Psychiatry is not about benevolence, care, or help. While psychiatric apologists such as Edward Shorter (1997) have long positioned psychiatry as the liberators of the mad, in actuality psychiatry imprisons and oppresses people labeled “mad” in astronomical numbers. At no time in earlier eras was the number caught within the auspices of the mad professions anywhere near the number today. While psychiatry Supporters make reference to the terror of Bedlam’ — currently still in operation, and the hospital in medieval and Renaissance England synonymous with “booby hatch” and memorialized in Shakespeare’s plays (see for example, poor Torn in King Lear) — the reality is that at any given time during this period only twenty or thirty people were actually held there; and as Porter (2002) makes clear, most people thought of as mad were allowed to rove the countryside without incarceration and without drugs. Such people were certainly often ill-treated — we are in no way depicting these earlier times as good — but without the relentless infringement that characterizes psychiatric practice today.
The history of psychiatry is the history of a profession that ruthlessly drove out all of its competitors — the women healers, the astrologers, ultimately even the psychoanalysts — and completely medicalized any and all conceptualizations of madness, developing both a “mental illness” construct and a world-wide crisis of iatrogenically-created drug addicts. In the epistemological violence of diagnosis, in the chemical violence of drugs that place one’s very brain into a strait jacket, psychiatry attacks women. By the same token, it attacks seniors. It attacks racialized people. It attacks trans populations. It attacks children. It attacks poor people. However, what is most pernicious about this institution is that it attacks not only these otherwise oppressed groups, it attacks everyone — all this in the name of help. One need only look at the multiplication of diagnoses in the progressive versions of the Diagnostic and Statistical Manual (D S M), to realize that this profession is intent on having more and more people under its auspices. This is an institution that is ultimately about pathologizing and “treating” everyday life.
We stand in a long and proud tradition of resistance. It may be argued that resistance to psychiatry is as old as psychiatry itself, albeit it is not until the nineteenth century that we find clear records of such resistance. In the nineteenth century, American psychiatric prisoner Elizabeth Packard brought a writ of habeas corpus against her husband who attempted to reinstitutionalize her; and, simultaneously, Hersilie Rouy, a psychiatrized woman in France and Mary Huestis Pengilly, a psychiatrized woman in Canada were engaged in similar activism (St-Amand and LeBlanc 2013). However we date it, there has long been not only resistance hut organized resistance to this institution. Inmates have demonstrated against it, scholars have written about it. Feminized and racialized people have objected to the targeting of their communities. Historians such as Foucault, moreover, have rigorously sought out and surfaced subjugated knowledges.
At times — and necessarily so — this resistance is tied intimately to identity politics. This has been enormously important and, indeed, the ongoing theorizing and resistance to psychiatry by women in particular has contributed substantially to the unmasking of psychiatry as an untenable, patriarchal, and otherwise oppressive institution. As such, identity politics has an absolutely essential role to play. In no way should that reality ever be questioned. As with all identity politics, however, identity politics in this area can at times tip into being exclusionary — and it is this that we question. The need to keep “other” theorists with “other” identities (or those who refuse to identify) at bay may be most keenly felt by people who openly identify as psychiatric survivors, mad, or “service users.” People who identify as such often do not want sane-identified people theorizing or engaging in activism on their behalf. This is understandable given the history of harm, domination, and co-optation by seemingly like-minded radical therapists and academics who have benefitted from inequitable alliances with psychiatrized people over the past half century. The marginalization, by seemingly radical therapists, of psychiatric survivors in the U S A that led to the creation of their psychiatric survivor movement is a clear example of such unconscionable domination. Indeed, there are times in every movement, and there are times in the lives of oppressed people, where it becomes important to keep people who do not share that oppressed identity at bay. Nonetheless, in the long run such divisions do not serve us, do not contribute to the task at hand. Neither is it tenable to artificially create dichotomies and divisions between activists and academics, between the openly psychiatrized and those who may refuse classification of their experiences or those who have escaped psychiatrization. The point is, given that we are all at risk of psychiatrization, we cannot afford to exclude the work and theorizing of anyone engaging in radical or mad activist scholarship, if we are to succeed. We indeed want to underscore how critical the psychiatric survivor voice is in engaging in a psychiatric survivor analysis (Finkler, 2013). However, identity politics alone will not win this fight — any more than the fight against classism would be won if we understood socialism as something that should only be theorized by and fought for by low-wage earners. While honouring the enormous importance of madness-related identity politics, accordingly, we theorize resistance against psychiatry as we would any other (r)evolution: something that demands the attention of all who are critical and where everyone has a role to play.