5/1/19

System Pride Day: An Exclusionist Double Feature

From TERFs to ace exclusionists, every identity group has people in it who think they get to decide who is and who isn't allowed in. The multiples community is no exception.



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2/3/19

Fad Diets For Psychiatrized Children: The Drug Paradigm In Disguise

  "The road to hell is paved with good intentions."
–English proverb of unknown origin, meaning people often do bad things for seemingly good reasons

As fighters of what seems like a losing battle, and in some cases really is, we are often tempted by what look like concessions to our cause, but are really not. For psychiatric survivors, Mad/Neurodivergent people, and anyone else critical of the mental health system, drugs often take the focus, thanks to their dangerous or even deadly "side effects" and multi-billion-dollar marketing campaigns. It can be a relief to hear the story of a parent going against doctor's orders and sparing their kid the harmful drugs. However, that doesn't necessarily mean no harm is taking place. There are lots of ways to hurt children besides drugging them, which many parent organizations are advocating for.

Look no further than anti-vaccine cult groups, and you will see people who are not only fond of resurrecting deadly diseases, but also of any other so-called alternative said to fix their children who aren't broken. They eagerly spend thousands at a time on vitamins, consultations with nutritionists, oxygen chambers, and anal bleaching (and not the fun porn variety). These are people who hate drugs not because they have demonstrable negative effects on people's livelihood, but because Big Pharma is a scary name. At best, we could conclude this pattern is evidence of our movement gaining traction− that someone would go out of their way to deceive us. More likely, these parents are only specifically against psychiatric drugging, and for bad reasons, while still operating within a pathology paradigm, potentially doing greater damage than drugs would.

Look further than anti-vaccination, and the bleach goes away but the diets remain. Healthism has gotten so out-of-control that it reaches beyond fatphobia and convinces people that ALL of their problems, real or perceived, can be solved by giving money to a nutritionist. The most popular diets bubble up and blow over in a series of fads, much like the fad drugs that proliferate advertising space until our culture gets tired of the name.

The Feingold diet became one of the most famous in the 1970's, still referenced with admiration today, despite a lack of credible research supporting its effectiveness. Growing up in the 90's and early 2000s, I remember when the headless torsos started appearing on television, scaring people into counting carbs and calories lest they become another anonymous fat body. At time of writing, the big fads are now eliminating gluten, fear of GMOs, "organic" versions of food typically farmed with pesticides, and flirting with overdose on vitamin supplements. The gluten-free fad is the one silver lining on this list: people with celiac disease or other gluten sensitivities can now more easily find food that is actually edible. Forcing gluten-free on a non-gluten-sensitive child, however, is imposing a restriction for no reason.

Fad diets are not harmless nor above criticism. They are not inherently challenging to the drug-based, pathological worldview. In fact, media messaging to promote diets, when not accompanied by a clear anti-psychiatry stance, often does more to support pathologizing madness/neurodivergence than to challenge it. These are more than pitfalls– they are fundamental patterns of ableism and abuse culture.

1. You are still trying to "treat" a perceived "mental disorder".


The definition of psychiatry is the diagnosis and treatment of mental disorders.

Not all practitioners of fad diets do so under the pretense of treating a disorder, but those who do are amateur psychiatrists operating under a drug-based paradigm. They are treating food the way a psychiatrist treats a drug: A substance you put in someone's body to cure them of their alleged illness. It's tempting to see a parallel between avoiding certain foods and avoiding psychiatric drugs, but since we actually need food to live, a message that your current diet is causing problems necessarily holds the subtext that putting something else into your body would solve those problems. Fad diets for psychiatrized children are psychiatry. They are also abuse.

No matter the method, regarding someone's natural state of mind as a health condition and attempting to eliminate it under the guise of "treatment", without asking whether they agree that it's unhealthy and consent to treatment, is psychiatric abuse. When it comes to children, we are usually talking about those labeled as "ADHD" or Autistic. Accurate or not, the label is the first psychiatric act against the child– I say "against" because what immediately follows is almost always a discussion of "treatment" options, skipping over the question of whether any intervention is actually necessary or beneficial.

New opinion articles appear on the daily, expressing concern about "over-diagnosis" of ADHD, and more recently autism as well– the latter held back by alarmist rhetoric claiming there are actually more Autistic people than before (Oppositional Defiant Disorder on the other hand can't be over-diagnosed, lest we imply that in some cases, disobeying your parents is not a mental illness). Children who are prescribed amphetamines based on a label that wasn't even the correct one to begin with are harmed immensely by forced drugging. In the same way, if you change a child's diet because someone decided they have a disorder now, when their diet was already healthy before, that's harmful too.

For someone who really is Autistic or kinetic or has some other real madness/neurodivergence that's just been pathologized with "disorder" affixed to its name, the harm remains. Responding to the correct label with a fad diet marketed as "treatment" is still trying to fix someone who isn't broken. They aren't broken because being Mad or Neurodivergent isn't an illness. If your coincidentally gluten-intolerant Autistic child has fewer Autistic meltdowns in the absence of constant allergic stomach aches, good for them. That doesn't mean autism is "caused" by gluten or "cured" by going gluten-free.

There is one difference though: Your correctly labeled child is not going to shed the labels as they grow up. The lasting internalized message will not be "my parents tried to cure my nonexistent disorder" because while the attribute in question isn't a disorder, it is real. No matter how much influence food has on surface states like fatigue or migraines, it can't change a brain attribute that is fundamental and pervasive, but if it could, that would still be abuse. When you talk about your child's state of normal as something unwanted, what you are saying to your child is "you have this label and that's a disorder. You are ill. The way you naturally are is bad and wrong." It doesn't matter if your strategy is drugs, food, or positive reinforcement. For adults, dying and being replaced by a more lovable doppelganger is the plot of a horror movie. Telling your child that you wish it upon them in real life is abuse. Maybe the literal drug approach would be extra dangerous, but take away the drugs and you still have a pathology problem. Not only do the ends not justify the means, the ends condemn the means.

