Getting Our Anti/Critical Psychiatry Authors Read: A Case for Book Activism

As a movement theorist, I have frequently written about ways of increasing our effectiveness as a movement (e.g., Burstow, 2014a and 2015a). While prioritizing strategic resistance, mostly, I have focused on practices so horrific that they scream out for redress—ECT, for example (Burstow, 2015b). The topic of this article, by contrast, is a far less heart-wrenching problem—the lack of mainstream attention to our publications—whether these be books by Breggin, Whitaker, Scull, or others. If this seems an issue that can safely be relegated to the “back burner” while we attend to the real horrors out there, I would point out that to an appreciable degree, our success as a movement depends on our ability to sway the general public—and if the mainstream press and media never afford our books their due—not even the blatantly cutting edge ones (and if anything, these are treated worse) and the general public, as a consequence, remains largely unaware of their existence, the likelihood of succeeding in our primary mission(s) is substantially reduced. The point is, secondary though this clearly is on a human level, it is a problem that we can ill afford to ignore.

That said, there are three related disjunctures underpinning this article. The first is the number of critical psychiatry or antipsychiatry authors who have confided in me of late that they have largely given up trying to get mainstream coverage and so are putting their energy elsewhere. While to be clear, this is a reasonable choice under the circumstances, the mainstream is a battleground that we can ill afford to cede. I would add that while I do not share the dim prognosis of many of my colleagues, nonetheless, as I ponder how to garner mainstream coverage for what should have been an easy book to get it for (Psychiatry and the Business of Madness, Burstow, 2015c), I too am aware that those of us who push the boundaries are up against a seemingly impenetrable obstacle. And herein lies the larger disjuncture. The point is, we make little sense to the mainstream press or media. Whatever role the financial cooptation of the media does or does not play here, our discourse is simply outside of their story line. Consequently, they provide negligible coverage of our books—ergo, the general public seldom hear of them, nor are primed to pick them up. And to be clear, the difference in treatment at issue here is not minor but palpable.

What is telling in this regard, when I emailed news editor Rob Wipond asking him his sense of the extent of the differential treatment—a phenomenon that he is uniquely positioned to assess—this was his response:

In my role as news editor for Mad in America, I go through reams of news alerts and notifications every day, and I can tell you that Jeffrey Lieberman's book celebrating the alleged successes of modern mainstream psychiatry has been getting an immense amount of coverage and reviews in the media. Conversely, since I started this job a year ago, I have not seen any book that takes even a slightly critical approach towards modern mainstream psychiatry get a tiny fraction of that amount of coverage.  (personal correspondence)

Not an easy truth for sure, but all the more reason that we need to face it head-on.

The third disjuncture (a smaller one) presented itself when I checked how Disability Incarcerated (Ben-Moshe, Chapman, and Carey, 2014) was faring on Amazon.ca, approximately one year after its release. This is a stellar anthology by American and Canadian authors which brings together prison abolition, critical disability, and antiracism. Having reviewed the book for the Canadian Journal of Disability Studies (see Burstow, 2014b), four weeks ago, as I was perusing books on Amazon.ca, I decided to see how that site’s readers were assessing the book (as reasonable an indicator as any of the interest being shown by the general public). To my disappointment, I found one review only. Not that most of our other books were faring any better. And to be clear, not that on some level that I was not painfully aware of what I would find.

That noted, the immediate problem that we are facing is this: Despite the transparently superior quality of our authors’ publications—and compare any of our leading books to, say, Lieberman’s (2015) book, and you will quickly see what I mean—and despite our authors’ best efforts to break into the mainstream, our books receive comparatively few reviews in the mainstream press; they are not picked up by the mainstream media; correspondingly, they are not shown the same interest by the casual reader.

Such is the dilemma and the challenge. 

For revealing accounts of why this is happening, see Whitaker (2010), Wipond (2013), and Burstow (2015c). That noted, “why” is not the focus of this article. The question being posed here, rather, is: Practically speaking, what can we as a movement do to turn this situation around? That is, how might we help increase the number of reviews which our authors receive in the mainstream press? How do we pry open the door to the mainstream media? And what can we do about the fact that a comparatively low number of people post comments about our books in the comments sections of sites like Amazon?

A good beginning, let me suggest, is taking the issue seriously. Also—and this may be a stretch for some—acknowledging that the movement as a whole has a huge vested interest in the success of our books, and as such, we have a role to play here. The point is: Yes, we can say that this is not our problem, that it is the problem rather of the authors and their publishers (without question, true to point), but if we do that, what is, after all, our cause suffers. A very different choice—and I am inviting fellow activists to consider it—is going in the opposite direction, that is, taking up what might be called “book activism,” whether in groups or at an individual level, whether systematically (developing concrete goals and a plan) or more sporadically. What I am suggesting? That individually and collectively, we concretely take this problem on as a movement. 

