Sunday, December 4, 2022

Comments by Emily Cutler

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  • Hi Dr. Kaplan,

    Thanks to your reply to my comment. I appreciate your recognition of the injustice of food deserts.

    I beg to differ on the idea that there is no evidence of insufficient caloric intake in North America. According to the Alliance for Eating Disorder Awareness, 1 in 5 women struggle with disordered eating or eating disorders. 46 percent of 9-11 year olds and 82 percent of their families report being on diets, and over 30 million Americans have been diagnosed with an eating disorder. To me it is very clear that disordered eating, which often involves caloric restriction/insufficient caloric intake, is a major issue in the US, and messages that promote rigid food rules and overly simplistic categorization of food as either “healthy” or “unhealthy” absolutely contribute to this.

  • I wanted to leave a comment on this article because as someone with involvement in both the social justice informed mental health/critical psychiatry world and the eating disorder community, I was troubled by what I felt to be an extreme misinterpretation of the results of the Minnesota Starvation Experiment.

    In the Minnesota Starvation Experiment, the food intake of 36 young men was limited to around 1500 calories per day. The purpose of the Minnesota Starvation Experiment was to study the effects of starvation and specifically, to study how to refeed victims of genocide during WWII.

    Like Dr. Kaplan and Dr. Rucklidge stated, 100% of the young men in the study experienced symptoms of depression, anxiety, ADHD, and/or psychosis as a result. (One man was so deeply impacted by the starvation that he cut his fingers off.) However, in this article, Dr. Kaplan and Dr. Rucklidge attributed these symptoms to nutrient restriction and compared the caloric restriction involved in the Minnesota Starvation Experiment with the consumption of processed foods today. There is no evidence supporting this claim or comparison.

    What the Minnesota Starvation Experiment does tell us is that caloric restriction can be quite dangerous. Inadequate caloric intake is far more dangerous to the brain and body than the consumption of any particular food or type of food.

    For many people, processed foods may be an affordable way to meet caloric needs. For some people, it may be the only way they have available right now to meet their caloric needs during this time. It can be a good thing to eat processed food – it is a much, much higher priority for the body to receive ENOUGH food than for it to receive the “right” kinds of food.

    The Academy of Nutrition and Dietetics recommends an “all foods fit” approach to nutrition and suggests that all foods in moderation can be part of a healthy, balanced diet. The reality is that the vast majority of us (excluding those of us with specific medical issues/allergies/sensitivities) need a combination of starches, fats, proteins, fruits, and vegetables in our diet, and all foods can offer us at least some of these macronutrients. Advocating that individuals restrict particular food groups or adhere to rigid food rules, especially without discussing the dangers of insufficient caloric intake, can lead to disordered eating and promote unhealthy relationships with food.

    For further information, I suggest looking into intuitive eating ( and the Food Psych podcast (

    Here is a summary of the Minnesota Starvation Experiment:

  • Hi all,

    Steve is taking a couple days off of moderation so I am stepping in temporarily (he will be back tomorrow). I really appreciate the discussion and perspectives being expressed here.

    However, I would like to ask that comments remain on the topic of the article, which is about the New Yorker article on Laura Delano. You are welcome to debate politics/economics via email or other personal communication.

    Thanks very much,


  • Hi all,

    Steve is taking a couple days off of moderation so I am stepping in temporarily (he will be back tomorrow). I really appreciate the discussion and perspectives being expressed here.

    However, I would like to ask that comments remain on the topic of the article, which is about the New Yorker article on Laura Delano. I would also like to ask that comments remain respectful of Matt Stevenson, whose death has had a huge impact on the Mad in America community and is still a very sensitive topic.

    Thanks very much,


  • Hi everyone,

    Thank you so much to all of you who contributed to the conversation! I really appreciate all of you who have shared your experiences with and perspectives on mental health care. This discussion has touched on so many important topics – abolition vs. reform of the mental health system, alternatives to psychiatric hospitalization, psychiatric drugs and withdrawal, and human rights.

    At this time, I will be closing the comments section, as I feel that most of the comments that have been coming in are off topic and have led to some arguments including personal attacks. Please feel free to continue the discussion in a respectful way on our forum.

    Best regards,

    Emily Cutler
    Community Moderator

  • Hi everyone,

    Thank you so much to all of you who contributed to the conversation! I really appreciate all of you who shared your views and perspectives about the way consumers/survivors are treated in both clinical settings and policy/research settings.

    At this time, I (as moderator) will be closing the comments section, as I feel that most of the comments that have been coming in are off topic and have led to some arguments including personal attacks. Please feel free to continue the discussion in a respectful way on our forum.

    Best regards,

    Emily Cutler
    Community Moderator

  • Hi Julie,

    I got “critical psychiatry” from MIA’s mission. MIA has always explicitly been identified as a critical psychiatry webzine, in that it publishes a broad range of views and perspectives critiquing the drug-based paradigm of mental health care, although it also does publish many antipsychiatry pieces.

    I personally don’t identify so much with critical psychiatry as anti-paternalism and cognitive liberty, but those viewpoints intersect with critical psychiatry and antipsychiatry.

  • Hi Richard,

    I remember that blog well! I read your comment and I think I mostly agree with it. In general, I tend to get frustrated with the idea that someone is either an oppressor or oppressed, and I think there are a lot of benefits to looking at how oppression plays a role in all of our lives and how we can all benefit by ending oppression, regardless of the varying degrees of oppression or privilege we experience. (Although I do also think it is really important to acknowledge that some traits and identities are more oppressed than others.) I’m not sure that this is exactly what your comment is saying, but that’s my general critique of identity politics.

    And YES, LGAT philosophy is almost exactly like “The Secret,” Law of Attraction, neoliberal “bootstrap theory,” and other standard victim-blaming ideology. It’s also similar to the prosperity gospel and a lot of religious ideas. The umbrella term for a lot of these ideas is the “just world hypothesis,” or the idea that the world is fair and people get what they deserve. You might enjoy a piece I recently wrote about victim-blaming, LGATs, psychiatry, and the just world hypothesis:

  • Hi Richard,

    Thank you so very much for your kind words and feedback, both on this piece and on my LGAT piece (I know the latter is fairly long, so I really appreciate you reading it!).

