorder? I should hope not. It is, after all, how medical science progresses.

    Psychiatry has shot itself in the foot in its desire to grow and expand. Medical science is now conducting research on a large array of people, an ever-dwindling number of whom probably have a functional disorder, joined with the majority that probably don’t.

    Added to this is the problem of the drugs, which themselves induce disorders in many people, another factor messing up all the research.

    If psychiatry pulled back willingly and rethought all this through it might stand a chance of helping progress.

    But I believe that is now unlikely to happen.

    Do I believe I have a functional disorder. I think, on balance of evidence, I probably do. But that is confounded by the fact that I suffered a serious brain trauma as a child and then in early adult life, suffered further brain injury due to forced psychiatric treatment. Although long before I had had any contact with mental health services I was suffering through life, and fucking it all up, as I ran the gamut of classic symptoms of mania and schizophrenia. And have gone on to, with very little respite. Whether I’ve chhsen to take drugs, or not. I still have to go on through the same unrelenting shit (some of which, I may add, is quite glorious shit that I wouldn’t be doing without, even if, all told, the good stuff doesn’t happen anywhere near as often as I’d prefer).

    I feel very sad for the many people whose lives and personas have been ruined by an overzealous psychiatry that has rapidly disappeared up its own a-hole.

    However, I find it disturbing that said people scoff at the very notion of a functional disorder being the root cause of some poeples’ lifelong problems and the suggestion that these peoples’ problems are simply bought about by not reading enough Szasz and parroting his — largely — spurious libertarian invectives.

    That’s not a heckle. That’s a declaration of a personal hard-won truth.

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      • Someone would have to define “function” and “disorder.” Such assumes that there is some ideal standard of “functioning” against which other types of “functioning” could be measured. It also assumes that those who don’t “function” in a way that is approved of those who define “functioning” are “dysfunctional.” It’s all nonsense. Human beings are not machines. They are not functions that can be disordered. Psychiatry attempts to reverse the teachings of Jesus. Instead of removing a beam in the eye to observe a mote, psychiatry attempts to place a beam in the eye of those it targets for domination. If there is anything functionally disordered among human beings it is psychiatry itself.

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    • No known organic disorder differs from no organic disorder, RR. But if they don’t know WHAT the disorder is how can they fix it? Right now they don’t even know if it exists.

      The reason many of us are angry is they diagnose people as hopelessly insane to the point of incompetence and keep our brains from functioning properly to make sure this prophecy comes true. Like paralyzing someone’s legs to “fix” restless leg syndrome.

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      • They diagnose ‘mental illness’, hard to avoid that phrase it seems. The prognosis can indeed be an iatrogenic self fulfilling prophecy Rachel. Even Prof Anthony Clare once the public face of psychiatry in the UK stated that the neurotoxin used to treat psychosis induced the ‘negative’ symptoms of these conditions.

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      • “No known organic disorder differs from no organic disorder, RR. But if they don’t know WHAT the disorder is how can they fix it? Right now they don’t even know if it exists.”

        There are plenty of people outside of the psychiatric system that claim to be able to fix severe mental illnesses. From time to time they hawk their magic on here. The niacin-fix, the shaman-fix, the let-me-play-daddy-so-I-can-tell-you-to-grow-up fix, the stare-at-this-inkblot and tell me about your childhood fix. The waking-up new age fix. And on and on they go.

        Psychiatry offers remedies, just like their cousins in general medicine. These remedies don’t suit everyone. But some people some of the time (or perhaps most people most of the time) take some solace and relief.

        “The reason many of us are angry is they diagnose people as hopelessly insane to the point of incompetence and keep our brains from functioning properly to make sure this prophecy comes true. Like paralyzing someone’s legs to “fix” restless leg syndrome.”

        If the psychiatric approach to your illness doesn’t agree with you, then learn ways of living with your problems without recourse to psychiatric drug-taking.

        If you are having difficulty adjusting to the naming of your problems, then focus instead on other things that make you feel good.

        If you are angry then explore that anger as authentically as you are able; this can be a painful process as you’ll have to acknowledge some element of personal responsibility and bad choice-making.

        But, if you have achieved all of that already, and you persist in blaming all of your problems on psychiatry, then what I would suggest is that psychiatry is also performing a social function, in that it is in many ways a kind of unspoken punch-bag for people who would otherwise be causing mischief elsewhere.

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        • RR, I’m angry that I was lied to and about for the best years of my life. I am grieving, to put it mildly. Like waking up from a semi-comatose state in my 40s after going under at 20.

          If shrinks want to hawk their wares as emotional pain killers to consenting adults, that should be legal. They should also share the poor long term prognosis of depending on these drugs to cope with life. But they don’t. Or MOST don’t. And they pretend they will prevent further brain damage along with other high pressure fear tactics.

          And they have the legal right to lock up their patients for rejecting their advice. No other medical specialty has this right. And they demonize those they claim to want to help on national television.

          That’s why there’s an anti-psychiatry movement and no anti-oncology or anti-cardiology movement.

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          • Hey Rachel. No problems with you aligning with antipsychiatry if you find the answers in it that you seek. For many people it’s a stage they need to pass through in order to take back control of their life. I’m more of an antibullshit type. Of course there is a lot of bullshit in psychiatry. There is also a lot of bullshit in antipsychiatry.

            I’m not ashamed of being mentally disabled. I’d rather I wasn’t but that’s pretty normal. I didn’t choose to be this way. Did any of us?

            You have to be careful with anger though. It is a very consuming emotion and can cloud the judgement.

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  7. “Mental illness” is a business, a big business and so long as we have ‘doctors’ labelling people as “mentally ill” we will have people being forced to be harmed, killed and kill other people by neurotoxic drugs for the profit of drug companies and ‘doctors’ . The big business has corrupted almost everything: regulators, media, law process, to get away with this crime against humanity. We challenge the use of these words, terms and labels because they normalise, verify and legitimise the abuse. They need to be deleted, psychiatry and it’s neurotoxic drugs needs to be abolished – this is a ‘profession’ whose work in murdering their patients informed the Nazi agenda and method of further mass murder – and the perpetrators of this drug/abuse crime need to be held to account in a court of law for crimes against humanity.

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  8. “Black holes are physical phenomena, and that’s the term used to describe them, so while it may be simplistic it is not a metaphor. I believe a linguist would concur.”

    The term “black hole” is a metaphor. A black hole is not literally a black hole. Physicists would agree with me. So would a linguist, if, they had a little grasp of the physics.

    Of course, we use many metaphors without even realising we are and it can be a little bit disconcerting to have this pointed out.

    “I think the important thing for Matt to grasp is that “mental illness” is indeed a figurative term and does not refer to anything which actually exists”

    I accept you think it is important for everyone to align with your analysis.

    But this is fundamentally flawed. As the great intellectual Rumsfield once pointed out, “there are known knowns; there are things we know we know. We also know there are known unknowns; that is to say we know there are some things we do not know. But there are also unknown unknowns – the ones we don’t know we don’t know.”

    What you are suggesting is that anything which is suggested as an illness is not an illness until it is established to be so, irrefutably, by medical science.

    And yet medical science doesn’t work that way and has identified many conditions and treatments for things which are known unknowns.

    Schizophrenia for instance is a known unknown.

    So is dementia.

    As is tinnitus.

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    • “Black hole” is not a metaphor, it is a descriptive label for a physical (i.e. material) phenomenon which in reality does exist. “Mental illness” does not describe anything which actually exists; it ascribes physical characteristics to an abstraction, which is what makes it a metaphor.