For those interested, there are many different ways to go about this—and we will be but scratching the surface in this article. However, let me begin with a global suggestion that has an immediate payoff even were we not explicitly thinking about getting these books into others’ hands. As educators and activists, among the most valuable tools at our disposal are precisely these books and articles—they provide evidence; they give details; they make vivid; they explain. So why not conscientiously put them to work? Toward this end, activists who are taking up this challenge and who have not already done so might begin by truly immersing themselves in the literature, turning themselves into authorities in their own right (common mistakes to avoid here are: 1) restricting oneself to one’s favourite author and assuming that “he” has “said it all”; and 2), failing to appreciate the significant differences between the books—the very specific perspective, the unique contribution, who is being spoken to, what it teaches or could be used to teach).   

With this expertise under one’s belt, one can readily go into “high gear”—and such is my recommendation. That is, as the occasion arises, use the familiarity gleaned to make effective selections to assist you in whatever task be at hand. If speaking with a person who is claiming that ECT does not cause brain damage, for example, you might cite specific passages in Breggin (2008). Alternatively, if calling the APA into question, Whitaker and Cosgrave (2015) could come in handy. And from the perspective of movement building, if trying to interest anti-colonial activists in our cause, you might draw on Mills (2013). Such an approach, note, has the obvious advantage of immediately serving your purpose while at the same time promoting the book(s) in question.

Those who want to approach the challenge more modestly, by contrast, can draw on methods already known to them. Some examples are: recommending specific books to friends. Lending out books. Correspondingly, those of us who are academics integrating such books into courses and  reference lists. 

Now, to be clear, none of foregoing in itself results in mainstream coverage. This notwithstanding, if enough of us do it, it increases the exposure of these books, additionally, in so doing, creates an atmosphere more conducive to mainstream coverage.

For those wanting to go further, on other hand, those, moreover, intent on proceeding methodically, one way of beginning would be developing criteria which could be used to judge which books to devote most of one’s energy to.  Examples of possible criteria are: a) the extent to which the book undermines psychiatry (the “attrition model” criterion); b) the coverage afforded sexism, racism, ableism, classism, etc. (the anti-oppression criterion); c) the degree to which the book hooks into issues currently in the news (the relevance criterion). A possible next step would be choosing a few books on which to focus. The pivotal steps of course are executing actions which create a stir about them.

That noted, the question arises: What actions? And where? One obvious venue is the social media—a revue, I would add, that a goodly number of survivors and their allies are already putting to good use. Individuals or groups might systematically use Facebook and/or Twitter to inform people about “pivotal books”. Other related and possible activities include: Sensitizing our “friends” and “followers” to a book by posting quotations; alerting them to news about the book; making a point of retweeting and reposting (thereby extending the work of other activists). Additionally, where a book is assessed as especially critical and you and/or our group are so inclined, more extensive internet-related book activism might be considered, including:

·      creating YouTube pieces about why it is important and/or what it reveals.

·      interviewing the author and mounting the interview.

·      creating pages and/or blog sites dedicated to it.

·      generating discussion about the book on Reddit (see http://www.reddit.com).

·      creating pointer pages for book-related events.

·      writing your own reviews, then tweeting about these.

Now the reader may well be thinking: Fair enough, but social media coverage hardly equates with mainstream coverage. True.  Nonetheless, the point is, if done skillfully, what you post can attract the interest of the general public—which is, after all, the ultimate goal.  For example, if one your tweets goes viral or if enough people put your messages on their timeline, a stir is created which takes the message far beyond the your original network. Correspondingly, if there is a big enough social media stir around any of these books, at that point the mainstream press and mainstream media themselves “sit up and take notice”. What is critical here, is not just posting occasionally (which many of us already do) but keeping the pressure up, retaining the focus.

That said, book activism can of course also include directly approaching the mainstream media and press. In this regard, if you know any reporters who write reviews in the areas of health or social change, you might approach them—and if you do this, where possible align your proposal in some way with a storyline that they have already used (a clear hook). Additionally or  alternatively, you might send individualized proposals involving a book to select programs. Watching previous shows makes sense as preparatory work for the familiarity so gleaned will help you choose judiciously and shape the proposal in ways that increase the likelihood of it gaining traction. Keeping an eye on current items in the news and linking with one of them is likewise an asset. And note, coordinating with others who subsequently submit overlapping proposals to the same program greatly enhances the chance of a proposal of this ilk being taken up. 

