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4,pycA1o I( CY//A rf /“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 societysquarely in the direction of the abolitionist goal (e.g., Burstow, 2014). In this article, I amonce again theorizing the “how” of activism—for understanding this territory is critical tomaximizing effectiveness. However, this time round, I am approaching it from an angleat once more general and more practical. That is, I am investigating the tools orapproaches at our disposal as activists. What relates to this, I will he discussing the genusof politic—that is, the manner of politics being engaged.

Pivotal questions grappled with in this article include: What fundamental approachesmight be taken to end/rein in psychiatry? What are the strengths and shortcomings ofeach? 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 someof the enigmas, or challenges facing us? And how might they be met?

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

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

To begin with persuasion, persuasion is predicated on the supposition that if we make ourpoints well enough, say, by assembling cogent evidence, by making it assessable, bypersonalizing this with sensitizing stories and other emotional persuaders, people willbecome convinced that action of the type suggested is called for—for example, that ECTshould be abolished. Correspondingly, it is assumed that there is an extremely closerelationship between people being persuaded and change happening. Now whatever thelimitation of this perspective and this approach, without question, persuasion is a keyelement in most change processes. Moreover, it is part of our existential nature to try topersuade and to move. Understandably, correspondingly, efforts at persuasion abound inour 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 inAmerica, 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, fbrexample, 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: soundscientific evidence, latest findings, cogent analysis, people’s stories, with ones withwhich 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 heavilyrelying on persuasion? Let me suggest that indeed, there are, with the risks different fordifferent types of persuasion. To begin with the simplest of these, when trying topersuade, especially when using personal stories as persuaders, we can readily fall intowhat has been called “the politics of compassion” (in the politics of compassion, we arein essence leveraging the compassion that people feel or can be induced to feel to effectthe changes sought; for an articulation of this concept, see Rosenthal, 1996). To he clear,I am in no way trying to minimize the importance of compassion. Nonetheless, thepolitics of compassion is at best a tenuous base from which to proceed. Why? For one,the presence of compassion does not in and of itselfmean that the shift that materializeswill be benign, despite our best efforts. In this regard, strange though this may seem, mostpeople who support forced drugging are convinced that there are thereby beingcompassionate to the objects of the force. Additionally, even good changes made on sucha basis tend to be less than reliable. Why? Because people whose political decisions stemoverwhelmingly from compassion seldom have a solid grasp of the territory.Correspondingly, the object of their compassion can shift—and as a result, such changescan be very short-lived.

One way that this happens is by the establishment likewise appealing to compassion. Inthis regard, in the early 1 980s ECT survivors frequently got on tv and moved the publicwith chilling stories of how the treatment ruined their lives—seemingly, real progress.Within short order, though, psychiatrists were bringing their own patients onto showswith them, with the patients testifying how ECT had saved their lives. The audience wasstill compassionate but compassion now culminated in support for the status quo.

Indeed, even when substantial (and benign) changes have materialized, in the absence ofa more solid base, they can quickly be reversed. Consider, in this regard, the great stridesmade with respect to psychiatric survivor rights in the 1 980s. In Ontario Canada, forinstance, education on the impossible plight of psychiatric survivors led to legal changespredicated on the notion that the default mode should be survivors making their owndecisions. Shortly thereafter, however, a man called Brian was killed by someoneidentified as “disordered” and the incident was seized upon by institutional psychiatry,its supporters, and the media. Whereupon, the public’s compassion shifted from survivorsper se to what was seen as their potential victims. The result was the passing of Brian’sLaw—a piece of legislation which dramatically lowered the bar on what suffices toincarcerate involuntarily (for details, see Burstow, 201 5a).

For changes to be benign, solid, and enduring, in other words, additional education isneeded that goes beyond the education typically associated with the politics ofcompassion. Examples are: education debunking the myth of the dangerous mental

patient, education around the inefficacy of and the harm done by the “treatments,” andeducation on psychiatry’s lack of foundation. More fundamentally, if substantial andenduring change is to be achieved, the politics of entitlement has to take precedence overthe politics of compassion. To hone in on consent, for example, the message that needs tobe 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 particularimportance are initiatives like Tina Minkowitz’ s, which culminated in the U.N. declaringinvoluntary treatment torture (see Minkowitz, 2014). And here we move from liberal toradical 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 whatpasses as common sense. In this regard, it is commonly believed that if provided withgood 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 indicatorthat 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 isthe very fact of power and how it works.

The point is that there are structures and there is a profession here endowed withauthority. And there are huge vested interests at play—the multinational pharmaceuticalcompanies, for example, armies of “professional helpers”, indeed the entirepsychiatric/psychopharmaceutical industrial complex. These yield enormous power,including the power to determine who and what is credible. Correspondingly, they can becounted on to use that power to further their own interests, including their own bottomline. On top of which the public is wary of people whom they see as mad— and so wantsuch structures in place. Moreover, the industry has vast sums of money and other capitalat their disposal, and whenever it has seen public sentiment shift against it, it hasinvariably responded by drawing on its extensive resources to wage a new campaign (fordetails, 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 anyrate, force. The point is, insofar as an oppressor wields power, and insofar as we aretrying to overturn a system that is inherently oppressive and all-encompassing, we tooneed to wield power. To be clear, I am in no way suggesting physical force, but nonviolent action such as that waged by visionaries like Gandhi (see Sharp, 1973).