    I often look back on my LGAT experience and think that my real work in the movement for the human rights of people labeled “mentally ill” didn’t start until after that training. It was the training’s ideology that compelled me to reclaim what principles of the movement I do and don’t stand for, and carve out a space and a voice to embody those principles. But it was the training’s coercive and cult-like nature that helped me understand the importance of having spaces like Mad in America where a multitude of voices and sets of values can co-exist.

    I really do appreciate your voice here in speaking out against Scientology and standing in solidarity with cult survivors/victims. And I hope we can stay in touch as well – it would be awesome to meet up when you’re in Florida!

  • I’m actually not only opposed to involuntary treatment.

    I’m an abolitionist of the prescription system, with the exception of antibiotics – I think people with varying degrees/types of medical expertise can play an important role in providing advice and consultancy on the effects of substances, but I don’t think anyone should get to decide for someone else what drugs they “need” or “don’t need” to take.

    So, in short, I don’t think anyone should be told by anyone else that they are “mentally ill” and “need” to take drugs or be in some sort of treatment. But, just like some people get tired sometimes and like to use caffeine (e.g., me), there might be some people who get anxious sometimes and want to use benzodiazepines or who are unable to focus sometimes and want to use stimulants. People with expert knowledge on these drugs could potentially play an important role in advising people on the effects of those substances.

    If you’re interested in learning more about prescription abolition, here’s a good video of a presentation by David Cohen on the topic:

  • Hi CatNight,

    Thank you so much for your feedback – both on my article and on MIA’s moderation!

    Just to clarify, I am a psychiatric survivor (although I prefer the word victim) – I have been involuntarily committed and coercively drugged. My experiences certainly weren’t as violent as many people who speak out every day on MIA, but I approach this work from my perspective as a victim of psychiatric violence, not as a professional.

    The Gathering Place does sound like a lovely model and I’m really sorry that you were denied the chance to start a similar program for people affected by trauma. I’m sure it would’ve helped so many people. It is really awful that the only “help”/support most people have access to is through the oppressive medical model.

    Good luck to you as well!

  • Well, I think one reason that there is a lack of movement unity is that there are so many different causes of mental suffering. There are often many different causes for each individual’s mental suffering. I like that Mad in America is a space where everyone can share the meaning they as an individual have made out of their mental suffering. (I like that it is also a space that sometimes acknowledges that mental differences don’t necessarily cause suffering in of themselves.)

  • Thank you so much for completing the survey! I really appreciate you taking the time to share your experiences.

    I agree that institutions of higher education can absolutely be horrifically coercive and promote some awfully oppressive ideas about “mental health” and people labeled “mentally ill.” I actually considered this a lot before deciding whether to go to graduate school. I’m sure that I’m not even close to prepared for the level of complicitness I will be engaging in by pretending to agree or not standing up to these ideas. But I believe that I have made the best choice available to me in choosing to study under a professor who has worked to promote critical psychiatry ideas and center the voices of people with lived experience for years, and at a university where three other professors have written for MIA! One professor in my department even worked with Judi Chamberlin for a while. So I hope I will get to stay true to my values and my voice at least most of the time 🙂

  • Wow, thank you so much, Oldhead – that means a lot 🙂 I agree that Steve is going to be an amazing successor.

    I will definitely continue to post on MIA on occasion, especially to keep people updated on opportunities to participate in research.

    You might also be interested in taking a look at a blog I started with a friend from Vermont Psychiatric Survivors, I post there fairly frequently (although I’m sure I’ll have less time to do so when school starts). It’s not meant to compete with MIA in any way since it’s more of a blog for people with lived experience/survivors and it focuses on the abolition of paternalism, not specifically psychiatry.

    I do, by the way, consider myself an abolitionist of the coercive system of psychiatry – in that I am an abolitionist of the power anyone has to declare what is or isn’t “mentally healthy” for anyone else, and in doing so force or deny access to drugs/disability accommodations/human rights. I’m pro choice on drugs though and see MIA as playing an important role in providing people with informed consent. I hope that helps clarify.

  • Thank you both so much for your perspectives! I hope you will participate in the survey.

    I define critical psychiatry really loosely – as any perspective that is critiquing the current paradigm of psychiatric care. That is the mission of Mad in America – to serve as a platform for a variety of critiques of our current mental health system.

  • Hi all,

    Frank, it is perfectly acceptable to critique the receiving of mental health services as you have above. What is not okay is calling mental health consumers derogatory names such as “wastrel.”

    Oldhead, it is also acceptable to make arguments, as you have done above, as to why mental health professionals may be similar to the gestapo. But it is against our posting guidelines to refer to all mental health professionals as “the gestapo” or “Nazis.”

    The key here is to stick to criticizing ideas, industries, systems, organizations, etc. and not individuals. I hope that makes sense.


  • Hi all,

    I want to clarify that it is perfectly acceptable to criticize the mental health field/industry on Mad in America – in fact, that is the purpose of our site!

    However, it is against our posting guidelines to call mental health professionals or mental health consumers derogatory names. I moderated two comments calling mental health professionals “the mental health gestapo” and mental health consumers “wastrel.” Please make sure to keep your comments and criticisms respectful.

    Best regards,

    Emily Cutler
    Community Moderator

  • Yeah, that’s fair. I myself am pretty critical of all the mental health professions or the idea that mental health professionals are needed. However, some people choose to seek support from mental health professionals for whatever reason, and it would be nice if they could receive support that is affirming of their differences/extreme states/etc (if they would like).

    Also, sometimes people are required to go to therapy by their school, parents, workplace, or other system. I think it would be great if the professionals they were required to see could tell their parents (as an example), “There’s actually nothing wrong with your kid, and just accepting them for who they are would go a long way.”