In this regard, numbers are all-important (as is independent status). If both author and the publisher try to pitch a book to the producers of a mainstream program, short of having a solid relationship with them, vital though it be that they make such pitches, in most instances, they stand little chance of being successful. By contrast, if say, over a three month stretch ten different people make similar but separate pitches, the producer is primed to surmise a growing interest in the area and respond accordingly.

Examples of Canadian programs that might be approached in this regard include: The Current, The Agenda, the Fifth Estate, The Passionate Eye, W-5. I leave it to readers from other parts of the world to generate comparable lists.

This sheds a bit of light on the first two questions. Which bringsn us to the issue of the paucity of comments afforded our books on online sites like Amazon and Indigo.

An obvious answer—and I will stick with one—is that we rectify such problems by posting in the comments sections ourselves. The good news is: Here our power as readers is considerable, and here we can make a major impact with very little effort. The point is that whether the target book (the book we are trying to promote) be Disability Incarcerated (Ben-Moshe, Chapman, and Carey, 2014), Psychiatry and the Business of Madness (Burstow, 2015c) Psychiatry Under the Influence (Whitaker and Cosgrove, 2015), Mad Matters (LeFrançois, Menzies, and Reaume, 2013), Decolonizing Global Mental Health (Mills, 2013), or one of Breggin’s works, the more of us who post comments about the book, the more significant the book looks; what goes along with this, by sharing what we ourselves think of the work, we are concretely suggesting to people who are specifically looking to be interested, why they should consider this book. Correspondingly, comments, as it were, themselves beget more comments. The point is, after reading several comments about a book which they themselves have read, people are tempted to “add their two cents”. And while there is hardly a one-to-one relationship, the more comments, the more readers for the book—all of which translates into more people potentially being “persuaded”.  By the same token, the more comments, the more that the mainstream media will take note, which further translates into broader coverage, and by extension, a broader readership. 

What, in a nutshell, is the process?

1.     Go to one of the online sites where the book is sold.

2.     Find and click on the book about which you would like to comment.

3.     Scroll down to the “Customer Reviews” section.

4.     Click on the box which reads “Create your own review” or a variant thereof.

5.     Rate the book (usually a 1-5 rating), and enter your comments.

6.     Then hit post or publish.

Do you need to have purchased the book from the outlet in question to post a comment? In the case of some sites, yes. With others, no.   

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That said, we all have multiple demands on our time and so while I have outlined some fairly extensive actions, I am aware that most people’s contributions will be on the modest side. All good. Should you choose to get involved in this dimension of our struggle, just do what you are comfortable doing. Have fun in the process—you may find yourself discovering skills that you never knew that you had. However large or small your individual contributions, each contribution adds up. Correspondingly, be assured that if we as a community have a mind to do this—and such is my hope—together we can turn ourselves into a force to be reckoned with.

Concluding Remarks

This article has put forward the case that pivotal to the success of our movement is getting our authors read by the public at large; it has noted the paucity of coverage by the mainstream press and media (a highly related issue); and it has recommended that we include book activism within our activist repertoire. The bulk of article focuses in on ways to go about such activism. Ways explored include: assiduously referencing our books when making points; use of social media; directly pitching a story to the mainstream media; and posting comments on online sites where the books are sold.

In ending, let me invite readers with experience in this or related areas to share their own suggestions about how best to do book activism. What have you yourself done?  What have you seen work? Not work? What do you know about the media in your area that it would be helpful for the rest of us to know?

An observation in closing: While for sure there are exceptions, generally, all coverage, including psychiatry “panning” our books works to our advantage. So do not worry if your postings culminate in psychiatry going on the offensive, that is, devoting their energy to attacking the target book—don’t even become alarmed it they start making spurious claims about it (to some extent, inevitable). The fact that they bother is itself an indicator that they are losing ground. Correspondingly, their doing so, spells controversy. And the value of controversy especially when handled skillfully may be gleaned from the PsychOut experience:

To wit, PsychOut was an activist University of Toronto conference on organizing against psychiatry. It received highly negative and indeed demeaning press—presenters being portrayed as “flakes”, the entire operation portrayed as a waste of the public purse—hence the controversy. A war of words ensued—which the knowledgeable activists won handily. The long and short? The bad press, together with activists’ able response to it, culminated in the most extensive and the best press that we activists/antipsychiatry scholars had received in decades (see Burstow and Diamond, 2011).

(For related articles, see http://bizomadness.blogspot.ca/).

References

Ben-Moshe, L., Chapman, C., & Carey, A. (2014). Disability Incarcerated. New York: Palgrave Macmillan.

Breggin, P. (2008). Brain-disabling treatments in psychiatry: Drugs, electroshock, and the psychopharmaceutical complex. New York: Springer.

