Madness and identity

Can and should madness be an identity?  I said recently that I want other mad people to recognize me as mad, but don’t want non-mad people to apply that label to me.

Madness means one thing when we affirm it for ourselves – it says, I have faced in myself what I was afraid of, what society caged me and forced drugs into me for, what is supposed to be ugly, and I find it to be beautiful and acceptable.  When someone else applies the label to me, it is restrictive, it says that all I am is what they saw when I was at my worst moments, at my most vulnerable moments that they will paste onto me for eternity.

(I’d like to recognize and appreciate the work being done by members of the RedEsfera Latinoamericana de la Diversidad Psicosocial on this question, and the proud statement by several members that they are mad, ‘Soy loca,’ ‘soy loco’, which has inspired me and informed my thinking.  Please view their webinars and Facebook page to learn more.)

I don’t embrace madness as a restrictive label that says we need some other set of rights that sets us outside society, or as a dog and pony show that we can get cookies for if we perform for somebody’s titillation.  I do think it’s necessary to embrace a mad identity in order to face down those who overtly or, more often covertly, apply tropes of madness in relating to us – ‘she’s getting upset now,  we have to calm her down’; ‘uh-oh she’s gonna blow’; ‘yeah she’s upset about her issues being left out, but we can’t let forced psychiatry dominate the agenda’.  Embracing a mad identity lets us say, or growl, ‘oh yeah? you’re afraid I’m gonna get crazy?  I’ll show you crazy!’ or, to think it and respond without fear of stepping out of line.  The lines are policed against those of us labeled as mad in ways that are both discriminatorily applied (‘uh-oh, danger to self and others) and rely on our internalized oppression leading to compliance in order to not be subject to reprisal which can include the repeated use of psychiatry as surreptitious punishment.  (Mad labeling, mental illness labeling, and the use of psychiatry against others, is always a coward’s way out – a way to avoid facing conflict with someone who pushes your buttons, who challenges you in ways you don’t want to deal with.  So you push them away through language and then through actual state-sponsored violence.)

This paradox itself of identity is something that law and policy on disability, bioethics, anti-torture, and ethics and jurisprudence in general, need to embrace and accommodate.  I am not sure how, but we cannot and will not accept being sidelined in disability politics, sidelines in anti-torture politics, sidelined for the most part in legal capacity, and channeled into debates on ‘human rights and mental health’ where we are placed once again in a defensive position being accused by experts who hold the power of discourse and the power of using state-sponsored violence as an instrument of law and policy.

We cannot, contra the recent report of the Special Rapporteur on Health, avoid the glaring problem of forced psychiatry which is pervasive throughout the world including in low and middle income countries of the Global South.  It beggars belief that anyone could imagine that our human rights could somehow be addressed by sidestepping that massive crime against humanity.  Our rights do not stop with eliminating forced psychiatry – we want way, way more.  None of us has ever advocated that this is all there is.  Economic security, including both an end to job discrimination and enough assistance to cover independent housing when we can’t work for any reason, is probably the number one issue everywhere in the world.  I can think of several people right now who are desperate for something to get them out of forced psychiatry situations, for whom lack of economic resources plus discrimination in the community related to housing and/or employment is the biggest barrier if and when they get released.  Acceptance and inclusion in the community even when we are in mad states or experiencing a crisis, is the other essential component to address in policy.  The relationship between support and acceptance has to be synergistic and interpenetrating; we need to look closely at people’s experiences of crisis/mad states with a CRPD lens to understand the variety of support needs that should be provided for, and the different ways support needs can be addressed including mutual support, self-support framed by the social solidarity to allow people time and space to take care of these needs, and dedicated crisis support whether from chosen personal assistants or designated supporters or from skilled and compassionate people who are evaluated and re-evaluated to make sure that they stay skilled and compassionate and respectful of human rights.

If we start from an identity based in this paradox of madness, we are grounded in our self-affirmation, with all that implies.  We are also simply survivors of an atrocity, or some of us are, and have a right to be known in that identity as well.  But that isn’t enough to do all the heavy lifting that replaces forced psychiatry with something else that has the power to displace psychiatry itself from its place of hegemony.  It’s only by reclaiming madness, as ours – positive, neutral and/or negative in any particular individual’s experience, but their own – and rejecting the power of anyone to use ‘madness’ as a label of judgment against another person, to avoid intersubjective relation as an equal, that we can create the right kind of policy.


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