2. It's still about control, not support.


Whenever concerns about fad diets reach the ears of parents who use them, one rebuttal is ready in the chamber: This isn't about changing someone's personality, it's helping them grow by removing toxins. Perhaps, for children who haven't been psychiatrized, this is sometimes true. Neurotypical children with no added labels get to eat a reasonable variety and treats in moderation, with an eye toward what is actually healthy and keeps them feeling good. Fad-inclined parents still overstep on occasion, but it's not about rejecting the personhood of their own child. That is until a pathologized label or deviant behavior enters the picture. At that point, dietary adjustments become about correcting behavior.

When your greatest hope for your child's new diet is that it will cause them to speak orally, or sit still in a classroom, or stop hearing voices, or stabilize their mood, I call bullshit on this being about support. Surely some parents genuinely believe that those things are necessary for enabling a child to thrive, except that "thrive" means "according to cultural notions of success" and success means fitting in and "fit in" is code for "be neurotypical." Like when a fat adult sees a doctor and automatically gets told to lose weight, "hit the treadmill for a month and then we'll talk about that broken leg," a neurodivergent child needs to be cured of an alleged mental illness that isn't really hurting anyone else. Only after that "cure" can we even ask the question of whether there is a legitimate physical problem to address.

Ultimately the presence or absence of a medical or health issue is irrelevant though. Ableist parents and their rarely-licensed doctors may claim that madness is somehow located in other places besides the brain, but even then, body changes are merely a strategy to cause mental changes. Literally everyone has gut bacteria, but only the ones that allegedly "cause mental disorders" are considered a problem.

Children can't consent. Somehow, this phrase manages to take away rights and protections rather than increase either of them. Children can't consent, so we should make the least dangerous assumptions? Get them vaccinated and wait on madness until they're 18 and can decide if it's a disorder or not? No. Children can't consent, therefore it's the parent's right to decide everything. Just like mentally ill people can't consent, therefore it's the medical professional's right to decide everything. Paternalism is paternalism, including when it involves a literal parent.

For children, the definition of a mental disorder can include talking too much, having too much energy, being easily distracted, playing loudly, not wanting to do their schoolwork, not obeying commands from adults, fidgeting, running and climbing. That's not one blogger's political commentary– those examples are all explicit diagnostic criteria in the DSM, the aptly nicknamed "Bible of psychiatry". Take away all those characteristics, and what are you left with? The end-goal psychiatrists have sold, and parents bought, is an emotionless drone that completes assigned tasks as commanded. A drone that doesn't play, think, explore, speak unless spoken to, express individuality, or ever disobey an adult. What you are left with hardly seems human, much less childlike.

Yet this is exactly what you are asking for when you lament your child being too loud, too talkative, too fidgety, too… human. Too "out of control"– whose control? Certainly not their own, or we would have that supposed disaster scenario where children do what they want. Surprise: raising a human being is not as simple as a pet rock. Independent thought and action don't prevent anyone from thriving, they're just too much of a burden on the parent. That's why they need to be eliminated. You figured out that punching your child is a bad way to do this, but you still haven't figured out how to teach through conversation, so now you are trying to control your child by deciding what goes into their body.

3. The problem of "ADHD"


I put "ADHD" in quotes only to point out that it is one of the most ill-conceived titles in the DSM (second perhaps to Borderline Personality Disorder). Someone must have really hated these people to put both "deficit" and "disorder" baked into the name, and still be so unsatisfied to then add a ridiculous contradiction that spells out "Attention Not-enough Too-much Disorder."

I don't, however, make the mistake of going on to say that there's no such thing as having a kinetic cognitive style. Yes, "ADHD" is over-diagnosed to sell drugs, but implicit in the term "over-diagnosed" is an admission that some non-zero number of people being labeled would be the correct number. Psychiatrists are terrible at describing things accurately and unbiasedly, but just because some number of people are bad at their job, or corrupted by bribes, doesn't mean their focus of study is made-up wholesale. "Schizophrenia" isn't a mental illness, but some people really do hear voices that aren't from other people. "Bipolar Disorder" isn't a disorder, but bipolar people are real. In the same way, kinetic people really do respond to drugs differently from neurotypicals, whether or not a million non-kinetic children are also incorrectly labeled as having ADHD.

It makes sense to identify as anti-psychiatry, if you believe that the whole system ought to be burned down and built anew, but that doesn't mean the concept of medication is fundamentally wrongheaded. People who want to alter their own mental state by ingesting a substance should be able to buy that product with informed consent, which we can because it's called food. People who want to use drugs for that purpose and give informed consent should be able to buy drugs as well. That includes children. Minors can't consent in the legal sense, but in practice with a truly caring parent, a little information and some yes-or-no questions go a long way. If you really can't reason with your child, either you the parent have a problem, or your child is too young to be in school.

Kinetic adults who choose to take drugs for focus used to be kinetic children who wanted them. The problem with psychiatry is the corruption and incompetence among the people recommending which drugs to take, not the chemical content of the drugs themselves. Some chemicals actually are beneficial for some category of people. If you can't make your own neurotransmitters, store-bought is fine. The goal of forced dieting is still to alter the brain; why not be open to whichever method is most effective?

4. Unhealthy relationships and eating disability


So what if people like fad diets? The real problem is treating made-up mental disorders, so why single out one particular strategy? Why such a fervent reaction to food? It's not like parents can harm their children just by changing what they eat. Except that they can. In fact, if you claim food is so powerful that a good diet can cure Mad/Neurodivergent people of our already non-diseased brains, you've just admitted that a bad diet can cause a comparable amount of damage.

The phenomena we hastily truncate as "eating disorders" have an underlying truth, and that is an unhealthy relationship with food. This simple language correction helps us recognize the lack of evidence to justify calling these patterns disorders. Relationships aren't spontaneously manifested chemical imbalances. Relationships are born from experience.

