As a psychotherapist who works with other Mad individuals in an L.A. county facility, it seems to me that the wider Mad community is not always aware of the diversity that exists within. While I am grateful for every person who has survived in spite of the limits of therapeutic environments available to many, rich and poor; survivors seem to promote what has worked for them without consideration for what other Mad individuals are dealing with. Many of us who have survived may fail to see the privileges that we have that have enabled ourselves not to get sucked into the institutions. We may think our way of making it is the only way. We may take for granted what we have used to survive. And we may not always learn the diversity lessons that we need in order to be there for our brethren.
Historically we are divided by DSM labels and social inequality and we may easily reinforce those divisions without knowing it. Some of us may consider ourselves members of a spiritual emergence narrative rather than a schizophrenic episode; many even argue that these are separate conditions requiring very different treatment. Others in recovery profess safety in a functioning bipolar community rather than among individuals who are genetically impaired with schizophrenia eugenics. Some want to divide up into individuals who hear voices verses those who are just delusional. And then there are the individuals who evade intrusion by coding up their words. And of course differences in heritage, class, gender and relation to historical trauma are likewise things that many survivors may not completely acknowledge. And still further, those who are wrapped up in the current debate in the Mad community over the use of medication run the risk of dividing us further without acknowledging the diversity of peoples experience and trauma.
The claim that I really object to is: this works for me, therefore it must be what everyone else needs.
Demands for Inclusion in the Movement:
Having gone from one day being a mental health worker who risked everything for social justice to being treated with the worst of what a state hospital has to offer; and, then, to return to a career in which I had to thrive with (instead of for) partners as a licensed professional, I experience the social order in the local survivor movement to be cutthroat. The demands for inclusion make many in it seem intolerant. From my vantage point, to really become promoted in the survivor community, you have to be off your medication, able to afford the conference circuit, able to volunteer, bearing of a prestigious university experience, or open to using stigmatic discernment in terms of who you do and so not associate with. When I interact with both the “chronically normal” and survivor communities, it is easy to feel invisible and irrelevant.
I have to admit that I was given fair warning when I heard local African American people say, “The thing about the recovery movement is that it is clearly a white movement.” Still, amid the very repressed individuals I work with, I have promoted recovery and inclusion with success. I have pointed individuals in the direction of the survivor community and then bound like a puppy into its arms only to face dominance. To my relief, some of the people I have helped may have fared better than me, but I also can say that I understand why a large concentration of brilliant people do not want to change what they are doing and embrace the rank of the movement. Perhaps because I make money off my own brethren: that would be an argument for exclusion that I could respect. But wellness leaders in LA County also make sustainable income as well.
Fitting in with the Misfits:
To be fair to local movement leaders, not fitting into community is something I have a lot of experience with. It has been easy for me to sniff out familiar things that have alienated me in the past, go flat and withdraw. Although in my group work with “psychosis” I teach Mad people that social skills are extremely important to counteract our retaliating and reacting to our Mad experiences, I still do not always use them. I still am known to get off popping in some ghetto references amid stodgy and insulated contexts. Walking like an Egyptian in Rome is a hard habit to rid myself of. No doubt this is one of the times when I need to take my own advice, but when I see mad people in a group setting feeling and acting alienated, I can and do relate to them. Maybe being excluded is part of what make me who I am and it is very easy to go back there. Maybe I just need to accept those feelings and persist.
A Little on my Vision of Learning from Mad Diversity:
But I have seen in Mad groups that Mad learning can come from Mad people connecting with Mad diversity. Higher levels of flexibility, humility, social functioning, and social justice can result.
For example, when I see those who have positive (syntonic) spiritual experiences mix with those who have more paranoid conspiracy focused (dystonic) ones (or any mix thereof); when I see more irritated mania Madness mix with the more dysphoric numbed out or catatonic type; or when I see those who hear voices and see visuals mix the people who code words and get magical intuition from interpersonal information; when I see those who are underprivileged mix with those who are provided for; and finally, when I see those who can go without medication mix with those who have come to a self-determined acceptance that they need it: when all this happens, the individual can gain a bigger cultural sense of who they are. They can become more aware of what advantages and strengths they have. It is an extremely diverse learning environment. And the diversity can be very healing. I see participants learn how they might use the differing perspectives of others to become less stuck with the current situations that limit them.
