Psychiatric Survivors Research Articles

Autism, “Recovery (to Normalcy),” and the Politics of Hope

This article draws on the traditions of critical discourse analysis (N. Fairclough, 1995, 2001; M. Foucault, 1972, 1980; J. P. Gee, 1999) in critically examining the discursive formation of "recovery" from autism in applied behavioral analysis (ABA) discourse and its relationship to constructs of hope. Constituted principally in the work of O. I. Lovaas (1987) and C. Maurice (1993), and central to ABA discourse on recovery, has been the construction of a particular vision of hope that has at least 2 integral conceptual elements: (a) Hope for recovery within ABA discourse is constructed in binary opposition to hopelessness, and (b) recovery within ABA discourse is discursively constructed as "recovery (to normalcy)." The author analyzes these 2 pivotal ABA texts within the context of an analysis of other uses of the term recovery in broader bodies of literature: (a) within prior autism-related literature, particularly autobiography, and (b) within literature emanating from the psychiatric survivors' movement. If, indeed, visions of hope inform educational policy and decision making, this analysis addresses S. Danforth's (1997) cogent query, "On what basis hope?", and asserts that moral and political commitments should be central sources of visions of hope and, therefore, inform educational policy and decision making for young children with labels of autism.

Psychiatric Survivors and Experiential Rights

Human rights may be categorised as belonging to ‘three generations’: political, social and ‘solidarity’ rights. This paper considers this schema theoretically, deploying the example of the ‘psychiatric survivor’ movement in Britain in support of its central claims. Psychiatric survivors comprise groups of psychiatric patients who have campaigned both for political and social rights in addition to a singular form of ‘right’, which is referred to here as ‘experiential’. The paper clarifies the meaning of the ‘experiential right’ and, drawing upon aspects of social theory, considers how it is to be understood in the context of the ‘three generations’ schema.

To See or Not To See “Schizophrenia” and The Possibility of Full “Recovery”

Since the beginning of modern psychiatry, the diagnosis of “schizophrenia” has epitomized the idea of chronic, severe mental illness. This engaging article looks at the beliefs and practices of biological psychiatry regarding “schizophrenia.” Guiding beliefs, however flawed they might be, determine perception and action, and this is very true in psychiatry. There are, however, significant differences between belief and fact in psychiatric theory. The author examines these differences and presents research about the safety and efficacy failures of treatment, especially regarding the antipsychotic drugs. He reviews important dissident literature from both psychiatric survivors and professionals showing that recovery from extreme states, from “schizophrenia,” is quite possible. Although the standard psychiatric outlook for recovery from schizophrenia is virtually nil, the essay concludes with an inspiring story of musical artists who have demonstrated a reemergence from diagnoses of severe mental illness and treatment with antipsychotic drugs and electroshock.

Putting Values into Practice: Public Policy and the Future of Mental Health Consumer‐run Organizations

The purpose of the paper is to reflect on value dilemmas in mental health consumer-run organizations and to discuss implications for research, policy, and practice. We review the roots of consumer-run organizations in the self-help movement and the psychiatric survivor liberation movement, focusing on the distinctive values espoused by consumer-run organizations. We also discuss evidence-based and value-based approaches to mental health policy formulation and mental health reform, noting the particular importance of value-based approaches and the role that consumer-run organizations can play in mental health reform. Based on our experiences conducting a participatory action research study of four mental health consumer-run organizations, we identify and examine several value dilemmas, discuss the lessons that we learned about these value dilemmas, and note their implications for future directions in research, policy, and practice.

Beyond the counter-narrative

The discourse of the medical model of mental illness tends to dominate people’s conceptions of the origins and treatments of psychopathology. This reductionistic discourse defines people’s experiences of psychological distress and recovery in terms of illnesses, chemical imbalances, and broken brains. However, the master narrative does not represent every individual’s lived experience, and alternative narratives of mental health and recovery exist that challenge our traditional understandings of normality and psychopathology. Guided by the method of interpretive interactionism, we examined how psychiatric survivors position themselves in relation to the medical model’s narrative of recovery. In its inception, the psychiatric survivor movement created a counter-narrative of protest in opposition to the medical model’s description and treatment of psychopathology. Since then, the movement has moved beyond the counter-narrative and has constructed an alternative narrative; one that is not defined in opposition to the master narrative but instead participates in an entirely different discourse.