Some sociologists put paradigm before language and talk about "eating disorder culture"– that is, the combination of trends in media messaging, peer attitudes, and parenting styles, which create and reinforce the emergent patterns we're still calling eating disorders. The media teaches us that we're supposed to want skinniness no matter the cost; our friends guilt us for eating the wrong things; and parents punish their children with shame (refusing to eat this means you're bad), Sophie's choices (you either eat this or I take away your privileges), sometimes physical abuse or even starvation, to correct for a natural, youthful disinterest in raw vegetables. The vegetable craze is so pervasive it can't even be considered a fad any more, but it perfectly illustrates the logical fallacy: Inflicting emotional and psychological trauma on a person, in an attempt to make that person healthy. It's the same logical fallacy used to justify confinement, electroshock, coercive behavior therapies, and forced drugging.

Growing up with excessive rules and restrictions around eating, enforced through manipulation and coercion, can lead to an unhealthy, restrictive relationship with food later in life (and with other things: teach a child they're not allowed to refuse broccoli and see what skill that future teen or adult has at refusing alcohol). It's not hard to trace causation from loss of autonomy to attempts at abstinence. From obsessive parental criticism of portions to binging and purging. From panics about "childhood obesity" to an anxiety around every meal as either a reward or shameful self-harm.

Considering that disabilities exist, you don't even need the manipulation or coercion. The food restriction itself can be a form of abuse. If your child has such intense taste sensitivities that they can only bear to eat five (5) different things, taking those away isn't going to expand their horizons. You can't increase variety using restrictions. That's another logical contradiction. All you're going to accomplish is to create an actual health condition, called starving. If your child has an allergy (or similar biological sensitivity) then of course you put safety first and restrict that particular allergen. That's the unfortunate fate of people with actual biological restrictions, not something you want to artificially imitate.

The dangers of food restriction don't stop with the individual either. In a world where not every host of a play date, party or co-op is enlightened about accommodating disabilities, there are social implications. Children below a certain age don't know to avoid their own allergens, so their parents have to watch over them and pull out of any event serving those allergens. Parents who play pretend as if their children have allergies are just as committed. Both groups wind up with a restricted social life, which can lead to other real problems like anxiety, depression, and self-perpetuating social isolation. Someone can't attend a social function because they are restricted from engaging in the planned activities– that sounds like an access barrier. If this kid wasn't disabled before, they are now!

Fad diets are not an alternative to psychiatric drugging. They are more of the same. Just like drugs, they don't "cure" any imaginary mental illnesses, and if they did, that would make them worse than drugs. They prevent people who would actually want drugs from getting them. They don't teach any life skills and may even take some away. They hinder social lives and disable the people they're imposed on. They create trauma, with lifelong ramifications.

My list of neurodivergences doesn't include kinetic cognitive style. As a child, I would have reacted to a prescribed amphetamine the way most people do. Yet I still would rather my parents have drugged me, than force me on a fad diet.

Image description: Open tin with pellets inside, unclear whether they are candy or drugs


1/11/19

Everything Wrong With "Everything Wrong With Split" (Autism Sins)

As if a movie portraying multiple systems as crazy serial killers wasn't bad enough, the criticism ignores it, at times even adding to the misinformation. It's times like these when it feels like you need to make a video just about how wrong the critic is, so that's what this is!



Click here to watch the original video by CinemaSins
(it's not good, but if you want some more context...):

Autism Sins is a snarky, sometimes satirical series, where I review media portrayals of autism in a rip off- er, I mean, an homage to the format of CinemaSins (or in this case CinemaSinsSins).

To see more of our videos, visit our YouTube channel.

8/18/18

Everything Wrong With Atypical, Episode Four (Autism Sins)

We're back with more Atypical, where every episode is worse than the last! Here we dive deep into parent sympathy, with an extended support group full of functioning labels. The toxic masculinity, of course, goes unchallenged as well.


Autism Sins is a snarky, sometimes satirical series, where I review media portrayals of autism in a rip off- er, I mean, an homage to the format of CinemaSins.

To see more of my videos, visit my YouTube channel.

7/20/18

Lessons Animation Taught Us About Institutions - Madness In Media

What lessons can children's cartoons teach us about confinement in psychiatric hospitals and institutions? This journey through time will show how these depictions have evolved over the years.



Welcome to Madness In Media, an exploration of works that feature mad themes and mad characters, and what they say about our society.

To see more of my videos, visit my YouTube channel.

6/29/18

Autism Sins: Carl from Arthur

This Very Special Episode makes a puzzle piece the center of the plot, and yup, that pretty much tells you how this is gonna go down.



Thanks YouTube user Nava Candi for recommending this episode.

Autism Sins is a snarky, sometimes satirical series, where I review media portrayals of autism in a rip off- er, I mean, an homage to the format of CinemaSins.

To see more of my videos, visit my YouTube channel.

6/15/18

What 13 Reasons Why is Really About - Madness In Media

What is 13 Reasons Why? A gross glorification of suicide? A reckless cash grab? Or a poignant social commentary aggressively ignored?



Welcome to Madness In Media, an exploration of works that feature mad themes and mad characters, and what they say about our society.

To see more of my videos, visit my YouTube channel.

3/30/18

Neuroqueering Judaism: Reflections on Mad Passover

They tried to kill us off. They failed. Let’s eat. (Give or take a few minor details.) Pesach, or Passover, commemorates the biblical tale of the Jewish people fleeing from Egypt, after a pattern of slavery and persecution designed to kill our culture. Within Reform Judaism especially, it is common practice to modernize the story with comparisons to current issues. You can bet there were many this year asking their community how Donald Trump or other modern leaders are similar to Pharaoh, maybe even imploring them to “let my people go” from slavery in mainstream prisons, where about half of inmates have been branded with a psychiatric diagnosis (some organizations use this statistic to prove how violent or how sick and in need of treatment we are; I call it discrimination).