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      • Apparently the metaphorical term “black hole” began its life as a similie, the nudist cousin of the metaphor, with the astrophysicist Robert H. Dicke, who said they were “like the Black Hole of Calcutta”. The similie was then later converted to metaphor by the physicist John Wheeler.

        The term black hole is a metaphor. A black hole is a complex mathematical equation which describes an effect in space-time, which no-one has directly observed. Evidence of its existence is entirely inferred.

        Mental illness is also a metaphor — as far as I am concerned — which also attempts to describe a functional disorder in the brain, which no-one has directly observed. Evidence of its existence is entirely inferred.

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        • Assuming the mind and the brain are synonymous. Many of us do not.

          A portion of the brain lights up when you think unhappy thoughts. Does the brain produce these thoughts out of nowhere? If thoughts emerged from random chemicals in our brains nobody’s thoughts would be relevant including the self-styled healers who “diagnose” those with the “wrong brain chemicals” which they infer from their materialist mindset and punish accordingly.

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          • As Frank Black once sang, rather gloriously, if you ask me, “Where is my mind?”.

            Straightforward answer is: no-where.

            Most sighted people when asked to locate the mind tentatively suggest it’s somewhere behind the eyes. It feels like it’s located there. Blind people were asked the same question and they predominantly locate it somewhere just in front of the eyes.

            There are some quite exotic replies too. Which I find intriguing. Perhaps the most bizarre is that the mind is located at the edges of the universe, and gets transmitted to the brain via (insert some bastardisation of quantum physics here). They say that the mind is immutable and perfect. All problems of the mind are problems of the brain only so far as a television set goes on the blink and does not pick up the signal correctly. This idea can be comforting or compelling to some people: go deeper with them and you’ll find out why.

            So there is a reverence for the brain. That gloopy, gelatinous deep-sea mutineer is, somehow, impeccable and perfect. What a peculiar and altogether unanticipated idolatory!

            I don’t think the premise of psychiatric inquiry is entirely wrong. Errors of processing in the brain result in various forms of bewilderment and suffering. I object to certainty. We know so little about the brain and how it manifests the mind, and then how the mind and the brain interact, that all hypotheses are crude and not developed enough to inform medical intervention.

            So, being logical and rational creatures, we’ve opted in ever greater numbers for medical interventions. An idiom for this is: shooting in the dark.

            Minds do not manifest without brains. And there are key developmental stages of the brain that if not reached, are pretty much lost forever. Most are agreeable to those facts.

            There are people that claim that minds don’t need brains. When people do that, a good response is to ask them to demonstrate it. I did this once and I kid ye not, they closed their eyes for a few seconds, and opened them, and said, “There. I did what you asked.” Impressive.

            There is a thing which we call “mental illness”. We could call it something else. We could call it “functional disorder” or “unknown processing deficit” or “developmental milestone impairment” or “redundant pattern-making bug” or “imagination leak” or “REM-sleep malfunction”. Point being that there is a “thing” only we know so little about it that naming it is controversial, if not, as we are seeing, downright catastrophic.

            I say, downright catastrophic, but then that’s a matter of personal taste. After Mengele et al the West formulated a new mandate: no more in vivo experimentation on human beings beyond a certain point of voluntary particpation. A new ethics.


            To get around this we have the psychiatric industry. Mad people have long been the guinea pigs of science. So too minorities. So too orphans. How to advance technologies and understandings of the brain without meddling with the brain? In some ways, psychiatry is the front of what would otherwise be unlawful human experimentation programmes. This is moving now into interesting areas. For instance, the targeted individual community. Amongst their claims are that new technologies are being aimed upon them and causing them great suffering and impairment. If they go to a psychiatrist they will invariably be considered delusional and then labeled and shooed away. Thus, the experiment is vanished with ease. Of course, how many of them are delusional and how many aren’t? It’s impossible to distinguish and so you have the perfect invisible weapon.

            Or, possibly, only a very few are actually targeted and the rest are caught up in group hysteria. But again, you have the perfect invisible weapon. And it’s been arrived at via subversion of the new ethics.

            So psychiatry performs many social functions and that is one of them. To cover up unlawful in vivo experiments. Don’t believe me? Research MKULTRA, the Kelloggs family and radioactive orphans, and the Tuskagee Syphilis Experiment. God knows what else was successfully buried and remains unknown.

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  9. ‘If your not confused you’ve been misinformed’. At least if you operate within the limits of being human. Psychiatrists might admit no such limits! Thus there’s often a natural confusion from honest appraisals. Part of psychiatry charm is to appear to remove confusion from some by asserting ‘mental illness’ but the confusion is deepened and hidden. This is an artificial confusion which robs people of the potential for truthful understanding of their troubles if any.

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    • I agree with this other than the certainty of it. Because it isn’t true for everyone. But is certainly true enough for enough people enough of the time to stand as a valid critique.

      Having said that, there is nothing stopping someone from picking up a book or these days searching the internet.

      For something so fundamental as the brain, if someone doesn’t have some measure of scepticism from the off, who are we to blame?

      Although that’s putting aside my only objection to all this palaver: forced treatment.

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  10. @ Whatuser May 27, 2018 at 3:42 pm
    “Someone somewhere must be pretty distressed at happy manic, hypomania, so called spiritual transformations, psychosis etc. such that you can be forcibly detained, coercive treated and left crippled by the process and any who might object are dismissed or equally oppressed.”

    I didn’t say that no-one is distressed by mania. I’ve been distressed by mania a number of times. I said it isn’t always distressing.

    You use the word “distress” universally and you annihilate positive experiences, you negativise the fullness of peoples’ subjective experience. What gives you the right to do that?

    But yes, many a manic joyously laughs their way through the corridors of psychiatry and it strikes me as outrageous that their joy is considered something worthy of stamping out.

    Stamping it out or denying it even happens (by negatively denoting it as distress) is bad both ways as far as I’m concerned.

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    • I didn’t say no one is distressed by mania. I’ve been distressed by mania a number of times – other people’s. It isn’t always distressing, for me or the person in a state of mania. I said someone somewhere (not usually the person in the alleged manic state of mind, maybe a family member) must be distressed enough to go looking for help and the subsequent treatment must be approved by persons claiming to offer or authorising such treatment.

      I’ve never approved of or suggested such treatment myself but do realise their is some call for interventions to ‘deal with’ extreme mental states like these. I wish humanity might progress to a point where the ‘annihilation of personhood’ was a not infrequent consequence of such ‘treatments’ and they where used sparingly if at all.

      You accuse wrongly – ‘you annihilate positive experiences, you negativise the fullness of peoples’ subjective experience’ – Having neither the inclination nor the power I avoid these common features of said treatments. So where did you get such notions from, you don’t know me?

      You seem like an intelligent person who has suffered great trauma, the best of luck to you.

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      • “You seem like an intelligent person.”

        Is that really necessary?

        Anyway, what I am, if anything, is humble, and I apologise for not being explicit about my objection to you or anyone deploying the word distress as a universal signifier for all mental strife and extremes.

        If you or anyone denotes euphoric mania as distressing you annihilate it’s beauty. It’s as simple as that. You are imposing a negativity on something which goes beyond pleasure, goes beyond all reasonable expectations of bliss.

        And yes you do have the power to deploy words as you wish. And in doing so you can unwittingly trample over the fullness of subjective experience, and, perhaps, through joining in with the idle cultural repetition of cliche, you encourage others to do the same.

        That is my objection. And that is all.

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        • I reported my reply because I got the wrong end of the stick. I apologise for getting the wrong end of the stick originally and, if my next reply to you does get through, please dismiss that too.

          “You seem like an intelligent person who has suffered great trauma, the best of luck to you.”

