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 (www.intuitiveeating.org) and the Food Psych podcast (https://christyharrison.com/foodpsych).
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.
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.
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.
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.
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.
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: https://www.radicalabolitionist.org/radical-abolitionist/2018/6/5/in-defense-of-victimhood
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!
As I said, I don’t really think it should be up to physicians to say whether people need to be treated or not. They can just talk about the potential risks and benefits of crack and the person can decide for themselves whether or not to try it.
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: https://www.youtube.com/watch?v=ELnKodaEh_Y
Thank you so much for your kind words about MIA! It is really validating to hear that others share similar frustrations with “pragmatic” “pseudo-consensus” processes in other kinds of political activism.
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.
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 sharing your experiences! While I don’t understand all of your comments, I really appreciate your recommendation that more people read Szasz and I could not agree more.
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, http://www.radicalabolitionist.org. 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.
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.
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.
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.”
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.
Yes, that absolutely is suspicious and points to the fact that so-called “mental illness” is culturally constructed rather than objective and biological. And I think that is what the field of mad studies is trying to point out.
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.
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.
It really depends how you define antipsychiatry. A lot of antipsychiatry efforts focus on dismantling the coercive system of psychiatry (institutional psychiatry) rather than taking away people’s rights to access voluntary treatment or use substances.
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.
I am so glad that Bonnie Burstow will be part of the series, too! I agree that the antipsychiatry perspective is integral to learning about the Mad movement/the movement for human rights of those labeled mentally ill.
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.
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.
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.
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.
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.
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.
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.
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.
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!!
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:
-https://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-10-9
-http://www.healthyweight.net/
-https://danceswithfat.wordpress.com/2012/04/21/for-fat-patients-and-their-doctors/
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: https://www.madinamerica.com/2018/01/subtle-ways-psychiatry-harmed-us/
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.
Thank you so much for reading this and sharing your perspective! I really like the idea of introducing the word “normalism” into everyday speech. I am also a big fan of the term “toxic normality” which is parallel to “toxic masculinity” and “toxic whiteness.”
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.
Thank you so much for contributing to this important discussion. As the moderator, I am asking that you make sure all future comments remain on the topic of this article. The comments section of this article is not to be used as a platform to discuss unrelated political issues.
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.
Thank you so much for all of your comments and for this lively discussion. As the comments now are mostly off the topic of the original post, I will now be turning off the comments section.
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.
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.
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.
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.
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.
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.
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.
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.
Just to clarify, the point of that “concession” was to say that we ALL have things to work on, and I don’t have any more that’s wrong with me/to work on than anyone else.
I’m really glad to hear that you escaped from the psychiatric system!
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!
I agree with you, Julie! No one should ever be labeled ill for deciding to change their minds or explore new career options. I admire how much you’ve done in your life and how willing you are to learn new skills!
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.
Sam, I appreciate your reply so much. Thank you for providing a counter narrative to the dominant idea that we all need to assure ourselves and overcome our fears on our own.
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.
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.
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!)
Thanks for your encouragement and support, J! I really appreciate how willing you are to call out sanism, gaslighting, and other types of prejudice and abuse. Please never stop all you are doing to empower Mad people!
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.
It’s great to hear that there are counselors who aren’t interested in diagnosing and labeling people! I think many “problems” can be accommodated through counseling, whether that’s from a professional, or just support/advice from friends and family.
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.
Thank you so, so much for sharing your story and perspective. I am so sorry to hear about all the abuse you have experienced. I know that your being so open about all of it will help others going through similar struggles.
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 know there is no true cohesive “movement” – which I actually appreciate for a number of reasons – but when I talk about my job and what I do I generally talk about working with survivors of psychiatry and professionals who are critical of or antipsychiatry.
Thank you so much, Bonnie! That means so much coming from you.
And yes, I think there is a great deal of misogyny within the BPD diagnosis. Being highly emotional, valuing romantic relationships and attachments, and dependence on others are all traits associated more with femininity, and both men and women who have these traits tend to get labeled with BPD.
I also find it fascinating that for men, a lot of the “symptoms” of BPD like uncontrollable anger, impulsive binge-drinking and sex, reckless driving and spending, etc. are considered part of being “young and stupid,” while for women, these behaviors are considered “symptoms of BPD.”
Thank you so much for your poignant comment and perspective. I can relate to so much of what you are saying here. I completely agree with you that feeling emotions deeply and being highly sensitive to the pain of rejection, ostracization, teasing, etc. does not make someone ill or disordered.
I also completely agree with your perspective on groups and society in general. Perhaps this is the reason that I thrive so much in romantic relationships – when two people can build a partnership that exists in its own world and culture, relatively separate and free from ostracization, groupthink, bullying, and outcasting that can occur in larger groups, that is a beautiful thing. That’s not to say that romantic relationships and other types of two-person partnerships are always free from power imbalances or abusive dynamics, but I think it can be easier to establish equality amongst two people than in groups, where people can gain power just by having other members of the group agree with them. (I’m not sure if this is exactly what you were getting at but I think it’s related!)
I’m not on Instagram but I did send you a Facebook request (my name is currently different on Facebook). I have stumbled across your work before and I am a big fan of all you do for the benzo survivor community.
I definitely can understand and appreciate the need to distance ourselves from othering.
When I’m asked to explain “mad pride” to people who don’t know what it’s about, I don’t frame it as a movement advancing the rights of a particular group of people or subset of individuals. It’s about advancing the rights of *everyone* to experience whatever gets labeled as “madness” in their own way. Hearing voices, experiencing emotions deeply, emotional pain and suffering, and being sensitive are all examples of things that get labeled “madness” that people have the right to experience without being told they are sick and locked up, forcibly drugged, or electroshocked.
Perhaps the term “mad” is irrelevant if everyone is “mad.” I think there is some degree of truth here. Unfortunately, there are experiences and emotions that continue to get labeled as “madness,” and “mad pride” is my preferred way of describing people’s rights to have those experiences and emotions.
That’s fair. “Trying to convince myself and others that I do not have Borderline Personality Disorder” wasn’t so much about accepting or rejecting the label, as convincing people that I don’t have the symptoms/experiences that Borderline Personality Disorder is said to describe. It was about saying that I’m not really that scared of abandonment compared to the average person, for example.
This article is about saying, even if I *am* terrified of abandonment, is that necessarily a disorder that needs to be cured? I agree with you that this fear is “normal” in our toxic culture.
To me, a major part of Mad Pride or mad studies is recognizing “madness” as a universal component of the human experience. In my opinion “madness” is itself what makes us human. Without emotions, unpredictability, different ways of being and processing the world, etc., we would just be mechanical robots. So I think our views are actually pretty similar (as I believe I said in our last conversation about this), even though we use different language.
In general, a big part of my passion for this work comes from the idea that it’s unfair to stereotype every member of any particular group as being abusive or harmful. There are a lot of writers here who have presented better arguments than I ever could about the dangerous of conflating emotional distress/suffering with abusiveness or harmfulness toward others. If you are interested in that perspective, I think Phil Hickey’s most recent article is excellent. That said, I do think that those who act in abusive or violent ways are often suffering from distress and trauma themselves, and it’s also unfair to label them or demonize them. Anyways, Igor, we may have to agree to disagree on this one.
Sam, just wanted to say how much I appreciate your perspective here and admire the fact that you and your wife included your son in her healing process. I will just say that for me personally, my parents were often embarrassed of my intense emotions growing up and really didn’t know how to handle them. This is part of the reason I felt so alienated and abnormal – even my own parents didn’t know how to understand me. I often wish that they had been more open about their distress and any experiences they had growing up that were similar to mine. I think I would have felt less alone or less like there was something about me that was fundamentally “unrelatable” to other people. Instead I got the message that adults and “normal” people are supposed to suppress their emotions and not feel the way I did.
YetAnotherAccount, I’m really sorry that happened to you. That sounds absolutely heartbreaking. I honestly don’t know how I would’ve gotten through that myself.
I will just say that I don’t think it’s your thinking that was twisted. I think it was the messages you received about yourself that were twisted. I think it’s the world and society that are twisted. Your feelings after that happened to you were an absolutely natural response to all of the external twistedness.
Also, correct me if I’m wrong, but I didn’t get the sense that you’re against all therapy, just against therapy that is based on diagnosis and treatment of “symptoms” as opposed to asking clients what is going on in their lives that is causing them to feel distressed.
Thanks for reading and responding to my article. I really appreciate it.
I absolutely agree with you and have noticed a similar trend. Whenever I told my DBT therapist about self-harm urges or suicidal thoughts, the response was always, “What skills can you use?” instead of, “What circumstances are leading you to feel this way and how can we address them?” It is very rare for people to ask the question “why.”
Thanks so much for your reply. As you know, I always enjoy reading all your comments and have learned a lot from you over the past few months as moderator 🙂
One question I had – if I told you that ten or twenty years from now, I hope I am in an executive position at a nonprofit organization, or in some sort of leadership role at a non-traditional, non-coercive mental health agency, would you also tell me that I am “not living in the moment”? These career goals of mine are indeed tied to the approval of others – it is not possible to get hired or get a promotion without being approved of at least to some degree. Would you therefore then say that these goals are indicative of attachment issues?
Would you tell someone to “shrug and go on” if they lost their job? If they lost their housing? Would you say they have attachment issues if they are unable to “shrug and go on” after these events?
Thanks for sharing your perspective, Steve! Yes, this is something I am working towards every single day – caring less about what others think about me and accepting myself for who I am regardless of others’ opinions. It is incredibly difficult to accomplish that in today’s society, though, where we have a cultural obsession with self-improvement and the diagnosing/labeling of people with distress and differences is so rampant. It is also very difficult to do this in a capitalist society, where what others think of you does matter to some extent in terms of whether you will be able to pay your rent, live comfortably, have a job you enjoy, etc. (Luckily I have found jobs I love at Mad in America and the National Empowerment Center, but that still doesn’t mean I’m 100% free from the influence of capitalism.)
Thanks for the work you do and for your recognition of the societal factors that play a role in “BPD”-type “symptoms.”
Thanks so much for sharing your perspective! I really enjoy reading your comments.