What I have come to believe is that although Madness made me grow happier and healthier (through a lot of pain and suffering) which fits the narrative of spiritual emergence, I relate very strongly to those still experiencing the pain and suffering. I believe that if I believe in them it is more likely to help them.
Indeed, some message receivers may be more the victim of trauma, some may be more spiritually endowed, and still others may be more afflicted with being scientifically different than others. When one voice rules the Mad nation and imposes their views on the others there is the potential for so much learning and cultural exploration to be lost.
Just Saving the Privileged?
I resist the general sense that treatment must skim the useful and talented from the top of the Mad pile to save them from going into the meat grinder and having horrific experiences. Once you have experienced the meat grinder or try to honor that experience, you may be seen as damaged goods. You may be seen as not worthy of promoting the true virtues of health. On days that I feel highly alienated from the movement, I often feel that I am seen this way.
From where I sit on a swivel chair, being horrified and appalled by repressive environments; unilaterally attacking them in a polarized manner with rank generalizations that alienate and dehumanize individuals who must accept them and learn from them in order to heal is not helpful. I’d argue that it is the proliferation of alienating stigma that divides Mad people instead of accepting and learning from them. Much as happened with the civil rights movement in the U.S., it can be easy for the oppressor to turn us against each other, keep us attacking each other, and recapitulating the pain and hatred we experienced on each other. Sometimes Mad people, myself included, may use one study or piece of evidence to presume they are right about the whole phenomenon.
Many of our early intervention programs are built in this very manner with this mentality. The root of cognitive therapy comes from a culture of privilege and may not be functional for those dealing with generational trauma and without financial support, those buried in oppression. What if the institutional qualities of the mental health corridors fit the familiar experiences you experienced in an institutional high school? The familiarity of the ghetto community may speak to you and help you heal. Then you have these rich kids are fighting for change and make the institutional feel more pretty, and this would alienate, trigger, and perhaps displace you? What’s worse is the imposed fidelity measures that denies the role of culture in such kinds of diverse contexts. While I do agree that cognitive therapy can be vitally important when people are in the stage of trying to socially rehabilitate and facing Stigma, knowing when and how to use it in the process of therapy is important in my opinion.
Diversity Lessons that can Eradicate Stigma:
The thing that makes the Mad community great in my mind is the opportunity to culturally grow and eradicate the role of Stigma in society. However, we can’t do this if we are so focused on our own experience that we clique into power coalitions and impose our will on others. If we spend our time creating research to prove that the lessons from our recovery can be replicated and applied to all of our people, we may not be envisioning the extreme diversity of our people. In fact, our understanding of ourselves may be more limited as a result of us not learning from people who have had vastly different experience. This is the very way our own hurts and biases can come down like an ax and guillotine people when we are not conscious of doing so.
Learning to Work Together:
Having persisted in the meat grinder, I now try to have a different relationship with it. I honor people who use it to improve their lives. I hope that the next time I need it, that I can do it with more sense of dignity. I know I won’t get that externally. It will have to be internal. And yet, I am faced time and time again when I reach out to the Mad community that people like myself get hurt and excluded when confronted with others who are different who don’t fit their vision. I do this and they do this. We hurt. Many times I have had to remind myself that I am not going to let a bunch of people who care nothing about what I’ve learned in my journey, bully me into not taking my medications or judge the people who use therapy to grow. For the most part I find myself warding off pain and persisting with relationships. I find myself ignoring the bruises and trying to learn from them instead of bruising back. I believe this is necessary in order to avoid just being another force that is used to exclude and create factions that divide Mad people and keep them from learning the diversity lessons that I do believe can lead to healing. I pray this will lead to healing. It is what I need. Perhaps it is what the community needs to overcome being so divided.