Researching Mad Pride: The Stigma and Violence of Knowledge Production

by Brigit McWade

Introducing myself

I am an early career researcher, whose work to date has led to my involvement in something called Mad Studies.

What is Mad Studies? As Lucy Costa, from The Empowerment Council in Toronto, Canada puts it: ‘Mad Studies is an emergent area of scholarship that aim to bring to the academic table the ‘experiences, history, culture, political organising, narratives, writings and most importantly, the PEOPLE who identify as: Mad; psychiatric survivors; consumers; service users; mentally ill; patients; neuro-diverse; inmates; disabled – to name a few of the “identity labels” our community may choose to use’ (Costa, 2014). The invocation of ‘madness’ is both a way of self-identifying and a mode of rejecting ‘mental illness’ or ‘disorder’ as labels that psychopathologise emotions, spirituality and neurodiversity.[i] It is against the reduction, stigmatization, and oppression that psychiatrisation[ii] entails: ‘Following other social movements including queer, black, and fat activism, madness talk and text invert the language of oppression reclaiming disparaged identities and restoring pride and dignity to difference’ (LeFrancois et al., 2013, p.10). Mad Studies is thus likened to other activist scholarship to emerge from identity-based social movements.

With the publication of Mad Matters: A Critical Reader in Canadian Mad Studies (LeFrançois, Menzies & Reaume) in 2013, Mad Studies is now gaining a higher profile internationally, bringing together mad-identified and mad-positive academics, activists, artists and people who aim to develop and strengthen what Peter Beresford has described as ‘democratic and feasible alternatives to support our understandings of and responses to madness and distress’ (Beresford in Menzies, LeFrançois, Reaume, 2013, p. ix). Whilst there is no singular agreed definition of mad studies, and no-one should claim to own it or attempt to police its borders, according to the introduction to Mad Matters, Mad studies is ‘a project of inquiry, knowledge production, and political action devoted to the critique and transcendence of psy-centred ways of thinking, behaving, relating, and being’ (LeFrancois et al., 2013, p. 13). It is an interdisciplinary field that centers Mad people and their culture, but works with allies, espousing critical pedagogical values to address relations of power in teaching, research and activism. As such it is ‘part of a wider revolutionary project dedicated to the radical restructuring of the mental health industry’ (LeFrancois et al., 2013, p. 17) that must remain relevant to those caught up in such complex webs of oppression and marginalization. There are many definitions of what Mad means within this movement, and this reflects its diversity. A particular definition I find most useful is that Mad Studies uses madness as a term “to celebrate a plurality of resistances and subversive acts against sanism” (Diamond in Le Francois et al, 2013).

Last week I went to London for a morning meeting with a group of psychiatric survivor researchers and allies to explore ways to support the furthering of mental health service user-led research in the UK through applying for funding and sharing skills and knowledge. We had a great conversation about what constitutes ‘user-led research’ and related terms in mental health such as ‘survivor’, ‘peer’ and ‘co-production’. We considered how research might be undertaken in ways that addresses rather than reproduces inequalities. It was a rich and thought-provoking discussion. Before catching the train home, I went along to a talk by Dr Mohammed Abouelleil Rashed entitled ‘Mad Pride, Cultural Identity and the Demand for Recognition’. This was given as part of a medical anthropology seminar series convened at UCL’s Institute for Advanced Studies. These two events, the meeting and the talk, were so contrasting it was a stark reminder of how far there is to go in attempting to shift psy-dominated narratives about mental health.

In the Leverhulme funded research project on Stigma we are working on, Imogen and I are thinking through what we term ‘the cultural and political economy of stigma’. This means rather than beginning with an idea of stigma as attached to an individual attribute, e.g. “mental illness”, we are examining stigma is an integral form of power and governance in advanced capitalist societies. My research for this project focuses on mental health, madness and stigma, and in a chapter for a forthcoming book entitled Madness, Violence and Power: A Radical Anthology,[iii] I am mapping how mental health anti-stigma campaigns that focus on “correcting” media representations by using the “facts of mental illness” reproduce psy discourse and power. Presenting a Mad Studies analysis, I argue that these psychiatric media-cultures are themselves stigmatising. My trip to London revealed another scene of representation that is complicit in securing psy power – academic research. 