          I am a mildy intelligent person but thanks for the compliment. I haven’t suffered great trauma, as such. I’ve had some very painful life experiences and maybe not the best of childhoods, or adulthoods for that matter, but I don’t identify as traumatised, it would be wrong too, as, for me, I set the bar quite high on that one, and I’m way under it.

          I did dally with the idea of identifying as a traumatised person, and even dabbled with the idea of claiming that I heard voices. This only persisted for about a month. I had to stop. I was desperate to find some way out of my horrid existence, and thought that I spotted a potential opening, but I don’t have the wherewithal of a Tania Head, and couldn’t keep it going. I don’t resent the fact that all the best openings seem to be for people that hear voices and have a trauma story, but I do think it is an awful shame that, to coin the book title, there is no place in the world for me. I think I have something to offer. But — and I think mania and paranoia plays a large part in this — I tend to fuck everything up. I despair of all this, but again, I think I’m too honest for my own good, and people, in the mental health world at least, don’t seem to warm much to my style of writing, except maybe, as a bit of a side-show entertainment.

          I did a lot of work trying to get my head back after the torture-by-injection. Took two or three years to read a novel again. Novels were once my greatest love in life. I find reading novels exceptionally difficult now, but thankfully read and digested a great deal before sustaining the damage. But my problems have simply never ended. Seem unresolveable. I’ve always been open to therapy, but have never offered any.

          I think again I may have told the internet that I had had therapy and that it helped me, in the pathetic hope that some therapist would approach me and offer more. Well, I had something therapy-like once, with an undergraduate, who I thought was a therapist. Now my understanding was that I was being audited as part of a nationwide project to audit all the mad people. He wanted to know how often I masturbated. I told him 3.5 times a week, on average. He asked about the “.5”? That’s the mid-week wank, I told him. It would be self-indulgent to have a full one mid-week.

          Being tortured with forced injections was a harrowing experience, but not, for me, traumatic. In that, I don’t suffer nightmares about it, and it only affected my life in the sense of semi-permanently affecting my intellect, inducing stress-related permanent tardive akathisia and stunting my intellectual growth.

          Funny you should claim to have been distressed by mania. I accept that yes it can be distressing for other people. I’m most likely off to the stars again as I write. This one being long in the making. Problem with this one is that, despite the overall clarity of thought, sleep is impossible (I’m managing about 1-3 hours per night), I am becoming very, very agitated, and so, I think, the best thing to do, is get away, far away from people, into the mountains again, and see what happens next.

          But thanks all the same and I appreciate you putting me right.

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  11. Much valuable thought throughout this… and much complexity.

    I would revert to Szasz’s simplest understanding and prescription:

    The problem is coercion. Outlaw involuntary “treatment” and eliminate the insanity defense. That’s all.

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  12. Here are some more functional disorders:

    Irritable bowel syndrome, Fibromyalgia, Chronic fatigue syndrome, Chronic pelvic pain, Interstitial cystitis, Temporomandibular joint pain. Beautiful, beautiful language, but o so much suffering for those afflicted.

    The amazing thing about the human brain is that apparently it hides no functional disorders, according to some, despite being the most complex and least understood organ in the body.

    Apparently, according to some, functional disorders only occur outside of the brain, in much less complex systems, such as the anus.

    Of course, sufferers of conditions such as irritable bowel syndrome and chronic fatigue syndrome have to put up with a lot of nonsense from people that attempt to deny that their functional disorder is genuine.

    “You’re laying it on!” they hear, in one way or another. Functional disorders are bullshit.

    And the same happens when people have functional disorders of the brain. They are disbelieved, and even, by some, despised.

    But what about the many people that have functional disorders such as irritable bowel syndrome and chronic pelvic pain and interstitial cystitis that also claim that the brain is an impeccable and mostly perfect organ that cannot possibly hide functional disorders, despite its extraordinary complexity, and despite the paucity of understanding of how it functions?

    What of them?

    What of the people that deny functional disorders of the brain yet readily accept that they have a functional disorder of the anus?

    Very, very odd, I say, Very odd indeed.

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    • Hmm. If I went to a doctor for IBS and he forced me to take something that disintegrated my bowels, despite my protests, he could be sued.

      A lot of folks with FM and IBS don’t waste time with allopaths because modern medicine doesn’t provide many answers. Not against medicine in most cases. But in dealing with painful, chronic conditions you should figure better techniques than popping pain pills all the time.

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  13. Apparently the metaphorical term “black hole” began its life as a similie, the nudist cousin of the metaphor, with the astrophysicist Robert H. Dicke, who said they were “like the Black Hole of Calcutta”. The similie was then later converted to metaphor by the physicist John Wheeler.

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    • And, to pursue a point, someone eventually ascribed the term to an actual thing, at which point it was converted from metaphor (to accept your description for the moment) to accepted terminology. . Unlike “mental illness,” which remains a metaphor and does not refer to a “thing,” whether abstract or material.

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      • The metaphor, black hole refers to a phenomenom in space-time. By becoming a widely used referent to that phenomenom, it doesn’t cease being a metaphor.

        We agree that “mental illness” is a metaphor too. You claim the term doesn’t refer to anything whatsoever. Which is just about the most bizarrely denialist claim I’ve ever encountered in my life in a mad setting, it kinda gallops out of Szasz’s Wild West critique, right off the planet, out of the solar system, to the very centre of the galaxy, where it disappears into a supermassive black hole of absurdity.

        And for that I tip my hat to ya, fellah!

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        • I likewise appreciate your imagery. However sometimes things which appear to be perfectly obvious turn out to be the opposite.

          Just to break down what I mean, which is obvious to me, although that means little unless it can be communicated:

          The many states of thought, feeling and behavior which are labeled “mental illness” (i.e. much of the spectrum of human experience) do not constitute definable categories of anything at all. Such claims are based on outward appearances and similarities in how people express themselves, not the true meaning of their behavior, which is unique for every person. This is not to deny the reality of people’s experience, whatever it might be, but to expose and denounce attempts to define an “it” — be it “mental illness” or demonic possession — when there is no “it” to define.

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          • P.S. I would call “black hole” a descriptive phrase, but not a metaphor. Your move. (The fact that black holes blur the boundaries of space-time does not disqualify them from being “things.”)

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          • There is no such thing as a “mental illness.” The myth of “mental illness” or the metaphor of “mental illness” has caused people to believe that there is such a thing as “mental illness” to such a degree that people now assume that it is something real. A real disease is made up of scientifically observable biological and physical phenomena such as a cancer or a virus. The term “mental illness” attempts to medicalize something that isn’t even there. Some suppose that “mental illness” describes a medical condition that is manifested in certain unwanted behaviors, but it is no more medical than the dietary habits of the Easter Bunny or the hygiene habits of the Tooth Fairy. “Mental illness,” therefore, is a very powerful myth that has deceived almost the entire world. Behind this deception, psychiatry claims to offer remedies to “mental illness.” But these “remedies” are just as mythical and even more harmful than the fictitious diseases that psychiatry invents. The entire DSM-V is a clever work of fiction. The labels in the anti-Bible of psychiatry don’t describe any actual diseases, but they sure fool people into thinking that “mental illness” is a real thing.

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          • Actually they should call it a “brain disease” (since that’s what psychiatry’s disciples mean) yet the term “mental illness”persists. On some level everyone must sense “mental illness” is not literal because they churn out articles and comics entitled, “What If We Treated Physical Illness Like Mental Illness?’ They don’t even realize that by posing that question they are acknowledging that there’s a difference. Since a brain tumor is a physical condition after all, not a “mental illness.”