Burstow, B. (2014a). The withering of psychiatry: An attrition model for antipsychiatry. In B. Burstow, B. LeFrançois, & S. Diamond (Eds.), Psychiatry disrupted: Theorizing resistance and crafting the revolution (pp. 34-51). Montreal: McGill-Queen’s University Press.

Burstow, B. (2014b). A prison by any other name: A review of Disability Incarcerated. Canadian Journal of Disability Studies, 2014, Volume 3. No. 3, pp. 137-143. 

Burstow, B. (2015a) “Doing” antipsychiatry on all cylinders: Possibilities, enigmas, challenges. Retrieved April 15 2015 from http://www.madinamerica.com/2015/04/antipsychiatry-cylinders-possibilities-enigmas-challenges/.

Burstow, B. (2015b). Protesting ECT: A moral/existential calling. Retrieved April 17 2015 from http://www.madinamerica.com/2015/03/protesting-ect-moralexistential-calling/

Burstow, B. (2015c). Psychiatry and the business of madness: An ethical and epistemological accounting. New York: Palgrave Macmillan.

Burstow, B. & Diamond, S. (2011). Building a global network of activists. Asylum, Vol. 18, No. 4,  pp. 21-22.

LeFrançois, B., Menzies, R., & Reaume, G. (2013). Mad matters: A critical reader in mad studies. Toronto: Canadian Scholars Press.

Lieberman, J. (2015). Shrinks: The untold story. New York: Little, Brown and Company.

Mills, C. (2013). Decolonizing global mental health: The psychiatrization of the majority world. London: Routledge.

Whitaker, R. (2010). Anatomy of an epidemic. New York: Broadway Paperbacks.

Whitaker, R. & Cosgrove, L. (2015). Psychiatry under the influence: Institutional corruption, social injury, and prescriptions for reform. New York: Palgrave Macmillan.

Wipond, R. (2103). Pitching mad: News media and the psychiatric survivor perspective. In B. LeFrançois, R. Menzies, and G. Reaume. Mad matters: A critical reader in mad studies (pp. 253-264). Toronto: Canadian Scholars Press.

First Review of Psychiatry and the Business of Madness is Out---and It's a Ringing Endorsement

Writes psychologist and theorist Philip Hickey, "This book is a major milestone in the antipsychiatry effort, and stands as a monumental challenge to psychiatry's continued existence as a branch of medicine."

What every author holds their breath for--the first review of Psychiatry and the Business of Madness is out--and it's a ringing endorsment.

Another memorable statements from Hickey?   Normally when I write a book review, I include some quotes from the work to enable readers to judge for themselves the quality and content of the material.  With Psychiatry and the Business of Madness, however, this presented a problem, in that virtually every one of the 264 pages of text contains eminently quotable material.

For Hickey's full review of the book, see his review in Mad in America

“Doing” Antipsychiatry on all Cylinders: Possibilities, Enigmas, Challenges

Year after year, we confront, we explain. Maybe we get minor concessions. Then presto, something happens, and even those handouts are gone. (S. R., activist and interviewee)

On several occasions I have written about the complexities of antipsychiatry politics, exploring more specifically, how to “do our politics” in a way that moves society squarely in the direction of the abolitionist goal (e.g., Burstow, 2014). In this article, I am once again theorizing the “how” of activism—for understanding this territory is critical to maximizing effectiveness. However, this time round, I am approaching it from an angle at once more general and more practical. That is, I am investigating the tools or approaches at our disposal as activists. What relates to this, I will be discussing the genus of politic—that is, the manner of politics being engaged.  

Pivotal questions grappled with in this article include: What fundamental approaches might be taken to end/rein in psychiatry? What are the strengths and shortcomings of each? What dangers do they present? To what larger genus of politic do they belong?  How are we to understand these in themselves? In relation to psychiatry? What are some of the enigmas, or challenges facing us? And how might they be met?

Now obviously, very different approaches might be adopted depending on the intended target of our change efforts—psychiatrists, survivors whom we hope to influence, our selves, the general public, the state. For the purpose of this article, I will largely be limiting the focal target to those with power in this area on one hand and the general public on the other.

That said, let me suggest that there are two overarching or umbrella approaches available to us as activists—persuasion on one hand and the application of political pressure on the other (for an articulation of these principles in relation a neighbouring movement, see Rosenthal, 1996).

To begin with persuasion, persuasion is predicated on the supposition that if we make our points well enough, say, by assembling cogent evidence, by making it assessable, by personalizing this with sensitizing stories and other emotional persuaders, people will become convinced that action of the type suggested is called for—for example, that ECT should be abolished. Correspondingly, it is assumed that there is an extremely close relationship between people being persuaded and change happening. Now whatever the limitation of this perspective and this approach, without question, persuasion is a key element in most change processes. Moreover, it is part of our existential nature to try to persuade and to move. Understandably, correspondingly, efforts at persuasion abound in our movement, whether we call what we are doing providing information, exposing, sensitizing, telling our story, or educating. Examples are: almost all the articles in Mad in America, the books that we pen, fact sheets that we produce, dialogues that we invite.