  • Hi Oldhead,

    I think the idea of Mad Pride is about reclaiming “madness” from its usual meaning and connotation in the public and in psychiatry. By and large, “madness” is seen as irrational, pathological, dangerous, etc. To me, Mad Pride is about saying that “madness” isn’t necessarily any of those things. Just as the word “queer” used to be associated with being weird, strange, different in a negative way, etc. – and queer studies/the LGBTQ movement has shown that being queer does not mean any of those things and can be celebrated just like any other form of diversity.

    I also think that one standard, traditional definition of “madness” is some sort of abnormality that is only present in one distinct category of people – the idea that there are mad people and sane people, and these are two separate categories. Mad studies scholars question that notion and instead emphasize the universality of the experiences that are constructed as “madness” within society. So to me, Mad Pride is not saying that there is one group of Mad people to be celebrated, but rather that we can all celebrate and value the “madness” within us, instead of pathologizing it or seeking to treat it through psychiatric means.

    Hope that helps clarify!


  • Hi streetphotobeing (and everyone else),

    Just want to acknowledge that I completely agree with your criticisms about the vast majority of mental health professionals. I agree that the institution of mental health/psychiatry is an oppressive one.

    But I also think there are some professionals (who are in the minority) who want to learn about non-pathologizing ways of supporting people in distress who just haven’t been given access to the right information and perspectives. So I think this is a good opportunity for those professionals.

    A few decades ago, almost all mental health professionals saw LGBTQ identities as something to be pathologized and cured. Now, many mental health professionals practice LGBTQ affirming therapy hat helps queer people accept who they are and cope with the oppression they face. I think bringing mad studies to mental health professionals could potentially pave the way toward approaches to therapy/counseling that affirm people’s differences, extreme states, natural reactions to oppression, etc.


  • Hi Oldhead,

    Thanks for your comment!

    As I said above (and I know we disagree on this), I think there is value in reclaiming and redefining the term “madness.” I think a lot of mad studies scholars (and for sure the ones who are part of this series) do an excellent job pointing out both the social constructedness and the universality of what we consider “madness.”

    I also don’t see how it is offensive to introduce mental health professionals to the perspectives within the field of mad studies. To me it seems that if professionals would want access to and are willing to learn non-pathologizing paradigms and approaches to extreme states/distress/differences then it’s a worthy pursuit to give them those tools.


  • Hi Dragon Slayer,

    Thanks for responding to my piece – it’s nice to hear from you!

    I think you make a really valid point. To what extent does the idea of reclaiming “madness” reinforce the arbitrary distinction between those who are considered “mad” and those who are not? To what extent does it reinforce the idea that those labeled “mentally ill” are irrational or pathological?

    To me, Mad Pride is about embracing the “madness” within all of us. Most mad studies scholars acknowledge that “madness” is, to some extent, universal, and that it’s not representative of any sort of abnormality or pathology/illness. That to me is a pretty strong rejection of psychiatry.

    I also think that there is some value to reclaiming and redefining the word “madness.” The LGBTQ movement has had success with that. The word “queer” used to mean weird or strange – and have very negative connotations – and it is now an identity and a way of being that is seen as something to be celebrated and accepted. It is my hope that “madness” can be seen as something to be celebrated and accepted as well. If madness is celebrated and accepted then it would no longer make sense to forcibly cure it or lock people up for it.


  • Hi Sam,

    Thanks so much for sharing your thoughts!

    I wanted to mention that Skylar and Missy Freels, who are part of a multiple system, will be presenting in our “Leading Mad Lives” panel in September.

    I also believe Ron Unger has written about dissociation on MIA and may speak a bit about this during his webinar.


  • Hi Richard,

    I think you bring up a good point. You’re right that capitalism and corporations play a big role in this. Income disparities leave many people without access to nutritious food and that is absolutely an issue that needs to be addressed. I believe that people should be able to make whatever food choices they want to, and of course that includes having economic access to all those choices.

    But I will just reiterate that I don’t see “obesity” as indicative of an unhealthy lifestyle, and I don’t believe it is my place to ever judge what is or isn’t healthy for someone else.

    I do, however, feel that shaming is hurtful (and therefore probably unhealthy) for most people. And I do think that saying someone’s physical or mental way of being should be cured/treated – even through bringing about the end of capitalism – comes across as somewhat shaming.

    I think what your analysis is missing is the ways capitalism convinces us that “obesity,” just like “mental illness” is a problem in need of fixing. The diet industry, fitness industry, wellness industry, etc. all profit off people’s moral panic about “obesity” and efforts to lose weight. The end of capitalism would also most likely be the end of pathologizing people’s body types.

    I myself have sensory issues and trauma issues that prevent me from being able to exercise or eat a lot of “healthy” foods. Those issues will stand regardless of what economic system is in place. What would not stand is the industry that makes a profit off convincing everyone that those traits I experience are inherently pathological.


  • I don’t think weight-based commentary is only inappropriate if aimed at fat people. But there is systemic and systematic discrimination against fat people that goes way beyond occasional shaming and microaggressions – there are real income disparities, housing and hiring discrimination, healthcare denial, coercive healthcare treatment, etc. (Although people do face coercive healthcare treatment for being underweight as well and that needs to be addressed.) Just as there is no such thing as “reverse racism,” it doesn’t really make sense to conflate “skinny shaming” with fatphobia.

    Here’s a great article on the topic:

  • Hi Julie,

    Thanks so much for bringing up this important point. It’s horrible to hear that the adverse effects of drugs are ignored and fat acceptance is used in this way.

    I wanted to mention though that I have also heard of the reverse – I have heard of people being kept longer in psych wards (and therefore given more drugs) because they are fat and therefore presumed to be unable to take care of themselves. One of my priorities as an activist is to combat this and speak out against this as much as possible, and I hope to research this issue as a PhD student.

    I’m not sure of other ways to be notified of these sooner besides the weekly newsletter and social media. I think many people (including myself, before I started working at MIA), follow us on Facebook or Twitter to be notified. Others just check the website regularly.


