Monthly Archives: December 2020

Identities and who gets to have them

Identity is a paradox. We’re all human, and society – well let’s say patriarchal, capitalist, colonialist/racist society – constructs all kinds of ways to select some people to rule over others and exploit them. Those who are on the bottom don’t get much say in their identity, or anybody else’s. Those at the top get to hide behind a mask of neutrality and objectivity, they are the gods naming everybody else and can remain unnamed themselves.

There is a paradox in oppressed people finding their own voices, because we are embedded in culture that has defined us as the objects for others’ use, for their manipulation and management. Yet every oppression also entails the oppressors knowledge that oppressed people are human beings, subjects with will and creativity and the power to turn their gaze on the oppressor, unmask the oppressor, appropriate even the oppressor’s language to change the common fabric of culture. (It is only by being aware of the humanity – the personhood – of those you oppress, that you instrumentalize their capabilities and seek their compliance; punishment and reward, manipulation and deception all demonstrate this paradox. Oppressed people develop strategies of resistance and accommodation both within and against an oppressive system, and suffer moral injury from compliance; political consciousness is not a given and cultivating it can be both painful and prolonged.)

It seems that there is first a sense of not being able to speak (or naming the reality that one’s speech is made an impossibility), having no words and no context to name the reality of who we are that is crossed out, named to death against us. Listening to ourselves, using the inherent creativity of a conscious being, what Hannah Arendt calls natality, by paying attention in new ways, we find what it is we need to say. Post-colonial studies, women’s studies, pedagogy of the oppressed, ‘hearing each other into speech’, creating separatist spaces to encounter one another free from the exempted gaze and discourse of those who speak from outside this reality and put together the shards of what needs to be made whole; or talk about the brokenness and witness the whole emerge.

Identity and material reality

I’m going to talk about survivor identity here, and the concept of psychosocial disability, users and survivors of psychiatry, and also women as in women’s liberation. Who the ‘we’ is that gets to define who ‘we’ are – that gets to name ourselves, to take the reins of power from the oppressed, to define the oppressed. So starting with women, because the identity has now become convoluted – if anyone can define themselves as a woman, and the oppressor class is now those who would gatekeep and deny such definition…. we see the oppressed pushed back into silence, denied the power and even the linguistic possibility of naming ourselves. We are defined out of existence as an oppressed class, by virtue of a theory that can admit even that society constructs oppression based on sex – what gender theory cannot admit is the existence of oppressor and oppressed classes that are materially constituted not as biological essentialism but as power, so that female human beings can be understood as a class naming themselves. (We do not have to claim a universal female experience; nor do we have to claim any universal or monolithic experience of any other oppressed group – e.g. every oppressed group contains both male and female human beings who are differently situated, and that is intersectionality.)

OK, so material oppression can be analyzed, and posited as a fact underlying this politicization of identity, a fact or a ground on which people who are experiencing oppression can recognize themselves as oppressed, separate themselves from the oppressor, and begin to speak against the oppressor and construct a new consciousness that leads toward a deliberate strategy to end the oppression materially.

Psychiatric oppression and madness-related identities

How does that apply to psychiatric oppression? Or, what does it mean to combat psychiatric oppression as a survivor of it, and how does that relate to the other identities that it has been linked to? We say there is no ‘there’ there, that the material reality of psychiatric oppression is the selection by psychiatrists of their victims through the acts of diagnosis and hospitalization and treatment that may be formally voluntary or involuntary but in which the person has no real power to negate the material fact of this selection if the psychiatrist insists on it through involuntary commitment actually carried out or threatened in order to gain compliance. But what about people who present themselves to psychiatry seeking services, who may use psychiatric drugs and struggle to go off them but have never been involuntarily committed and lead full lives? What about people who go through a period of madness without being locked up? And really what about those of us who were locked up once, got out and never looked back? What is it that defines all of us as a collective? Is there a material reality to madness – again a kind of black-box, what does it mean? – we can reframe it as distress or unusual thoughts or perceptions, does that help? Is that actually an experience common to all people, and could we say something about this experience significantly impacting a person’s life either for a period of time or long-term? Including the long-term impact of the profound discrimination and violence entailed in the psychiatric selection and subjugation? (Maybe, maybe not; do we need to refer to madness and define it – if we refer to it I think it has to be defined so as to avoid romanticism and circular subjectivism; is it useful to define a material reality as a basis for our collective reference group, and is ‘madness’ the starting point for such definition that makes most sense?)