Housing, income support and mental health: Points of disconnection

There exists a disconnection between evolving policies in the policy arenas of mental health, housing, and income support in Canada. One of the complexities associated with analysing the intersection of these policies is that federal, provincial, and municipal level policies are involved. Canada is one of the few developed countries without a national mental health policy and because of the federal policy reforms of the 1970s, the provincial governments now oversee the process of deinstitutionalization from the hospital to the community level. During this same period the availability of affordable housing has decreased as responsibility for social housing has been transfered from the federal government to the provincial and/or municipal levels of government. Canada also stands alone in terms of being a developed nation without national housing policy instead what is considered "affordable" housing is partially dependant upon individuals' personal economic resources. As well, over the past decade rates of income supports have also been reduced. Psychiatric survivors have long been identified as being at risk for homelessness, with the disconnection existing between housing, income and mental health policies and the lack of a national policy in any of these policies areas further contributing to this risk.

Recovery and the Good Life: How Psychiatric Survivors Are Revisioning the Healing Process

The recovery literature in clinical psychology often focuses on abstract outcome measures of mental health and wellness that in turn serve to shape the process and goals of psychotherapy. However, there is often an experiential disconnect between these conceptualizations of recovery and the lived experience of psychological suffering and healing. In the current article, the authors present alternative views of what recovery or, more accurately, what living a good life means for a group of people who identify themselves as psychiatric survivors. Like the feminist paradigm, the psychiatric survivor movement does not separate the personal and political, and thus this counterculture facilitates the telling of alternative narratives of recovery that more closely represent people's lived experiences. The authors discuss how these alternative discourses of the movement conceptualize the good life in terms of creating countercultural communities, engaging in political activism, and working for social justice and human rights in the mental health system.

A Qualitative Analysis of Turning Points in the Recovery Process

Recovery from serious psychiatric disabilities is a multidimensional, nonlinear process that consists, in part, of a transformation from illness-dominated identities to identities centered on empowerment and agency. This transformation may be punctuated by critical turning points. Analysis of these turning points may provide insight into the recovery process and how recovery can be initiated and advanced. In this qualitative study, in-depth personal interviews were conducted with 16 psychiatric survivors who were also providers of consumer-operated services. Participants were asked to discuss the critical turning points instrumental in their recovery processes. Analysis of these turning points using grounded theory revealed that participants played an active role with the help of supportive allies in initiating and sustaining their recoveries and that recovery consisted of a complex and ongoing struggle against multiple constraints to establish more positive identities. Implications of these results for m...

Living through exposure to toxic psychiatric orthodoxies: exploring narratives of people with ‘mental health problems’ who are looking for employment on the open labour market

This article explores lived experiences and insights of five people with long‐term ‘mental health problems’, focusing on their search for employment in a disabling society. In our qualitative, inductive analysis we investigate why it seems almost impossible to attain a status as respected adult workers. We present five central findings: (1) losing the game before it starts; (2) internalizing the vicious circle of victim blaming; (3) from control overload to a life with inadequate supports; (4) from crushed dreams back to passive inactivity; (5) signs of resilience and resistance. In meaningful dialogue survivors give voice to alternative and plural epistemological grounds of life with ‘madness’. In our concluding reflections we argue that psychiatric discourses, what we term toxic psychiatric orthodoxies, silence, disable and construct survivors as unemployable.

The Role of Self–efficacy in Recovery from Serious Psychiatric Disabilities: A Qualitative Study with Fifteen Psychiatric Survivors

This qualitative analysis applied the theory of self–efficacy to results from a study that used grounded theory to identify the factors that influenced the recoveries of 15 psychiatric survivors. Participants identified the development of a more competent and efficacious sense of self as a central aspect contributing to their recoveries. Analysis also revealed four factors related to this development: meaningful activities, supportive professional relationships, peer-support and choice among a variety of treatment alternatives. Participants' description of the recovery process and how they were able to develop a competent sense of self, possessed several parallels with Bandura's social cognitive theory of self–efficacy. This article argues that self–efficacy may provide practitioners with a useful guide for creating the contexts that facilitate the recovery process. Implications for practice and research will be explored.

"Antipsychiatry" and "Consumerism": Perspectives and Definitions

"Antipsychiatry" and "Consumerism": Perspectives and Definitions

The evolution of the consumer movement.