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  14. Matt,
    I haven’t read thru the comments: so I’m not responding in any way to any of them.

    If you want this ‘movement’ to reach some critical mass, then get it out of the domain of the “Left” and find some common ground with the other half of the country. As someone who used to be on the Right, but now, happily and firmly lives in the middle, I have grown tired of the smugness of both sides. You mention Black Lives Matter and the LGBT movement and others, and the Right would point to the defense of the unborn and a host of social outreaches that are largely missing on the Left.

    This website is so Left leaning, that it is a little tiring hearing all the self-righeous moralizing assumptions that come from the main commenters. I often wonder why the founders of the website are largely absent, and I’ve been told, moving on.

    In the past I’ve tried to argue for the key place that SO’s and families hold in turning the tide on this scourge against our common humanity, but instead I get treated more like I’m the enemy and a NAMI spy than embraced as someone who has NEVER seen my wife’s d.i.d. as anything other than a quite logical reaction to terrible trauma. And yet if we SO’s who don’t take the typical route and drug or institutionalize our mates, complain even slightly about how hard it is day in and day out to help our loved one heal and all the sacrifices it requires to do so, then we are attacked like we are shaming those with mental health issues and they should just be allowed to be whatever they want to be as if their issues occur in some kind of magical bubble that doesn’t affect anyone else.

    So, until you open up your eyes, get past your Leftist tilt, and embrace not only those struggling with the fallout from mental trauma but those in their sphere of influence, this will just be another piece of a rather tiring culture war that I’m no longer interested in partaking of. I kept my wife out of the mental health system and she is healing better than anything ISSTD can even imagine is possible, and yet I still get attacked like I’m part of that oppressive system.

    I do wish you well. One of my wife’s ‘alters’ has opened my eyes to social justice issues, and I do believe in them, but until all of us find a way to bridge the Left/Right divide and see our common humanity, instead of moralizing about the decadence of the other tribe, we will continue spinning our wheels in the culture wars.

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    • I’m a right winger myself. So is Slaying the Dragon. Communism and psychiatry can make very happy bedfellows. Ever heard of “Sluggish Schizophrenia”?

      Taking Big Pharma advertisers to court for false advertising in their commercials would be great. As a whole a major pharmaceutical company is untouchable. But taking out a smaller advertising company or even individual writers might be doable.

      And it would bring the Truth to public notice.

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      • I would challenge you to stretch your brain a bit and try to come up with a definition of “right-wing” that communicates anything other than rhetoric. Same for those who say “left” without defining it. I bet I could point out more than a few differences between the analyses of you and Dragon Slayer. For the purpose of communication I think people here should avoid such buzzwords unless they convey something clear and specific. At the moment both the so-called “left wing” and so-called “right wing” are cooperating in flying psychiatric bombing missions over our brains.

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          • Rachel777 makes some excellent points, and I am grateful that there is someone else to push back against some of the “liberal” nonsense that is so rampant. I also agree with oldhead that we need to be more clear about explanations of principles on “left” and “right,” and any “isms.” For my part, I am a proponent of thoughtful conservatism, properly understood, and many people will understand my position to be “right” leaning. But I have definite sympathies for some “leftist” concerns such as the care of the poor and the disadvantaged in society, and resistance to the so-called “alt-right.” But most importantly for this site, I am pro-liberty and pro-responsibility, a position which is naturally anti-psychiatry, since psychiatry is anti-liberty and anti-responsibility. But I am not a libertarian like Szasz, even though Szasz got most things right about psychiatry.

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          • I am not a libertarian like Thomas Szasz either, I am a libertarian like Frank Blankenship.

            How can you be pro-liberty without being libertarian? A libertarian is merely a person who places the highest value on individual liberty.

            “Libertarianism, political philosophy that takes individual liberty to be the primary political value.”


            “Libertarianism (from Latin: libertas, meaning “freedom”) is a collection of political philosophies and movements that uphold liberty as a core principle.”


            If you believe in free will you are a libertarian. If you believe in determinism, you are not a libertarian.

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          • Another term which has become meaningless to just about anyone except those who identify as such. Just like anarchism, socialism, communism, etc. I’m not saying that some of these terms don’t have “correct” definitions, but as used in MIA discussions all the “isms” only serve to confuse, something I will be attempting to correct in my own writing from now on.

            As for what is the “correct” definition of Libertarian, I think it depends which Libertarian tendency or philosophy you adhere to. Though Wikipedia in this case seems to be correct, I still think to take their word for anything is what you like to call “folly” — unless you consider factuality to be primarily subjective.

            Do you differentiate between “liberty” and “freedom” btw.?

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          • Hardly, OldHead. It’s not about identity, it’s about language. How one word means one thing and not another. Had I a curricula, I wouldn’t be dropping philosophy from it.

            I don’t take one word for it’s opposite. A libertarian should not be an slaver.

            Do I differentiate between liberty and freedom? Well, I’d have to see what the dictionary had to say about them, and that goes for any related term, too. Independence, say.

            A libertarian is a person who believes man is the master of his fate, a non-libertarian is a person who believes fate is the master of his man.

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          • We’re all libertarians now so, by Frank’s reckoning, at least in the West and increasingly elsewhere you’d be hard pressed to find any belief system not subscribing to free will, pro-liberty and at the very least struggling to be masters of our own fate.

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          • Actually, Whatuser, there are people who consider themselves necessitarians or determinists, and who don’t consider us free by nature, or for whatever reason, and there are varying positions taken between those who say we are free, and those that say we are fated.

            I was influenced by Jean-Paul Sartre who famously said that man was condemned to be free. Then I came upon Thomas Szasz holding freedom in esteem, a libertarian view, and I figured two views are not so incredibly far apart. Always one of the left, I don’t have a problem with being called a left-libertarian.

            “Left-libertarianism (or left-wing libertarianism) names several related, but distinct approaches to political and social theory which stress both individual freedom and social equality.

            In its classical usage, left-libertarianism is a synonym for anti-authoritarian varieties of left-wing politics, e.g. libertarian socialism, which includes anarchism and libertarian Marxism among others.”…


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          • Hi Frank, whether we are ‘condemned to be free’ or hold our freedom in esteem might depend on circumstance. Living under Nazi occupation and other adversities may have gifted Sartre with more difficult choices and responsibilities than Szasz.

            Most peoole here are presumably concerned about how bio-determinism is oversold, without evidence (accepting the effects of various neurotoxins) in relation to conditions ill defined by psychiatry and subsequent or prior abuses and excuses for harmful acts. We should be aware as you are that some theorists even regard free will itself as an epiphenomenon of the brain, not always even as a necessary illusion presumably. I’m not sure how we account for occasions when some people lose conscious awareness and control of their minds however. That’s a bad way of putting it as no one ever has total awareness or control of their minds but you know what I mean.

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          • A libertarian is a person who believes man is the master of his fate, a non-libertarian is a person who believes fate is the master of his man

            I’m not a scholar on this nor interested in becoming one. But I suspect that Richard if he’s out there would have a spirited response to the above. To tell you the truth it sounds like a slogan from a publicity blurb. What is truly “libertarian” is a matter of definition, and just like “left” and “right,” extremely limited in its ability to address specifics.

            Still can’t get over your using Wikipedia as a “reference,” even if it’s sometimes correct; so is a broken clock.

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          • I get the gist. I think you are going outside of the realm of ordinary experience with your example, but, as they say, ‘shit happens’.

            I think it is important, too, for people to realize that they don’t have to become a statistic. If they do, then perhaps they can be skeptical regarding the negative clairvoyant powers of bio-psychiatry from the time of their first exposure to it.