That said, I would agree that this is a necessary, even pivotal dimension. Why, for example, would the public support banning ECT short of becoming convinced that it is inherently damaging? Our tools here—and it is important to master them—include: sound scientific evidence, latest findings, cogent analysis, people’s stories, with ones with which public can identify being particular important, for they heighten empathy, lead to “aha” movements, and motivate. And with all of this, painstaking accuracy is critical. Note, the establishment can get away with lying, twisting, and exaggerating—we cannot.

That granted, a number of questions arise. First, are there risks involved in heavily relying on persuasion? Let me suggest that indeed, there are, with the risks different for different types of persuasion. To begin with the simplest of these, when trying to persuade, especially when using personal stories as persuaders, we can readily fall into what has been called “the politics of compassion” (in the politics of compassion, we are in essence leveraging the compassion that people feel or can be induced to feel to effect the changes sought; for an articulation of this concept, see Rosenthal, 1996). To be clear, I am in no way trying to minimize the importance of compassion. Nonetheless, the politics of compassion is at best a tenuous base from which to proceed. Why? For one, the presence of compassion does not in and of itself mean that the shift that materializes will be benign, despite our best efforts. In this regard, strange though this may seem, most people who support forced drugging are convinced that there are thereby being compassionate to the objects of the force. Additionally, even good changes made on such a basis tend to be less than reliable. Why? Because people whose political decisions stem overwhelmingly from compassion seldom have a solid grasp of the territory. Correspondingly, the object of their compassion can shift—and as a result, such changes can be very short-lived. 

One way that this happens is by the establishment likewise appealing to compassion. In this regard, in the early 1980s ECT survivors frequently got on tv and moved the public with chilling stories of how the treatment ruined their lives—seemingly, real progress. Within short order, though, psychiatrists were bringing their own patients onto shows with them, with the patients testifying how ECT had saved their lives. The audience was still compassionate but compassion now culminated in support for the status quo.

Indeed, even when substantial (and benign) changes have materialized, in the absence of a more solid base, they can quickly be reversed. Consider, in this regard, the great strides made with respect to psychiatric survivor rights in the 1980s. In Ontario Canada, for instance, education on the impossible plight of psychiatric survivors led to legal changes predicated on the notion that the default mode should be survivors making their own decisions. Shortly thereafter, however, a man called Brian was killed by someone identified as  “disordered” and the incident was seized upon by institutional psychiatry, its supporters, and the media. Whereupon, the public’s compassion shifted from survivors per se to what was seen as their potential victims. The result was the passing of Brian’s Law—a piece of legislation which dramatically lowered the bar on what suffices to incarcerate involuntarily (for details, see Burstow, 2015a).

For changes to be benign, solid, and enduring, in other words, additional education is needed that goes beyond the education typically associated with the politics of compassion. Examples are: education debunking the myth of the dangerous mental patient, education around the inefficacy of and the harm done by the “treatments,” and education on psychiatry’s lack of foundation. More fundamentally, if substantial and enduring change is to be achieved, the politics of entitlement has to take precedence over the politics of compassion. To hone in on consent, for example, the message that needs to be delivered is: Irrespective of how others may feel, it is everyone’s right to be free.

This being the case, public education on people’s rights is important. And of particular importance are initiatives like Tina Minkowitz’s, which culminated in the U.N. declaring involuntary treatment torture (see Minkowitz, 2014). And here we move from liberal to radical education, and, indeed, consciousness-raising. 

At this point the question arises: If education is both more thorough and more radical, will it then suffice? At risk of frustrating the reader, let me suggest, for the most part, no. And here, we come up against the limitations of persuasion, also the inadequacy of what passes as common sense. In this regard, it is commonly believed that if provided with good evidence and ways to relate, people can be persuaded to see things differently; correspondingly, once enough people or the right people are so persuaded, social change, ipso facto, will occur. The very fact that for decades now an abundance of  scholars, activists, and survivors have masterfully provided such education (e.g., Szasz, Breggin, Frank) and yet psychiatry continues to command respect and to grow is itself an indicator that such an understanding is too simplistic. While of course, on some level or other, persuasion is generally at work when change happens, what such a perspective ignores is the very fact of power and how it works.