Now indeed, albeit it is underutilized, to varying degrees nonviolent resistance too hasalways figured in our repertoire. Note, in this regard, the Highlander work, whereinsurvivors 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, seehttp ://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 makingthis demand, they challenged the American Psychiatric Association and the NationalInstitute of Mental Health to point to a single study showing that “mental illness” isbiological—which, of course, they could not. This action was nothing short ofremarkable; it included among its team no less a figure than the former head of“schizophrenia studies” at National Institute ofMental Health; it brought togethersurvivors 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, asis critical in strategic activism; correspondingly, it constituted a formidable education inits own right. At the same time, even this stellar piece of activism fell short of achievingits 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, 201 5b), standing up and beingcounted is important irrespective ofeffectiveness. And so is raising awareness even whennothing 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 ofpressure can we bring to bear that might actually materialize in change? In short, thereare two types of pressure involved in non-violent action. The first is moral force, alsoknown 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 harmdemonstrable.

That said, while moral force is absolutely critical—and for sure it was being wielded inthat hunger strike—it similarly does not suffice. In this regard, history teaches us—andwe ignore this to our peril—that moral pressure needs to be combined with pressure of amore 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 todesegregate the commercial centre of their city, they were successful because not onlyhad they moral force, they used and leveraged the power of numbers to obstruct. In thisregard, the oppressed inhabitants of India greatly outnumbered the British occupiers, didall the work utilized by the regime, and so by the very act of striking, they were able tobring 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 overwhelmingmajority of Black residents (plus allies) had joined the ongoing boycott of storespracticing segregation (more or less all stores in central Nashville) and had engaged in itlong enough, the seemingly intransigent merchants of Nashville were, in essence, broughtto 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 youcan materially affect companies’ bottom line constitutes leverage. Now generally, theleverage in question is of an economic nature, but there is no obvious reason why thismust be so. That noted, the question facing our movement is this: Besides the morality ofour 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 weacquire more?

The answer to this question is anything but obvious. A course which I teach (CreativeEmpowerment Work with the Disenfanchized) is instructive in this regard. Year afteryear, I have engaged students in an exercise—and it invariably ends with the sameimpasse: The class having been divided into three, each group is tasked withbrainstorming a strategic piece of resistance that would stand a reasonable chance ofbeing successful—group one, in regard to homelessness, group two with respect toprisons, 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 orgenerating leverage. Boycotting the drugs, clearly, would not get the unity needed andwould otherwise backfire. And in the end, even at its best, the only pressure of use to usthat would arise from a hunger strike is moral pressure, which short of having a personwith 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 someguesses about direction. Insofar as lack of numbers presents a formidable obstacle to anystrategy, let me suggest that coalition politics appears to be called for. Note, if even amodest percentage of the people poorly served by society banded together, we wouldgreatly outnumber the establishment, and as such, arguably, the necessary critical masscould be forged. Though to accomplish this, obviously, ongoing work reaching out andco-visioning would be critical.

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

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

Indeed, as you go about your work, I invite the reader to continue pondering thedistinctions, 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’? Asan addendum, correspondingly, I leave you with the following consideration:

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

One possibility in this regard is using the violence of ECT as a symbol for psychiatryoverall (see Burstow, 201 5b). What might be at least as potent—and I think that wewould do well to seriously entertain this possibility—is to focus in on the psychiatrizationof 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. Hereinlies a powerful symbol. Question: If we leverage it properly, might not the public at largebe 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 be1ief’ understandably (given that theyoung in particular are entrusted to our care), people are readily outraged by whathappens 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 majorityof ones publicly weighing on these issues are in the opposite camp, have become, inessence, an extension of psychiatry. By the same token, a particularly formidable weaponin psychiatry’s current arsenal are pro-medical model family organizations like NAMI,tutored, funded, and otherwise resourced by the psychopharmaceuticals. Thisnotwithstanding, those of us who organize in this area have witnessed first hand theenormous power that can be unleashed when parents suddenly realize that they havebeen, as it were, “sold a bill of goods”. As such, arguably, if we put our minds to reachingand 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/psychopharmaceuticalindustry in relentlessly pursuing this erstwhile “untapped market”—the real reason thatour children have been targeted—could prove to be its own undoing.

(For this and related articles, see t://bizomauness.ozspoLca/).

References

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Burstow, B. (2015a). Psvchialty and the business olmadness: An ethical andepisiemological accounting. Toronto: Paigrave Macmillan.

Burstow, B. (2015b). Protesting ECT. Retrieved on April 3 2015 from1tp:/ v’ .niclian ion/O 5/03/p otest g ctmorIe\’LswnI h1—ca) h ng’.

Mckeown, M., Creswell, M., and Spandler, H. (2014). Deeply engaged relationships. InB. Burstow, B. LeFrancois, & S. Diamond (Eds.), Psychiatry disrupted: Theorizingresistance and crafting the revolution (pp. 145-162). Montreal: McGill-Queen’sUniversity Press.

Minkowitz, T. (2014). Convention on the rights of persons with disabilities and liberationfrom psychiatric oppression. In B. Burstow, B. LeFrancois, & 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. Baumohi(Ed.). Homelessness in America (pp. 20 1-232). Phoenix, Arizona: Oryx Press.

Sharp, 0. (1973). The politics of nonviolent action. Boston: Porter Sargent Publications.

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

York, S. (2000). A force more powerful (PBS). New York: IJnited States Institute ofPeace.