This year, I helped a local advocacy group in the development and execution of a Mad Passover Seder. To the delight and validation of our vision in creating this event, the Seder was attended by various flavors of Jewish people as well as non-Jews who identify as Mad, neurodivergent, survivors, or allies. I introduced myself as “only technically Jewish,” a product of pro-assimilation immigrants who prioritized doing things the “American” way. Some of us learned the Passover story, some learned about Mad Pride, and some learned about neurodiversity (and some all of the above).

A plate of five symbolic foods are traditionally served at Passover, such as bitter herbs symbolizing the harshness of the slavery the Jewish people endured in Egypt. Our first act of modernization was to add a sixth symbolic item to the Seder plate: a lock and key, to represent the violence and oppression of imprisonment in psychiatric institutions and the trauma of losing one’s bodily autonomy. On this night we would celebrate our freedom from both physical incarceration in psychiatric institutions and emotional incarceration in a pathology paradigm. On a last-minute whim, I also contributed one of those new fad stim cubes (AKA “fidget widget”), to represent the neurodivergent community (stimming is most closely associated with autism, anxiety, and kinetic cognitive style). In hindsight, I should have brought kinetic sand, to symbolize the desert traversed by the Jewish people in the Passover story.
Image description: Photo of a Seder plate with the five traditional foods on it, as well as a lock, key, and stim cube.

For our Haggadah, the reading material that guides the Seder activities, we added to the biblical story with a collection of essays, poems, and personal stories from Jewish Mad people, as well as a list of the 10 modern plagues: psychiatric incarceration, forced drugging, electroshock therapy, restraint, seclusion, coercive behavior therapies, outpatient commitment, the pathology paradigm, sanism, and societal coercion to recover. We asked ourselves why we eat bread or matza on other nights, but only matza on this night — a traditional Seder question with an established answer — then we asked ourselves why we are called Mad or ill or disordered on other nights, but only Mad on this night.

In developing the Mad Haggadah, I was asked to recommend writings on neurodiversity, to complement the pieces more focused on Mad identity. The first name that came to mind was Nick Walker, a neurodivergent Jewish scholar and author of several essays considered foundational to the neurodiversity movement, including “Throw Away the Master’s Tools” and “Neurodiversity: Some Basic Terms & Definitions.” While visiting his blog to print these essays, a third one caught my eye: “Neuroqueer: An Introduction.” Neuroqueering is a concept that refers to subverting or defying various societal norms, in ways that are similar to the queer community’s subversion and defiance of gender and sexuality. For example, I neuroqueer society by producing video critiques of neurodivergent movie characters, often citing that their portrayal embodies a normative external perception rather than internal experience, and is therefore bad acting. Neuroqueer can also refer to subversion or defiance that is directly related to literally being queer in terms of gender and sexuality, in addition to neurodivergent. I neuroqueer society by existing openly as a transgender Autistic person whose subjective internal experience of gender is directly informed by being Autistic.

It was upon fulfilling this consulting request that I came to understand Mad Pride and anti-pathology as being a fundamentally neuroqueer practice. Choosing to reclaim the word “Mad” for ourselves is an act of subversion with clear parallels to how the LGBTQIA, or just “gay” community at the time, reclaimed the word queer. Anti-pathology is neuroqueer because it outright rejects the underlying assumptions of the psychiatric model, unlike say the peer support/recovery movement which merely claims to do a better job of treating mental illnesses than a professional psychiatrist does. An example of how the Mad Pride perspective can queer a major segment of the neurodiversity community is when people say “autism is not a mental illness”, countering that with “nothing is a mental illness. Mental illness doesn’t exist.”

As a launching point for what became an hour-long discussion, we looked to the neuroqueer introduction essay for its 9 examples of what neuroqueer means, interpreted into plainer language for the sake of a smooth read:
  1. Understanding oneself as neurodivergent (or Mad) the same way Queer Theory understands being queer. We don’t need to be “born this way” but we also don’t need a doctor’s permission for our identity. We are members of minority groups with our own natural inclinations, which lead to having our own cultures.
  2. Being both neurodivergent and queer, with some awareness of how the two interact. Queer people, especially asexual and transgender people, are no strangers to the harm inherent in being medically pathologized, nor to how much more liberating it is to free one’s identity as simply a way of being. Though most of the community has now forgotten, homosexuality was once a mental disorder too.
  3. Embodying neurodivergence/Madness in ways that queer other identities. Identities such as being Jewish. I personally queered my Jewishness by reclaiming it in the face of a culture that infected my bio-family with internalized assimilationism.
  4. Intentionally altering one’s own thoughts to diverge further from the norm. Recognizing that there’s nothing wrong with being neurodivergent/Mad is one thing; seeing it as good or preferable is even more radical.
  5. Undoing conformist conditioning to express oneself authentically as a neurodivergent/Mad person. This was the understated power of adding a stim toy to our Seder plate. It spread a semi-conscious attraction throughout the room and encouraged people to re-discover the kinds of stimulation their bodies naturally want.
  6. Adopting “neuroqueer” as an identity label because of these practices.
  7. Making art that centers the internal experiences of neurodivergent/Mad people. While the closest thing to art we made on the spot was a verbal discussion, the Haggadah supplement included Mad people’s essays, memoirs, and poetry.
  8. Critically responding to media portrayals of neurodivergent/Mad people or characters. At one point we reflected that the character of Moses, if he were alive today, would probably be considered Mad, and in this cultural climate, his contributions to the world would have been suppressed by locking him away or sedating him with drugs.
  9. Advocating for these practices to be accepted in society. By meeting as an advocacy group but for a social and cultural event, we reaffirmed our sense of community, our support for one another in the many battles ahead.
To bring the conversation full circle, we then added a 10th item to the list, explicitly a discussion question: “How do we as Jewish people neuroqueer our non-Jewish society, our own Jewish communities, and ourselves?”

