Abstract
Reviewed by: Victoria Armstrong, Durham University, UK
Since its publication in 2013, Mad Matters: A Critical Reader in Canadian Mad Studies has prompted an interest in Mad Studies across the globe. As the editors suggest in their introductory chapter, Mad Studies brings together antipsychiatry and survivor narratives, with a focus on a new generation of activists, and activist scholarship, including allies of the movement. In doing so, the editors also acknowledge and emphasise the debt Mad Studies owes Disability Studies. A leitmotif of Mad Studies, and indeed this collection, concerns the masking of social inequalities and oppression via mainstream mental health policy, services, and the psy-disciplines. From a Mad Studies perspective, contemporary western neoliberal political agendas transform structural and institutional subjugation into individual concerns. Mad Matters foregrounds the experiences of Mad people whilst social inequalities, psychiatric oppression, and a concern for social justice form the central themes of this critical reader.
Mad Matters is organised into five parts; the first relates to ‘Mad people’s history, evolving culture, and language’. In the first of the five chapters in this section, Starkman’s contribution places Mad activism in the context of wider social movements and importantly, outlines the development of the ‘mental patients’ liberation movement’ in Western Europe and North America. Starkman’s chapter was originally published in 1981 and highlights a ‘culture of professionalism’ where doctors, lawyers, teachers, and social workers are considered ‘experts’ via the development of language others are often unable to understand, ignoring the ‘perceptions of their clients’ (pp. 28–29). In chapter 2, St-Amand and LeBlanc focus on ‘Women in 19th-century asylums’, eloquently bringing to the fore an element of lost history in the form of first person accounts of women who have been incarcerated, storying their resulting achievements as activists. Following this, Beckman and Davies chart the process of a collaborative project involving the creation of a documentary about the history of the Mental Patients Association (MPA) formed in Vancouver in the early 1970s. By the central positioning of lost and/or marginalised histories, we are reminded as we are with many of the chapters included within Mad Matters, of the importance of oral histories when we come to do Mad Studies. Consequently, Diamond’s chapter considers ‘what makes us a community?’ and reflects on anti-sanist practice. In doing so, Diamond raises a pertinent concern relating to co-optation of activists and members of the activist community which serve to further divide psychiatrised people and weaken grassroots initiatives. The final chapter in this section is by Burstow, contemplating the significance of words in the battle against psychiatric power. Burstow urges us to think again about our own use of language in everyday life and practice.
The second part of the book relates to ‘Mad Engagements’ and contributions exploring the ‘political dilemmas involved in challenging the premises and practices of the contemporary mental health system’ (p. 91). Poole and Ward consider how notions of grief have been colonised by contemporary medicine and wider society, exploring how those who deviate from the norms perpetuated as a result of this colonisation are deemed Mad. In chapter 7, Lee analyses the autobiographical stories of five Canadian psychiatric survivors, detailing their experiences of pain and suffering, and struggles with psychiatry as forms of symbolic violence. However, Lee recognises that whilst stories of trauma are common in survivor narratives, there are also more successful stories of identity transformation, achievements, and community organising. In the next chapter, Liegghio provides a poignant narrative of her mother’s death from terminal cancer who Liegghio suggests, having previously been diagnosed with bipolar disorder, is denied a sense of personhood as a result of her psychiatrised status. Fabris concludes the second part of the book, by considering the politics and ethics of peer support in a Canadian context. Fabris delineates the scope for co-optation of peer support workers, highlighting how the politics of contemporary peer support may augment medical services and psychiatry which serve to stigmatise, marginalise, and undermine the experiences and voices of peer support workers. This notion of co-optation by political agendas and powerful institutions is a reoccurring theme throughout Mad Matters, providing the reader ample opportunity and space to apply and develop similar critiques which could be levelled at domestic policies and practices in their own country.