Back to table of contents Previous article Next article LetterFull AccessLetterGregory LudwigGregory LudwigSearch for more papers by this authorPublished Online:1 Aug 2006https://doi.org/10.1176/ps.2006.57.8.1213AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail To the Editor: During the past 27 years, I have studied psychiatry and psychology as a student, as a patient, and as a professional, and since college I have written and edited published work in these areas. From this perspective, I would say that although the Open Forum by the Rissmillers, which claims to survey the "antipsychiatry" movement, aims for a worthy goal, it is weak because of its imprecision about concepts, its less-than-adequate research, and its rather stereotyping characterization of certain intellectual figures in the 1960s and 1970s and the significance of their more responsible ideas. Perhaps the best way to undermine the authors' central apparent argument—that antipsychiatry was a golden banner that started as an intellectual game among a few radicals and then, after virtual exhaustion, was picked up by a movement among obstreperous consumers that seemed nostalgic for 1960s leftist political and intellectual styles—is to quote from Dendron, a sort of samizdat newsletter that eventually provided the basis for the organization Support Coalition International, whose name was changed last year to MindFreedom International. In a 1988 interview with none other than the renowned psychiatrist R. D. Laing by David Oaks, editor of Dendron at the time and currently director of MindFreedom, Oaks asked, "How can ex-inmates [of psychiatric wards] and progressive therapists work together?" Laing answered, "I'd have to sit down with actual people, and simply talk about it. I don't know enough about what Americans call the 'hands-on' situation to come up with a formula, some key to open up possibilities. The whole thing is: this is stitched together by personal trust [and] confidence between actual people" ( 1 ). If he was describing how a "progressive therapist" might help the budding "psychiatric survivor" movement, Laing was also characterizing the most fundamental method of relating between doctor and patient. But if this was so, it may have been unintended and ironic because he definitely seemed surprised that Americans—with their homely "hands-on" efforts—could have a pragmatic way of organizing a pro-patient movement. In fact, his tone seems that of a musty old European doctor-patient fundamentalist.So much for the Rissmillers' claim or suggestion that there is some substantive continuity—almost on the order of a grand, insidious historical error—between Laing, Szasz, and others and between their hermetic intellectual efforts and the more modern consumer efforts, now enabled by the Internet.The more likely reason for the growth of the consumerist movement might be today's widespread style of practice of psychiatry and such things as the pharmaceutical industry's medical hegemony. More fundamentally, the better reason among many people involved in the movement might simply be good sense.Mr. Ludwig is a freelance editor and writer, Highland Lakes, New Jersey.Reference1. Exclusive Dendron interview: R.D. Laing. Dendron, Feb 1988, pp 1,6,7Google Scholar FiguresReferencesCited byDetailsCited ByAdvanced Materials Research, Vol. 1000 Volume 57Issue 8 August, 2006Pages 1213-1213PSYCHIATRIC SERVICES August 2006 Volume 57 Number 8 Metrics PDF download History Published online 1 August 2006 Published in print 1 August 2006

The Necessity of Madness

Back to table of contents Previous article Next article Book ReviewsFull AccessThe Necessity of MadnessAnita Everett M.D.Anita Everett M.D.Search for more papers by this authorPublished Online:1 May 2006https://doi.org/10.1176/ps.2006.57.5.730AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail The title draws you in; is there a useful aspect to madness in human and psychological development? Certainly individuals throughout time have hoped and searched for meaning in the experience of madness. Families as well have hoped and prayed that on the other end of a period of psychosis or madness will come new insights and interpersonal growth. Although this may happen sometimes, it is also true that for many people periods of madness or psychosis are disruptive and distracting and do not result in useful interpersonal development. Dr. Breeding asserts that "madness is a dynamic process which can result in breakthroughs to deeper levels of spiritual maturity and a richer fuller life." This is one of several tenets included in this work that bring a perspective that is inconsistent with the way most professionals and advocates today characterize mental illness, which is exactly the point of Dr. Breeding's work.The Necessity of Madness includes numerous opinions espoused on a variety of subjects that have in common Breeding's views on mental health. Three central themes are: "Psychiatry is inherently coercive" and has been developed as a social mechanism to control nonconformational behaviors and beliefs; our current understanding of mental illness as a medical disease is not well founded; and with hope, courage, complete self-appreciation, and the "good attention of another safe caring human being," individuals can set about to do the work of emotional recovery. From the perspective of a psychiatrist who has spent more than 20 years working in partnership with consumers, patients, professionals, advocates, elected officials, and family members to improve the lived experience of individuals with mental illness on many levels, the continued psychiatry bashing in this work is very difficult to wade through. Dr. Breeding makes numerous references to the use of psychiatry as a tool of the Third Reich to control and exterminate mentally ill and otherwise nonproductive and defective individuals. It is inarguable that there were aspects of international unrest preceding World War II that led to a hope that science, including social science, would help to solve many levels of problems. However, most of us would not go so far as to blame psychiatry as the principal cause of Nazi atrocities, although it is undeniable that there were physicians who participated in the atrocities. Perhaps we are comfortably in denial, and perhaps that is part of the value in a very biased work such as this, salted with ideas that at least partially resonate.If you are looking for a book that depicts many of the themes and ideas that are upheld by individuals who identify with the psychiatric survivor movement, this would be a very practical resource. The prominent antipsychiatry language distracts from Breeding's useful ideas regarding recovery and self-care near the end of the book that would be very helpful to certain consumers who are looking for a high level of intellectual peer-to-peer support and exchange of positive and constructive ideas they could incorporate into their own recovery. Hopefully, in the not so distant future, we might all be able to work together to advocate for necessary tools so that all people affected by mental illness can pursue a meaningful life in the community of their choice.Dr. Everett is senior medical advisor for the Substance Abuse and Mental Health Services Administration in Rockville, Maryland. FiguresReferencesCited byDetailsCited ByNone Volume 57Issue 5 May, 2006Pages 730-731PSYCHIATRIC SERVICES May 2006 Volume 57 Number 5 Metrics PDF download History Published online 1 May 2006 Published in print 1 May 2006