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        • I could pose the question to you, OldHead, but you apparently have an issue with the form in which it is put. Are you the master of your fate, or is fate the master of you? It’s a simple question. No bones about it.

          I never had a problem when it came to disagreeing with Richard. We do so all the time, don’t we? All the same, I hope we can find common ground in some areas.

          I’m not an anti-wikipedian if that’s what you’re implying. I don’t think the standard brand name, or the university, encyclopedia all that much more exacting than the peoples’ encyclopedia. At least, anyone can offer a correction to a Wikipedia entry, unlike the case with your more authoritarian texts, but stick to whatever you can stomach, OldHead, and I will do the same.

          I use WIkipedia as a reference all the time, in fact, and it hasn’t let me down yet.

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          • No, I’m the “anti-wikipedian” if you want to call it that. I consider it one opinion among many, not an authoritative source of anything. You must forget that “anti-psychiatry” section, which sounds like it’s written by a “mental health consumer” shill.

            Re: Richard, I’m just saying he would no doubt have a very specific set of disagreements with your espousal of libertarianism. What they might be would be for him to say.

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          • Hello!? Anybody has the ability to edit that “anti-psychiatry” section, OldHead. Even you.

            As for Richard, sure, he tends to put more emphasis on the effect of adverse circumstances than on the possibility of surmounting them. We could listen and all be waiting for the revolution to take place like the pious on some kind of a religious miracle. He has his polemic arguments to make. I don’t think that need be anything I need to kowtow to. I think we’re better off for our differences.

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          • Anybody has the ability to edit that “anti-psychiatry” section, OldHead. Even you.

            And any other clown could then re-“edit” it some other way. Is this a new concept, i.e. “fact fluidity”?

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    • Samruck2,

      Thank you for the reply. I happen to agree with what you say about common humanity, and off of the internet my world is pretty heterogeneous. I tried to communicate most of the article as such, and to do so, I committed the sin of using the phrase mental illness, which is where most people understand these issues. Ad hominem ensued, along with spirlangly insular comments, all from people I have no contact with.

      I write about other social movements in relationship to left/right dynamics because historically social movements have gained more power, voice, and support on the left, while conservatism has positioned itself in favor of traditional orders, if not in stark opposition to them. It’s a tactical decision more than anything else.

      As for a right/left issue, I’m also influenced by the work of Thomas Mann and Norman Ornstein, longtime observers of American politics. Roughly a decade ago, in their text, “It’s even worse than it looks,” they cautioned about division and bitterness in American politics, just as everyone else does, but with one key distinction: it’s asymmetrical. Democrats are insular, but as an organization they at least remain within the boundaries of inherited political mores. They identified Republicans as an “ideological insurgency” – hostile to the legitimacy of their opppstion, scornful of compromise, unconcerned with a conventional understanding of the facts, and altogether deeper and more committed to their extremes than their opposition. When in power, it poses a direct threat to the future of life, and if this is what the Right is when in power, then I absolutely oppose it. If there was any skepticism of Mann and Ornstein’s warning then, there shouldn’t be after Trump. And unfortunately, I think this obstinacy is reflected in right-wing media as well. It’s not that I don’t also want to speak to their readership and base. I very much do – I share a lot more with them than I do Roger Ailes. Wayyy more. They are not my enemy. I just don’t have faith that anything could take hold and advance from the right within their power structures and political commitments.

      For what it’s worth, I also have a distaste for the smugness one finds in the commentariat elsewhere. I write on this website because it’s one of only a few places where I have a platform. But I would love to reach out to the other half! In fact, charging towards the mainstream is exactly what I want to do.

      Perhaps we can work together, and thanks for the encouragement!

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  15. Matt, the following are excerpts from an article written by Liberty about what she calls: “Psychiatric Dogmatism”. She offers a perspective that leans neither Left nor Right, but Back.
    In a nutshell, the psychiatric establishment of today mirrors the same forms of institutional and systematic oppression, the same functions of reality-defining, law-making and king-building as the Medieval Church.
    [From the article “Talking Back to Tumblr: Swallowing Salvation”
    First published on Plurality Resource Forums, October 24, 2016]

    Apart from its critics, other fields of science aren’t treated by laypeople with nearly the devotion and certainty as is psychiatry.

    What makes a Freud or a Jung so different than an Einstein or a Hawking?
    Why is DSM called the “Bible of Psychiatry”?
    Is there a “Bible” of Geology? Physics? Biology?
    Why is psychiatry, rather than cardiology or any other field of medicine, used as a method of individual oppression and social control? One can’t be hospitalized against their will and detained indefinitely for having a heart attack.
    What is it about psychiatry that even allows for that to be possible?
    Well, we might have an answer to these questions about the secular mystique that surrounds psychiatry.
    The answer is in the word “Psychiatry” itself.
    “Psych-” “-Iatrist”

    Translated literally, it means:
    “Soul Healer”

    As organized religion lost its appeal, and spiritual understandings of human experience began to fall short of their expectations, laypeople sought meaning elsewhere.
    To the laity, “SCIENCE!™” is almost universally considered as an opposing “either” equivalent to religion’s “or”.
    Essentially, they’re seen as interchangeable.
    Even then, it is still mis-characterized and oversimplified in unscientific terms.
    Either God made us out of dirt, or we are descended from monkeys.
    The Universe is either 6,000 years old or the result of random chance.

    Science and religion are not opposing or interchangeable. They are both attempts to understand the world and human nature. Both science and religion explore the mysteries and come to conclusions based on their theories. When science finds out it’s incorrect, it will change its perspective until a new way of looking at things becomes available; and so on and so forth.
    Since religion deals more with the inter-/intra-personal, the great hereafter, good and evil, sin and salvation, it places such a heavy emphasis on being “correct” that people will murder those who think and speak differently.
    When was the last time a theoretical physicist was thrown from a building for being a proponent of String Theory?
    What is it about religion that makes it such a commonly used method of social control?
    What makes it vulnerable to unthinking beliefs and inhuman acts?
    What is it?
    The opposite of science is not religion.
    The opposite of science is dogma.

    When it comes to the nigh-universal, cross-cultural belief in a “soul” of some sort, science has a readily-available model. And given that it has the blessing and endorsement of “SCIENCE!™”, it can be considered an absolute truth.
    The Mind and the Self became the new soul.

    **Laypeople living in a post-modern desert of meaning have substituted an idolized parody of psychiatry in place of traditional religion. The practice of psychiatry has become their new church.**

    This is no hyperbole.
    In the absence of a church, the trappings of psychiatry have functionally replaced the meaning laypeople derived from the rites and rituals of organized religion.
    This is “Secular Mysticism”.

    By and large, psychiatrists do not see themselves in this way.
    But to the suffering layperson desperately seeking a better life, psychiatrists and psychiatry are the way and the truth.
    This is especially true for those who have been burnt out on religion.
    Despite their irreligion, they are used to having the truth given to them by others.
    They need stand-ins to take the place of what they no longer have.
    The secular apostasy consider a psychiatrist as, literally, a “soul-healer”; and based on their previous experiences with religion, they have every reason to believe so:
    He has a formal title and letters after his name.
    He wears special clothing, unique to his station.
    He has power bestowed upon him by an institution.
    He is wise and knows things you cannot.
    He, by virtue of his status, is deferred to with reverence.
    He is considered a “healer” and practices “medicine”.
    He has a private place where you may disclose and confess your troubles.
    He can see into your soul and knows your shortcomings, your sins; your symptoms.
    He has a book of revealed wisdom he reads from, telling you he is right.
    He gives you validation in the form of a diagnosis.
    He predicts your future in the form of a prognosis.
    He knows how to save you from suffering and live a happy life in the form of a treatment plan.
    He tells you what you must do, and if you fail you will suffer once more.
    You are responsible to him.
    You must comply with everything he says.
    You must not listen to dissenting voices; neither your own nor others.
    You must ingest his medicines, both literally and metaphorically, to keep your “mind/body/spirit” in good health.
    You must keep to meeting with him regularly at an appointed day, place and time.
    You must do all of this, for the rest of your days, or suffer the consequences.
    Much of the same regimen can be found in other area of healthcare.
    However, the gravity behind psychiatric treatment is different from other medical practices, because…

    Your sanity, your self, your mind,
    depends on it.

