The Experience of Survivors of Psychiatry in Brazil

Editor’s Note: This article originally appeared on Mad in Brasil. The author, Mariana Witte Lins, is a psychiatric survivor and moderator of an online peer support group for women in the process of withdrawing from psychiatric drugs.

I spent years of my life thinking that mental disorders were illnesses like any other, and that this idea was unquestionable by anyone from a scientific point of view. I myself had a psychiatric diagnosis, which made perfect sense to me. It was in a lecture at an anti-asylum struggle week event that I realized I was wrong. In it, I discovered that for a long time now, academics, health professionals and former psychiatric patients have pointed to the lack of scientific evidence that indicates that the phenomena we call mental disorders have any biological basis, and have denounced the harmful consequences of different types of psychiatric interventions.

Since then, I started to see myself as a survivor after understanding that I had suffered several forms of violence during the psychiatric hospitalizations to which I was subjected, as well as developing several health problems due to having taken psychiatric drugs since I was 16 years old.

I studied the substances I took through the website The Withdrawal Project,
created by North American survivor Laura Delano. This website also has a
platform called The Withdrawal Project Connect, which allows people dealing with unpleasant physical or psychological effects and who wish to stop or reduce the use of psychiatric drugs to talk and exchange strategies to deal with the difficulties inherent to this process, which weighs heavily on a body that has adapted to drugs.

And in 2022, two Brazilian survivors decided to create a WhatsApp group inspired by this initiative, so that we would also have this space for exchanges in Portuguese. This was the first time, as far as we know, that Brazilian psychiatric survivors came together.

In Brazil, we historically do not have movements of survivors, only movements of
RAPS (Rede de Atenção Psicossocial, or “Psychosocial Care Network”) users. What differentiates Brazilian users’ movements from survivors’ movements that exist around the world is that, while users understand that they have a disease that needs treatment and demand that this treatment be humanized, psychiatry survivors understand that they are not sick and that placing your questions, which are not of a biological nature, as objects of medicine is something inherently inhumane.

I soon joined the group, which allows women in withdrawal or thinking about
withdrawing from drugs to exchange information about the substance used and how to reduce it, as well as strategies for dealing with difficult symptoms that arise in the process. The search for a professional who correctly monitors the reduction process is encouraged and the idea is not to offer medical advice, but to provide support. Over time, the group also became a space for exchanges about adverse experiences with psychiatry in general.

There are several common difficulties. One of them is that psychiatrists do not usually
recognize problems caused by drugs, even when they appear on the medication leaflet itself, or when they are symptoms of akathisia, a syndrome that the DSM itself already recognizes as being caused by psychiatric drugs. In desperation to get rid of
symptoms, many patients try to stop taking medication all at once, developing withdrawal symptoms and being blamed for them, hearing from psychiatrists that this would be “the disease coming back,” even when the symptoms have nothing to do with it. Even when they find a professional who is willing to withdraw the drugs, they are usually unaware of the existence of a safe way to do so.

Another challenge is finding psychologists who have any knowledge of the harm caused by psychiatric drugs and who do not interpret the option of not using them as “resistance to treatment.” Reports of violence committed by professionals and adverse experiences with psychiatric drugs are invalidated. Even professionals who claim to be critical of psychiatry are only critical until the patient reaches a “psychiatry topic” such as suicide, self-mutilation or hearing voices. When patients try to bring any of these topics to the psychologist, in an attempt to elaborate on them, they hear back “Are you taking your medication?” or “Did you tell this to your psychiatrist?” implying that these are issues that should only be medicated, not verbalized, and blaming the person for what they experience: if they still feel that way, it is because they must be doing something wrong, not following treatment. This does not match reality, as many patients have been taking medications for years and feel that they are only getting worse.

Therefore, many survivors who want to work on their issues give up on psychotherapy. In my case, I only returned to therapy when I saw a psychologist posting about the psychiatry survivors movement on Instagram, because I wanted a professional who believed in me. Thus, I was able to elaborate on years of trauma caused by psychiatric hospitalizations and violence suffered by health professionals. Having this violence seen for what it is, violence, makes all the difference. For a psychologist to recognize that another professional committed violence is rare, as they normally assume in advance that the specialist, who possesses the knowledge, was right, and the person diagnosed, irrational, and wrong.

In CAPS, unfortunately the situation is often the same as in the private sector. In addition to not knowing how to withdraw medication and repeating the same blaming speech,
professionals coerce users into using psychiatric drugs, either by conditioning their participation in other CAPS activities on the use of drugs, or by threatening involuntary hospitalization for those who do not want to.

One point that becomes clear in survivors’ reports is that the suffering and reactions
caused by physical, sexual or psychological violence, common in women’s lives, are
pathologized. It is possible to see this in cases where a survivor’s anger is read as “inappropriate” because it bothers the psychiatrist and the abusive family, for example. The focus of interventions, in turn, is entirely on the behavior of victims. In fact, reports of violence appeared so much in our group that this was one of the reasons for the vote that only women would enter. Many reported not feeling comfortable with the risk of men invalidating their stories, something they have experienced before, including with health professionals. Another interesting point is that more women also appear on our Instagram page, many making it clear that they are feminists. Feminists are already accustomed to institutions that claim to be “neutral” but in fact serve the interests of the patriarchy.

But not every survivor was pathologized for being a victim of violence. Some report having experienced a particularly difficult or stressful period, seeing a psychiatrist and ending up immensely worse than when they arrived at the office, with symptoms they had never experienced before. What unites survivors is the search to rethink what was placed on them by psychiatry, and in many cases, the experience of a process of demedicalizing their own suffering, through critical reflection on their own history. When we understand that our issues are not caused by an illness, we open the door to construct new meanings. Stories that used to be “I am deeply sad because I have depression” can become “I am deeply sad because I actually lived through a very sad situation.”

The experience of exchange between women who have gone through the same situation or who simply show themselves available and supportive of each other’s pain, shows that a medical diagnosis is not necessary for suffering to be recognized and validated, nor for exchanges to occur between people with the same situation.

Today, this group has already reached its maximum capacity, with 15 participants, due to the limitations of the WhatsApp format and the capacity of the moderators, who ensure that no dangerous behavior, such as the abrupt withdrawal of any drugs, is encouraged. We encourage new groups of survivors to organize to address the issue of psychiatric drugs or other topics. We are open for exchanges, sending reports and building projects on Instagram @sobreviventesdapsiquiatria.