The reason this becomes important is that we cannot actually rely on people to come out about their experience in any uniform way; this is true about any identity that is not immediately visible, including (for some people) being gay or lesbian, and even about identities that are immediately visible such as people who have limited mobility – no one is required to claim any particular identity even if others might apply it to them. (Note that madness is imputed and therefore visible in some sense, and the markers for perceiving someone as mad say more about the social construct of madness than about any characteristic of a person; this can be said about other identities as well but madness imputes an internal state of being to the person that is impossible for anyone else to directly ascertain, even if it can be well defined.)

The madness-related identities, including simply being labeled and treated as a mad person by others – and perhaps madness amounts to this exact disconnection – but then what about those who simply use mental health services, who might identify as having a mental health condition, or might simply say, I see a therapist for trauma counseling, or I use a psychiatric drug to help me stay alert and focused – are they all on the same continuum? We might have converging interests for example in banning electroshock and banning or seriously challenging the prescribing of neuroleptic drugs (the equivocation about neuroleptics in contrast to the banning of electroshock reflects the state of negotiated consensus among the constituency; more people use neuroleptics satisfactorily by choice than have satisfactory experiences with electroshock, among activists in the human rights-focused – as opposed to medical model – movement of the collective); we might converge in caring about reform or abolition of psychiatry and mental health discourse, or psy disciplines (again the equivocation reflects ongoing debates about reform vs abolition of psychiatry etc and what this might mean; it is a separate question from abolition of involuntary commitment).

We might also converge on fighting for abolition of psychiatry’s power to select and subjugate, i.e. all the powers related to involuntary commitment, because anyone close to the mental health system can get sucked under in a moment if a drug wreaks havoc unexpectedly, perhaps from a new prescription or change in the dosage, or by confiding newly emerging deep and raw feelings to a therapist or psychiatrist who is unprepared and decides this makes you a danger to self or others.

Does it matter that we have different experiences? Does it matter that some of us experienced a crisis (also somewhat of a black box requiring explication) only once, and whether or not we were locked up and therefore claim a survivor identity? Does it matter if we still experience trauma from being locked up? Does it matter if the only discrimination we currently face is by identifying as a survivor, bearing witness and fighting for abolition, and thus confronting all the prejudice that reads ‘survivor of psychiatric violence’ as ‘mental patient’, ‘mentally ill person’? Who has the choice to identify in or out, and how much depends on political solidarity? If my identification as a survivor and indelibly part of ‘this collective’ is based on bearing witness, declaring ‘never again’ and understanding that no one in ‘this collective’ of identities related to madness is differently situated than me in that we all have been or are vulnerable to being exposed to psychiatric violence and related oppression – is it a personal identity? Does it say anything about me, other than that I refuse to exempt myself, refuse to escape a collective fate? (Well, I personally stay far away from psychiatry and there is no one left in my life who has an agenda of psychiatrizing me, so I don’t feel myself to be at risk except as a form of political retaliation that could mobilize my identity and acknowledged history, and this comes to the surface when I am called upon to take risks in any kind of activism for human rights. But beyond that, is there a survivor guilt or simply a political commitment and calling to do the work I do?)

Problematizing identities and the choice to not identify

I need to problematize these identities and the diversity within our collective, because the choice of whether to identify or not is political, especially when a person is doing work on ‘our issues’. That is to say, when a person is in a position of advocating ‘for the human rights of people with psychosocial disabilities’ or pronouncing on these rights in an official capacity, and has had relevant experiences but feels that they do not really qualify or prefers not to take on the identity in doing the work. Sometimes people in such roles openly acknowledge that they use mental health services, and may also consider that they are being treated for a ‘mental health condition’, but balk at the suggestion that this places them within the collective of ‘people with psychosocial disabilities’. (They should know, by the way, that the Committee on the Rights of Persons with Disabilities instructed Spain that it could not maintain a false distinction between people with mental health conditions and people with psychosocial disabilities; for purposes of the Convention all people with mental health conditions are to be treated as people with psychosocial disabilities. This came in the context of Spain having argued that the Committee’s recommendations to repeal legislation authorizing deprivation of liberty based on psychosocial disability had nothing to do with Spain, because their legislation only authorized involuntary hospitalization based on a mental health condition. Well, that was a non-starter for the CRPD Committee which emphatically told them otherwise. (This illustrates a material convergence of interests irrespective of whether or not an individual chooses to self-identify.))