  • Hi all,

    I just wanted to add to this thread that it feels a little victim-blaming to suggest that the solution to fatphobia and systemic sizeism is to stop caring what others think.

    Sizeism is a real and tangible form of discrimination and oppression that results in not only shaming and social rejection but also income disparities, hiring and housing discrimination, education discrimination, denial of healthcare, and yes, coercive medical treatment (the APA, for example, recently released guidelines on how to modify the behavior of fat children).

    Would you all suggest that the solution to systemic homophobia or transphobia is just to stop caring what others think?

    To be honest, what you are saying sounds a little like NAMI’s messaging, which primarily focuses on encouraging people to reduce their “self-stigma” and negative attitudes around “needing help,” instead of taking a look at the systemic roots of sanism, which would require addressing the issue of force and coercion.

    This isn’t just an issue of some individuals feeling shame or stigma over being “mentally ill” or fat. It’s an issue of societal institutions utilizing shame, force, and coercion to get people to conform to arbitrary standards of “normality” in the name of physical and mental health.


  • Hi Uprising,

    I will just say that I do know many people who feel that their lives have been saved by smoking. Many people who are withdrawing from heroin or other drugs (including psychiatric drugs) find smoking absolutely crucial in helping them get through this difficult, almost unbearably painful time. I know people who credit smoking with saving their life. So who am I to say that smoking is universally bad or good for anyone?

    Incidentally, my life has been made significantly better by having those people around. So perhaps my life has been saved, in some way, by smoking too!

    This doesn’t mean I think everyone should take up smoking or that smoking is inherently positive or that I would encourage my friends to try out cigarettes. (I feel that you have twisted my words a couple times in the comments of this post so I want to make that clear.) It is just not up to me to decide whether smoking is good or bad for anyone else. I fundamentally believe in trusting each person as the expert of their own experience.


  • Hi Richard,

    I think we might just have to agree to disagree. I am a staunch abolitionist of paternalism.

    I do support the legal right to ECT, as long as there is TRUE informed consent. I don’t think ECT should be presented as legitimate medical practice or paid for by insurance, but I think it should be legal. Much of my activism revolves around supporting people’s literal right to suicide. And so I feel that it would be hypocritical for me to support that and also police what people can and cannot do with their bodies. I happen to think very few people would ever sign up for ECT if they had full knowledge of all the risks, and I love being part of Mad in America because it is a place where people can find information about the risks. But that’s a separate issue.

    I also absolutely support the legalization of sex work. I know many sex workers who find this job empowering. I also think that the criminalization of sex work only leads to more exploitation and violence, as does the criminalization of most things.


  • Hi Richard,

    Thanks so much for reading the piece and sharing your perspective!

    Like Sarah said in many of her comments above, the issue is about choice. I think everyone is welcome to have their own fitness and health related goals for themselves, but it’s about whether they choose to maintain those as personal/individual goals or whether they choose to impose those goals onto everyone else as a universal definition of “health.” I think it’s great to take pride in meeting physical fitness goals – just as it’s great to take pride in improving one’s skill level in art, music, science, video gaming, and other hobbies. But it’s not okay to assume everyone has or should have those same goals, or think less of people for not being physically fit/choosing to focus on other areas of their life.

    I also want to point out that there are plenty of fat people who are physically fit and who exercise a lot. I say this as someone with thin privilege who chooses not to exercise – physical fitness has little to do with weight. I encourage you to look into “Health At Every Size” initiatives which promote exercise and fitness programs for people of all sizes.


  • Hi Uprising,

    I didn’t say conversion therapy should be allowed to present itself as legitimate therapy. I didn’t say insurance companies should reimburse for this as medical treatment or that it should be considered a form of “mental health care” in any way. I said it should be legal, if freely chosen (I definitely don’t think it should be legal for parents to coerce their kids into it, for example). At the end of the day, whatever happens between two consenting adults is none of my business and certainly not the state’s.

    I also didn’t say junk food is nutritious. I said sometimes junk food can contribute to one’s overall health and well-being if it brings pleasure or enjoyment into that person’s life, and Sarah and I both used personal examples.


  • Hi Sam,

    I’m sorry I didn’t reply to your comment. My time is limited because I am getting ready to move from Los Angeles to Tampa, Florida for graduate school – my road trip begins on Friday. So I have to keep my replies fairly short.

    I did want to clarify that I don’t see healing from trauma as necessarily negative. I just don’t believe it should be the required or expected approach for all cases. If your wife wants to heal and has made that decision for herself then that is great for her. But people should also have the right not to heal and to be accepted for who they are.

    I see the issue as similar to conversion therapy. There are plenty of LGBTQ people who choose to go to conversion therapy, and I think that should be legal/they should have the right to make that decision. But I also think being queer should be accepted within society and not understood as something that necessarily needs to be healed from.

    Hope this makes sense!


  • Thank you so much for sharing your story. I am SO sorry that you had to go through all of this – that sounds like multiple levels of workplace abuse, victim-blaming, gaslighting, and silencing, and I cannot imagine the traumatic impact that must’ve had on you. I really appreciate your willingness to speak out about it. I am sure that your legal action played an important role in preventing this kind of abuse in the future.

  • I’m glad you maintain that perspective – I know this is a super unpopular view, but I don’t really see how calling out someone’s privilege is all that different from what many of us have heard growing up: “Be quiet, don’t complain, the starving kids in Africa have it worse than you.” I think the message that we don’t deserve to feel sad or be in emotional pain because we don’t have it bad enough is fairly crazy-making…and similar to psychiatry!

    That said, when someone is clearly unaware of their privilege and acts like everyone can do something just because they’ve done it (e.g. “I work hard to pay my bills; poor people should just go get a better job like me”), I think it can sometimes be productive to bring attention to that person’s privilege. Hopefully that distinction makes some degree of sense.

    LOL re: going to a Burger King interview dressed as Ronald McDonald! Thank you for the laugh!!