The point is that there are structures and there is a profession here endowed with authority. And there are huge vested interests at play—the multinational pharmaceutical companies, for example, armies of  “professional helpers”, indeed the entire psychiatric/psychopharmaceutical industrial complex. These yield enormous power, including the power to determine who and what is credible. Correspondingly, they can be counted on to use that power to further their own interests, including their own bottom line. On top of which the public is wary of people whom they see as mad— and so want such structures in place. Moreover, the industry has vast sums of money and other capital at their disposal, and whenever it has seen public sentiment shift against it, it has invariably responded by drawing on its extensive resources to wage a new campaign (for details, see Burstow, 2015a). All formidable reasons why persuasion does not suffice.

If the combination of logic, facticity, and fellow feeling, while essential, do not suffice—and I am suggesting that they do not—what else is needed? At this point in history at any rate, force. The point is, insofar as an oppressor wields power, and insofar as we are trying to overturn a system that is inherently oppressive and all-encompassing, we too need to wield power. To be clear, I am in no way suggesting physical force, but non-violent action such as that waged by visionaries like Gandhi (see Sharp, 1973).

Now indeed, albeit it is underutilized, to varying degrees nonviolent resistance too has always figured in our repertoire. Note, in this regard, the Highlander work, wherein survivors  pointedly modeled themselves on the civil rights movement. Note the demonstrations in the UK (see Mckeown, Creswell, and Spandler, 2014). Correspondingly, witness MindFreedom’s 2002 hunger strike (for details, see http://www.mindfreedom.org/kb/act/2003/mf-hunger-strike/hunger-strike-news?searchterm=hunger+ ).

The latter, I would add, is a particularly instructive action to probe. The protestors’ ultimate demand was the provision of choice in “services”; and in the process of making this demand, they challenged the American Psychiatric Association and the National Institute of Mental Health to point to a single study showing that “mental illness” is biological—which, of course, they could not. This action was nothing short of remarkable; it included among its team no less a figure than the former head of “schizophrenia studies” at National Institute of Mental Health; it brought together survivors and radical professionals, drawing on the knowledge of each; it garnered press; it brought goals, methods, and means of measurement into alignment with each other, as is critical in strategic activism; correspondingly, it constituted a formidable education in its own right. At the same time, even this stellar piece of activism fell short of achieving its objective. Nor did it exactly create a base from which to proceed. And here is the rub.

Now to be clear, as I have stated elsewhere (Burstow, 2015b), standing up and being counted is important irrespective of effectiveness. And so is raising awareness even when nothing concrete materializes. Nonetheless, insofar as our goal is social change, effectiveness in the strictest sense of the term matters. So the question is: what kind of pressure can we bring to bear that might actually materialize in change? In short, there are two types of pressure involved in non-violent action. The first is moral force, also known as the force of truth (and the personal stories alluded to earlier are a part of this). Such is arguably achievable in our movement, for the cause is just and the harm demonstrable.

That said, while moral force is absolutely critical—and for sure it was being wielded in that hunger strike—it similarly does not suffice. In this regard, history teaches us—and we ignore this to our peril—that moral pressure needs to be combined with pressure of a more material kind. Note, in India when Gandhi mobilized against the British colonizers, or to add a second example, when the Black community in Nashville sought to desegregate the commercial centre of their city, they were successful because not only had they moral force, they used and leveraged the power of numbers to obstruct. In this regard, the oppressed inhabitants of India greatly outnumbered the British occupiers, did all the work utilized by the regime, and so by the very act of striking, they were able to bring production to a halt and in the process, undermine the British. By the same token, the Black community in Nashville was sufficiently large that once the overwhelming majority of Black residents (plus allies) had joined the ongoing boycott of stores practicing segregation (more or less all stores in central Nashville) and had engaged in it long enough, the seemingly intransigent merchants of Nashville were, in essence, brought to their knees (for a blow-by-blow of this very extensive campaign, see York, 2000).

To put this simply, the question facing any movement intent on change is leverage. Having large enough numbers that you can stop the work of industry constitutes leverage. Being able to wield sufficient economic power that simply by refusing to purchase you can materially affect companies’ bottom line constitutes leverage. Now generally, the leverage in question is of an economic nature, but there is no obvious reason why this must be so. That noted, the question facing our movement is this: Besides the morality of our cause, exactly what is our leverage? And if we haven’t sufficient leverage now—which I am suggesting is the case—what kind of leverage can we get and how do we acquire more?

The answer to this question is anything but obvious. A course which I teach (Creative Empowerment Work with the Disenfanchized) is instructive in this regard. Year after year, I have engaged students in an exercise—and it invariably ends with the same impasse: The class having been divided into three, each group is tasked with brainstorming a strategic piece of resistance that would stand a reasonable chance of being successful—group one, in regard to homelessness, group two with respect to prisons, group three with regards to psychiatry. While all three encounter difficulties, almost invariably, it is the students in the antipsychiatry group that flounder. Why? Precisely because, try though they might, they cannot locate a point of leverage.