Jewish history is a repetitious tale of refusing to conform. We are deviants in every nation (yes, even Israel), pressured to assimilate, to give up our cultural identity and conform to the social standards of the majority. Had we given in to this pressure, Judaism and Jewish culture would have ceased to exist. We did not. We have been defiant and we live on. Though Reform Jews often marry outside their community, they continue to pass the culture on to their children. My genetic neighbors, who sought assimilation for its own sake, are a minority. While in antisemitic language being Jewish is not considered a medical condition to heal from as individuals, it is very much considered a blight on society whose erasure would supposedly help everyone.

Psychiatric “recovery” is a code word for conformity, for assimilation. People who are either born deviant or who later gain differences within a conformist society need to be beaten, broken, and reset so they can get back in line. Perhaps the most blatant example lies in the field of Autistic Conversion Therapy, obfuscated by psychiatrists as “Applied Behavior Analysis.” This field celebrates children becoming “recovered from autism” based on the measurement that they are now “indistinguishable from peers.” In other words, compliance training has taught them to be convincing actors, cultural outsiders successfully assimilated. If not — if someone is so far-gone in their “illness” that they cannot be trained to conform for their own good — then they need to be locked up, “out of sight, out of mind” to spare their ugliness from society.

As a Mad, neurodivergent, disabled, queer Jew, I completely reject the idea that conformity and assimilation is the “solution” to the Jewish problem or to the problem of mental illness, because I reject the assumption that either is a problem to begin with. As a psychiatric survivor, saying this places me on a radical sociological frontier, but as a Jew it is not a new thought. Regardless of how pure we are in our religious observance, from Orthodox Jews who follow the Torah and Talmud unerringly all the way to Jewish atheists, we’ve maintained our identity as a culture.

For millennia, Jewish people have neuroqueered the world simply by sticking together, refusing to give up our cultural practices, continuing to exist as Jewish people. Now is the time for Mad and neurodivergent people to do the same. They tried to kill us off. They failed. Let’s eat.

3/15/18

How Would We Know If We Overthrew the Mental Health System?

The radicalness of the anti-psychiatry movement has unfortunately become one of its greatest hurdles to overcome. Even in otherwise radical spaces like prison abolition, neurodiversity, or intersectional feminism, the most common reaction to anti-psychiatry ideas is to dismiss them as so intuitively ridiculous they need not be engaged with. Sanism, behaviorism, drugs and force have permeated our culture to the point many people literally can’t imagine life without them.

On a good day, our leaders pontificate about “reforms” that would somehow fix a system whose deepest foundation is a bed of violence, oppression, and at best pseudoscience. They ask for cultural awareness training, yoga classes, art therapy, and healthier food options in psychiatric facilities, without ever questioning the confinement that made those things unavailable in the first place (let alone the coercion involved when participation in such activities becomes a condition of release).

Reform is a jail cell with pretty wallpaper. We don’t need mental health reform, we need total abolition of force and coercion. The system doesn’t just have problems, it IS the problem. So if we really fixed everything that’s wrong with the mental health system, there would be no more mental health system.

We have to be careful, of course, about rebranding. We’ve seen this happen with institutions for disabled people, renaming themselves to talk about independence, while still keeping people locked in and forcing drugs on them. Changing the name to something other than “mental health” means nothing if whatever name we replace it with offers all the same abuses. If we truly eliminated all the horrid practices that are currently committed by the mental health system, what would the world look like? What would it take to go about abolishing psychiatry and the mental health system?


What follows are 15 ways our society would need to change before we could be confident that we are free from the tyranny of the mental health system.

1. No one would be deemed incompetent.

No person would ever be declared unqualified to make decisions about their own life. Not because of a mental illness, disorder, diagnosis, health condition, disability, nor any other title. There would simply be no system in place to allow such a thing. The idea of meeting legal requirements to be conserved, confined, or made a ward of the state would become as anachronistic as the idea of meeting legal requirements to be enslaved. Everyone would be the ultimate authority on their own bodies.

Mentally ill” is a legal term which translates into plain language as “unable to make decisions.” Not biologically, but legally. Unable to decide where to live, whether to live, who to live with, what food to eat, and what drugs to take or not take. Efforts to attack the term “mentally ill” as an offensive slur haven’t done anything to combat this legal designation. All that’s changed is that people with “mental health challenges” or “psychiatric diagnoses” are deemed unable to make decisions.

The fact that such a designation exists within the law — in letter, spirit, and execution — makes the mental health system, and by extension our whole society, intrinsically unjust and oppressive, because someone will always be designated by it. Truly overthrowing the mental health system, as opposed to just forcing it to get more subtle or rebrand, would mean that any remaining systems fully support cognitive liberty: the principle that everyone can do whatever the hell they want, with restrictions only ever placed on actions that harm other people.

2. All psychiatry programs in all schools would be replaced with Mad studies and neurodivergent studies programs.

As part of a total abolition of the mental health system, it would be necessary to put a complete halt on any influx of new mental health practitioners. For students in the middle of their training, it would be unfair to pigeonhole them into finishing, with a degree in a field that no longer exists. Instead, those students would be given transfer credits and an opportunity to change programs with full scholarship.

Mad studies and neurodivergent studies would open up as new programs that these students would have the option to transfer into. These areas of study already exist in a small number of universities, but by freeing up funding from psychiatry programs, they would have the opportunity to expand.

The meaning of the prefix “psychiatric” is undefined in all fields, so the only difference between a medical drug and a psychiatric drug is that one is called a psychiatric drug. The study of these drugs would be taken up by medical doctors, who are already required to learn about drugs.

3. Mad and neurodivergent people would be managers, not “peer specialists.”

The creation of various “peer” positions has accomplished very little besides handing out a few minimum wage jobs to disabled people. A requirement of “lived experience” rather than a degree makes a vaguely defined identity group into the primary qualification.