  • Hi Oldhead,

    I just wanted to clarify that the fat acceptance movement is not just about improving people’s social lives. Fat people face income disparities, hiring discrimination, workplace discrimination, housing discrimination, are less likely to be believed in court, are held in psychiatric institutions longer due to perceived incompetence, and many other real, tangible consequences that can’t just be chalked up to “vicissitudes of their social lives.”

    I also want to point out that ostracization, lack of community, and social rejection have a real, tangible impact on people’s brains and bodies and are associated with increase physical health problems as well as increased risk for suicide. So I think dismissing the impact of social rejection can be incredibly harmful and divisive.

  • Thanks so much for the feedback. I agree with you that we should respect the rights of all people to have good nutrition and make whatever nutritional choices they want.

    Here are some sources that you requested:

    Hope this helps!

  • To be honest, the idea that it’s personal is something I’m willing to debate too, haha. Body piercings and tattoos aren’t necessarily considered personal – so why should scratching or cutting be? I think the more we are able to talk about it, the less stigmatized/pathologized it will be.

    Anyways, I’m not sure if it is a deliberate communication or not! It definitely isn’t a conscious communication since it is more reflexive/instinctive. But I’m sure there are lots of psychodynamic theories that point to more unconscious strategies it could represent. I do know that growing up, my family didn’t really talk about emotions a lot and still tends to put a lot of emphasis on external appearance/monetary values, so perhaps this was my way of requiring some sort of attention to be paid to my internal state. I really don’t know though!

    I actually read something recently about how fatness can be a way for women to take up space under a patriarchy that says we shouldn’t. I often think this is the case for “madness” in women as well – it can represent a rebellion or refusal to adjust to patriarchy. Anyways, it’s interesting how fatness can serve either the role of hiding or taking up space, or something totally different, or no role at all – it just is, depending on each person’s own particular conceptualization.

  • I think not regarding your body with shame or disgust is definitely something to be very proud of! In today’s society, where pretty much everyone is told to hate/be ashamed of at least some aspect of their bodies or minds, that is a very radical statement. I have no doubt that your own resistance to shame and disgust has empowered others to resist it as well.

    Thanks for reading my piece! Scratching up my face hasn’t been a very conscious choice for me – there are some instances when I am so panicked and dysregulated that I sort of “lose control” and end up reaching for my face (the first time I did this was when I was 7 years old, so it’s been part of how I react for a while). I do know that can have serious repercussions in some contexts, so whenever possible I try to take a step back, breathe for a second, and at least get myself to a place where I can make a more “conscious” choice to scratch up my stomach or legs. But sometimes I am in such an intense state of panic that scratching my face feels almost reflexive.

  • Thank you so much for reading the piece and for your willingness to find some common ground. I really appreciate your empathy for the pain these two groups of people have had to endure.

    I know we have had our discussions (and disagreements) about “DID” in the past. MIA recently published a personal story by two people living in one body as part of a system that do not identify as having “DID.” I thought it was a really well thought-out and articulated alternative conceptualization of multiplicity to DID. I was wondering if you had seen it? Here is the link:

    I know this framework doesn’t work for everyone and it sounds like it doesn’t work for your wife, but it might help you understand where people are coming from in wanting traits that are seen as “severe mental health issues” to be accepted and not treated or healed.

  • Yes, that is so, so true. Psychiatry is a very easy way for people to evade responsibility for the impact their actions have on others. If I had a dollar for every time one of my high school teachers said that it wasn’t the bullying I was experiencing, but an underlying mental illness that made me more sensitive, causing my distress, I would be rich.

  • I absolutely love this approach, LavenderSage!

    I think being proud of and speaking confidently about our traits that are pathologized/shamed is one of the most powerful statements we can make as activists.

    I actually wrote a recent short piece about taking this approach to my “self-harm.” I think you might enjoy it. Here’s the link:

  • Hi all,

    I just wanted to thank everyone who has contributed to the discussion about the notion of “psychiatric slavery” thus far. As this discussion has veered very far off topic from the original subject matter of Dr. Kelmenson’s article, I am now asking for this debate to close. Please keep future comments on the topic of the original post.

    Best regards,

    Emily Cutler
    Community Moderator

  • Hi all,

    The reason I have not been replying to this thread lately is that it seems like some comments are implying that people with a variety of mental and emotional differences are a burden onto their significant others and family members. I just wanted to be honest and open about the fact that those kinds of statements are pretty painful for me to hear. I struggle with a lot of self-doubt and often worry that I am completely wrong for being proud of my differences. I fear that the things I consider unique and good about myself are actually symptoms of an illness that negatively affect others. Through the process of writing these articles, I have learned that listening and believing those internal voices of self-doubt/self-criticism, as well as external voices that feed into those ideas that I am a burden, negatively affect my personal well-being and self-esteem (and, ironically, that in turn very much can negatively affect others!).

    As someone who has been the significant other of a person who experienced extreme states and identified for a period of time as “bipolar,” I will say there very much indeed was “something in it for me.” I greatly appreciated the depth of his emotions and his uniqueness. His internal experiences surely made him a deeper person and a more empathetic person, and I am grateful to have had him in my life.

    And I don’t think I am wrong to say that “there is something in it” for my current partner (and past significant others). I know for a fact that my current partner (and past significant others) is not staying with me out of obligation or because he feels that he has to heal me or fix me in some way. He is with me because he appreciates my worldview, enjoys learning from me, and feels unconditionally accepted by me. I do think that my ability to accept the very stigmatized differences in myself makes me more accepting of those differences in others, and that does not go unappreciated.

    As an assistant editor at MIA and as the writer of this piece, I am really glad that these types of discussions are taking place here, and I hope this thread will continue. I am now stepping out aside from moderation.


  • Hi Sam,

    Thanks for clarifying, and I’m glad to hear that! I know that finding a partner who allows me to decide for myself what parts of me I feel are helpful and unhelpful to my well-being/functioning, as opposed to deciding for me what I should and should not change/heal from, has been a huge part of building my self-esteem and feeling more comfortable with who I am.