    This is Psychiatric Dogmatism.

    Get it now?
    -LibertyΝΥΞ (10/24/16)

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    • Christianity has traditionally referred to sin as a spiritual disease. Not to be treated with physical remedies for obvious reasons.

      Not all extreme states even count as sinful according to the Bible though. Nor vice versa. A lot of truly evil people are articulate and “with it.” Their conscience causes them no pain so it doesn’t drive them bananas.

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      • Rachel,
        I was raised a conservative, evangelical Christian and even have a ministry degree…and I’m really NOT sure I understand your statement about extreme states being sinful according to the Bible???? Now I know that some (ignorant) Christians consider my wife’s d.i.d. as a form of demon possession, especially if they would have talked to my wife’s defender in the beginning (gravelly voice filled with hatred and vitriol), but which ‘extreme states’ are you talking about that would be considered sinful???

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        • Talking to family and friends in a cruel way, cursing, ingratitude, rebellion, drunken orgies, overwhelming urges to lie or steal, physical or emotional abuse of spouse. These are supposedly “symptoms” of “mental illnesses.” And we’re supposed to go on murderous rampages if not drugged till we die.

          Belief that I had a brain disease that would make me do these things troubled me greatly. I wondered if I had a soul. Because I was a morally bankrupt monster (I believed) killing myself seemed like an altruistic act–the only loving thing I could do for those around me.

          Then I began to wonder. Despite my “diagnosis” I never did most of these things. This made me angry since by labeling a large, heterogeneous group of mostly innocent eccentrics and those drafted into the mental illness system through a bad drug reaction and branding us with the same label as depraved murderers on TV psychiatrists were insulting all who had committed no crimes at all.

          Basically it’s like sending developmentally delayed teens and random strangers off the street to live in prison with Ted Bundie type killers and telling the local population that the prisoners were all serial killers. Guilt by association inflicted by the psychiatrists who imprisoned us. Shame on them!

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          • Ah, thanks for the explanation. I guess I had a much narrower understanding of ‘extreme states’ but do see what you mean. It’s truly a shame that so many Christian weaponize their ignorance and twist so many things into ‘spiritual’ issues in an attempt to control and manipulate others.

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          • Sam, many “normal” people indulge in the behaviors I listed above. Including shrinks–like the Angry Congressman Tim Murphy.

            This has led to discussions and arguments among the experts about “bad behaviors” versus “mental illness.” They can’t figure it out–because there is no clear cut difference.

            And hearing voices/visual hallucinations/and prolonged unhappiness aren’t sins by any stretch. It’s way more complicated than most religious folks or shrinks want to admit.

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  16. Thank you, Matt Perry for the earnest article.

    I believe that there is an equivocation in the article and subsequent comments between the population of people who are diagnosed as ‘mentally ill’ with the population who are actually mentally ill. This is the cause of discrimination based upon mental diversity. The disparity—which I’ll explain—between the diagnosed ‘mentally ill’ and the actually mentally ill (often the diagnoser: abstract society) is the cause—the cause—of the discrimination against minority and/or politically-nonexpedient diversity of the mind. This disparity in catagoric identification between those who should be identified and those who are actually correctly identified mentally ill causes discrimination (so-called sanism).

    Huh?! Let me explain, then try rereading my introduction.

    My point above is that our mentally ill society does not want to improve its group mind, so—in its laziness—scapegoats individuals’ mental healths based upon political expediency. Sometimes these scapegoats minds are ill—others—and often, are not. Moreover, those scapegoated are declared ill, sometimes because they have ‘mal’-adapted in ways which might actually politically heal (and I do not believe that ‘heal’ is a metaphor) the group mind. For example, people with ‘unusual beliefs’, or people who challenge wrongly accepted othodoxies are sometimes declared ill by psychiatrists or culture.

    One big contributor to group mental illness is textual advertising. Advertisements propagate unrealistic perfectness based on the false promise that the advertised product is all that is missing to obtain the portrayed perfection. We need to be primed to a sense of illness at ease in the spirit (mental disease, if you like), in order to be susceptible to advertisement. Adverts prey on promising to fix our sense of not being at ease—all I think disease literally means, at its simplest—in order to promise the alleviation of this sense of disease.

    Those that don’t adapt well to this toxic economy are unpersoned.

    To resolve the debate about terminology, we need to first resolve ideology. The ideas are not defined, so how can we define their terms?

    Disability and disease attract discrimination and shame. When gay-rights movements correctly identified that being gay is not an illness, the rhetoric about whether their mistreatment would have been okay were being gay to really be a disease got lost. The assumption is that mistreatment of gay people was wrong, only because it is not really an illness.

    I believe that we need to not repeat this: we need to be careful that our argument is not ‘discrimination based upon mental individuality is wrong because mental individuality is not a disease’; but that our argument is ‘discrimination based on individuality of mind is wrong, just as is discrimination against the diseased and disabled; and discrimination based upon mental individuality is wrong also when the diversity is not clinical, or not clinical, but called clinical as an insult which exploits societal prejudice against the diseased and disabled.’

    We could design a new nosology which prescriptively defines disease (not necessarily wrong, and something that I am interested in), but that would be a guide for discussion rather than the DSM’s ’mental-offences’ statute. But, for arriving upon moral imperatives, I think that the person should be empowered to take ownership of deciding whether their suffering in their life is ill (unuseful or counterproductive to spiritual growth), or productive to spiritual growth. If someone wants to change a suffering or minority mental response to something, then that should usually uphold—if someone regards a suffering or other inexpedient response as a healthy response, then, providing they have the freedom to consider this, that should always uphold when it does not affect other people who don’t want to be affected.

    Therefore we need to be clear whether we are taking about mental diversity in general, minority mental diversity; and most pertinently, whether we are taking about people with mental states they regard very unhelpful, people who have mental states they on the whole are content with (including healthy suffering), people who are content in their minds, but oppressed based upon pseudoscientific mental nosologies, and, don’t forget: people who are suffering mental illness, but who have not been diagnosed by the currently pseudoscientific psychiatry because their suffering is not politically inexpedient (their suffering is usual, but not healthy, or not regarded strange). The latter group might object, perhaps popularly, to being called mentally ill, especially for those not culturally regarded strange; but they are discriminated against by sanism just as much, because they will not seek treatment. Of course, this would not be the pseudoscientific psychiatric treatment peddled by the pharma-monopolised psychoscientists who currently call themselves spiritual healers (psychiatrists).

    This latter group, the societal majority, would instead, under sanism, keep on trying to fix their sense of illness at ease (they might not be fully aware of) by resorting to drugs, junk food, poor communication gambling, unambition in their careers, working in a rut, … or becoming a practitioner of pseudoscientific psychiatry: all things big business can advertise and sell us.

    Perhaps try rereading my introductory paragraph, to see if it’s discursiveness is clearer now in light of the rest of my post.