I did want to mention that I think some forms/styles of therapy can be very ethical and helpful. I personally see a narrative therapist. Narrative therapists usually reject diagnoses and encourage people to see the way they are thinking, feeling, and acting as inseparable from their social/cultural context.
I do absolutely agree that the majority of therapy is sadly about changing the individual, not their environment.
And I of course agree with you that the State should be taken out of psychiatry and recovery.
Sometimes, when I try to describe our movement to the mainstream, I tell people that our movement is made up of a bunch of people who are keenly aware of how awful and screwed up the world can really be, and who have been called irrational and sick for having that knowledge and coping with that knowledge to the best of their ability.
Thanks so much, LavenderSage! I really appreciate your thoughtful feedback and kind words. I especially appreciate your thoughts on striving for self-acceptance and societal acceptance of people of size. One of my personal dreams is to see the mad pride/psychiatric survivors movement united with the fat acceptance/people of size movement. They are both about combatting paternalism and oppressive definitions of health/normality.
I agree with that. I’m definitely not on board with biological determinism or any sort of determinism – I think humans are inherently unpredictable.
I think it’s always helpful for anyone to learn new perspectives and ways of thinking, but I’m just not sure that anyone in particular or specific group of people need to learn new ways of thinking. I think a lot of people labeled “mentally ill” are thinking about the world more rationally than those who are not labeled such.
I think it’s all about how you define madness/insanity and how you define sanity. That of course is dependent upon cultural context.
At the moment, our culture constructs things like hearing voices, being sensitive, experiencing emotions deeply, grappling with the desire to die, etc. as madness. Is there any reason that we shouldn’t be proud of, or at least accept, any of those things?
In some contexts, being queer is constructed as madness. Shouldn’t queer people be proud of themselves?
Just to be clear, this piece isn’t about reclaiming the term “Borderline Personality Disorder” and identifying with that label. I definitely don’t plan to use that term to describe myself.
What I intended to do in this piece is examine the experiences/traits/”symptoms” that the term “Borderline Personality Disorder” is said to describe, and discuss whether or not those specific experiences and traits are necessarily negative or need to be changed.
So that is the part of your comment that I am most curious about. When you say, “You CAN change and learn new ways of thinking,” what part of my thinking do you think needs to be changed?
Thanks so much for sharing your perspective. Your openness about your relationship, and the way you place such high value on attachment and commitment in romantic relationships, contributed to my thinking behind this piece. I really like that you’ve pointed out our cultural obsession with independence (my roommate has a book referring to this as “counter-dependence,” a term I’ve started to use) and our tendency to encourage people to break off commitments, cut people out of our lives, etc.
I just wanted to clarify that I didn’t intend the message of this piece to be that nothing is wrong with me. I am far from perfect!! But I don’t necessarily agree that something is more wrong with me than the average person. To be human is to be imperfect. I hope that clarifies my message a bit.
I completely agree with you that Personality Disorders are pretty egregious and defamatory!
And I also like what you said about taking the labels someone gives you and using it bak against them. The notion of Mad Pride is doing just that – it’s saying, “Okay, so you think I’m crazy. You think I’ve gone mad. Well maybe I have and maybe that’s not such a bad thing!”
It’s similar to the word “queer,” I think. In the past that word was used as an insult, and now the LGBTQ community has successfully reclaimed it.
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In Mad in America’s posting guidelines, we ask that comments remain on topic and engaged with the ideas of the piece. For this reason, I am now closing this particular comment thread. All future comments in this thread that are unrelated to Kim Auth’s thoughts on conferences will be moderated.
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I have tried reaching out to you via email but have had some difficulty getting in touch.
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Thanks so much for sharing your feedback and personal experience, Julia. I am so glad that you knew to avoid Erhard Seminars and the other trainings like it. I am so sorry to hear about your experience with psychiatric abuse – thanks for the work you are doing to help others heal from this.
I told my therapist about my texts. At the time I was convinced that I really did have Borderline Personality Disorder and I needed to get well, so I was compliant with the treatment program and was honest about all my thoughts, urges, and actions.
I’m so glad your fiancé took you out of the day hospital! Even if it was mostly benign it sounds like it was not helpful.
So, so true. Being restricted and deprived of picking at my nails or having certain thoughts made me feel much more driven to do so!
I really think Borderline Personality Disorder is one of the most insidious diagnoses out there. It totally changed the way everyone interacted with me and most of all it changed the way I thought of myself.
I’m so glad you were able to get your diagnosis removed!
Thank you so, so much Julie. That was my primary goal when writing this article – to extend the conversation beyond pills (even though that of course is an incredibly important part of the conversation), and really open up a serious and engaging discussion on the ways force and coercion affect us. It is such a huge compliment to hear that I accomplished this goal!
I remember the moment when I realized I prefer terms like “crazy,” “mad,” “nuts,” “bonkers,” etc. to “mentally ill” or any sort of health/medical language.
It was right before my second forced hospitalization. I was bawling and begging not to be hospitalized. Some of my family members were present, and they said, “Poor Emily. She is just so, so sick right now that she doesn’t even know she needs help.”
It was in that moment that I realized there is something very insidious and specific about being told that a form of abuse is happening for your own good. I’d rather them say, “Emily is a crazy nutso. Lock her up.”
Also, one reason that I prefer the word “mad” to “crazy” or any of the others is that in the U.S., “mad” has the connotation of anger. I have been labeled as borderline and so many other diagnoses due to my anger. So much of my Mad Pride is about embracing that anger!
My apologies for taking so long to answer this question. DBT is Dialectal Behavior Therapy, the standard therapy for people diagnosed with Borderline Personality Disorder.
DBT consists of both private sessions and group sessions. My private sessions consisted of tracking all my suicidal thoughts, self-harm urges, and urges to engage in any behaviors that my DBT therapist didn’t like or saw as symptoms of my Borderline Personality Disorder. So every day I would rate on a 1-5 scale how high my urge was to commit suicide, self-harm, pick at my nails, eat unhealthy food, drink or use, yell, or send rants via text to my friends. If I had any urges to do any of those things, I would have to go to the board and write a chain of the event that led me to have the urge, my interpretation of the event, my reaction to the event and how that made the situation worse, and what skills I should have used instead. In group sessions, I would learn about those skills to use instead of engaging in “borderline” behaviors.
There were extremely strict rules around therapy sessions and interactions with my therapist. For example, being even a minute or so late to the session was marked on my chart (and I would usually have to write up a chain about it on the board), and if I missed more than three sessions that was automatic disqualification from the program. In addition, clients were instructed that they could call their therapists up to twice a week for phone coaching, in the case of a self-harm urge or suicidal thought. However, therapists were told to answer coaching calls coldly and curtly, so that clients would not be rewarded for their self-harm urges and suicidal thoughts with compassion or warmth.
In DBT, as with other behavior therapies, human experiences are viewed as behaviors to be controlled through rewards and punishments. Once, when describing to my therapist how I was having intrusive flashbacks about my forced hospitalization, he said, “Well, I know a lot of people who were hospitalized at the psych ward you went to. And pretty much all of them share your experience – it is incredibly traumatic for them. But that’s a good thing! It really deincentivizes future suicide attempts. Think about it – if these places had nice, warm conditions, people would be rewarded for their suicidal behavior, and they’d attempt suicide again and again to get to go back. But since these places are so traumatizing, it really scares people from attempting suicide again.”
When I became angry with him for saying that, and threatened to switch therapists, he said that was very typical of borderline patients – that I was idolizing and devaluing him. Clearly my Borderline Personality Disorder was very severe and I needed more DBT. I am ashamed to say that I bought it and stayed in therapy with him for 5 more months. In a lot of ways, my DBT experience had a bigger impact on me than my hospitalization.
As Kindredspirit mentioned, some of the skills that DBT teaches in the group sessions can be very helpful. Basic self-care tips like exercising, taking a bath, etc. instead of self-harming, or distress tolerance and mindfulness skills, can absolutely be useful. However, they are fairly easy to learn on your own or with a friend/peer supporter, or with a humanistic therapist who integrates them into their sessions. There is no need for the coercive manipulation and self-monitoring/restriction of DBT as a therapy program.
Steve, I absolutely love what you said about re-inventing therapy for every client you meet. That rings so true for me – therapy should be something uniquely individual for every single person.
Thank you so much, Julie. This comment was incredibly validating. I’ve been beating myself up for still feeling disoriented/hypervigilant (how very NOT Mad Pride of me, I know 🙂 ) even though it’s been more than two months since I had this experience. It’s good to know there are others out there who have found even a brief run-in with these programs to be highly traumatic.
Also, your comparisons of religious/spiritual/New Age cults to psychiatry and therapy are so spot on. In Dialectal Behavior Therapy I had to track all my suicidal thoughts, self-harm urges, and urges to do any sort of behaviors my therapist thought of as symptoms of Borderline Personality Disorder, like pick at my nails, eat unhealthy food, or send my friends rants about random things via text. Any time I had an urge to do any of those things, I’d have to write a chain on the board, discussing the event that led me to have that urge and my interpretation of the event, and what DBT skills I should have used instead of having that urge. Talk about confession!!
Oldhead, I want to say that I really do respect and like your perspective! I absolutely 100% agree that madness/”mental illness” is a social construct.
My understanding of the Mad identification is similar to Antipsychiatric ReprisOwl’s. From what I understand, hearing voices and extreme states are very, very real experiences for many people. And from firsthand experience I know that feeling extreme sadness after a traumatic event, having suicidal thoughts, and having meltdowns are very real experiences. The idea that these experiences are indicative of “mental illness” and necessitate force or coercion to recover is what is constructed to oppress people.
To me, “Mad” is to schizophrenia, borderline personality disorder, depressive disorder, anxiety disorder, etc. what “queer” is to homosexuality disorder, gender identity disorder, etc. All are real experiences and I think it is important for people to have words to describe them. What is constructed and oppressive is the pathology paradigm.
I also usually say words like “prejudice”, “bigotry”, and “discrimination.”