  • Hi Sam,

    Thanks again for answering my questions!

    The reason I so strongly want to know what your definition is of being “dysfunctional” is because you seem to be suggesting that anything resulting from trauma is inherently dysfunctional. You seem to be saying that just because your wife and girls’ multiplicity resulted from trauma, that means they are inherently dysfunctional.

    For me personally, there are so many things about me that result from trauma that I am very proud of. Being severely bullied in school has made me much more sensitive and empathetic to people who are shamed, outcasted, and excluded in any way. Surviving coercive psychiatry has made me more passionate about fighting coercion in any way I can, as well as better able to question authority and not just uncritically accept concepts and ideas because they are espoused by authority (I know this is a trait we have in common! 🙂 )

    This is of course not to justify bullying or psychiatric coercion in any way at all. But I am a firm believer in post-traumatic growth, and I think that the qualities and cognitive/emotional/physical/existential ways of being in the world that result from trauma are not inherently dysfunctional.

    I also do not deny the reality of the incredibly distressing and awful experiences that can result from trauma as well. One of my strongest beliefs is that it is up to each individual to decide for *themselves* which effects of trauma they are okay with/proud of/accepting of, and which effects of trauma they want to heal/work on.

    I have had a great deal of experience with people – mental health professionals, friends, family members, and significant others – deciding for me which traits of mine they believe are unhealthy and dysfunctional and that I need to work through, and which traits of mine they believe are healthy and okay to keep. In Alabama, this happened frequently with my being Jewish and queer – I was told these traits could not possibly be positive or acceptable because they contradict religious fundamentalism. Later on in life, it has happened with my attachment style/fear of abandonment, my need to fidget/stim, my struggle to make small talk, and my strong emotions. I have to say that when others impose their own definitions of “health” or “functionality” on me, instead of asking me what ways of functioning and living feel best to me, it makes me feel judged, disempowered, and invalidated. It makes me feel like others do not trust me to know what’s best for myself. I really try to minimize my involvement with people who think they know what’s best or what’s most healthy for me, as this, for me, was the most traumatic aspect of being psychiatrized.

    Thanks again for listening and for the interesting discussion.


  • Hi Sam,

    Thanks so much for taking the time to answer my questions. I know I asked a lot of them so I really do appreciate it! It can’t have been easy.

    And I really do appreciate your opposition to forced drugging and hospitalization – I do feel I have much more in common with people who have your perspective than people who are on board with “mad pride” but still pro-force in some way.

    The main question I had when reading your response is about how you define health and again, how you define dysfunction. To use your example of a broken leg, this is something that causes great physical pain and suffering unless treated.

    My friends who live happily as multiples/systems are not suffering. They do struggle with the effects of societal prejudice and bigotry, but the fact that they are each multiple people in one body itself does not cause them suffering. I have witnessed glimpses of how the individual members of each system work together to support and cooperate with one another, and it is quite beautiful. I have noticed within my friends who are multiple extraordinary insights into group dynamics, conflict resolution, and interpersonal relationships because the members of their system are constantly developing these skills in order to get along with each other or peacefully co-exist every day. In my opinion, my friends who are multiple are more functional than the average person!

    So I was wondering why you think my friends need healing? What about being a multiple is inherently unhealthy or dysfunctional? Why do you think it is something that indicates a need for healing, if a system is not suffering but rather thriving as multiple people?

    I agree with you that most people benefit from having strong attachments and relationships in their life. I know I do. For me, that has nothing to do with healing a condition, though, and everything to do with having and providing companionship and support through the universal struggles of the human experience that are manifested and reacted to in each of our own particular ways.

    Happy Thanksgiving!


  • Hi Julia26,

    Thanks for listening to me. I appreciate that even though we have very different perspectives you are willing to hear me out 🙂

    I did explain to my partner before I ever had a meltdown – close to the very beginning of our relationship – that these were things that happened, and informed him of how he could best respond. So I think maybe saying something like that to a small child, in whatever kinds of language they understand, could really help. I do think kids understand much more than we give them credit for.

    The hypothetical situation you posed – in which my partner would be triggered by my meltdowns – is, to me, what relationships are all about. Meltdowns or no meltdowns, “madness”/”mental difference”/”mental illness” or not, every single relationship and partnership in the world has things like this they need to work out. What if one partner is super messy and the other is extremely tidy? What if one partner has low hearing and the other is noise sensitive and likes to speak softly? What if one partner is religious and the other is atheist? What if one partner wants to live in the city long-term and the other wants to live in the country? These are all differences that many partnerships need to work through and find a compromise on that feels okay for both partners. None of the preferences or needs I mentioned above have anything to do with a disorder, illness, deficit, or problem that either partner has. Each of the preferences mentioned above is valid. Relationships are all about compromise.

    So, in the hypothetical situation you posed, if both my partner and I were committed to making the relationship work, I have no doubt we would find a compromise that works for both of us. That might be me or them stepping out of the room when I’m having a meltdown, or both me doing my best to learn to have less frequent and less intense meltdowns and them doing their best to learn to become more tolerant of meltdowns.

    Hope that makes sense. If you’d like to continue this conversation outside of the public forum you can always email me or Facebook message me, although sometimes it does take me a while to get back to people.


  • Hi Julia26,

    In my opinion, blaming people for any reaction they have to oppression, prejudice, bigotry, bullying, and abuse is victim-blaming. Most of us (hopefully) don’t blame people for crying out or screaming when they experience physical pain, and similarly I don’t blame people for reacting to emotional pain.

    I disagree with blaming someone for their reaction to a break-up. While breaking up with someone is not abuse and the person who does the breaking up with should not be held responsible, it is only natural to feel sad and maybe even devastated when losing a relationship that has been meaningful in one’s life. When close friends of mine have come to me feeling absolutely devastated after a break-up, I take that as a sign of how much they loved and valued their relationship, not as a sign of weakness, illness, or bad choices.