The essential function of a “peer specialist” is to appear non-threatening, earn people’s trust, and convince them to stay on their meds. Hiring managers know that these positions only exist because others don’t, that there are far more job-seekers than jobs to fill, and thus that anyone they hire is easily replaceable. “Peer specialists” are grunt laborers with no real power to meaningfully affect the establishment that brought them in. If a radical abolitionist gets the job and conscientiously objects to their assigned duties, they just get fired like in any other job.

If a patient is prisoner to the medical facility, while their counselor has never been imprisoned and is free to leave at the end of their shift, then the counselor does not have the same lived experience and is not a peer to their client. They are just another generic white coat whose income stream depends on keeping others locked up and coercively medicated.

If the “peer specialist” has more power than the patient, then they’re not a peer, and if they have the same or less power, then they’re not needed.

Advisory committees made up of “peer advocates” are not effective either. They are a token position with no actual power. They can tell the managers what to do, but the managers have no obligation to follow their advice. In many cases all that’s accomplished is to create the appearance of listening, placating any protesters while creating no real policy change.

What reformists say would be fixed by additional “peer specialists” would actually be fixed by having Mad and neurodivergent people in management positions, with actual decision-making power. This situation could be achieved legislatively, through diversity quotas, or culturally, through the understanding that Mad and neurodivergent people not only have instant added value in their wide range of lived experiences, but also can be just as skilled or more than any neurotypical.

The hierarchal structure of business means that putting good people at the top would eventually improve the immediate service at the bottom, because we understand our own needs better than someone who just needed a job.

4. Crisis hotlines would be prohibited from tracking callers or dialing law enforcement without the caller’s consent.

In today’s cultural landscape, crisis hotlines are being pushed as a way to access the mental health system quickly and without insurance. Currently, all hotlines train their staff as mandated reporters, to listen for key phrases and if the caller utters one of them, secretly send people with guns and a history of recklessly using them, directly to the caller’s location. The sole exception is Trans Lifeline, which is of course exclusively for trans people, only a fraction of everyone who might want to call a crisis hotline.

Rather than fixing these serious safety hazards, reforms to crisis hotlines include expanding hours of operation, adding text options, and starting new hotlines for identity groups like teens or LGBT. All that gets accomplished here is increasing the number of people who get tricked into putting themselves in danger, while thinking they’re getting an emotional support or referral service.

Crisis hotlines are undoubtedly part of the mental health system as long as they behave this way. So in order to overthrow the system, the hotlines would need to be more regulated. Specifically, the regulations would give hotline callers the same confidentiality rights they have with a doctor or therapist, which under this new paradigm would of course include the right not to be locked up for hearing voices or being a danger to yourself.

5. Compliance with Olmstead “community living” would mean Housing First with no strings attached.

The supreme court decision of Olmstead vs L.C. declares the right of disabled people, including those disabled by psychiatry, to live “in the community” instead of in institutions.

Unfortunately, the implementation has been a lot more fuzzy than the decision itself. Prisoners of institutions wishing to leave must first establish a place to go ahead of time, which means they must have either the money to leave on their own or a solid support network. Obviously people who have been disabled and stigmatized are not always going to have those things.

A few public supports exist, such as transitional housing for homeless people, but these all come with a heaping spoon of coercion. They may require residents to regularly see a psychiatrist, comply with drug prescriptions, eliminate their use of non-prescribed drugs, get chummy with their neighbors or attend a minimum number of religious cult meetings each week.

Some cities have implemented Housing First programs, meaning that homeless people are taken off the street and given free permanent homes, in some cases with no strings attached. These programs have been a huge success, even by dogmatic standards like increases in employment and decreased use of non-prescription illegal drugs (because they’re not so stressed by being homeless).

If you truly want to free people from institutions and homelessness, just give them homes.

6. Service providers would be trained to consider doing nothing as a valid option.

An emotional crisis or spiritual emergency doesn’t always require an intervention of any kind. Sometimes the interventions we’re told are “best practice” only make the situation worse. Sometimes the person experiencing the situation already knows their best coping strategies, and will do a much better job at implementing them than someone they have to be explained to. Sometimes their friends are already familiar with the best ways to support them. An emergency psychiatrist necessarily isn’t, and neither is a so-called peer counselor.

In a post-psychiatry world, both would be regularly, sternly reminded of their humility. Moreover, they would be taught when not to intervene, and they would not need to have basic respect packaged as just another proprietary methodology, with a sexy name like “Open Dialogue,” “Intentional Peer Support,” “Emotional CPR,” or even “Alternatives to Suicide.”

Suicide attempts aren’t always a “heat of the moment” thing. We all die. Some of us would like to decide how, and some of us would also like to decide when. Sometimes a deeply introspective, thoroughly logical contemplation reveals that suicide is the mode of death most consistent with one’s beliefs and values. An immense degree of arrogance is needed to say that this person should be required to live against their will, in a facility where all their freedoms are taken away, which could only make a reasonable person more certain that they would rather die. An even greater arrogance is needed to say that stripping a person of everything they have, emotionally and literally, would improve their health.

Whether you place the highest importance on health or liberty, using force and coercion makes no sense because doing so improves neither. It makes much more sense to think of counseling a suicidal person as end-of-life care: the professional listens, acknowledges feelings, reflects on them, and doesn’t send someone with a gun to make sure their client dies faster or goes to prison. It’s not assisted suicide; it’s just respecting another person’s beliefs and values, even if you disagree with them. You may even find that when people have the freedom to talk about their feelings without having violence committed against them, they might be more inclined to keep on living.

Knowing when not to intervene is just as important as knowing a good methodology. In many situations doing nothing is the best strategy available. To overthrow the mental health system, we must train professionals, as well as the general public, to regularly and seriously consider the option of letting people make their own decisions without trying to threaten them out of it.