This said, arguably, the single biggest task confronting us as a movement is finding or generating leverage. Boycotting the drugs, clearly, would not get the unity needed and would otherwise backfire. And in the end, even at its best, the only pressure of use to us that would arise from a hunger strike is moral pressure, which short of having a person with the reputation of Gandhi at the helm, is not going to advance the movement far. 

I do not have a clear answer to the dilemma posed here, though I can hazard some guesses about direction. Insofar as lack of numbers presents a formidable obstacle to any strategy, let me suggest that coalition politics appears to be called for. Note, if even a modest percentage of the people poorly served by society banded together, we would greatly outnumber the establishment, and as such, arguably, the necessary critical mass could be forged. Though to accomplish this, obviously, ongoing work reaching out and co-visioning would be critical.

Not an easy or a quick answer, I agree, but one with the added advantage of being holistic and truly leading in the direction of a better society.

In summation, there are very serviceable tools at our disposal as antipsychiatry activists—and these include various kinds of persuasion and force. Correspondingly, it is critical that we know them, select and use them skillfully. At the same time, major challenges confront us.  Getting past our conviction that persuasion suffices is one of them—and then there are the material problems, together with issues like power and leverage. Hopefully, this article has shed a little more clarity on all of such aspects. And hopefully, the reflections and dialogue started here can continue.

Indeed, as you go about your work, I invite the reader to continue pondering the distinctions, queries, and challenges raised. In particular, I invite you to ask yourself: What power do we wield? Could we wield? Who historically have our allies been? (e.g., homelessness activists, prison abolitionists, Quakers) And who might new allies be? As an addendum, correspondingly, I leave you with the following consideration:

No campaign is successful without images. And if chosen judiciously, symbols can be of considerable help in generating leverage.

One possibility in this regard is using the violence of ECT as a symbol for psychiatry overall (see Burstow, 2015b). What might be at least as potent—and I think that we would do well to seriously entertain this possibility—is to focus in on the psychiatrization of children. By this I do not mean what happened to current adult survivors when young (important though this dimension is), but the rampant targeting of children going on now (see Whitaker, 2010). Children being placed on Ritalin. Children being labeled ADHD. Children being controlled/subdued chemically in classrooms around the world. Herein lies a powerful symbol. Question: If we leverage it properly, might not the public at large be moved to rally in protection of its children? And were that possible, in the long run, might not such a focus deliver the numbers needed for strategic action? 

What is significant here, irrespective of espoused belief, understandably (given that the young in particular are entrusted to our care), people are readily outraged by what happens to children, and more pointedly, what happens or could happen to their child. And significantly, the vast majority of the human population are parents, grandparents, and the like. Now for sure, a frightening number of parents, moreover, the vast majority of ones publicly weighing on these issues are in the opposite camp, have become, in essence, an extension of psychiatry. By the same token, a particularly formidable weapon in psychiatry’s current arsenal are pro-medical model family organizations like NAMI, tutored, funded, and otherwise resourced by the psychopharmaceuticals. This notwithstanding, those of us who organize in this area have witnessed first hand the enormous power that can be unleashed when parents suddenly realize that they have been, as it were, “sold a bill of goods”. As such, arguably, if we put our minds to reaching and leveraging the power of this very considerable constituency (of which we, after all, are a part), for the first time in history, we might be able to create the leverage needed—indeed, potentially, leverage beyond our wildest dreams—a good beginning.

Insofar as this is the case, I would add, the greed of the psychiatric/psychopharmaceutical industry in relentlessly pursuing this erstwhile “untapped market”—the real reason that our children have been targeted—could prove to be its own undoing.

References

Burstow, B. (2014). The withering of psychiatry: An attrition model for antipsychiatry. In B. Burstow, B. LeFrançois, & S. Diamond (Eds.), Psychiatry disrupted: Theorizing resistance and crafting the revolution (pp. 34-51). Montreal: McGill-Queen’s University Press.

Burstow, B. (2015a). Psychiatry and the business of madness: An ethical and epistemological accounting. New York: Palgrave Macmillan.

Burstow, B. (2015b). Protesting ECT. Retrieved on April 3 2015 from http://www.madinamerica.com/2015/03/protesting-ect-moralexistential-calling/.

Mckeown, M., Creswell, M., and Spandler, H. (2014). Deeply engaged relationships. In B. Burstow, B. LeFrançois, & S. Diamond (Eds.), Psychiatry disrupted: Theorizing resistance and crafting the revolution (pp. 145-162). Montreal: McGill-Queen’s University Press.

Minkowitz, T. (2014). Convention on the rights of persons with disabilities and liberation from psychiatric oppression. In B. Burstow, B. LeFrançois, & S. Diamond (Eds.), Psychiatry disrupted: Theorizing resistance and crafting the revolution (pp. 129-144). Montreal: McGill-Queen’s University Press.