    And yes, it is worth the trade-off. That is precisely what I am saying. It is worth the pain of abandonment to love more deeply, and it is worth the pain to feel happiness more deeply.

    To answer some of your final questions, I think it is okay to have a meltdown in front of your child as long as you aren’t hurting your child and as long as you explain to your child what’s going on and why you are reacting the way you are, and make sure they know they aren’t responsible. I know as a kid I very much wished my parents would express their emotions like I was. I often felt crazy and unrelatable because I was the only one in the family who seemed to be feeling things so deeply, and I almost never saw my parents express intense sadness or heartbreak – just anger. I think my life would have been different if my parents had been more comfortable expressing these emotions in front of me.

    I personally have meltdowns in front of my partner because he is okay with it. The fact that he is there with me during them and does not shame me for them actually helps a great deal, and because of that they don’t last as long. But I am always very clear with my partner that he is welcome to take a break, leave the room, leave the house, etc. if it ever gets to be too much for him.

    Hope that answers your questions.


  • Hi Sam,

    Thanks for sharing more in-depth information about what you and your wife are going through. I really appreciate your openness.

    First, a couple points of clarification:

    1) The intention of my article and my advocacy is not to say that self-acceptance or mad pride work for everyone or every type of difference/experience/trait. Some people have traits or symptoms that they themselves want to work on/fix/eliminate for whatever reason, and I support their right to do so. My goal is merely to offer a mad pride/self-acceptance perspective as an option. The dominant paradigm, positing that all distress and difference needs to be fixed/cured/changed, is so pervasive that many people do not know there are alternative ways to conceptualize their distress or differences. My intention is to give people a choice.

    2) I don’t think that mad pride or self-acceptance are at odds with your perspective. For some people, mad pride may mean acknowledging that the feelings and thoughts they are experiencing are a natural response to trauma/difficult life circumstances/social injustices/isolation. For example, growing up queer and Jewish in a pretty conservative and religious area, I often felt depressed due to prejudice and social rejection. I of course did not want to remain depressed, but I also did not attribute my depressed feelings to something wrong with myself/that I needed to change about myself, but rather to my external environment. Today, I am not *glad* that I felt depressed growing up, but I am proud that I was knowledgeable enough to pick up on the social injustice, prejudice, and discrimination occurring around me, and have a response to that. This, to me, is still mad pride.

    Second, I have some questions for you that I thought might help me understand where you are coming from a bit better. Please feel free not to answer any of these that you might feel uncomfortable with! (Also, these questions are not meant to offend you in any way, and I apologize in advance if they do.)

    1) You say that your wife’s functioning is inhibited in some way. I was wondering if you could explain more about what you mean by that? Which traits or behaviors of hers do you consider dysfunctional, and how did you decide that they were dysfunctional? For example, I know plenty of people who identify as multiples and live as systems of two or more individuals in one body. They are perfectly content living as systems and do not consider being a multiple to be any sort of dysfunction or disorder that needs to be fixed in any way. Both of the systems that I have gotten to know closely are extremely successful students, speakers, and advocates. What about your wife’s multiplicity/systemhood/dissociation makes her dysfunctional?

    I also wanted to bring up the example of not being physically intimate. While this may be an issue for your relationship, for other couples, this is not an issue, and would therefore not be considered a sign of dysfunction. Both perspectives are valid. What I’m trying to get at here is the subjectivity of what constitutes dysfunction/disorder, and I’m hoping this helps illustrate it.

    2) I was wondering if there is anything you and your wife like and appreciate about her “dissociative identity disorder?” Is there anything about the traits/experiences categorized as “DID” that make her who she is or make your relationship stronger?

    I ask because there are so many traits I have that are categorized as “BPD” that make me who I am and that I am becoming more and more proud of. For example, I think the fact that I am so afraid of abandonment makes me appreciate romantic relationships more and love more deeply than I would otherwise. And the fact that I feel emotions very intensely means that I get to feel happiness, as well as sadness, more deeply. This very much informs my mad pride/self-acceptance perspective. If there were nothing I liked or appreciated about my “BPD” traits, then I wouldn’t adopt the mad pride perspective.

    Hope this helps explain a bit!


  • Hi Knowledgeispower,

    Thanks so much for sharing your perspective. I agree that the “BPD” label is very stigmatizing.

    I did just want to say that for me, DBT was incredibly traumatic and very much exacerbated my distress. Given a choice between having to be forcibly drugged again or forced to participate in DBT, I would probably choose the drugs, which should speak for just how awful my experience was. I agree with Julie that DBT felt very infantilizing. The program I did was also very behaviorist, encouraging me to rigidly monitor my thoughts and feelings, and all behaviors I did that my therapist considered self-destructive, including picking at my nails and texting angry rants to my friends. I also had to track my “oversharing” – sharing what my therapist deemed as excessive information about my personal life.

    No program or therapy has ever caused me as much self-doubt, guilt, shame, and anxiety as DBT did. Even as I wrote this essay, even as I provide peer support which does include disclosing my own experience, I have to stop to ask myself if what I am doing is just “oversharing” – a symptom of BPD. I sometimes still feel guilty when I pick at my nails or engage in any other behavior that feels natural to how I move and physically exist in the world. I am still overcome with guilt and shame when I have meltdowns, as the message of DBT is that meltdowns occur when people aren’t using their skills effectively.

    My DBT therapist once told me that he was glad my hospitalization was so terrible because it would serve as a deterrent from future suicidal thoughts or attempts. This is just one more thing that causes me to doubt whether I am justified in feeling traumatized by my involuntary commitment every day.

    DBT was not helpful for me at all. What HAS been helpful is allowing myself to feel distress and pain, and respond to that in the way that feels most natural to me (as long as it is not harming others), without suppressing it with “skills” or beating myself up over it via tracking/monitoring.


  • Hi Oldhead,

    Thanks for clarifying about Judi Chamberlin. I guess I got confused because she played a key role in founding the National Empowerment Center (another organization I work at), which is very much tied to the recovery model and supports recovery of life from the psychiatric system and labeling, not recovery from “mental illness.” My apologies for my misconception!


