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Write a paragraph (200 words) with a brief summary of the key points, analysis, and arguments of the reading, and any insights you might want to share (response format). Make sure to integrate at least two authors in your response.Reading(s):will be attachedEasy vocabulary. No plagiarism (studypools standards are 15\% and below). lewis.pdf price.pdf Unformatted Attachment Preview CHAPTER 9 A Mad Fight: Psychiatry and Disability Activism Bradley Lewis In the late summer of 2003, six people gathered at a small building in Pasadena, California and starved themselves for twenty-two days. The small group of hunger strikers were later joined by over a dozen “solidarity strikers” around the world. Their strike was about “human rights in mental health” and, in particular, it sought to protest the “international domination” of biological approaches to psychiatry and the ever-increasing and widespread use of prescription drugs to treat “mental and emotional crises” (Mindfreedom, July 28, 2003). The hunger strike caught the attention of the LA Times, The Washington Post and, most important for those involved, the attention of the American Psychiatric Association (APA). One of the central aims of the strike was to challenge the main institutions in psychiatry—namely the American Psychiatric Association, the National Alliance of the Mentally Ill (NAMI) and the U.S. Surgeon General—and to rouse them into providing “evidence that clearly establishes the validity of ‘schizophrenia,’ ‘depression’ or other ‘major mental illnesses’ as biologically-based brain diseases” (Mindfreedom, July 28, 2003). The fasters demanded evidence that mental and emotional distress results from “chemical imbalances” in the brain; a view that underpins the biopsychiatric medical model and which currently dominates mental health treatment in the West. In demanding this evidence, the strikers were taking a risk. Using a hunger strike to challenge psychiatry and its scientific findings (which are now almost ubiquitously accepted throughout the medical world and wider culture), the protestors faced the possibility of being labeled “mad”— after all, isn’t psychiatry a science? Shouldn’t scientific questions be decided in laboratories and in peer-reviewed articles filled with graphs and statistical analysis? What sense does it make to hold a hunger strike to challenge contemporary scientific beliefs? The hunger strikers took the risk because, indeed, they are mad. They are all members of a psychiatry disability activist group known among their friends and allies as “Mad Pride.” This activist group is an international coalition devoted to resisting and critiquing clinician-centered psychiatric systems, finding alternative and peerrun approaches to mental health recovery, and helping those who wish to do so minimize their involvement with current psychiatric institutions. They affectionately call themselves “Mad Pride” because they believe mainstream psychiatry over exaggerates psychic pathology and over enforces psychic conformity in the guise of 116 | BRADLEY LEWIS diagnostic labeling and treatment—which all too often comes in the form of forced or manipulated hospitalizations, restraints, seclusions, and medications. Like the celebratory and reappropriative uses of the terms “Crip,” “Queer,” and “Black Pride,” the term “Mad Pride” overturns traditional distinctions and hierarchies. It signifies a reversal of standard pathological connotations of “madness.” Rather than pathologizing mental difference, Mad Pride signifies a stance of respect, appreciation, and affirmation. In this chapter, I discuss the relation of Mad Pride to disability studies, review the history the movement, and work through its contemporary struggles with psychiatry. Throughout the discussion, I highlight the importance of Mad Pride’s efforts to go beyond “politics-as-usual.” Mad Pride, like other forms of “biocultural” activisms (such as Women’s Health Movement and AIDS Coalition to Unleash Power), is located at the interface of bioscience and politics. As such, Mad Pride continuously struggles with epistemological issues along with more typical political issues. In short, the people in Mad Pride struggle over both truth and values. This commingling of politics, power, and truth is familiar ground for disability studies. Similar to Mad Pride, disability studies unpacks and undermines stereotyped representations of disability in science and popular culture to understand and intervene in how “representation attaches meanings to bodies” (GarlandThomson 1997, 5). Michael Oliver gives a good sense of these stereotyped disability representations by dividing them into key themes of “individualism,” “medicalization,” and “normality” (Oliver 1990, 56, 58). Individualism refers to the perspective that disability is a “personal tragedy.” This frame undergirds a “hegemony of disability” which views disability as “pathological and problem-oriented” (Oliver 1996, 129). It leads