The point is that playing word games about identity doesn’t get to the real issue. If you say you’re not a person with a disability, large numbers of people who identify as mental health service users or as survivors of psychiatry also don’t like the term disability and don’t identify with it personally; it’s a tool to claim our human rights and the concept of disability non-discrimination works well as applied to core issues of this constituency; our version of the social model of disability is that every person is fine just as they are and society needs to accommodate them and act in solidarity with them rather than trying to ‘fix’ the person – not the version that parses out impairment from social disablement and links them through the existence of barriers. If you say you’re not oppressed – well not all of us who identify have been either. Not all of us have been locked up, not all of us struggle to go off psychiatric drugs, not all of us experience long-term or intermittent distress or unusual thoughts or perceptions. Not all of us have been electroshocked, not all of us have been neurolepticized, not all of us have been put in restraints or institutionalized long-term, not all of us have been locked up. Not all of us live in poverty, not all of us experience racial oppression or oppression based on sexual orientation, gender identity, or sex. It is a heterogeneous identity or heterogeneous collective, in that it includes people whose experiences do not overlap with each other. (So what is it that leads some to identity and others not, and why does it matter?)

Sometimes people disclose experiences privately that inform their passionate advocacy for legal capacity or abolition of forced psychiatry or, perhaps more problematically, ‘human rights in mental health’. I don’t out people unless they are disclosing experiences of another person – e.g. if someone discloses that a family member is a person with psychosocial disability, I do inform my colleagues in the movement that this person is a family member because that’s an identity to watch out for especially when the person advocates the permissibility of any forced interventions. But I don’t disclose a person’s confidences about having used mental health services or having experienced madness. I think we have a right to our own privacy. (If someone has once put themselves forward as a member of a delegation of a representative organization of users and survivors of psychiatry, I may also clarify that I was under the impression that this person was a member of the collective, as we do not put forward others to speak for us. There are material interests at stake, in terms of reputation and credibility, and I do reject the simultaneous attempt to benefit from such elevation and denying a personal stake in the issue as to which expert status is claimed.)

Keeping these confidences puts me in an awkward and problematic position. I want to challenge those who confide in me, or who might think of doing so, to think about the self-exemption that they have chosen in contrast to my choice of solidarity. I would like them to understand that there is no inherent difference between us – and especially that appealing to the question of whether or not a person has been oppressed by virtue of madness-related experience is not read by society as the meaning of ‘psychosocial disability’. (If this applies to you, reader, you might consider the impact of occupying space by virtue of speaking on issues about which you disclaim any personal stake, which is a privileged position, and either come out about your own stake in the matter or give up your space to someone who possesses human rights expertise and is willing to claim their personal stake as well. It is not by claiming an identity, but by claiming expertise, that you occupy a space illegitimately. The world needs more of us who challenge society’s disconnect between madness and reason, not fewer; and you cannot escape your personal contradiction by doing the work while remaining closeted.)

The world reads self-identification as part of this collective, whether as a survivor of psychiatric violence, mad person, mental health service user, etc., as categorically meaning a person with mental illness who then must always speak as a patient, as a petitioner for others’ attention, and never as an authority – never as a legal innovator, except accidentally and exceptionally; never as an official of state. If we have these extra identities, they are superimposed on ‘mental patient’ rather than understood as who we are in the world, coming from a standpoint as survivors of psychiatric violence, etc. It’s important for those who use mental health services but don’t identify with the collective, to consider what you are keeping by remaining separate, and to reflect on and be open about your own relationship to mental health services or madness – yes, including ‘distress’ – when you are discussing mental health policy, abolition of forced psychiatry, legal capacity.

Nobody can make you identify in a way that you don’t, nobody can make you join a group that you don’t want to join or to speak in a representative capacity. But if you don’t identify your own particular stake in the work, if you speak in a voice that claims neutrality and objectivity, you are in effect privileging your own position by refusing to put it in dialogue with others in the heterogeneous collective. Everyone ought to put their own standpoint on the line publicly, including family members, friends, people who have no relationship to it whatsoever and might be curious – it can’t be that self-identified survivors, people with psychosocial disabilities, mental health users are ‘marked’ and those who choose not to self-identify, or who never had any connection on the receiving end of the drug or the needle or therapy, get to stay outside as ‘unmarked’ and their position privileged as having no axe to grind.