The Seminar

The room fills up with what I assume to be postgrads and academic staff members. There are about 40 to 50 people present. Rashed is researching the Mad Pride movement through a selection of publications. His aim is to analyse Mad Pride discourse and consider the validity of their claims for recognition for Mad identities and culture, asking under what conditions the demands of Mad Pride might be meaningfully met. To begin his presentation, Rashed provides a potted history of Mad Pride. It is a well-rehearsed history – you start by asserting that the persecution of mad people and their resistance to it go back a long time. You might mention Margery Kempe, a voice-hearer from the 14th century. Then you jump forward to the 1960-70s and the rise of the mental/psychiatric patients’ liberation movements, citing Judi Chamberlin’s treatise On Our Own, before moving onto examples such as Survivors Speak Out and Survivor poetry in the 80s, and Mad Pride in the 90s. I’ve told this story myself. It may be well-rehearsed but it is not yet widely known. I’ve told it to audiences not familiar with mad politics or mad people’s history as way to disseminate vital and ongoing activism, to present a counter-narrative to the usual stories we get told about mental health.

After recounting this brief history, Rashed identifies four key elements of mad pride discourse and explaining how he will assess the validity of their claims, their moral and political justification, and what responses they might invoke. He then reflects on the politics of his project, asking ‘can I or should I write an analysis of Mad Pride?’ He notes disability studies work such as Mike Oliver’s that claim that research about disabled people should involve them; that we should not research about them but with them. Oliver’s argument is more than this. In Understanding Disability: From Theory to Practice, Oliver (2009) suggests that in order to address and change the relationship of power integral to social research, we need to overcome both the fetishisation of individual experience and tokenistic inclusion under the guise of participatory design. From his paper, it is not clear that Rashed has fully grasped the implications of this argument. Instead, Rashed argues that as his project is about how to recognise the demands of Mad Pride, he is well situated to undertake this research as he doesn’t belong to the movement. Recognition, he argues, requires an ‘Other’ – it is done between self and other. I have reservations about this claim to objectivity. In his identification as ‘Other’ Rashed draws a line in the sand; the Mad are here, the non-Mad over there and never the twain shall meet. The former is making demands; the latter, the experts and scientists, have the power to validate those demands. The control remains with the researcher and not the researched. My reservations are amplified as the disablist politics of invalidation reveal themselves quite forcefully during the post-talk discussion.

The Discussion

To begin the discussion a young, white, clean-cut, smartly-dressed professor sighs dramatically and declares that he is “so tired of these people” because They deny that there is any suffering involved in mental ill-health.  The audience press Rashed for more information. An anthropologist eagerly want to know what Mad Pride culture looks like ethnographically – has he been to any of their meetings to observe Them? It transpires that many of the audience are psychiatrists or psychologists. The (oversimplified) account of collectivist work asserting pride through identification and activism provided by Rashed is met with psychiatric tales of individuals. In this individualising rhetoric, the role of the psychiatrist and the psychiatric system are effaced and we are drawn to examine the mad person, the suffering person, the dangerous person. In the discussion, psy professionals parade a couple of case-histories of patients who killed themselves or killed someone else. They keep returning to the question of the violence committed by those diagnosed as “mentally ill”. They assert that Mad-identified people don’t address these issues. They proclaim that Mad folk deny that, as the young professor asserts, “these people do harm, real harm” and therefore they need to be sectioned under the Mental Health Act.

I make an intervention. I tell Rashed that I appreciate the ethos of his project is to consider how to meet demands for social justice, but I ask him to consider how his presentation might have been different if there were psychiatric survivors and mad-identified people in the room? Turning to the room, I comment that there has been a “They” invoked in the room but that representatives affiliated with Mad movement aren’t there to speak for themselves. Rashed set up a conversation to think about how “their” demands might be met, but he is the only person here to represent these demands. In the space opened up through “their” absence, the audience have returned the discussion to reductive stories about individuals being dangerous and causing harm. I correct them in their assertions that those involved in this activism don’t think about the question of violence. I cite work such as the Psychiatric Survivors Anti-Violence Framework (PDAC, 2015), Madness, Violence and Power (Daley, Costa & Beresford, forthcoming), and the Campaign to Support the Convention on the Rights of Persons with Disabilities Absolute Prohibition of Commitment and Forced Treatment. I explain that the kind of violences being addressed here are multiple, from the physical violence within hospitals and welfare regimes to structural violence and inequalities.

To a consideration of violence, we also need to add the symbolic violence reproduced by academic research. As Peter Beresford & Jasna Russo (2015) have argued it is not only clinical research that excludes people with lived experience from research. The social sciences and humanities frequently reproduce inequalities by positioning patients/users/survivors as outsiders, objects for interpretation and research ‘on’ rather than ‘with’. Indeed I witnessed how the discussion was shaped both by anthropological cultural reductionism and individualising psychiatric case-studies. These two disciplines share a history that is rooted in colonialism and eugenics. Methodologically, they observe and reproduce difference in ways that assert hierarchies of humans through classification. This made it impossible for them to hear or indeed recognise the demands of a rights movement rooted in a pride politics that refuses the terms of engagement.