The Necessity of Madness

Back to table of contents Previous article Next article Book ReviewsFull AccessThe Necessity of MadnessAnita Everett M.D.Anita Everett M.D.Search for more papers by this authorPublished Online:1 May 2006https://doi.org/10.1176/ps.2006.57.5.730AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail The title draws you in; is there a useful aspect to madness in human and psychological development? Certainly individuals throughout time have hoped and searched for meaning in the experience of madness. Families as well have hoped and prayed that on the other end of a period of psychosis or madness will come new insights and interpersonal growth. Although this may happen sometimes, it is also true that for many people periods of madness or psychosis are disruptive and distracting and do not result in useful interpersonal development. Dr. Breeding asserts that "madness is a dynamic process which can result in breakthroughs to deeper levels of spiritual maturity and a richer fuller life." This is one of several tenets included in this work that bring a perspective that is inconsistent with the way most professionals and advocates today characterize mental illness, which is exactly the point of Dr. Breeding's work.The Necessity of Madness includes numerous opinions espoused on a variety of subjects that have in common Breeding's views on mental health. Three central themes are: "Psychiatry is inherently coercive" and has been developed as a social mechanism to control nonconformational behaviors and beliefs; our current understanding of mental illness as a medical disease is not well founded; and with hope, courage, complete self-appreciation, and the "good attention of another safe caring human being," individuals can set about to do the work of emotional recovery. From the perspective of a psychiatrist who has spent more than 20 years working in partnership with consumers, patients, professionals, advocates, elected officials, and family members to improve the lived experience of individuals with mental illness on many levels, the continued psychiatry bashing in this work is very difficult to wade through. Dr. Breeding makes numerous references to the use of psychiatry as a tool of the Third Reich to control and exterminate mentally ill and otherwise nonproductive and defective individuals. It is inarguable that there were aspects of international unrest preceding World War II that led to a hope that science, including social science, would help to solve many levels of problems. However, most of us would not go so far as to blame psychiatry as the principal cause of Nazi atrocities, although it is undeniable that there were physicians who participated in the atrocities. Perhaps we are comfortably in denial, and perhaps that is part of the value in a very biased work such as this, salted with ideas that at least partially resonate.If you are looking for a book that depicts many of the themes and ideas that are upheld by individuals who identify with the psychiatric survivor movement, this would be a very practical resource. The prominent antipsychiatry language distracts from Breeding's useful ideas regarding recovery and self-care near the end of the book that would be very helpful to certain consumers who are looking for a high level of intellectual peer-to-peer support and exchange of positive and constructive ideas they could incorporate into their own recovery. Hopefully, in the not so distant future, we might all be able to work together to advocate for necessary tools so that all people affected by mental illness can pursue a meaningful life in the community of their choice.Dr. Everett is senior medical advisor for the Substance Abuse and Mental Health Services Administration in Rockville, Maryland. FiguresReferencesCited byDetailsCited ByNone Volume 57Issue 5 May, 2006Pages 730-731PSYCHIATRIC SERVICES May 2006 Volume 57 Number 5 Metrics PDF download History Published online 1 May 2006 Published in print 1 May 2006