I have often been told that I am “stigmatizing” mental health services by referring to psychiatric hospitals as institutions or speaking out about confinement as a form of violence. So I do think the general public sees “stigma” as stigma against seeking treatment, or stigma against psychiatry, rather than prejudice and bigotry against people labeled/considered mentally ill.
I am a huge fan of the words ableism, sanism, and healthism as well, because they speak to the ways our society considers people with certain types of bodies and minds to be superior to people with other types of bodies and minds.
YUP. There have been a couple times when the police were called on me for having a melt down in public, and they immediately started asking me questions about my mental health and evaluating me for hospitalization. So scary!
I have gotten in so much trouble for crying in public as a woman (my high school required me to see a therapist because I cried too much about being bullied), and I can only imagine how awful it is for boys and men.
I am just now getting interested in feminist perspectives on mental health/psychiatry. It is fascinating how traits associated with femininity – like crying and being sensitive – are highly pathologized, and even more pathologized when experienced by men.
That totally makes sense! That absolutely used to be the reason I didn’t really use the autistic label or identify with the neurodiversity community. Then I got a chance to meet more radical Autistic/neurodiversity advocates who say that being bipolar, schizophrenic, borderline, suicidal, experiencing extreme states, hearing voices, etc. is all okay. That of course is rare to find (even within our community!). I do like more general terms like Mad, neurodivergent, and queer better as political identifications for that reason – to say that it is ALL okay.
I relate to that so much. I have had to learn (and am still learning) to control my emotions in public – I’ve only very narrowly avoided a couple hospitalizations now that almost happened due to crying in public. Safety always comes first, of course.
Thank you so much for sharing that, Sam! I agree that suicidality is often a completely valid and natural response to circumstances. I’m glad that it drives you to continue working on the root of the issue.
Yes, I of course think it’s up to everyone what labels they would like to use or not use! What I meant by “affirming” therapy was that these parts of people’s experiences, whatever people choose to call them, would not be pathologized as illness but accepted and embraced.
One point of clarification on autism – the Autistic community views autism as a way of being, and a part of our identities, not a disorder or an illness. So just like it doesn’t make much sense to find out if someone’s gay by seeing if they have a diagnosis of “homosexuality disorder,” being Autistic doesn’t have much to do with having or not having a diagnosis of autism. If you relate to the experiences and culture of the Autistic community, and you find that Autistic is a word that helps describe your identity and experience, you are welcome to use it. Or not. It really is up to you.
Thank you SO much, Julie, for reading my piece and for sharing your personal experience. I had read in some of your other comments that you are a cult survivor, so I was very interested in getting your take on this.
(To be honest, I still hesitate to use the word “cult survivor” for myself – I was only in this training for such a short amount of time before leaving.)
I’m so sorry that you had such traumatic experiences with both the religious cult and the cult of psychiatry/therapy/mental health. I am definitely being very cautious not to “ping pong” between different cults, although it is very hard – it feels like most groups/organizations have at least some cult-like elements.
Thank you also for the book recommendations. I am looking to start doing some reading on cults, especially New Age ones, so these look like good starting points.
Exactly! I see so much of the anti-psychiatry/critical psychiatry/psychiatric survivors community’s work as defending the radical notion that people know what is best for themselves.
I really like that distinction! “Counseling” and “coaching” imply that the professional has more of a consulting/advising role, while therapy usually implies a more medical, treatment-oriented role.
Another term I like is “affirming” therapy. I know some professionals are now practicing LGBTQ-affirming therapy, which embraces all queer identities as being healthy, valid experiences, not pathology. I think more professionals need to practice Mad-affirming therapy, voice hearing-affirming therapy, Autistic-affirming therapy, etc.
Thanks so much for your feedback and perspective! So glad to meet another fan of Szasz 🙂
Maybe I should have clarified and said “accepting 100% responsibility for overcoming distress.” I of course don’t believe that people should take *zero* percent responsibility for their emotional well-being/”mental health care,” but our instructor (and my fiancé) specifically taught that we were 100 percent responsible.
There are usually some small (or big) things we can do to improve our emotional well-being, whether that’s attending peer support groups, asking for accommodations/changing our environment, or gaining the knowledge and language to help others understand what we are experiencing and what kind of support we need. But taking responsibility for those few acts of “self-care”/self-advocacy still don’t make us 100 percent responsible for our emotional distress (just as no one is to blame if they choose not to engage in those kinds of steps).
Thank you so much for this incredibly valuable perspective! I could not agree more with you that some (maybe even most) therapy is inherently paternalistic, with one person, the “well” individual, claiming to know what is best for another person, the “sick” individual. I do think this very much describes behavior therapies.
I have had positive experiences with client-centered, humanistic therapy, so I hesitate on the idea that all therapy is inherently paternalistic or coercive. I currently see a narrative therapist who acts more as a consultant in my life and operates from a strengths-based paradigm. That has been very helpful and effective for me. But I assume this is relatively rare.
I will have to watch that Daniel Mackler video – sounds very insightful. My personal experience with behavior therapies (and society in general) is that the goal was very much to get me to suppress my emotions and be more indifferent to my surroundings.
Thanks so much to both of you for your feedback. Even though I do disagree with you, absolutewhat – I am an abolitionist on all forced treatment – I am really glad that you shared your perspective.
I wanted to add that I don’t think suicidality is ever selfish. Death is pretty terrifying, and for someone to be considering it, they have to be in a great deal of pain.
I really appreciate you continuing to reflect on my piece!
I do want to clarify and say that by no means do I ever want to suggest that Mad Pride is the end all be all and works as a panacea for everyone all the time. Ideally, I would like there to be as many conceptualizations and approaches available as possible, and people can choose how they would like to think of their own experiences, without being pressured or coerced into any particular model.
The point I was trying to get at in my essay is that all too often, people are pressured into accepting that they have a biological brain disease, or into accepting 100% responsibility for their emotions and experiences, and are not given any other option. For me personally, Mad Pride was how I broke out of that limited framework. It’s a perspective that took me a while to find, so I hope everyone can at least have the option of embracing that perspective. But you are totally right that “mental health” is much, much more complicated than just these three options. I hope that through continued writing and discussion, our community will be able to offer thousands of different non-pathologizing, non-coercive ways to conceptualize distress and difference.
I also want to clarify that I don’t mean to deny that suffering exists, or that we should just always accept our suffering and never seek to heal from it. As someone who has struggled with suicidality, I absolutely know what it is like to be in a great deal of pain and wish for it to stop. The Mad Pride perspective has helped me to understand my suicidality as a response to trauma and work through it with social support and changing my environment.
As for “healthy” vs. “unhealthy”, the notion of “health” has never been very helpful to me personally. (I did grow up in a fairly healthist household, where being “unhealthy” was the worst thing you could possibly be – much worse than immoral or unhappy – so this might just be a response to trauma from me!)
Is feeling suicidal unhealthy? Maybe. How does one define “unhealthy?” Is suicidality unhealthy because it is abnormal? Is it unhealthy because psychiatrists have agreed it is a symptom of a mental illness? Is it unhealthy because western religion has declared it a sin (therefore it is spiritually unhealthy)? Is it unhealthy because it could possibly lead to one’s death? Maybe, but in that case, is waking up and deciding to drive on the streets of Los Angeles every day also unhealthy?
In my opinion, the concepts of “healthiness” and “unhealthiness” are too often heavily moralized, vaguely defined social constructs. What has been more helpful to me personally is to ask myself, “Does this pattern of behavior that I am engaging in increase my happiness or decrease it?” And, “Would efforts to change this behavior increase my happiness overall, or add totally unnecessary stress and pressure to my life that isn’t worth it in the long run?”
Of course, if the concepts of healthiness and unhealthiness are helpful for you and/or your wife, and you are both making a choice to utilize those concepts (and it sounds like you are), then I have nothing against that!
Hope this helps clarify. And thank you again for your perspective and for your dedication to helping your wife heal in such a non-coercive, compassionate way!
Thank you! I am glad you enjoyed it. And I still feel very grateful for the work of Szasz and Foucault for helping me recognize some of the coercive aspects of this group.
Thanks so much for reading my piece and responding!
I have heard a little bit about the Alternatives to Violence Project and I have to say it sounds absolutely incredible. I definitely want to learn more about it and hopefully participate in a training sometime.
I do agree with you that sometimes group dynamics can be very healing, productive, and empowering. I have experienced this with my involvement in Emotional CPR through my role at the National Empowerment Center. It sounds like the Alternatives to Violence Project has a lot in common with Emotional CPR, in that they both foster intercultural dialogue and community healing.
Thanks so much, Tom! As always I really appreciate your perspective on coercion, 12-step programs, and cults.
I also find the word “cult” to be strange. I think there are cult-like elements to almost every group and organization, and to set aside only specific ones as “cults” seems counterproductive. What we need to fight against is not individual “cults” but our whole entire culture’s unquestioning acceptance of coercion and authoritarianism.
I have not yet watched Leah Remini’s show but I definitely plan to at some point.
Exactly! I love being highly sensitive. It is of course very difficult to live in a world where society constantly pathologizes and medicalizes sensitivity, instead of just accepting it. I dislike that societal attitude – not the trait itself.
For me it is similar to being Jewish and growing up in Alabama, where I did experience a lot of anti-Semitism. I absolutely love being Jewish, and my Jewish values inform all the work I do. But when I was growing up in Alabama, I strongly disliked my community’s attitudes toward my Jewish identity.
Thanks so much, Beckys11! Just to be clear, I don’t think anyone ever deserves to be locked in a psych ward, whether they are actively or passively suicidal. Force and coercion help no one.
I agree that AA can be very helpful to some. I personally was falsely labeled an alcoholic after combining alcohol and Xanax to cope with the effects of trauma and extreme distress. I needed support and community, not to be told I had a disease. But I know this model does work for some people.
To me, it is all about choice. I do think that far too many people are hastily labeled an alcoholic or addict and coerced into 12-step programs when they are actually just coping with trauma and need support in that process. I think people should be able to choose their own way of healing from substance use/addiction, including the right to choose to continue using substances.