  • Julie, I absolutely love your idea that using help from others can be a form of self-reliance.

    I think this is the general idea behind the independent living movement for disabled people – that people deserve the right services and supports (which can include help from others) in order to live independently in the community as opposed to in a institution.

    I of course agree with you that people shouldn’t be infantilized or told they can’t take care of themselves/need to be supervised.

  • Frank, thanks for clarifying that!

    I agree with your critiques of the recovery model. I do think that a lot of the strongest and earliest proponents of the recovery model (Judi Chamberlin, Dan Fisher) didn’t intend recovery to mean “recovery from an illness” but recovering one’s life from the psychiatric system and the mental patient role. So it is very similar to what you, Julie, are saying as well.

    I do struggle with both valuing self-reliance but also wanting it to be okay to depend on others at times. I think the disability rights movement has done great work promoting the message that just because a person may need to depend on others to care for themselves or accomplish everyday tasks, that does not mean that person is inferior to anyone else or should have any less liberty and autonomy than anyone else. The disability rights movement has been instrumental in ensuring that people who cannot care for themselves have access to in-home supports and services (if they want, and 100% on their own terms) rather than being forced to live in institutions.

    I think it should be okay to voluntarily ask for services and supports, and for all of us to depend on one another for our collective well-being. I don’t think it’s okay for “services” to be forced on someone or for a person’s need to depend on others to be used as criteria for them to be locked up.

  • Hi Frances,

    Thank you so much for your kind words, and for sharing your own story, both here and in your piece for us!

    I just wanted to say how happy I am to hear that you recognize the environmental and familial factors that shaped your experiences. It sounds like your anger was VERY justified. No one should ever be labeled with a disorder for having a natural response to neglect and emotional abandonment. And it sounds like your separation anxiety was very justified too.

    I’m so glad to hear you found your own path to healing and transcending your anger.


  • Hi Julie,

    Thank you so much for your kind words and for sharing your own experiences! I really love your perspective. I especially love how willing you are to laugh at your own awkwardness 🙂

    I do understand what you are saying about perfectionism, and I absolutely don’t think people should be pathologized or labeled for striving to get good grades, achieve lofty goals, etc. But I will just say that my perfectionism did not result from having goals or wanting to do well, but instead from a terror that my high grades or achievements were the only good thing about me, and if I stopped attaining those, I would stop being liked or approved of by everyone around me.

    Learning to be okay with my imperfections, and having friends and loved ones who support me and respect me regardless of my grades or achievements, has made my life so much better.

    My current partner recently told me that his favorite thing about me is my world view (specifically, my views on disability, psychiatry, “madness,” etc). I was so excited to hear that because that’s something that’s a pretty consistent and important part of who I am internally, not something external I have to continually strive for like grades or achievements. I will of course continue to strive to attain my academic and career goals, but it’s nice to know that if I fail, I am surrounded by loved ones who will support me.

    I hope that makes sense and clarifies what I mean when I talk about my perfectionism!

    By the way, I also love what you said about being young. The therapist who diagnosed me with “BPD” used the fact that I had changed my career goals a few times to justify the idea that I had an “unstable sense of self.” I remember asking, “But isn’t that just part of being in my 20s? Aren’t so many people in their 20s still trying to figure out what they want to do with their lives?” He pretty much flat out ignored the question. I definitely need to remind myself more often that it’s okay to not have everything figured out, and to feel at times like I’m on an emotional roller coaster, since I’m in my 20s. (I also think these things are okay at any age!)


  • Hi YetAnotherAccount,

    I actually do a lot of work in addition to my critical psychiatry/antipsychiatry work on challenging notions about what it means to be “stupid” and “ugly.” I strongly support the fat acceptance movement, which seeks to challenge the idea that being fat is unhealthy or ugly. I also am starting to learn more about efforts to critique our education system and the ways we measure intelligence. I agree with you that both “ugliness” and “stupidity” are vary both culturally and according to personal preferences.

    I would say it is the same idea with “madness.” What gets constructed as “madness” or “mental illness” very much varies according to cultural context and personal preferences/values.

    So, with that in mind, I’d like to ask you – who gets to decide how much fear of abandonment is excessive? Who gets to decide whether it is my fear of abandonment harming relationships, or whether it is our society’s counter-dependence/fear of those who are too attached/dependent? Who gets to decide which person’s fear of abandonment needs to be overcome and which person’s fear of abandonment is helpful and okay? Would you agree that the answers to these questions would all vary according to cultural context and personal preferences/values?

    My intention with this essay is to make the case that maybe having a fear of abandonment isn’t a bad thing that needs to be overcome. I don’t believe my fear defines me at all – it is far from the only thing about me, and my fear of abandonment absolutely doesn’t drive the way I act in most or all situations. But at the same time I also don’t know if it is something that I need to change about myself.

    In the same way that food tastes better and is more satisfying when we are hungry, and in the same way that people who have been unemployed may appreciate having a job more, I believe my fear of abandonment helps me take romantic relationships less for granted. So I’m not sure whether this should be changed or overcome.


  • I share these concerns too, Alex. I do think I like the term “counseling” better than “therapy” since it sounds more like advising or supporting, rather than medically or clinically treating an illness.

    And I really like your perspective that counselors are the people that can take risks with us when our partners, family members, and loved ones have too much invested to take those risks.

  • Hi again,

    Frank, I agree with you that it’s not good for people to take themselves too seriously, and a little levity/humor is always helpful! And it’s always great to have perspective.

    But does that mean people shouldn’t have personal or career goals at all, or plan the direction of their life? I know Judi Chamberlin and a lot of the strongest proponents of the recovery model have written that dreams, hopes, and plans for the future are the very stuff that helps people thrive. I have seen firsthand how helping people discover their dreams and hopes for the future can be life-saving.

    I’m sure there must be a balance somewhere?