    BTW, I am not against advertising per se, but I am against its very toxic forms, prominent and pervading in the mass-media. Advertising which respects it’s audience is vital for market democracy. However, such advertising only works on evoking mature and healthy reasoning and emotion; which would destroy the interests of big business’ sales—those that currently pivot the balance of power in the economy.

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      • I chose to respond to the need identified by Mr Perry to bring together a multifaceted social, cultural, and political analysis with my own multifaceted considerations. Unfortunately, the pseudoscientific psychiatric ethos is somewhat of a ‘Gish gallop’—it calls for a thorough rebuttal drawing together all contributory factors.

        Unfortunately, ‘Gish gallopers’ enjoy ‘tldr’. A few snappy lies, misinterpretations, and fallacies require a lengthy rebuttal. This is how psychiatrists can snack on pharma soundbites, but tldr rational analysis of the cherrypicked literature.

        A challenge of opponents of discrimination based upon mental individuality (in all its forms) is how to rhetorically respond to ‘Gish gallops’. One response is to walk away from a Gish galloper, such as a psychiatrist … but they have taken that option away from some of the people whom they supply their, erm, art. So we are drawn into having to engage pseudoscientific psychiatrists. Or, perhaps, thinking aloud, should we instead organise a boycott en mass, where psychiatrists are just ignored by their captives? Would that even be a moral request? Would it succeed? Would it be fair to some of the distressed people to expect this of them, or is my fear patronisingly infantilising distressed people away from their own agency?

        I should draw my post to a close now, before I rant another long post!

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    • Something tells me you would like the works of Peter Breggin. Our society is crueler than ever to the disabled. Although mistreatment of any but the “mentally ill” and maybe the developmentally delayed is officially frowned upon.

      Dad was teaching a class and mentioned forming movements to end discrimination. Not one student thought of the disabled.

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  17. Okay, I do have to say this:
    If you describe “social justice discourse” as “very rigid, destructive, and ultimately narrow”… to the point where you have to put up hella obvious disclaimers against anticipated criticism…
    maybe it’s time to reconsider your concept(s) of “social justice”?
    I dunno.
    Just a thought.

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    • “Social justice” dis course, “social justice” dat course — sounds like an academic problem, don’t ya think? 🙂

      I was only recently that I realized that the term had been hijacked from its original, literal meaning and now seems to be something to bs about at parties as an adjunct to scoring.

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    • Hella obvious, hella predicted, and yet it happened anyway.

      Key distinction, though: on the internet.

      I don’t think my beef if with the concept of social justice so much as with the butchered form it takes online. It’s the method that’s the issue. All disclaimers were a preemptive strike to invite a give-and-take dialogue as opposed to a one way attack. I think a little bit of that came up here. A modest gain for a modest article.

      Next time I just won’t bother with trying to appease anyone up front 😉

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  18. @ oldhead

    Your tenacity astounds me. And I happily concede the game to you, sir. Not because I don’t want to play chess, but simply because if you refuse the rules of chess (a metaphor for the rules of language) then I’m not actually abandoning a game of chess, you are refusing to play one in the first place!


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  19. Conversations like this serve to remind us how much more Thomas Szasz knew than almost anyone alive today, and that Karl Kraus knew just as much during the time when “mental illness” was popularized. Mad in America is generating a lot of garbage recently because there is such gross historical illiteracy. By all means, people should be free to express themselves and to write as many articles as they like. But reading is a good prerequisite to writing.

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  20. @ slaying

    “A real disease is made up of scientifically observable biological and physical phenomena such as a cancer or a virus.”

    To do that you need scientific instruments capable of conducting an observation at that functional level.

    There is currently no scientific technology anywhere near able to conduct an observation of brain functions, let alone the scientific knowledge-base of how the brain functions.

    But here you are dogmatically pre-empting the future of science.

    I agree with you that it’s wrong to arrogantly claim that known unknowns are actually known knowns and then dupe people with crap about chemical imbalances.

    However, given the complexities here, you read like someone that is more interested in revenge against psychiatry, rather than being openminded.

    Mental illness, such as it is, is something inferred. If you think that the human brain, unlike every other organ in the body, is incapable of functional problems, then I respect your faith (even if I also find it alarming and denialist), but I do not join with you in calling off the scientific investigation or claiming that all the inferred evidence of functional disorder is wrong and does not cause tremendous suffering and disablement.

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  21. Managing the perceptions and language of Joe Public seems like a rather tall order. I wonder if something can be achieved by trying to define what we expect of the major stakeholders – a big picture framing of ideas that people might be able to unite around? Rights would seem like a good starting point.

    There are several big stakeholder groups:
    1. People seeking help (what to do, how to do it) and support (encouragement and TLC) – a group with diverse needs and perceptions, all of whom want to be treated with respect and expect the professionals who serve them to be well informed and trained (rights)
    2. Professionals who offer “services” – are they clear on who they are serving? We (society) have installed a conflict, charging some of them with protecting society “from” individuals they deem to pose a risk. How do we know they are up to date on best practice or progress in their field?
    3. The associations that represent and speak on behalf of their professional members – I recall a Bob Whitaker article on this site that pointed out that the APA mission is to serve the interests of the profession, rather than the customer. That is a high value target we can petition – who should they serve?
    4. Family and friends – it seems to me we could do much better at educating this group and coaching them to provide helpful support, instead of leaving them to “cope” in the hope that a tablet will make the problem more manageable
    5. Government – have we done enough to engage policy makers? Surely we can expect our government to make sure that psychiatrists are properly detailed (what a pharmaceutical rep is tasked to do when marketing to a doctor) in how to help a service seeker make an informed decision. Surely we can demand that every psychiatrist has a leaflet that points people to alternatives. My doctor asks me a few questions once a year about my state of mental health – a form has to be filled in. Surely we can demand that psychiatrists certify at each new prescription cycle that they have taken proper steps to inform the service seeker of the options/alternatives, benefits (and explain them), the cons – those side effects are real, not just statistics that the psych accepts as a good trade off. Since we know that the “evidence” in this field is stuck in the past, can we not lobby a group of respected professionals from say ISPS to draft “best practice” … instead of relying on the idea that an individual psych will be informed and up to date. If drug companies can “fast track” development cycles on drugs with promise, then how can we leverage that to fast track new evidence into best practice and task the government with ensuring that the gatekeepers, those ‘diagnosing’ are in fact working from best practice. Surely we have that right. (I realize some will say that government are part of the problem – they are also potentially the best point of leverage)
    6. Joe Public – let us campaign for education at schools. Catch em early I say.

    It seems to me that Joe Public is the most difficult group to influence – and they are not participating in Mad In America discussions. We are a diverse a group – it would be good to chunk the debate up to a point where we do have a shared need (respect, rights, realistic expectations of professionals and a way to ensure them).

    Here is a straw man that says let us find a few initiatives ( < 5) that target high value levers in the system, framed at the level of rights, of what we can expect from our institutionalized organizations:
    1. A bill of customer rights in plain english – I should find one in every practice waiting room (there are several out there from other countries). There are people that seek help, denying that there is a problem seems unhelpful.
    2. Let's get a band of INFORMED professionals and service seekers in the system (preferably global with UK, EU nouse) to develop best practice guidelines that a service user can reference in a discussion about choice and consent, instead of leaving it to the professional. When the Mayo Clinic website still says " Schizophrenia requires lifelong treatment, even when symptoms have subsided. Treatment with medications and psychosocial therapy can help manage the condition. In some cases, hospitalization may be needed" we KNOW this is not best practice. Frankly, I think that puts them and others in the same boat at risk, legally.
    3. The "fast track" idea appeals to me. How can we get a trio of universities to champion recent research and learnings into best practice policy at government level? Government should be higher than psychiatric associations in the power hierarchy.