I’m so glad you read this too 🙂 I was hoping you would – I absolutely loved your comments on the “Stand Firm: Resisting the Self-Improvement Craze” article we posted in Around the Web last week. Thanks so much for commenting.
Thanks so much for reading and commenting. I totally agree with you – I think this training could potentially be traumatizing for anyone, not just autistic people or people who have experienced trauma.
Even if the training were only traumatizing for those who are autistic or those who have experienced trauma, though, that does not justify the coercion or manipulation! That just makes the training more discriminatory and ableist/sanist.
I completely agree with you that some of these things can at times be helpful, especially if carried out in a compassionate, client-centered, humanistic way.
One question I do struggle with a lot is whether these therapies/groups themselves are inherently coercive, or if they are inherently neutral and can be carried out in a non-coercive way. I personally do think Dialectal Behavior Therapy is pretty inherently coercive, if you look at the behaviorist ideology and philosophy behind it. However, some therapists do incorporate the skills and principles of DBT into a more humanistic, client-centered, non-coercive practice (but this is a fairly radical departure from Linehan’s original conceptualization of DBT, and therefore is not really DBT).
LGATs may be more neutral. I am definitely open to the idea that it is possible to teach an LGAT without the coercive elements or bullying. I think this is the case as well with 12-step programs and many self-help support groups.
I’m so glad that you left the training that you found to be coercive/bullying! Thanks so much for your encouragement.
Thank you so much for contributing this valuable perspective. I have just begun helping out with comment moderation on MIA, and I just wanted to start by saying that I’ve read many of your comments and really admire your dedication to supporting your wife and all of the compassion, understanding, and sensitivity you bring to that role.
I don’t think Mad Pride or self-acceptance is necessarily at odds with the notion of healing or recovering. I think the fundamental question we must ask is, “If X, Y, or Z were experienced by everyone, or by over 50 percent of people, would it still inherently cause suffering?” For example, if everyone in the world were Deaf and spoke Sign Language, then being Deaf would not inherently cause suffering. But if everyone in the world had cancer, it would still be awful to have cancer.
If something inherently causes suffering – regardless of societal attitudes or accommodations – then of course healing and recovery are important. And I think your approach to this is very aligned with the Mad Pride/self-acceptance model – to accept that you/your loved one is suffering, and that there is nothing wrong with you/your loved one for suffering, and that healing will come with time and patience.
I think the core message of Mad Pride and self-acceptance is that, suffering or not, every person has agency and can make their own decision about whether or not they want treatment, support, etc. Whether a condition inherently causes suffering or not, force, coercion, and manipulation are never justified. And it sounds like you are doing an amazing job of supporting your wife in making her own decisions about what she wants to change, what kind of support she wants, etc.
Re: your question about trauma – I actually don’t really agree with the notion that just because something is caused by trauma, it is necessarily bad, or that other traits/experiences are necessarily worth accepting only because they are inborn.
For me personally, there are some really great things that have come out of my traumatic experiences. Because of my coercive experiences with psychiatry, I am much more sensitive to coercion and very passionate about the activist work I do. I wouldn’t trade that for anything (even though that absolutely still does not justify the trauma having occurred).
To be honest, I don’t really know what caused me to be Autistic, and finding the cause also doesn’t really matter to me. Maybe I was born highly sensitive; maybe certain traumatic events (or positive events!) caused me to develop higher sensitivities. Maybe (probably) it’s a combination of both. Either way, I like being Autistic, and I like being highly sensitive, so I don’t feel the need to change.
Thanks again for your perspective and my apologies for the long reply!
Thank you so much for reading my article and offering this insightful perspective! I really like your perspective on how our capitalist/consumerist culture feeds off and perpetuates guilt, shame, and feelings of inadequacy, which lead to the desire to be fixed/cured.
I agree with you about 9/11 and Jonestown! I do still think there are some forms of societal oppression and structural inequality that we are all responsible for to some degree (but not 100%), but that’s definitely not what the training was arguing.
J, thank you so much for your concern and your anger on my behalf! One of my favorite things about the psychiatric survivor community is how much we all advocate and stand up for one another.
Just to clarify, my family alone was not responsible for hospitalizing me. I said a comment expressing passive suicidal thoughts to an ER doctor. I was then locked in a psychiatric emergency room and evaluated by a psychiatrist, who put me on a 3-day hold at a nearby psychiatric institution. My family was present in the emergency room, and they did not advocate against my confinement or hospitalization.
It is easy, and tempting, to blame individuals for what happened. I greatly regret saying the suicidal comment and very much feel responsible. Since my family did not advocate against the hospitalization, they too are responsible. But as FeelinDiscouraged pointed out, we are all victims of a system that responds to acts of speech and expression with force and coercion, and that has led the public to believe that control and deprivation of liberty are effective ways of treating suicidal ideation (and that suicidal ideation is an unnatural, abnormal illness that necessarily needs to be treated at all!). I think it is much more important and effective to direct our anger toward the system than toward individuals who have fallen prey to it.
That said, my family has since learned more and more about the critical psychiatry perspective and psychiatric survivors movement, and some of my family members have become quite strong allies 🙂
Thank you so much for reading my story and for all of your encouragement!
A blog or podcast with interviews with survivors sounds absolutely amazing. (Have you heard about Oryx Cohen’s Oral History Project for MindFreedom? It would be cool to do something similar for younger generations of survivors.) Please keep me posted on that!
Thank you so much for reading my story and responding so thoroughly.
I completely agree with you – I was very lucky when deciding to come out, and I faced relatively few negative consequences compared to many other survivors who have come out. I want to clarify that I did not intend for my story to urge all people to come out. I of course realize that some people cannot come out for safety or job security reasons, and I completely respect their decision.
Also, I agree with you that it is very important for the psychiatric survivor movement to strengthen our social justice efforts and use other tactics, like direct action, to make change.
Thank you so much for reading my story, and for all of your participation in the MIA community. I too hope the psychiatric system will begin to recognize that so many distressing psychiatric symptoms are the result of the adverse effects of psychiatric drugs, not biological illnesses that necessitate the use of more drugs.
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.
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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 (www.intuitiveeating.org) and the Food Psych podcast (https://christyharrison.com/foodpsych).
Here is a summary of the Minnesota Starvation Experiment: https://www.apa.org/monitor/2013/10/hunger
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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,
Emily
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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,
Emily
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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
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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
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Thanks, Becky!
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Thank you so much, msmonique!
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I also really disagree with the separation of “dialogue” from “action.” I think dialogue is action. The written word is action.
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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.
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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: https://www.radicalabolitionist.org/radical-abolitionist/2018/6/5/in-defense-of-victimhood
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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!
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Thanks, Eric!
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Hi CatNight,
I actually feel pretty strongly about the word “victim” and victimhood being part of my identity. I wrote an article describing why here if you’re interested: https://www.radicalabolitionist.org/radical-abolitionist/2018/6/5/in-defense-of-victimhood
I too am very inspired by Emma Lazarus! I had no idea that cancer used to not be treated in a hospital – thanks for sharing that.
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As I said, I don’t really think it should be up to physicians to say whether people need to be treated or not. They can just talk about the potential risks and benefits of crack and the person can decide for themselves whether or not to try it.
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Yes, I most definitely do!
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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: https://www.youtube.com/watch?v=ELnKodaEh_Y
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Thank you so much for your kind words about MIA! It is really validating to hear that others share similar frustrations with “pragmatic” “pseudo-consensus” processes in other kinds of political activism.
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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!
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Thank you, Fiachra! Just to clarify, I didn’t invent the word “polyphony,” but it is certainly an awesome word!
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Thanks, Pat 🙂
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Thank you so much, knowledgeispower!
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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.)
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Thank you so much for sharing your experiences! While I don’t understand all of your comments, I really appreciate your recommendation that more people read Szasz and I could not agree more.
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Thank you so much, Steve!
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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 🙂
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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, http://www.radicalabolitionist.org. 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.
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Thank you! And I absolutely love that perversion of such an awful term!
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Thanks for responding, Oldhead. I hope you will consider taking the survey! Your voice is so important.
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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.
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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.
Emily
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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
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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.”
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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!
Emily
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Thanks, Whatuser!
Yes, that absolutely is suspicious and points to the fact that so-called “mental illness” is culturally constructed rather than objective and biological. And I think that is what the field of mad studies is trying to point out.
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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.
Emily
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I’m glad you think so! 🙂
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Thank you so much for your feedback and kind words! I agree with you that this kind of balanced view is very much needed.
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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.
Emily
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It really depends how you define antipsychiatry. A lot of antipsychiatry efforts focus on dismantling the coercive system of psychiatry (institutional psychiatry) rather than taking away people’s rights to access voluntary treatment or use substances.
Here’s a great article on the myths and facts of antipsychiatry: https://www.madinamerica.com/2014/10/antipsychiatry-revisited-toward-greater-clarity/
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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.
Emily
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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.
Emily
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I am so glad that Bonnie Burstow will be part of the series, too! I agree that the antipsychiatry perspective is integral to learning about the Mad movement/the movement for human rights of those labeled mentally ill.
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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.
Emily
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Absolutely. Fat-shaming played a major role in my own eating disorder.
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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: https://qz.com/1079537/body-shaming-why-skinny-shaming-is-not-the-same-as-fat-shaming-and-masks-thin-privilege/
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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.
Emily
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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.
Emily
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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.
Emily
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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.
Emily
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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.
Emily
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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.
Emily
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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!
Emily
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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.
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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!!
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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.
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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:
-https://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-10-9
-http://www.healthyweight.net/
-https://danceswithfat.wordpress.com/2012/04/21/for-fat-patients-and-their-doctors/
Hope this helps!
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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.
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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.
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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: https://www.madinamerica.com/2018/01/subtle-ways-psychiatry-harmed-us/
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.
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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.
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Thank you for sharing your thoughts. I’m glad this resonated with you.
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Thank you so much! I am so glad you enjoyed it.
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Thank you so much for reading this and sharing your perspective! I really like the idea of introducing the word “normalism” into everyday speech. I am also a big fan of the term “toxic normality” which is parallel to “toxic masculinity” and “toxic whiteness.”