Anyone working on these issues needs to ask themselves, what is your connection to ‘mental health’, to madness and to forced psychiatry? Did you ever call the police on somebody to involuntarily commit them? Did you ever exclude somebody from your land group or political committee because they were too difficult and you decided they were bipolar or had borderline personality disorder? We’re all in this in our real lives, and nobody is exempt.

‘Occupying space’ as a mad person, as a woman, as a lesbian

There is the question of whether you are taking the place of someone who deserves it more than you, if you are only seeing a therapist and have never been locked up or taken psychiatric drugs, do you really count? But I would like to say, there are not a finite number of ‘spaces’ to occupy. Nor is it a particular space that one occupies in a figurative sense, by coming out about one’s personal relationship to an issue. The identities as such don’t matter – except when someone categorically sets themselves apart from this identity that they see others as falling within. Nobody – certainly not I – chooses to occupy space as a mad person, as the mythologized stigmatized other created by societies and augmented by psychiatry. I put myself forward to represent this collective as an affirmation that nobody deserves to be placed in that role – to erase the identity by claiming our rights in the context of the CRPD. It deserves to be a disappearing identity, is not one that I have any desire to hold onto or make meaningful. I suppose I differ in that regard from those who claim ‘mad’ as a positive identity meaning something like, resisting society’s normality. (I am revisiting here an issue I addressed in an earlier blog on madness and identity.) My work on CRPD is a bearing witness, an act of reparation and transformative justice, that calls for the opening out of those labeled as mad, into simple humanity, really a spectrum of intense and often painful experiences that are unintelligible until the way is found to articulate them.

Can gender work the same way? Well if it’s only gender in isolation sure, we can say gender as sex-linked roles and expectations (stereotypes, or constellations of meaning) is not necessary and can be abolished. And society’s construct of sex-based oppression, not just a conceptual but a material construct, can be dismantled, and we are all human beings finding our own ways to flourish. The sexed body is its own reality as our experiences of distress or unusual thoughts or perceptions are real, and as madness in the sense of radical disconnection and unintelligibility that can transform itself in an instant, is real. But we don’t get to that abolition by substituting mere subjective identification for a material analysis of the basis of oppression and how different people are situated in relationship to it; in this case based on sex as well as based on different kinds of conformity or non-conformity to sex stereotypes, including the impact of deceptive or assimilative self-presentation (passing) or apparent sex contrary to one’s actual embodiment, and the complications introduced by hormones and surgeries. Again, we need to look at the actual situated positions and their implications for a person’s standpoint on any given issue. We don’t disappear gender by waving a magic wand, only by everyone speaking especially those who are gendered as the class whose reproductive labor is appropriated by the other, unmarked gendered class. Nobody wants to be a ‘woman’ unless they are romanticizing oppression or unless they are remaking the meaning of solidarity and self-regard, coming to consciousness, of those of us with female bodies and experiences related to socialization as this subjugated gender – or unless they are members of societies that avoided gender oppression so that the meaning is a word of strength and centrality to human community rather than victim of predatory exploitation.

Lesbian, I have to add, is an irreducible identity. It may be a historically situated one, as everything we do is historically situated. But it is an identity that once found, I would not like to see disappear. It has meaning as a core of female sexuality and the autonomous mutual relation of female beings to one another, it has a spiritual dimension and a political one as well as being social and sexual. Lesbian cannot be merged into LGBTQI, and it has been contested, or has had to contest for space, in the context of ‘woman’; merging lesbians into LGBTQI further pushes us out of the context of ‘woman’ and pushes ‘women’ back into compulsory heterosexuality in which their reproductive labor for men cannot be refused. It doesn’t matter if ‘every woman can be a lesbian’ in a literal sense; heterosexual women’s sexuality is as authentically theirs as lesbians’ is ours; it is in a societal sense that lesbians relate to the existence of an autonomous women’s movement as part of a continuum that rejects the gendered compulsory linkage of woman with man while man is able to stand alone.

I’d like to bring these themes together, but I can’t. Lesbian is an irreducible identity to me, that I find joyful. Being a survivor of psychiatric violence is a fact stamped on my life by oppression, I take it as it comes and work with it, work through it, towards human liberation. (Being a woman is a stamp on my life as well, that leads me to solidarity and to separation of female embodiment, and the culture we create as female-embodied persons, from gender oppression that encompasses male subjugation of females and the ideology, including sex stereotyping, that rationalizes this subjugation.) They don’t intersect so much as coexist. And this complexity is fine, because we don’t need a complete theory of identities, we need theory that is useful for the purposes at hand.