    Is there a news organization that we can get onside? We need a Rachel Maddow or Anderson Cooper to take an interest to raise our visibility. Or … how do we tie in to an existing platform that is more public? On here, even if we disagree, we are preaching to the converted. And arguing about political correctness is a dead end in my opinion.

    We need a few ideas that unite us around a cause (something simple and actionable) instead of defending our experiences as 'normal' – when people can't even relate to it.

    I am not suggesting any of this is easy and I cannot claim to be much of an organizer – I am simply suggesting that we might be better served if we focus on a few things, phrased positively in language that Joe Public can relate to.

    I am hoping someone will see something, say something that sparks an idea…

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    • My man! This is a smart and appreciated comment. Thank you, thank you, thank you.

      “It seems to me that Joe Public is the most difficult group to influence – and they are not participating in Mad In America discussions. We are a diverse a group – it would be good to chunk the debate up to a point where we do have a shared need (respect, rights, realistic expectations of professionals and a way to ensure them).”

      I think you hit the nail on the head. Speak to the middle ground amongst a broad mass of people. Would require a mainstream platform that for now seems non-existent, though I am certain that there is a large, large population who would like to see these issues addressed, given how widely they impact people.

      “2. Let’s get a band of INFORMED professionals and service seekers in the system (preferably global with UK, EU nouse) to develop best practice guidelines that a service user can reference in a discussion about choice and consent, instead of leaving it to the professional. When the Mayo Clinic website still says ” Schizophrenia requires lifelong treatment, even when symptoms have subsided. Treatment with medications and psychosocial therapy can help manage the condition. In some cases, hospitalization may be needed” we KNOW this is not best practice. Frankly, I think that puts them and others in the same boat at risk, legally.”

      Here in illinois, there is a group called the Paychothrapy Action Network (PsiAN) working on that, along with some of the earlier points you raised about public participation and education.

      Does anyone else know of organizations that are doing similar work?

      “3. The “fast track” idea appeals to me. How can we get a trio of universities to champion recent research and learnings into best practice policy at government level? Government should be higher than psychiatric associations in the power hierarchy.”

      That’s a good question. What institutions are doing research that we want to see put in practice? I know the University of South Florida has interesting mental health programs, and there is a small number of Disability Studies Programs in the US that may have something to offer.

      As for mainstream figures – I don’t know who is and isn’t sympathetic. There is a trend amongst famous people of identifying with a psychiatric diagnosis, generally with affirmative, pro-social intentions. There ought to be somebody who is winnable there, and who could be an advocate. But right now, I don’t know who.

      You mentioned Maddow – she had an unfortunate incident at the start of 2017 about guns and mental illness. Seems to really, really believe in assumptions of violence and mental illness. As for her views on the rest of the system, I don’t know. But that was an infamous moment, and one which will be hard to overcome, barring annadmission of fault and an apology.

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      • Maddow and others believe in a direct correlation between “mental illness” and violence because the “expert” shrinks on television tell everybody how dangerous all the “untreated SMI” are. No other medical profession talks that way about those it wishes to help. Or claims to wish to help.

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        • The end goal is a better form of help. Psychiatry may or may not be part of it.

          In the “hearing voices and extreme states” field for example, there are several non drug approaches that are making progress through the research process:

          From King’s College London are:
          – The Avatar Study – which helps people face persistent and bullying voices to change the relationship with the voices they hear.

          – SloMo – an approach to help people slow their thinking down to find alternative interpretations of voices that are less distressing. When it works well the NHS will make it available via an App for free.

          From Vestre Viken Hospital Trust in Norway, is a form of exposure therapy used to help people better control their experiences and avoid the need for drugs, applied across several ‘conditions’ including psychosis:

          I myself apply variations of these three to prevent the recurrence of psychosis, to create good experiences in the mind (instead of defending the subjectivity of extreme states as ‘normal’) and achieve good outcomes in life. I have knocked off the extremes. Being in control of your experiences is easily more rewarding (literally) than mania and/or paranoia.

          btw, Mania is a problem in how it distorts our sense of priorities. It may feel good in the experience, but does not translates to a sense of achievement in expressing ourselves with others. Viewed in the longer term it is a distraction from creating a story that brings appreciation, respect, progress, independence. I prefer to assess the effect on my story rather than to defend mania as a good experience (nobody cares).

          I developed my variations on these three ideas independently based on my practice of Neuro Linguistic Programming:
          – I made caricatures of the voices I hear to exaggerate their worst characteristics and gave them childish names to minimize their claims to power. I name them, define them, own the relationship and shut down the formation of unhelpful beliefs about them.
          – I use a simple interrupt/replace technique from NLP to own the interaction with voices which is the experience in the moment. I create good experiences by dismissing voice stimuli and bringing my attention to real world stimuli, mindfully, to proactively stimulate a good reward progression. I choose which stimuli to give significance to.
          – I mapped themes I had become sensitive to. You find them in the topics in which voices are busy, where the reaction/response is paranoia, mania or reticence. I mapped them against my goals to eliminate those that do not matter in my story, then addressed the remainder in my interrupt/replace as a form of exposure therapy until my sensitivity to them faded to nothing.

          I have three other simple tools that I apply to help create the conditions for success. These are self help tools that anyone can learn to apply. I prevent psychosis and have no need for a psychiatrist or medication in spite of voices that have been particularly cruel.

          In simplest terms I formulate my understanding of the ‘hearing voices’ experience as a natural response to weird stimuli. I simply had to work harder at filtering that information to reestablish emotional equilibrium. Once done, the maintenance effort is low.

          The same ideas are applicable to some other states such as anxiety, depression and OCD. It helps to think of of them as “states” we can change, given the know how in practical tool format. Using simple mind strategies we can use information to create better experiences and to feel more in control of them.

          Whilst I have made psychiatry irrelevant to me, I don’t go so far as to dismiss the idea that there is possibly a place for prescription drugs, bio feedback mechanisms, imaging or some novel technique in offering point solutions or in helping create the conditions for success, in some future version of psychiatry.

          There is little doubt to me that a form of best practice will emerge because it helps us learn from others and shortens the lead time to success, however we choose to define it. Some group will be the curators of that best practice and work to keep it current and available.

          Will it be Psychiatry? The question is at what point does new evidence overtake the current model and is the new evidence psychiatry, or psychology, or NLP for that matter?

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          • Many disagreements on MIA stem from difference of experience. Some of us felt fine but got locked up by meddling family members. Others needed emotional help like I did.

            I was afraid to leave my dorm room and took to sleeping non-stop from fear of facing other students. Sounds weird now. But ugly church politics and a whispering campaign against Dad led to our family’s homelessness after my freshman year of high school. As the new kid I decided not to try to fit in. After several moves I was sick of fighting my way into a new herd. Hard for teen girls anyhow. Like a lioness kicked out of her pride or a she-wolf banished from the pack.

            The kids took to gossiping about me and bullying/sexual harassment every day. Finally got to college, but had social phobias without my family support to fall back on.

            A more insightful therapist could have used exposure therapy to help me overcome this fear. Maybe let me take a semester off to do it. Getting sucked down the psych rabbit hole made me lose 4 years in getting the degree and wrecked all hopes of any career.

            But Brian–bless his heart–thought psychiatry might have answers he didn’t.

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  22. Funny how people love to use the word “we” without defining whom is supposed to be included in this presumably enlightened group. In any case the interest expressed by the main participants in this discussion seems to be social engineering and “mental health reform,” bypassing any mention of WHY or for the benefit of whom, and based on the undefended hypothesis that psychiatry should exist.

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