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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: https://www.radicalabolitionist.org/radical-abolitionist/2018/4/26/a-mad-pride-moment-being-proud-of-my-self-harm-1
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Thanks for letting us know. The link has been corrected.
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Hi all,
I just want to clarify that Mad in America does not collect data from the people who post on our site.
Best regards,
Emily Cutler
Community Moderator
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Hi Julia,
I will remove all future comments that are off topic from this report.
Emily
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Hi all,
Thank you so much for contributing to this important discussion. As the moderator, I am asking that you make sure all future comments remain on the topic of this article. The comments section of this article is not to be used as a platform to discuss unrelated political issues.
Best regards,
Emily Cutler
Community Moderator
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Corrected. Thank you!
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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
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Corrected. Thank you!
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Hi everyone,
Thank you so much for all of your comments and for this lively discussion. As the comments now are mostly off the topic of the original post, I will now be turning off the comments section.
Emily
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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.
Emily
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Thank you so much for your feedback, LavenderSage! I completely agree with you. This is so helpful to know for next time.
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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.
Emily
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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.
Emily
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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!
Emily
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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.
Emily
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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.
Emily
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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!
Emily
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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.
Emily
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Hi Sally,
Just to clarify, the point of that “concession” was to say that we ALL have things to work on, and I don’t have any more that’s wrong with me/to work on than anyone else.
I’m really glad to hear that you escaped from the psychiatric system!
Emily
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Hi Sally, thanks so much for reading my piece and sharing your perspective. Could you tell me what makes you think I’m still tangled up in the system?
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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!
Emily
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I agree with you, Julie! No one should ever be labeled ill for deciding to change their minds or explore new career options. I admire how much you’ve done in your life and how willing you are to learn new skills!
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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.
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Sam, I appreciate your reply so much. Thank you for providing a counter narrative to the dominant idea that we all need to assure ourselves and overcome our fears on our own.
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Thanks so much, Kev! I completely agree with you and I really appreciate all your work.
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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.
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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.
Emily
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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!)
Emily
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Thanks for your encouragement and support, J! I really appreciate how willing you are to call out sanism, gaslighting, and other types of prejudice and abuse. Please never stop all you are doing to empower Mad people!
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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.
Emily
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Hi Dr. Kelmenson,
Thanks for sharing that insight. I have definitely seen the “borderline” label applied in this way too.
Emily
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It’s great to hear that there are counselors who aren’t interested in diagnosing and labeling people! I think many “problems” can be accommodated through counseling, whether that’s from a professional, or just support/advice from friends and family.
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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.
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Registeredforthissite,
Thank you so, so much for sharing your story and perspective. I am so sorry to hear about all the abuse you have experienced. I know that your being so open about all of it will help others going through similar struggles.
Emily
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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?
Emily
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Thanks Oldhead, I really like that perspective!
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Sorry to hear your mom reacted that way. It is so frustrating that some people will not or cannot understand our perspective no matter what we say.
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I know there is no true cohesive “movement” – which I actually appreciate for a number of reasons – but when I talk about my job and what I do I generally talk about working with survivors of psychiatry and professionals who are critical of or antipsychiatry.
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Thank you so much, Bonnie! That means so much coming from you.
And yes, I think there is a great deal of misogyny within the BPD diagnosis. Being highly emotional, valuing romantic relationships and attachments, and dependence on others are all traits associated more with femininity, and both men and women who have these traits tend to get labeled with BPD.
I also find it fascinating that for men, a lot of the “symptoms” of BPD like uncontrollable anger, impulsive binge-drinking and sex, reckless driving and spending, etc. are considered part of being “young and stupid,” while for women, these behaviors are considered “symptoms of BPD.”
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Hi Ally,
Thank you so much for your poignant comment and perspective. I can relate to so much of what you are saying here. I completely agree with you that feeling emotions deeply and being highly sensitive to the pain of rejection, ostracization, teasing, etc. does not make someone ill or disordered.
I also completely agree with your perspective on groups and society in general. Perhaps this is the reason that I thrive so much in romantic relationships – when two people can build a partnership that exists in its own world and culture, relatively separate and free from ostracization, groupthink, bullying, and outcasting that can occur in larger groups, that is a beautiful thing. That’s not to say that romantic relationships and other types of two-person partnerships are always free from power imbalances or abusive dynamics, but I think it can be easier to establish equality amongst two people than in groups, where people can gain power just by having other members of the group agree with them. (I’m not sure if this is exactly what you were getting at but I think it’s related!)
I’m not on Instagram but I did send you a Facebook request (my name is currently different on Facebook). I have stumbled across your work before and I am a big fan of all you do for the benzo survivor community.
Emily
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Hi Oldhead,
I definitely can understand and appreciate the need to distance ourselves from othering.
When I’m asked to explain “mad pride” to people who don’t know what it’s about, I don’t frame it as a movement advancing the rights of a particular group of people or subset of individuals. It’s about advancing the rights of *everyone* to experience whatever gets labeled as “madness” in their own way. Hearing voices, experiencing emotions deeply, emotional pain and suffering, and being sensitive are all examples of things that get labeled “madness” that people have the right to experience without being told they are sick and locked up, forcibly drugged, or electroshocked.
Perhaps the term “mad” is irrelevant if everyone is “mad.” I think there is some degree of truth here. Unfortunately, there are experiences and emotions that continue to get labeled as “madness,” and “mad pride” is my preferred way of describing people’s rights to have those experiences and emotions.
Emily
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Thanks, uprising! That means a lot coming from you.
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Thank you 🙂
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That’s fair. “Trying to convince myself and others that I do not have Borderline Personality Disorder” wasn’t so much about accepting or rejecting the label, as convincing people that I don’t have the symptoms/experiences that Borderline Personality Disorder is said to describe. It was about saying that I’m not really that scared of abandonment compared to the average person, for example.
This article is about saying, even if I *am* terrified of abandonment, is that necessarily a disorder that needs to be cured? I agree with you that this fear is “normal” in our toxic culture.
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Hi Oldhead,
To me, a major part of Mad Pride or mad studies is recognizing “madness” as a universal component of the human experience. In my opinion “madness” is itself what makes us human. Without emotions, unpredictability, different ways of being and processing the world, etc., we would just be mechanical robots. So I think our views are actually pretty similar (as I believe I said in our last conversation about this), even though we use different language.
Emily
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In general, a big part of my passion for this work comes from the idea that it’s unfair to stereotype every member of any particular group as being abusive or harmful. There are a lot of writers here who have presented better arguments than I ever could about the dangerous of conflating emotional distress/suffering with abusiveness or harmfulness toward others. If you are interested in that perspective, I think Phil Hickey’s most recent article is excellent. That said, I do think that those who act in abusive or violent ways are often suffering from distress and trauma themselves, and it’s also unfair to label them or demonize them. Anyways, Igor, we may have to agree to disagree on this one.
Sam, just wanted to say how much I appreciate your perspective here and admire the fact that you and your wife included your son in her healing process. I will just say that for me personally, my parents were often embarrassed of my intense emotions growing up and really didn’t know how to handle them. This is part of the reason I felt so alienated and abnormal – even my own parents didn’t know how to understand me. I often wish that they had been more open about their distress and any experiences they had growing up that were similar to mine. I think I would have felt less alone or less like there was something about me that was fundamentally “unrelatable” to other people. Instead I got the message that adults and “normal” people are supposed to suppress their emotions and not feel the way I did.
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YetAnotherAccount, I’m really sorry that happened to you. That sounds absolutely heartbreaking. I honestly don’t know how I would’ve gotten through that myself.
I will just say that I don’t think it’s your thinking that was twisted. I think it was the messages you received about yourself that were twisted. I think it’s the world and society that are twisted. Your feelings after that happened to you were an absolutely natural response to all of the external twistedness.
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Also, correct me if I’m wrong, but I didn’t get the sense that you’re against all therapy, just against therapy that is based on diagnosis and treatment of “symptoms” as opposed to asking clients what is going on in their lives that is causing them to feel distressed.
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Hi Alex,
Thanks for reading and responding to my article. I really appreciate it.
I absolutely agree with you and have noticed a similar trend. Whenever I told my DBT therapist about self-harm urges or suicidal thoughts, the response was always, “What skills can you use?” instead of, “What circumstances are leading you to feel this way and how can we address them?” It is very rare for people to ask the question “why.”
Emily
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Hi Frank,
Thanks so much for your reply. As you know, I always enjoy reading all your comments and have learned a lot from you over the past few months as moderator 🙂
One question I had – if I told you that ten or twenty years from now, I hope I am in an executive position at a nonprofit organization, or in some sort of leadership role at a non-traditional, non-coercive mental health agency, would you also tell me that I am “not living in the moment”? These career goals of mine are indeed tied to the approval of others – it is not possible to get hired or get a promotion without being approved of at least to some degree. Would you therefore then say that these goals are indicative of attachment issues?
Would you tell someone to “shrug and go on” if they lost their job? If they lost their housing? Would you say they have attachment issues if they are unable to “shrug and go on” after these events?
Emily
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Hi Dr. Kelmenson,
Thank you so much for your very encouraging comment. This felt incredibly validating to hear!
And thank you for all of the work you do as a writer for Mad in America.
Emily
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I agree – love, not labels!
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Thanks for sharing your perspective, Steve! Yes, this is something I am working towards every single day – caring less about what others think about me and accepting myself for who I am regardless of others’ opinions. It is incredibly difficult to accomplish that in today’s society, though, where we have a cultural obsession with self-improvement and the diagnosing/labeling of people with distress and differences is so rampant. It is also very difficult to do this in a capitalist society, where what others think of you does matter to some extent in terms of whether you will be able to pay your rent, live comfortably, have a job you enjoy, etc. (Luckily I have found jobs I love at Mad in America and the National Empowerment Center, but that still doesn’t mean I’m 100% free from the influence of capitalism.)
Thanks for the work you do and for your recognition of the societal factors that play a role in “BPD”-type “symptoms.”
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Yes, Francesca, I think the label is used to say that a lot. In my case the label was just to justify forced treatment and coercive care.
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Thanks so much for sharing your perspective! I really enjoy reading your comments.