to a ubiquitous medicalization that legitimizes the medical infrastructure for acquiring knowledge about the disabled individual. The logic of this medical infrastructure rests on notions of normality and the dichotomy between normal and pathological. The able-bodied and the disabled, the valued and the devalued, become coconstituted cultural divisions which structure medical and cultural preoccupations (Davis 1995). One side of the binary defines the other and both operate together as “opposing twin figures that legitimate a system of social, economic, and political empowerment justified by physiological differences” (Garland-Thomson 1997, 8). Together, these stereotyped disability representations direct the health care industry toward a near exclusive focus on individual biomedical cures. Rather than adjust social environments to meet differing bodily needs, medical interventions seek to cure the individual “abnormal” body. Disability activists resist these individualizing and medicalizing approaches by reframing disability as a social restriction and oppression rather than simply a medical problem. Emphasizing a social model rather than a medical model they call attention to the fact that much of the suffering of different bodies comes from social exclusion, isolation, and lack of opportunity, along with the often pernicious side effects of a medical industry bent on aggressive intervention to achieve “normal” bodies.1 The task of undermining stereotyped representations of individualism, medicalization, and normality are also central to the Mad Pride movement. Individualistic approaches to mental difference and distress blame and punish the victim for structural problems that are often better understood as located in families, communities, and society. Medicalization, or psychiatrization, legitimizes the medical community’s expert authority over the A MAD FIGHT domain of mental difference. And the binary between normal and abnormal shores up this psychiatrization by providing tremendous social and psychological pressure to stay on the side of normality, or sanity. Disability studies scholars refer to social stigma and oppression against the physically different as “ableism”; those in Mad Pride refer to social stigma and oppression against mental difference as “mentalism” or “sanism” (Chamberlin 1977, 219; Perlin 2000, 21). Despite these similarities, disability activists and Mad Pride members have had difficulty forming a sustained coalition. Part of this difficulty involves the simple fact that two groups are composed of different subcultures—with different histories, different cultural artifacts, and different networks of association. But, beyond this, there are other, deeper reasons. Some disability advocates continue to harbor sanist style associations toward mental difference and do not wish to be associated or “tarnished” by Mad Pride. Likewise, many in Mad Pride (like many in the Deaf community) express discomfort with the “disability” label. They do not see their mental difference as a disability, but rather as a valued capacity. In addition, many in Mad Pride feel that disability struggles are separate from their concerns because physical disability does not involve the same level of state coercion. People with physical differences are often inappropriately confined (through limited choices and multiple manipulations), but Mad Pride activists must deal with an additional layer of state sponsored coercion in the forms of involuntary commitment and forced medication laws.2 Like many in both movements, however, I believe it is wise to foreground the similarities between disability activism and Mad Pride. Clearly, all of the new social movements, in one way or another, have to struggle with both truth and values—largely because biomedical science has been | used to justify such a broad range of subordination practices. But, more than most, Mad Pride and disability activism face a combined political and epistemological struggle. The very heart of these activisms begins with expressly biomedical assignments of impairment. This comes not in the form of a general pronouncement of inferiority, but in a direct and specific diagnosis and treatment process. Because of this, Mad Pride and disability activist efforts to reduce individualization, medicalization, and ableism require a dual struggle that goes beyond politics-as-usual. The challenge of this dual epistemological and political struggle requires all the allies you can get. When disability activist and Mad Pride work together, they can form a formidable coalition. THE BIRTH OF MAD PRIDE MOVEMENT Mad Pride activists have had extensive experience going beyond politics-as-usual. Their lesson of dual engagement goes back to the nineteenth century efforts of Mrs. Elizabeth Ware Packard, an early precursor to today’s Mad Pride movement. In 1886, Packard, a former mental hospital patient and founder of the Anti-Insane Asylum Society, began publishing a series of books and pamphlets critical