7. Short-term and long-term housing would be unlocked 24/7.

Peer respites, emotional wellness centers, urban safety retreats — whatever we wind up calling the former “mental health” facilities — they are all unlocked both ways, allowing the people who stay there to come and go as they please. Common areas like kitchens and TV rooms would remain open and powered as well. Strongly worded legislation would be passed to shut down any facility that resembles an institution, such as ones that don’t pass the burrito test.

Confinement is always violence. Involuntary homelessness is always violence. Lock-ins, lock-outs and curfews cannot ever be therapeutic because they violate a person’s safety and autonomy.

Furthermore, consent is not possible any time the consenting party needs someone else’s permission to leave. Even when people technically have the legal right to refuse drugs, or not choose the “healthy” food, or abscond from group therapy, they can be coerced into doing those things because it influences someone’s opinion of how long they need to be held. Therefore, the overthrow of the mental health system is incompatible with the continued operation of locked facilities.

8. Every care unit would be funded in a way that decreases the length of stay and gives visitors the drugs they want.

It’s bad enough that anyone with a badge, a degree, or a child can create a 72-hour imprisonment with no crime, no victim, no due process, not even a charge. 72 hours can cost you your job, your home, or even your life. Yet for many, those 72 hours are only the beginning.

Most psychiatric facilities try to keep people for even more absurd lengths such as weeks or months. One reason they want people to stay longer is because medical insurance companies are willing to pay for psychiatric services. The longer the stay, the more money the facility gets. Ironically, what is otherwise considered “good insurance” paints a target on the heads of false commitment victims, whereas “bad insurance” may end up saving a person’s life.

In these environments, it’s very easy to get a forced injection of tranquilizers by acting non-compliant, yet it’s challenging to impossible to get the drugs you actually want and need, or even to continue them based on existing prescriptions.

Although we should have already banned outright cages at this point, it’s difficult to completely eliminate all coercion. Doctors and psychiatrists can be persuasive pressurers who espouse the importance of their snake oil, or they can refuse to administer legitimate life-saving services until after an arbitrary screening period.

To fix all of these problems, the end of the mental health system would have to include a revision of how care facilities are funded. Rather than getting a flat rate for each day a visitor stays, they would get a variable rate that diminishes according to the amount of time the person stays in the facility, instead of moving back into community living with proper supports.

This way, care facilities have a financial incentive to give visitors the services they asked for quickly, including drugs if desired, so that those people are satisfied enough to leave earlier.

9. All drugs would be legalized, including prescription drugs.

As said by Thomas Szasz, considered by many to be the father of anti-psychiatry, prescription drugs are illegal. You cannot waltz into a drug store and buy a prescription drug without a prescription. Prescribing to yourself is a crime. Prescribing to your friends or family is a crime. It is a crime to give someone else a drug that was prescribed to you, and it is a crime for you to take a drug that was prescribed to someone else. No other form of property is treated this way, except for illegal drugs.

Criminalization and prescription are two sides of the same coercive coin. Together, they mean that people who need or want a drug either can’t get it at all, or can only get it if they are wealthy enough, normative enough, and socially savvy enough to convince an arbitrary authority to grant permission. Restricting your choices is not on the same level as forcing a substance into your body, but it is one of the many ways the mental health system oppresses us.

Without the mental health system, there would be no such thing as a psychiatric prescription because all drugs would be legal. Supporters of the status quo often ask “how would you get the medication you need without a doctor prescribing it?” The answer is right there in the question: without a doctor prescribing it. In other words, the same way you get any other product: you go to a store and buy it.

To overthrow the mental health system, we must abolish the prescription system, and replace it with a system of informed consent. Psychiatrists would no longer be the gatekeepers who decide whether you will be allowed to take the drugs you actually want. Instead, the role of a psychiatrist would be to give recommendations and safety warnings. The paper you leave with would simply be a reminder note of what name and dosage to grab off the shelf.

Also, it would be nice if we released, pardoned, and compensated everyone who is currently in jail (including the jails that are called hospitals) on a non-violent drug charge.

10. Adverse drug effects would be independently studied, listed on the box, and discussed without taboo.

Informed consent is the only true consent. The reason is simple: if a person was not made aware of the risks and downsides, then that person did not consent to them. Abolishing prescriptions would be a major victory, but that alone would not guarantee a system of informed consent. Although banning untested drugs altogether is yet another act of paternalism, to protect you from yourself, it is nevertheless the obligation of a responsible society to protect individuals from predatory companies.

There are two parts to this change: Studying and labeling.

Trials for new drugs would be conducted by independent parties. “Independent” must mean sufficiently divorced from the manufacturer such that the people collecting data do not know the name of the drug or the company that made it. Double-blind, placebo-controlled is a good foundation for a standard, but we must also add the full human spectrum to the subject pool, including people of diverse ages, people of size, disabled people, and people who have a uterus (currently biomedical research often excludes anyone with a uterus because it would be inconvenient if they got pregnant).

As a precaution against residual paternalism from the mental health system, the results of these studies would have to be made freely accessible and open source. Once a drug goes mass market, the people who take it would be able to submit anonymous complaints (petition for redress of grievances) to an open-source government site, and a certain number of people submitting the same complaint would automatically prompt a re-investigation.

Once the drug effects are known to the elite few who understand, care about, and have time to comb through data, that knowledge must be disseminated. The most effective method is to require warning labels directly on the product. PSAs on TV, in newspapers or online all have a selection bias, word of mouth clearly hasn’t overpowered marketing money yet, and warnings in doctor’s offices would be a moot point after abolishing the prescription system. A mandatory warning on the package in the store ensures that everyone who receives the product receives the warning. Voila, informed consent.