I did want to mention that I think some forms/styles of therapy can be very ethical and helpful. I personally see a narrative therapist. Narrative therapists usually reject diagnoses and encourage people to see the way they are thinking, feeling, and acting as inseparable from their social/cultural context.
I do absolutely agree that the majority of therapy is sadly about changing the individual, not their environment.
And I of course agree with you that the State should be taken out of psychiatry and recovery.
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Thanks for your kind words, Someone Else 🙂
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Yes!
Sometimes, when I try to describe our movement to the mainstream, I tell people that our movement is made up of a bunch of people who are keenly aware of how awful and screwed up the world can really be, and who have been called irrational and sick for having that knowledge and coping with that knowledge to the best of their ability.
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Thanks so much, LavenderSage! I really appreciate your thoughtful feedback and kind words. I especially appreciate your thoughts on striving for self-acceptance and societal acceptance of people of size. One of my personal dreams is to see the mad pride/psychiatric survivors movement united with the fat acceptance/people of size movement. They are both about combatting paternalism and oppressive definitions of health/normality.
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I agree with that. I’m definitely not on board with biological determinism or any sort of determinism – I think humans are inherently unpredictable.
I think it’s always helpful for anyone to learn new perspectives and ways of thinking, but I’m just not sure that anyone in particular or specific group of people need to learn new ways of thinking. I think a lot of people labeled “mentally ill” are thinking about the world more rationally than those who are not labeled such.
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I think it’s all about how you define madness/insanity and how you define sanity. That of course is dependent upon cultural context.
At the moment, our culture constructs things like hearing voices, being sensitive, experiencing emotions deeply, grappling with the desire to die, etc. as madness. Is there any reason that we shouldn’t be proud of, or at least accept, any of those things?
In some contexts, being queer is constructed as madness. Shouldn’t queer people be proud of themselves?
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Just to be clear, this piece isn’t about reclaiming the term “Borderline Personality Disorder” and identifying with that label. I definitely don’t plan to use that term to describe myself.
What I intended to do in this piece is examine the experiences/traits/”symptoms” that the term “Borderline Personality Disorder” is said to describe, and discuss whether or not those specific experiences and traits are necessarily negative or need to be changed.
So that is the part of your comment that I am most curious about. When you say, “You CAN change and learn new ways of thinking,” what part of my thinking do you think needs to be changed?
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Hi Sam,
Thanks so much for sharing your perspective. Your openness about your relationship, and the way you place such high value on attachment and commitment in romantic relationships, contributed to my thinking behind this piece. I really like that you’ve pointed out our cultural obsession with independence (my roommate has a book referring to this as “counter-dependence,” a term I’ve started to use) and our tendency to encourage people to break off commitments, cut people out of our lives, etc.
I just wanted to clarify that I didn’t intend the message of this piece to be that nothing is wrong with me. I am far from perfect!! But I don’t necessarily agree that something is more wrong with me than the average person. To be human is to be imperfect. I hope that clarifies my message a bit.
Emily
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Thank you so much! Yes, I absolutely love MLK’s quotes on this, especially his notion of being “creatively maladjusted” 🙂
Another quote I really like is that either everyone’s crazy or no one is.
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Thank you so much for your kind words!
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I completely agree with you that Personality Disorders are pretty egregious and defamatory!
And I also like what you said about taking the labels someone gives you and using it bak against them. The notion of Mad Pride is doing just that – it’s saying, “Okay, so you think I’m crazy. You think I’ve gone mad. Well maybe I have and maybe that’s not such a bad thing!”
It’s similar to the word “queer,” I think. In the past that word was used as an insult, and now the LGBTQ community has successfully reclaimed it.
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Hi Larry,
The comment that was removed for moderation stated that some women want to be beaten or abused by their partners. Our posting guidelines prohibit sexist statements. Also, here at Mad in America we strive to be a safe space for all people. Many of our readers and commenters have experienced abuse and domestic violence. Comments that include victim-blaming statements may be re-traumatizing for people with such backgrounds.
We ask that all further comments remain on the original topic of the article. If you have any further questions about comment moderation, you can email me at [email protected].
Best regards,
Emily Cutler
Community Moderator
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Thanks for the feedback. The post has been updated to say that the article is subscription only.
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Hi all,
Thanks very much for your participation in the comments of this article.
In Mad in America’s posting guidelines, we ask that comments remain on topic and engaged with the ideas of the piece. For this reason, I am now closing this particular comment thread. All future comments in this thread that are unrelated to Kim Auth’s thoughts on conferences will be moderated.
Fiachra and Scintilla (and anyone else), if you wish to continue this particular discussion in a respectful way, please do so in the forum or via email.
Best regards,
Emily Cutler
Community Moderator
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Hi The_Cat,
I have tried reaching out to you via email but have had some difficulty getting in touch.
Unless there is any proof that W-BAD is “astroturf posing as a grassroots campaign by benzo victims,” repeating this statement amounts to misrepresentation, which is against Mad in America’s posting guidelines. As the moderator, I will not be allowing any further misrepresentations of W-BAD.
Thanks,
Emily
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Corrected. Thank you!
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Thank you so much for this very insightful quotation (I love Erich Fromm!). It is so applicable to my experience.
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Thanks so much for sharing your feedback and personal experience, Julia. I am so glad that you knew to avoid Erhard Seminars and the other trainings like it. I am so sorry to hear about your experience with psychiatric abuse – thanks for the work you are doing to help others heal from this.
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Julie, thank you so much for your nuanced perspective on this!
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I’m glad you got out of DBT too, kindredspirit!
I told my therapist about my texts. At the time I was convinced that I really did have Borderline Personality Disorder and I needed to get well, so I was compliant with the treatment program and was honest about all my thoughts, urges, and actions.
I’m so glad your fiancé took you out of the day hospital! Even if it was mostly benign it sounds like it was not helpful.
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Oldhead, I would love to see that photo! Any chance you could email it to me? Sounds like my kind of sign 🙂
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So, so true. Being restricted and deprived of picking at my nails or having certain thoughts made me feel much more driven to do so!
I really think Borderline Personality Disorder is one of the most insidious diagnoses out there. It totally changed the way everyone interacted with me and most of all it changed the way I thought of myself.
I’m so glad you were able to get your diagnosis removed!
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Thank you so, so much Julie. That was my primary goal when writing this article – to extend the conversation beyond pills (even though that of course is an incredibly important part of the conversation), and really open up a serious and engaging discussion on the ways force and coercion affect us. It is such a huge compliment to hear that I accomplished this goal!
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Wow. Day treatment sounds so terrifying and cult-like! I am so sorry that you both experienced that.
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I remember the moment when I realized I prefer terms like “crazy,” “mad,” “nuts,” “bonkers,” etc. to “mentally ill” or any sort of health/medical language.
It was right before my second forced hospitalization. I was bawling and begging not to be hospitalized. Some of my family members were present, and they said, “Poor Emily. She is just so, so sick right now that she doesn’t even know she needs help.”
It was in that moment that I realized there is something very insidious and specific about being told that a form of abuse is happening for your own good. I’d rather them say, “Emily is a crazy nutso. Lock her up.”
Also, one reason that I prefer the word “mad” to “crazy” or any of the others is that in the U.S., “mad” has the connotation of anger. I have been labeled as borderline and so many other diagnoses due to my anger. So much of my Mad Pride is about embracing that anger!
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My apologies for taking so long to answer this question. DBT is Dialectal Behavior Therapy, the standard therapy for people diagnosed with Borderline Personality Disorder.
DBT consists of both private sessions and group sessions. My private sessions consisted of tracking all my suicidal thoughts, self-harm urges, and urges to engage in any behaviors that my DBT therapist didn’t like or saw as symptoms of my Borderline Personality Disorder. So every day I would rate on a 1-5 scale how high my urge was to commit suicide, self-harm, pick at my nails, eat unhealthy food, drink or use, yell, or send rants via text to my friends. If I had any urges to do any of those things, I would have to go to the board and write a chain of the event that led me to have the urge, my interpretation of the event, my reaction to the event and how that made the situation worse, and what skills I should have used instead. In group sessions, I would learn about those skills to use instead of engaging in “borderline” behaviors.
There were extremely strict rules around therapy sessions and interactions with my therapist. For example, being even a minute or so late to the session was marked on my chart (and I would usually have to write up a chain about it on the board), and if I missed more than three sessions that was automatic disqualification from the program. In addition, clients were instructed that they could call their therapists up to twice a week for phone coaching, in the case of a self-harm urge or suicidal thought. However, therapists were told to answer coaching calls coldly and curtly, so that clients would not be rewarded for their self-harm urges and suicidal thoughts with compassion or warmth.
In DBT, as with other behavior therapies, human experiences are viewed as behaviors to be controlled through rewards and punishments. Once, when describing to my therapist how I was having intrusive flashbacks about my forced hospitalization, he said, “Well, I know a lot of people who were hospitalized at the psych ward you went to. And pretty much all of them share your experience – it is incredibly traumatic for them. But that’s a good thing! It really deincentivizes future suicide attempts. Think about it – if these places had nice, warm conditions, people would be rewarded for their suicidal behavior, and they’d attempt suicide again and again to get to go back. But since these places are so traumatizing, it really scares people from attempting suicide again.”
When I became angry with him for saying that, and threatened to switch therapists, he said that was very typical of borderline patients – that I was idolizing and devaluing him. Clearly my Borderline Personality Disorder was very severe and I needed more DBT. I am ashamed to say that I bought it and stayed in therapy with him for 5 more months. In a lot of ways, my DBT experience had a bigger impact on me than my hospitalization.
As Kindredspirit mentioned, some of the skills that DBT teaches in the group sessions can be very helpful. Basic self-care tips like exercising, taking a bath, etc. instead of self-harming, or distress tolerance and mindfulness skills, can absolutely be useful. However, they are fairly easy to learn on your own or with a friend/peer supporter, or with a humanistic therapist who integrates them into their sessions. There is no need for the coercive manipulation and self-monitoring/restriction of DBT as a therapy program.
Steve, I absolutely love what you said about re-inventing therapy for every client you meet. That rings so true for me – therapy should be something uniquely individual for every single person.