Rosenthal, R. (1996). Dilemmas of local antihomelessness movements. In J. Baumohl (Ed.). Homelessness in America (pp. 201-232). Phoenix, Arizona: Oryx Press.

Sharp, G. (1973). The politics of nonviolent action. Boston: Porter Sargent Publications.

Whitaker, R. (2010). Anatomy of an epidemic. New York: Broadway Paperbacks.

York, S. (2000). A force more powerful (PBS). New York: United States Institute of Peace.

The Book is Out, The Wait Over: Psychiatry and the Business of Madness Has Been Published!

The date given for the publication of this book (the anticipated date) was April 1, 2015. The countdown was almost unbearable.  March 29, March 30, March 31; finally April 1 came --and still no book in my hands--nothing had arrived from the publisher!  So I did what every person does who realizes or at least suspects that this is the best work that ever s/he is likely to pen (for in all honesty, it is).  I took a deep breath, then queried the publisher.  No answer that day.  Why?, I wondered. Had something unexpected happened?  Finally the next day, the answer to the puzzle came--an unfortunate glitch had happened, though my author's copies of the book were now on their way to me.

Now it is common practice to wait until you have a copy of your book in your hot little hands before declaring a book published.  So not wanting to "jump the gun",  again I wait.  Next day, still nothing. 

Then came the first sign. An email arrived from one of the people who would be speaking at the London book launch--Cheryl Prax--informing us that her copy of the book had arrived. Halleluiah! 

Could I now declare it published?  Maybe I should wait. After all,  because just because someone in London has it (London being home to Palgrave Macmillan's largest headquarters, people in London might well get it first), that does not mean that it is readily available elsewhere.  I sighed, then let the issue go and trundled off to a CAPA (Coalition Against Psychiatric Assault) meeting. 

Shortly after the meeting commenced, a member called Oriel entered the room. What is it that she was holding?  Could it be?  Yes, it was.  There in her hands was a copy of Psychiatry and the Business of Madness: An Ethical and Epistemological Accounting. 

She sat down, open the booked, began thumbing through it.  She had clearly gone over it with a highlighter, for passage after passage in page after after page had been highlighted in yellow!  An indication that it had not just arrived.

Given the mounting evidence, by the powers vested in me as author, I hereby declare the book Psychiatry and the Business of Madness published! 

The chapter breakdown is: 

1. Introduction to the Study: Unveiling the Problematic
2. The Evolution of "Madness": A Journey "through Time"
3. Modernity (1890-2014): A Journey through Time, Part Two
4. Probing the Boss Text: The DSM—What? Whither? How? Which? 
5. The Beast/In the Belly of the Beast: Pinioned by Paper
6. The Psychiatric Team
7. Marching to "Pharmageddon": Psychopharmacy Unmasked
8. Electroshock—Not a Healing Option
9. Dusting Ourselves Off and Starting Anew

Comments about the book to date are:

"This is a powerfully unsettling book. Burstow expresses outrage about, and level-headed analysis of, the oppressive and alienating practices of psychiatry and holds out hope for emancipation that builds on everyday interactions in a transformed society. It's an outstanding contribution to critical thinking about mental health, and to ethics, law, and social change—a no-holds barred, take-no-prisoners radical history and deconstruction of all modern mental health practices and an ambitious, inspiring 'eutopian' proposal for their reinvention."
- David Cohen, Professor and Marjorie Crump Chair in Social Welfare, University of California, Los Angeles, US 

About the book
Psychiatry and the Business of Madness deconstructs psychiatric discourse and practice, exposes the self-interest at the core of the psychiatric/psychopharmacological enterprise, and demonstrates that psychiatry is epistemologically and ethically irredeemable. Burstow's medical and historical research and in-depth interviews demonstrate that the paradigm is untenable, that psychiatry is pseudo-medicine, that the "treatments" do not "correct" disorders but cause them. Burstow fundamentally challenges our right to incarcerate or otherwise subdue those we find distressing. She invites the reader to rethink how society addresses these problems, and gives concrete suggestions for societal transformation, with "services" grounded in the community. A compelling piece of scholarship, impeccable in its logic, unwavering in its moral commitment, and revolutionary in its implications.

That said, let me encourage people to pick it up, read it. My guess and my promise is that it will hold your interest. And whether you like it (very possible), hate it (also possible), or are uncertain (possible as well), let us all know what you think. And do consider posting a comment on Amazon or Indigo-on-line, letting the world at large know your impression. 

Note, despite the limitations of the medium, there is a democratization of opinion-giving happening with the Internet, and good that we all avail ourselves of it.