On the train home from London, I reflect that perhaps the most important question is not how to validate the claims of Mad people, but rather to better understand the process and practices of invalidation which continually undermine their demands for justice.  If I were to study the audience at the research seminar, I would report that they are so caught up in their own culture of risk aversion and harm-reduction that they are unwilling to really listen to the knowledge produced by the Mad community, or indeed contemplate that psy knowledges and practices are themselves the historical cause of much of that violence and harm.

What is research and what is research for?

My experience of the discussion in London highlighted many of the issues I grapple with in my research about how I am positioned in relation to mental health activists, psychiatric survivors, and Mad-identified people (and these are only three of multiple identifications available). In 2015 I spoke at the transdisciplinary Changing Worlds conference. This conference was organised by postgraduate and early career researchers and its aims are to foster ‘an inclusive forum for exchange, discussion, and collaboration among artists, academics, activists, and other people concerned with science and technology issues.’ The conference papers touched regularly on questions concerning the relationship between academics and activists working towards social change.

My paper explored my involvement in the emerging field of activist based scholarship, Mad Studies, to think about the practicalities of such work. I drew on my experiences of attempting to make space in the academy for mad knowledges and practices, through a series of events (see for example Mad Studies and Neurodiversity: Exploring Connections) to think about how to negotiate different, hybrid identities in academic research, including the practice of organising inclusive research events (for more on this see Jen Slater’s great blog post. Mad Studies is about centering mad voices and mad politics within all aspects of knowledge production. This means undertaking research as an ally to the movement, not researching it as an outsider. It requires us to recognise that to research is a privilege; it is access to resources to do research, to be paid for research, to have the authority to produce knowledge about the world. As researchers we need to consider what and for whom our research is for.

There is an established history of academics, professionals, activists, artists, users and survivors working together in disability and mad politics. According to Mike Oliver (2009) researchers need to ‘put their knowledge and skills in the hands of the research subjects themselves. …[This] implies that we need to develop a language (or discourse) that does not continue to maintain the artificial distinction between researcher and researched’ (p. 115). An example of such alliance work is evident in Kathryn Church’s (1995) book Forbidden Narratives. Such linking of research and activism requires that we turn our attention to the ways in which academia as an institution and set of practices devalues such alliance work.

 

[i] There is no wholesale uptake of the identity of ‘Mad’, for many it is still too stigmatizing a term or it doesn’t accurately reflect their experiences. As you can see from the litany of identifications possible (and the list provided by Costa isn’t exhaustive) this movement is incredibly diverse.

[ii] For a discussion about the different meanings of ‘psychiatrization’ see: http://wellnesswordworks.com/what-does-psychiatrized-mean/

[iii] Edited by Andrea Daley, Lucy Costa and Peter Beresford, published by University of Toronto Press. Due late 2016.

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5 thoughts on “Researching Mad Pride: The Stigma and Violence of Knowledge Production

  1. Hi! I found it very thought-provoking when you said that you “witnessed how the discussion was shaped both by anthropological cultural reductionism and individualising psychiatric case-studies. These two disciplines share a history that is rooted in colonialism and eugenics”. I can see how anthropological cultural reductionism is rooted in colonialism and eugenics, but I why,or rather how, the same the case for the psychiatric practice of discussing individual case studies? Can you recommend some articles/books that discuss this latter connection at length?

    1. Hi Camilla, Thanks for your comment. I argue that both the disciplines of anthropology and psychiatry are share a history rooted in a history of colonialism – not the practice of case-histories per se. Thanks, Brigit.

  2. Bias, prejudice, discrimination, shame but not stigma

    Stigma is a physical mark of hysteria and has been manufactured by the behavioral health industry as an attention getting slogan to focus on the individual’s defects in order to remove from attention the issues of poverty, trauma, violence, … the deprivations.

    Negative framing just embeds what it purports to counteract. This wording guides us to shame the person who isn’t using available resources so that we don’t explore why, why our resources aren’t meeting that person’s needs, or the community’s needs, and how much the shaming stems from the professionals. 

    Wellness is an intricate web of interdependent genetic, biochemical, physiological, economic, social, and psychological factors. Focusing on this larger picture and including the impact of bias and shame can change the professional culture and lead to better overall health outcomes. We will understand what happens differently

    Because changing the words changes the ideas.

    Some of my least favorite words describing the situations are stigma and suffer, which refer more, I think to the population than to the person. Thank you for exploring this.

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