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Thank you so much, Julie. This comment was incredibly validating. I’ve been beating myself up for still feeling disoriented/hypervigilant (how very NOT Mad Pride of me, I know 🙂 ) even though it’s been more than two months since I had this experience. It’s good to know there are others out there who have found even a brief run-in with these programs to be highly traumatic.
Also, your comparisons of religious/spiritual/New Age cults to psychiatry and therapy are so spot on. In Dialectal Behavior Therapy I had to track all my suicidal thoughts, self-harm urges, and urges to do any sort of behaviors my therapist thought of as symptoms of Borderline Personality Disorder, like pick at my nails, eat unhealthy food, or send my friends rants about random things via text. Any time I had an urge to do any of those things, I’d have to write a chain on the board, discussing the event that led me to have that urge and my interpretation of the event, and what DBT skills I should have used instead of having that urge. Talk about confession!!
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Thank you so much! I am really excited about all the discussions going on 🙂
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Oldhead, I want to say that I really do respect and like your perspective! I absolutely 100% agree that madness/”mental illness” is a social construct.
My understanding of the Mad identification is similar to Antipsychiatric ReprisOwl’s. From what I understand, hearing voices and extreme states are very, very real experiences for many people. And from firsthand experience I know that feeling extreme sadness after a traumatic event, having suicidal thoughts, and having meltdowns are very real experiences. The idea that these experiences are indicative of “mental illness” and necessitate force or coercion to recover is what is constructed to oppress people.
To me, “Mad” is to schizophrenia, borderline personality disorder, depressive disorder, anxiety disorder, etc. what “queer” is to homosexuality disorder, gender identity disorder, etc. All are real experiences and I think it is important for people to have words to describe them. What is constructed and oppressive is the pathology paradigm.
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I also usually say words like “prejudice”, “bigotry”, and “discrimination.”
I have often been told that I am “stigmatizing” mental health services by referring to psychiatric hospitals as institutions or speaking out about confinement as a form of violence. So I do think the general public sees “stigma” as stigma against seeking treatment, or stigma against psychiatry, rather than prejudice and bigotry against people labeled/considered mentally ill.
I am a huge fan of the words ableism, sanism, and healthism as well, because they speak to the ways our society considers people with certain types of bodies and minds to be superior to people with other types of bodies and minds.
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YUP. There have been a couple times when the police were called on me for having a melt down in public, and they immediately started asking me questions about my mental health and evaluating me for hospitalization. So scary!
I have gotten in so much trouble for crying in public as a woman (my high school required me to see a therapist because I cried too much about being bullied), and I can only imagine how awful it is for boys and men.
I am just now getting interested in feminist perspectives on mental health/psychiatry. It is fascinating how traits associated with femininity – like crying and being sensitive – are highly pathologized, and even more pathologized when experienced by men.
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That totally makes sense! That absolutely used to be the reason I didn’t really use the autistic label or identify with the neurodiversity community. Then I got a chance to meet more radical Autistic/neurodiversity advocates who say that being bipolar, schizophrenic, borderline, suicidal, experiencing extreme states, hearing voices, etc. is all okay. That of course is rare to find (even within our community!). I do like more general terms like Mad, neurodivergent, and queer better as political identifications for that reason – to say that it is ALL okay.
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Thanks for the clarification!
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I relate to that so much. I have had to learn (and am still learning) to control my emotions in public – I’ve only very narrowly avoided a couple hospitalizations now that almost happened due to crying in public. Safety always comes first, of course.
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Thank you so much for sharing that, Sam! I agree that suicidality is often a completely valid and natural response to circumstances. I’m glad that it drives you to continue working on the root of the issue.
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Yes, I of course think it’s up to everyone what labels they would like to use or not use! What I meant by “affirming” therapy was that these parts of people’s experiences, whatever people choose to call them, would not be pathologized as illness but accepted and embraced.
One point of clarification on autism – the Autistic community views autism as a way of being, and a part of our identities, not a disorder or an illness. So just like it doesn’t make much sense to find out if someone’s gay by seeing if they have a diagnosis of “homosexuality disorder,” being Autistic doesn’t have much to do with having or not having a diagnosis of autism. If you relate to the experiences and culture of the Autistic community, and you find that Autistic is a word that helps describe your identity and experience, you are welcome to use it. Or not. It really is up to you.
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Thank you SO much, Julie, for reading my piece and for sharing your personal experience. I had read in some of your other comments that you are a cult survivor, so I was very interested in getting your take on this.
(To be honest, I still hesitate to use the word “cult survivor” for myself – I was only in this training for such a short amount of time before leaving.)
I’m so sorry that you had such traumatic experiences with both the religious cult and the cult of psychiatry/therapy/mental health. I am definitely being very cautious not to “ping pong” between different cults, although it is very hard – it feels like most groups/organizations have at least some cult-like elements.
Thank you also for the book recommendations. I am looking to start doing some reading on cults, especially New Age ones, so these look like good starting points.
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Thanks for your feedback, Oldhead!
Just curious if you’re against all slur reclamation or only this one in particular? For example, are you opposed to the use of the word “queer”?
I absolutely agree with you about stigma! Labelling anything as a disorder/disease/illness is pretty much inherently saying it’s a bad thing.
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Thank you so much 🙂
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I had not heard of David Small but I just read the links you posted. He is amazing. I love the focus on power.
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Exactly! I see so much of the anti-psychiatry/critical psychiatry/psychiatric survivors community’s work as defending the radical notion that people know what is best for themselves.
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I really like that distinction! “Counseling” and “coaching” imply that the professional has more of a consulting/advising role, while therapy usually implies a more medical, treatment-oriented role.
Another term I like is “affirming” therapy. I know some professionals are now practicing LGBTQ-affirming therapy, which embraces all queer identities as being healthy, valid experiences, not pathology. I think more professionals need to practice Mad-affirming therapy, voice hearing-affirming therapy, Autistic-affirming therapy, etc.
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Thanks so much for your feedback and perspective! So glad to meet another fan of Szasz 🙂
Maybe I should have clarified and said “accepting 100% responsibility for overcoming distress.” I of course don’t believe that people should take *zero* percent responsibility for their emotional well-being/”mental health care,” but our instructor (and my fiancé) specifically taught that we were 100 percent responsible.
There are usually some small (or big) things we can do to improve our emotional well-being, whether that’s attending peer support groups, asking for accommodations/changing our environment, or gaining the knowledge and language to help others understand what we are experiencing and what kind of support we need. But taking responsibility for those few acts of “self-care”/self-advocacy still don’t make us 100 percent responsible for our emotional distress (just as no one is to blame if they choose not to engage in those kinds of steps).
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Thank you so much for this incredibly valuable perspective! I could not agree more with you that some (maybe even most) therapy is inherently paternalistic, with one person, the “well” individual, claiming to know what is best for another person, the “sick” individual. I do think this very much describes behavior therapies.
I have had positive experiences with client-centered, humanistic therapy, so I hesitate on the idea that all therapy is inherently paternalistic or coercive. I currently see a narrative therapist who acts more as a consultant in my life and operates from a strengths-based paradigm. That has been very helpful and effective for me. But I assume this is relatively rare.
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I will have to watch that Daniel Mackler video – sounds very insightful. My personal experience with behavior therapies (and society in general) is that the goal was very much to get me to suppress my emotions and be more indifferent to my surroundings.
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Thanks so much to both of you for your feedback. Even though I do disagree with you, absolutewhat – I am an abolitionist on all forced treatment – I am really glad that you shared your perspective.
I wanted to add that I don’t think suicidality is ever selfish. Death is pretty terrifying, and for someone to be considering it, they have to be in a great deal of pain.
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Hi Sam,
I really appreciate you continuing to reflect on my piece!
I do want to clarify and say that by no means do I ever want to suggest that Mad Pride is the end all be all and works as a panacea for everyone all the time. Ideally, I would like there to be as many conceptualizations and approaches available as possible, and people can choose how they would like to think of their own experiences, without being pressured or coerced into any particular model.
The point I was trying to get at in my essay is that all too often, people are pressured into accepting that they have a biological brain disease, or into accepting 100% responsibility for their emotions and experiences, and are not given any other option. For me personally, Mad Pride was how I broke out of that limited framework. It’s a perspective that took me a while to find, so I hope everyone can at least have the option of embracing that perspective. But you are totally right that “mental health” is much, much more complicated than just these three options. I hope that through continued writing and discussion, our community will be able to offer thousands of different non-pathologizing, non-coercive ways to conceptualize distress and difference.
I also want to clarify that I don’t mean to deny that suffering exists, or that we should just always accept our suffering and never seek to heal from it. As someone who has struggled with suicidality, I absolutely know what it is like to be in a great deal of pain and wish for it to stop. The Mad Pride perspective has helped me to understand my suicidality as a response to trauma and work through it with social support and changing my environment.
As for “healthy” vs. “unhealthy”, the notion of “health” has never been very helpful to me personally. (I did grow up in a fairly healthist household, where being “unhealthy” was the worst thing you could possibly be – much worse than immoral or unhappy – so this might just be a response to trauma from me!)
Is feeling suicidal unhealthy? Maybe. How does one define “unhealthy?” Is suicidality unhealthy because it is abnormal? Is it unhealthy because psychiatrists have agreed it is a symptom of a mental illness? Is it unhealthy because western religion has declared it a sin (therefore it is spiritually unhealthy)? Is it unhealthy because it could possibly lead to one’s death? Maybe, but in that case, is waking up and deciding to drive on the streets of Los Angeles every day also unhealthy?
In my opinion, the concepts of “healthiness” and “unhealthiness” are too often heavily moralized, vaguely defined social constructs. What has been more helpful to me personally is to ask myself, “Does this pattern of behavior that I am engaging in increase my happiness or decrease it?” And, “Would efforts to change this behavior increase my happiness overall, or add totally unnecessary stress and pressure to my life that isn’t worth it in the long run?”
Of course, if the concepts of healthiness and unhealthiness are helpful for you and/or your wife, and you are both making a choice to utilize those concepts (and it sounds like you are), then I have nothing against that!