of psychiatry. Packard’s writings challenged the subordination of women to their husbands and the remarkable complicity of the political and psychiatric establishment to this subordination (Packard 1868, 1874). As Gerald Grob explains, “When Packard refused to play the role of obedient [minister’s] wife and expressed religious ideas bordering on mysticism, her husband had her committed in 1860 to the Illinois State Hospital for the Insane” (Grob 1994, 84). Packard remained incarcerated for three years and only won her freedom by going to court to challenge her confinement. The trial 117 118 | BRADLEY LEWIS received national publicity and eventually led to Packard being declared sane by the court and released from the asylum. She spent the next twenty years campaigning for personal liberty laws that would protect individuals from wrongful commitment and retention in the asylums. Even in this early precursor to today’s movement, the issues of epistemological struggle and political struggle are inseparably intertwined. Packard challenged pathologizing diagnostic practices that would treat people as insane “simply for the expression of opinions, no matter how absurd these opinions may appear for others” (quoted in Geller and Harris 1994, 66). And she challenged the political abuses that occurred once the insanity diagnosis had been made. Lunatic asylums, she argued, too often left people at the complete mercy of hospital despotism where they were treated worse than convicts or criminals. Packard’s dual stress on both the “facts” of insanity and the inhumane treatment of those considered to be insane reverberate into today’s resistance to psychiatry. The more proximate antecedents to today’s Mad Pride movement began in the 1970’s. Mad Pride activists, during these years, gained momentum from the black civil rights movement, the women’s movement, and from the early stages of lesbian and gay movement and the disability movement. Like Elizabeth Packard almost a century before, the key experience that motivated Mad Pride activists was their negative treatment within the psychiatric system. Early founders of the movement shared common experiences of being treated with disrespect, disregard, and discrimination at the hands of psychiatry. Many also suffered from unjustified confinement, verbal and physical abuse, and exclusion from treatment planning. The testimony of Leonard Roy Frank, cofounder of the Network Against Psychiatric Assault (1972), provides a helpful glimpse into the experiences of many. After graduating from Wharton, Frank moved to San Francisco to sell commercial real estate. He was in his own words “an extraordinarily conventional person” (Farber 1993, 191). Gradually, during his late twenties, he started discovering a new world within himself and began going through an “obvious clash between . . . my emerging self and that of my old self” (191). He later thought of this as a “spiritual transformation.” But, at the time, he responded by doing serious reading and reflection on his emerging insights. He ended up rethinking everything in his life: “what was happening to me was that I was busy being born” (191). A key text for Frank during his transformation was Mohandas Gandhi’s autobiography. Frank took seriously Gandhi’s message that one’s inner life and outer life should interact and complement each other. Reading Gandhi opened his eyes to the violence of political injustice and to the power of non-violent resistance. It also raised his awareness that animals had feelings and could suffer. The more Frank thought about Gandhi’s writings on meat-eating, the more he concluded it was inescapably cruel to both animals and to humans: “We can’t avoid harming ourselves when we harm other beings, whether human or animal. Meat-eating was an excellent example of how this principle played out in real life . . . Because it was inherently cruel to animals and morally wrong, it affected the wrong doers by causing them to become sick and cutting short their lives” (206). This combination of insights made it difficult for Frank to continue his previous lifestyle and his work selling commercial real estate; he soon lost his job, grew a beard, became vegetarian, and devoted himself to full time spiritual exploration. Frank was exhilarated by the process, but his parents were deeply concerned. Seeing Frank’s transition through the stereotyped A MAD FIGHT frames of individualization, psychiatrization, and sanism, they thought he was having a “breakdown.” They tried to persuade him to see a psychiatrist, but Frank resisted. They responded by arranging an involuntary commitment. The hospital records show that Frank’s psychiatrists document symptoms of “not working, withdrawal, growing a beard, becoming a vegetarian, bizarre behavior, negativism, strong beliefs, piercing eyes, and religious preoccupations” (193). The psychiatrists diagnosed him as “paranoid schizophrenia,” and they started a sustained course of court authorized insulin-electroshock treatments