The third part of the book showcases ‘Critiques of Psychiatry: Practice and Pedagogy’ and begins with Shimrat’s contribution which details ‘The Tragic Farce of Community Mental Health Care’. Shimrat’s shocking first person account is punctuated by the drugging and electro-shocking of psychiatric patients and elucidates how resistance to ‘treatment’ is often considered a ‘marker’ of ‘mental illness’. Weitz’s chapter focuses on electroshock treatment and radically critiques such ‘treatment’ as a ‘form of torture under the guise of therapy’ (p.142), noting how medical professionals rarely critique this practice. More positively, Reville reflects on eight years of teaching Mad People’s History and A History of Madness at the School of Disability Studies at Ryerson University in Toronto; in doing so, Reville suggests that Mad Studies is an emerging new field of inquiry. Finally, Church complements Reville’s contribution by describing her experiences as a co-teacher on the same programme and acknowledges the necessary yet complicated relations raised by incorporating Mad Studies into the curriculum. These latter two chapters contain key considerations for anyone attempting to undertake Mad Studies both in and beyond institutional settings.
The fourth and penultimate part of Mad Matters reflects on ‘Law, public policy, and media madness’ and contains five chapters which consider the politics of resistance in the public sphere. There are contributions from Costa who provides an account of survivor activism which has laid the foundation for more recent ‘legal activism’ where Mad patients become legal intervenors in Canadian courts. Warme, a psychiatrist, considers the implications of removing the civil rights of Mad people, and Finkler uses a psychiatric survivor analysis of housing for those who have been psychiatrised. In chapter 17, White and Pike provide a damning account of recent Canadian policy initiatives in mental health which are grounded in appropriations of anti-stigma and recovery models. Finally in this part, Wipond, a writer and journalist considers how human rights issues might be ‘pitched’ to the gatekeepers of mainstream media. Although the chapters in this section are set in a Canadian context, the themes and critiques of the policy are relevant to policy and practice in many western countries, particularly in terms of the removal of rights, and political appropriations of anti-stigma campaigns and recovery models.
The fifth and concluding part of the reader is entitled ‘Social justice, madness and identity politics’ and contains contributions which are concerned with developing a Mad political agenda for the 21st century (p. 265). In the first chapter of this section, Gorman articulates a warning to us all involved with Mad Studies; advising that ‘there is a danger that Mad identity – historically a product and cultural extension of the consumer/survivor movement – will be absorbed into white, middle class narratives of disability’ (p. 269). Tam importantly raises the concept of ‘race thinking’ to help us deepen our understandings of oppression as it relates to psychiatry and how we might avoid perpetuating oppressive and racist practices in the doing of Mad Studies. In chapter 21, Daley considers the experiences of queer women in psychiatry and the complexity of intersecting oppression. Voronka critically reviews a report commissioned by the Canadian government relating to youth violence which is, Voronka argues, oblivious to intersections of class and racial oppression. Voronka makes a compelling argument to suggest that this leads to young people understanding themselves through the psy-disciplines and ‘their trouble in individualized, often biomedical frameworks that decontextualize the role that structural oppressions play in the constitution of their personhood’ (pp. 318–319). Finally, Morrow focuses on the concept of recovery and how the term has been co-opted by policy makers to feed the neoliberal agenda which individualises structural and social inequalities. Whilst calling for resistance against psychiatric and structural oppression is not a new project in itself, this part of Mad Matters provides us with suggestive directions for the future of Mad Studies. It forms foundations for resistance and provides renewed hope for Mad collaborations, scholarship, and activism.
Critically and innovatively, the experiences of Mad people and their accounts, whether they be written or oral, spearheads each and every contribution to Mad Matters. As suggested by this seminal collection, contemporary concerns for Mad Studies include the co-optation of Mad people’s knowledge; the political appropriation of notions of peer support, anti-stigma campaigns and recovery models; and the collaborative exploration of new ways to resist oppressive practices and languages of a largely un-democratised psychiatry. The collection lays bare many mechanisms of the psy-disciplines and highlights how mental health support services and the political agenda informing their implementation and practice can often serve to perpetuate structural oppression and mask inequalities. From a UK perspective, Mad Matters has been considerably influential since its publication in 2013; proving instrumental in prompting the formation of activist groups and forums, the beginnings of conversations, collaborative conference endeavours, and scholarship and learning. Whilst Mad Matters does not provide a blueprint to challenge oppression or necessarily do Mad studies, it provides us with a number of critical starting points and a foundation to move forward as activists, academics, and practitioners.