Hope this helps clarify. And thank you again for your perspective and for your dedication to helping your wife heal in such a non-coercive, compassionate way!
Emily
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Thank you, FeelinDiscouraged!
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Thanks so much, Fiachra. Yes, it definitely did irritate me, and afterwards I felt very overwhelmed and depressed.
LGAT is Large Group Awareness Training. There were about 25 of us in the group, paying $1,600 each. So our trainer made $40,000 in five days.
(I’m generally not against people making large salaries, but this does seem fairly extreme.)
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Thank you! I am glad you enjoyed it. And I still feel very grateful for the work of Szasz and Foucault for helping me recognize some of the coercive aspects of this group.
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Thanks so much! I agree that it was a little bit Brave New World like, as well as Orwellian (as Michael Cornwall referenced above).
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Thanks so much for reading my piece and responding!
I have heard a little bit about the Alternatives to Violence Project and I have to say it sounds absolutely incredible. I definitely want to learn more about it and hopefully participate in a training sometime.
I do agree with you that sometimes group dynamics can be very healing, productive, and empowering. I have experienced this with my involvement in Emotional CPR through my role at the National Empowerment Center. It sounds like the Alternatives to Violence Project has a lot in common with Emotional CPR, in that they both foster intercultural dialogue and community healing.
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Thank you so much, Dr. Cornwall! As a professional and activist in this movement whose work I deeply respect, your feedback means a lot to me.
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Thank you so much. I really appreciate it, and am glad you enjoyed it.
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Thanks so much, Tom! As always I really appreciate your perspective on coercion, 12-step programs, and cults.
I also find the word “cult” to be strange. I think there are cult-like elements to almost every group and organization, and to set aside only specific ones as “cults” seems counterproductive. What we need to fight against is not individual “cults” but our whole entire culture’s unquestioning acceptance of coercion and authoritarianism.
I have not yet watched Leah Remini’s show but I definitely plan to at some point.
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Exactly! I love being highly sensitive. It is of course very difficult to live in a world where society constantly pathologizes and medicalizes sensitivity, instead of just accepting it. I dislike that societal attitude – not the trait itself.
For me it is similar to being Jewish and growing up in Alabama, where I did experience a lot of anti-Semitism. I absolutely love being Jewish, and my Jewish values inform all the work I do. But when I was growing up in Alabama, I strongly disliked my community’s attitudes toward my Jewish identity.
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Thanks so much, Beckys11! Just to be clear, I don’t think anyone ever deserves to be locked in a psych ward, whether they are actively or passively suicidal. Force and coercion help no one.
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Thank you so much, Sarah. I can’t tell you how much I appreciate all your support during this process and this past week especially.
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I agree that AA can be very helpful to some. I personally was falsely labeled an alcoholic after combining alcohol and Xanax to cope with the effects of trauma and extreme distress. I needed support and community, not to be told I had a disease. But I know this model does work for some people.
To me, it is all about choice. I do think that far too many people are hastily labeled an alcoholic or addict and coerced into 12-step programs when they are actually just coping with trauma and need support in that process. I think people should be able to choose their own way of healing from substance use/addiction, including the right to choose to continue using substances.
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Wow, that’s amazing!
I’m so glad you read this too 🙂 I was hoping you would – I absolutely loved your comments on the “Stand Firm: Resisting the Self-Improvement Craze” article we posted in Around the Web last week. Thanks so much for commenting.
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Thank you so much. I did file a complaint.
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Thanks so much for all your support through this process, Matt!
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Thanks so much for reading and commenting. I totally agree with you – I think this training could potentially be traumatizing for anyone, not just autistic people or people who have experienced trauma.
Even if the training were only traumatizing for those who are autistic or those who have experienced trauma, though, that does not justify the coercion or manipulation! That just makes the training more discriminatory and ableist/sanist.
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Could not agree more!
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Yes! Exactly. You summed it up perfectly. Both approaches are coercive and cult-like.
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Thank you so much for this valuable perspective.
I completely agree with you that some of these things can at times be helpful, especially if carried out in a compassionate, client-centered, humanistic way.
One question I do struggle with a lot is whether these therapies/groups themselves are inherently coercive, or if they are inherently neutral and can be carried out in a non-coercive way. I personally do think Dialectal Behavior Therapy is pretty inherently coercive, if you look at the behaviorist ideology and philosophy behind it. However, some therapists do incorporate the skills and principles of DBT into a more humanistic, client-centered, non-coercive practice (but this is a fairly radical departure from Linehan’s original conceptualization of DBT, and therefore is not really DBT).
LGATs may be more neutral. I am definitely open to the idea that it is possible to teach an LGAT without the coercive elements or bullying. I think this is the case as well with 12-step programs and many self-help support groups.
I’m so glad that you left the training that you found to be coercive/bullying! Thanks so much for your encouragement.
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Good to see you on here, J! Thanks for reading my piece 🙂
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Thank you for your encouragement!!
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Hi Sam,
Thank you so much for contributing this valuable perspective. I have just begun helping out with comment moderation on MIA, and I just wanted to start by saying that I’ve read many of your comments and really admire your dedication to supporting your wife and all of the compassion, understanding, and sensitivity you bring to that role.
I don’t think Mad Pride or self-acceptance is necessarily at odds with the notion of healing or recovering. I think the fundamental question we must ask is, “If X, Y, or Z were experienced by everyone, or by over 50 percent of people, would it still inherently cause suffering?” For example, if everyone in the world were Deaf and spoke Sign Language, then being Deaf would not inherently cause suffering. But if everyone in the world had cancer, it would still be awful to have cancer.
If something inherently causes suffering – regardless of societal attitudes or accommodations – then of course healing and recovery are important. And I think your approach to this is very aligned with the Mad Pride/self-acceptance model – to accept that you/your loved one is suffering, and that there is nothing wrong with you/your loved one for suffering, and that healing will come with time and patience.
I think the core message of Mad Pride and self-acceptance is that, suffering or not, every person has agency and can make their own decision about whether or not they want treatment, support, etc. Whether a condition inherently causes suffering or not, force, coercion, and manipulation are never justified. And it sounds like you are doing an amazing job of supporting your wife in making her own decisions about what she wants to change, what kind of support she wants, etc.
Re: your question about trauma – I actually don’t really agree with the notion that just because something is caused by trauma, it is necessarily bad, or that other traits/experiences are necessarily worth accepting only because they are inborn.
For me personally, there are some really great things that have come out of my traumatic experiences. Because of my coercive experiences with psychiatry, I am much more sensitive to coercion and very passionate about the activist work I do. I wouldn’t trade that for anything (even though that absolutely still does not justify the trauma having occurred).
To be honest, I don’t really know what caused me to be Autistic, and finding the cause also doesn’t really matter to me. Maybe I was born highly sensitive; maybe certain traumatic events (or positive events!) caused me to develop higher sensitivities. Maybe (probably) it’s a combination of both. Either way, I like being Autistic, and I like being highly sensitive, so I don’t feel the need to change.
Thanks again for your perspective and my apologies for the long reply!
Emily
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Thank you so much for reading my article and offering this insightful perspective! I really like your perspective on how our capitalist/consumerist culture feeds off and perpetuates guilt, shame, and feelings of inadequacy, which lead to the desire to be fixed/cured.
I agree with you about 9/11 and Jonestown! I do still think there are some forms of societal oppression and structural inequality that we are all responsible for to some degree (but not 100%), but that’s definitely not what the training was arguing.
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Thank you so much for your kind words!
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Thanks for sharing your perspective!
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Thank you so much for your encouragement – this means a lot to me.
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Thank you so much for your kind words, and for the clarification!
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J, thank you so much for your concern and your anger on my behalf! One of my favorite things about the psychiatric survivor community is how much we all advocate and stand up for one another.
Just to clarify, my family alone was not responsible for hospitalizing me. I said a comment expressing passive suicidal thoughts to an ER doctor. I was then locked in a psychiatric emergency room and evaluated by a psychiatrist, who put me on a 3-day hold at a nearby psychiatric institution. My family was present in the emergency room, and they did not advocate against my confinement or hospitalization.
It is easy, and tempting, to blame individuals for what happened. I greatly regret saying the suicidal comment and very much feel responsible. Since my family did not advocate against the hospitalization, they too are responsible. But as FeelinDiscouraged pointed out, we are all victims of a system that responds to acts of speech and expression with force and coercion, and that has led the public to believe that control and deprivation of liberty are effective ways of treating suicidal ideation (and that suicidal ideation is an unnatural, abnormal illness that necessarily needs to be treated at all!). I think it is much more important and effective to direct our anger toward the system than toward individuals who have fallen prey to it.
That said, my family has since learned more and more about the critical psychiatry perspective and psychiatric survivors movement, and some of my family members have become quite strong allies 🙂
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Thank you so much for reading my story and for all of your encouragement!
A blog or podcast with interviews with survivors sounds absolutely amazing. (Have you heard about Oryx Cohen’s Oral History Project for MindFreedom? It would be cool to do something similar for younger generations of survivors.) Please keep me posted on that!
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Thank you so much for reading my story and responding so thoroughly.
I completely agree with you – I was very lucky when deciding to come out, and I faced relatively few negative consequences compared to many other survivors who have come out. I want to clarify that I did not intend for my story to urge all people to come out. I of course realize that some people cannot come out for safety or job security reasons, and I completely respect their decision.
Also, I agree with you that it is very important for the psychiatric survivor movement to strengthen our social justice efforts and use other tactics, like direct action, to make change.
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Thanks so much for your work too!
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Thank you so much for sharing more in depth about the story of Purim! Hope you had a great holiday.
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Thank you so much for reading my story, and for all of your participation in the MIA community. I too hope the psychiatric system will begin to recognize that so many distressing psychiatric symptoms are the result of the adverse effects of psychiatric drugs, not biological illnesses that necessitate the use of more drugs.
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Thanks for all your support and encouragement, Matt!
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Thanks so much for sharing! I’d never heard of Jael before.
Here is a link to the most thorough version of my survivor story, in the Jewish Currents: http://jewishcurrents.org/going-mad/
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