The warning label method does have one weakness though: Many people don’t bother reading them, not because they don’t care, but because it’s so unheard of that these drugs might not be perfect. For this reason and many others, the overthrow of the mental health system would have to be not only a series of legislative victories, but a cultural shift too. Feeling like there must be something wrong with the individual, rather than the drug, is one of the insidious ways the mental health system prevents survivors from coming out, which prevents conversations about adverse effects from being normalized. More psychiatric survivors must open up about their experiences, and it must be safe for us to do so.

11. Every program that recommends drugs would also offer support for quitting drugs.

Even after the prescription system is replaced by a system of informed consent, psychiatric drug withdrawal is very real. Those who were informed and consented to the drugs may still decide to stop taking them later. Any withdrawal is a difficult process and requires support.

The lack of support for people who want to stop taking their drugs makes it difficult to have free choice over the use of mind-altering substances. Expecting people to suffer alone while they taper off the drugs or go cold turkey is essentially pressuring them to stay on the drugs. It’s a form of coercion, and thus part of the mental health system.

In a world free from the mental health system, everyone who is trained to recommend drugs would also be trained in how to help people taper off, and drug dealer facilities would also have a withdrawal unit, both for safe tapering and for maintaining a relative amount of safety while quitting all at once.

12. All psychiatric diagnoses would be recognized as bunk and removed from medical records.

Despite all the “biological brain disease” rhetoric justifying the pseudoscience of psychiatry, no so-called “diagnosis” in DSM 5 has ever been demonstrated by a biological test. In the few cases where we have discovered a biological cause, such as trisomy 21 for Down syndrome, that classification has ceased to be the domain of psychiatry.

Because these “diagnoses” are little more than pseudoscience, made up by psychiatrists to oppress people and gain money, the end of the mental health system would mean the end of the DSM. Every DSM classification would cease to be a disorder in public or professional consciousness, and they would become obsolete from medical records, because they are not medical information.

What about legitimate identities that happen to be falsely pathologized? How would they get services?

Firstly, there is no logical dependency between a group existing and that same group being classified as a mental disorder. You can have one without the other. Legitimate categories such as multiplicity, hearing voices, or Autistic would be recognized as cultural identities, similar to the way we now recognize gay as an identity, now that psychiatry finally let go of homosexual disorder to free its hands to grab transgender and asexual.

A pseudoscientific medical diagnosis is not necessary in order to get services such as communication devices, gender affirming surgery, and the anti-convulsants some people take to hear voices. The requirement of DSM classifications makes it harder to get those services, not easier. Under a system of informed consent, rather than the gatekeeping prescription model, cultural minorities would more often get the services they want and need.

13. Consent laws and consent culture would obsolete compliance.

Enough about information. What about the consent part? Atop the slain corpse of the mental health system, all procedures would require consent from the recipient. Consent must be freely given and can be revoked at any time for any reason. Patients checking into a medical facility would be able to leave whenever they want, not weeks later when the doctor finally signs the discharge papers because insurance ran out.

There could certainly still be conduct agreements, for example “no yelling in the meditation room,” but anyone who can’t or doesn’t want to abide by the rules can opt out of the entire situation.

Mental health is one of a handful of industries, along with education and government, where the person paying for the service, in effect the employer, is expected to complete arbitrary rigors and assessments, or else face inescapable consequences decided by their employee. Without the mental health framework, expecting compliance with doctor’s orders would no longer make sense, because the doctor-patient relationship can be terminated at any time. Instead, the professional would be expected to comply with the wishes of the person requesting their service, or else be fired and replaced.

14. Social Security would be replaced with Universal Basic Income.

Wait, what does welfare have to do with mental health? Well, the legal definition of a disability is still pretty stuck in the medical model — the idea that people are disabled by medical conditions, rather than by access barriers like stairs and strobe lights. Therefore, one must get a “diagnosis” from a doctor to qualify for any disability-based government program.

Aside from the inherent dangers in handing over your recorded history of madness to multiple corporations and the government, the current bureaucracy creates a problem within the mental health system itself: imbalance of power. Those who are unable to work due to systemic hiring discrimination rely on welfare programs, which require you to convince a doctor to say you’re unable to work. If you’re magical and manage to convince them that you’re a victim of discrimination, that doesn’t count.

If your survival within a capitalist system depends on you qualifying as legally disabled, and a doctor wields the power to decide whether you’re legally disabled, then the relationship you have with that doctor is inherently coercive. The doctor can let you die if they feel that your madness is too weird, or that you smell bad, or you didn’t say “please” enough.

Keeping doctors the gatekeepers of disability benefits is no better than keeping them the gatekeepers of drugs. You can’t revoke your consent to the doctor-patient relationship because the doctor holds something you need and can’t get without them. That is the definition of coercion. In order for patients to have the power to revoke the relationship with their doctor, they must not require a doctor’s permission to get the services they need, including income. In order to revoke the power of coercion from doctors, we would have to revoke the power of their signature in disability benefits.

15. Any use of force in a psychiatric context would be illegal.

In case it wasn’t clear, freeing ourselves from psychiatric tyranny requires the complete and total abolition of all interventions that lack the consent of the person whose life is being intervened in. Not reduction, not higher standards of proof, not “last resort” policies, total abolition.

Anything less than total abolition is playing within the system, using the master’s tools to ask for minor cosmetic changes and lip service. If nine hundred people were force-drugged this year instead of last year’s thousand, we still have a problem.

The master’s tools will never dismantle the master’s house. Create a list of criteria so the cops can’t just lock up anyone for any reason, and they’ll use those criteria to shop around for people who meet them. Make force a “last resort” and the first resort will be to halfheartedly skim through a checklist. Add a “peer specialist” to the team and they’ll hire someone who’s up to their eyeballs in the medical model and a paradigm of health first, liberty never.

We are not free from the mental health system as long as one person is under threat of legalized force. All the other changes on this list are ways to keep laws enforced or to reduce manipulation and coercion. But first and foremost, we need far-reaching legislation, with broad definitions, that makes every use of psychiatric force automatically a crime.