Surviving the Tornado of Mental Illness: Psychiatric Survivors' Experiences of Getting, Losing, and Keeping Housing

Surviving the Tornado of Mental Illness: Psychiatric Survivors' Experiences of Getting, Losing, and Keeping Housing

Open Forum: Surviving the Tornado of Mental Illness: Psychiatric Survivors' Experiences of Getting, Losing, and Keeping Housing

This qualitative study explored experiences of psychiatric consumer-survivors related to housing. Nine focus groups involving 90 people were conducted in urban and rural areas in South-Western Ontario. A set of open-ended questions was used. Many participants described a devastating experience of losing much of what was important to them and going through a long arduous process to rebuild their lives. Group discussions were audiotaped and transcribed. Individual and team analyses of the transcripts revealed that psychiatric survivors experienced three levels of upheaval, loss, and destruction, similar to the effects of a tornado: losing ground, struggling to survive, and gaining stability. Within each of these levels, five major themes were identified: living in fear, losing control of basic human rights, attempting to hold onto and create relationships, identifying supports and seeking services, and obtaining personal space and place. A caring community response, including adequate housing, income support, and community care, can help people rebuild their lives.

"It's Important to be Proud of the Place You Live In": Housing Problems and Preferences of Psychiatric Survivors

It is important to understand housing and mental health issues from the perspective of psychiatric survivors. This paper reports findings from a series of focus group meetings held with survivors of mental illness to address issues concerning housing preferences and housing needs. The discussions were recorded, transcribed, and analyzed using an ethnographic method of analysis. The themes that emerged related to oppression, social networks and social supports, housing conditions, poverty and finances, and accessing services. Participants described the ongoing stigma, discrimination, and poverty that reduced their access to safe, adequate housing. They preferred independent housing where supports would be available as needed. Participants described the dilemma of having to choose between the housing they wanted and the supports they needed, since supports were often contingent upon living in a less desirable housing situation. Nurses and other mental healthcare workers need to be aware of these issues for discharge planning, community support, and ongoing advocacy. The survivor voices need to be heard by decision-makers at various levels of government in order for housing policy to become more receptive to their realities.

How do we Recover? An Analysis of Psychiatric Survivor Oral Histories

This article analyzes interview and survey data collected during the course of the MindFreedom International Oral History Project from June 1 through September 1, 2001. The purpose of the MindFreedom Oral History Project was to gather stories of experiences in the mental health system from the psychiatric survivor or ex-patient perspective. Thirty-six people participated in the study, most of who consider themselves “psychiatric survivors.” Qualitative and quantitative analysis reveals four major themes emerging from these histories: trauma, social control, internalized oppression, and recovery. The focus of this article is on the theme of recovery. Participants demonstrated resiliency and a strong ability to “recover.” No “magic bullet” was found to work for all participants’ recovery process; instead, participants used a variety of self-designed strategies to recapture their once broken lives.

Psychiatric “survivors” and testimonies of self-harm

UK “Psychiatric Survivors”—a variety of activist groups comprising individuals who have been on the “receiving end” of psychiatric treatment—have, since the mid-1980s, mounted a challenge to the psychiatric system. “Survivors” have formulated their own knowledge-base concerning a range of human problems hitherto regarded as the province of “official” psychiatry only. “Official” knowledge stresses scientific classification, professional expertise, and statistical evidence: “Survivor” knowledge, by contrast, emphasises individual experience, the traumas of the life-course, and the personal testimony of the survivor as itself expert data. This paper focuses upon the truth-claims enacted by the “testimony of the survivor” and the relation of “testimony” to political practice. Specifically, I analyse a key text containing the testimonies of female survivors whose behaviour has been officially labelled as “deliberate self-harm”; that is, women who harm themselves, through self-poisoning or self-laceration, and subsequently receive medical/psychiatric treatment. The main focus is upon the political functions of testimony in theory and practice—the ways in which “survivors” challenge the power of psychiatry.

Review of A Fragile Revolution: Consumers and Psychiatric Survivors Confront the Power of the Mental Health System.

Review of A Fragile Revolution: Consumers and Psychiatric Survivors Confront the Power of the Mental Health System.