that lasted nine months and included fifty insulin comas and thirty-five electroshocks. When the psychiatrists were not giving him shock treatments, their “therapeutic” interactions with Frank revolved around his behavior: particularly his refusal to shave or eat meat. There was never any discussion of his emerging beliefs or his spirituality. Instead, Frank’s psychiatrists focused on changing overt signs of “abnormality.” They even went so far as to shave his beard while he was unconscious from an insulin treatment. Frank eventually came to realize that his hospital resistance was futile, and, with the ever increasing numbers of shock treatments, he also came to fear he was in a “life or death” situation: “These so-called [shock] treatments literally wiped out all my memory for the [previous] two-year period . . . I realized that my high-school and college were all but gone; educationally, I was at about the eighth-grade level” (196). Rather than risk more “treatments,” Frank surrendered. He played the psychiatrists’ game and did what they wanted: “I shaved voluntarily, ate some non vegetarian foods like clam chowder and eggs, was somewhat sociable, and smiled ‘appropriately’ at my jailers” (196). After his release, it took six years to recover from his treat- | ment. But, throughout it all, he never gave up on his beliefs, and he never saw another psychiatrist for treatment. He went on to become a major figure in early Mad Pride activism. During the early 1970s, people like Frank began to recognize they were not alone and started organizing local consciousness-raising groups. In the United States this includes such organization as the Insane Liberation Front in Portland Oregon (1970), the Mental Patient’s Liberation Project in New York City (1971), and the Mental Patients’ Liberation Front in Boston (1971). These groups built support programs, advocated for hospitalized patients, lobbied for changes in the laws, and educated the public through guest lectures and newsletters. In addition, they began the process of developing alternative, creative, and artistic ways of dealing with emotional suffering and psychological difference outside the medical models of psychiatry. The publication of Mad Pride activist Judi Chamberlin’s book On Our Own (1977) in the mainstream press was a milestone in the development of peer run alternatives (Van Tosh and del Vecchio 2000, 9). Chamberlin used the book to expose her own abuse at the hands of psychiatry and to give a detailed account of burgeoning consumer run alternatives. The eloquence, optimism, and timing of the book was a critical catalyst for many in the movement. As ex-patient Mary O’Hagan puts it: “When my mood swings died away I was angry and amazed at how the mental health system could be so ineffective. There had to be a better way. I searched the library not quite knowing what I was looking for. And there it was, a book called On Our Own by Judi Chamberlin. It was all about ex-patients who set up their own alternatives to the mental health system and it set me on my journey in to the psychiatric survivor movement” (quoted in Chamberlin, 1977, back cover). 119 120 | BRADLEY LEWIS The newly formed local Mad Pride groups also organized an annual Conference on Human Rights and Psychiatric Oppression to help connect local members with the wider movement. At these meetings, activists from across the country gathered to socialize, strategize, and share experiences. They gained solidarity and increasing momentum from the experience of being with like minded activists. Between meetings local groups communicated through a newspaper forum. The San Francisco local newsletter, Madness Network News, evolved into a newspaper format which covered ex-patient activities across North America and around the world. This publication became the major voice of the movement, with each issue containing a rich selection of personal memoirs, creative writing, cartoons, humor, art, political commentary, and factual reporting—all from the ex-patient point of view (Hirsch 1974; Chamberlin 1990, 327). This early period of the Mad Pride movement was also the most radical in its epistemological critique. Early leaders of the movement drew philosophical support from high-profile critical writers that, as a group, came to be known as “antipsychiatry.” Writers such as Erving Goffman (1961), R. D. Laing (1967), Thomas Scheff (1966), and Thomas Szasz (1961) may have differed widely in their philosophies, but collectively their main tenets were clear. Mental illness is not an objective medical reality but rather either a negative label or a strategy for coping in a mad world. As Laing put it, “the apparent irrationality of the single ‘psychotic’ individual” may often be understood “within the context of the family.” And, in turn, the irrationality of the family can be understood if it is placed “within the context of yet larger organizations and institutions” (Laing 1968, 15). Put in context ... Purchase answer to see full attachment