One of the objectives of Beautiful Distress is to fight stigma. Therefore we regularly publish a column about stigma on our site. Read the new column by Grietje Keller.
Grietje Keller works at the The Public Health Service of Amsterdam (GGD Amsterdam) and chairs Reading groups in Mad Studies with the Perceval Foundation.
Organizations that combat stigmas would rather counteract (self) stigmatization. Personally I have come to the conclusion that the problem is not the stigma, but the psychiatric diagnosis itself. I therefore prefer concentrating on the discussion of the medical rational in psychiatry, rather than combating the stigma.
Some people who had ever had a psychiatric diagnosis come, sometimes years later, to the conclusion that making that diagnosis was totally irrelevant for finding a solution to their problems. Indeed it just made their problems bigger. This is a curious phenomenon. Mad Studies have given me the words and concepts to understand how that is possible.
Mad Studies are-just like Women's studies, Queer Studies, Postcolonial Studies, Disability Studies, Deaf Studies, Fat Studies and Black Studies-academic studies that arise from emancipation movements. Mad Studies comes from the consumer/survivor/ex-patient movement – such as the client-movement in the United States and Canada calls itself. Mad Studies do not view craziness and psychological difference from a medical, but from a socio-scientific perspective. That is to say: Mad Studies view the problems of people with psychological intricacies not only as an individual problem (a brain disease, problems during youth) with individual solutions (medications, psychotherapy), but also as a political and social problem that needs analyses within the social sciences. It is a small field. The publication of the book Mad matters, a critical reader in Canadian studies in 2013 has put Mad Studies on the map. In emancipation movements and the academic fields that support them, it is about making an analysis from the perspective of the minority in question. Mad Studies base themselves on the experiences of people with a psychiatric label and insist that the analysis of those experiences remains in the hands of the people it is about.
Thanks to Mad Studies, I have learned to improve my discomfort about psychiatric diagnoses. A psychiatrist who diagnoses someone applies a technique in which, according to his method, he speaks a truth. He reveals who someone really is. This has major consequences for the patient’s self-image and how others see him. The 'good ' patient accepts the diagnosis and therefore the psychiatric truth. This is called disease-insight: the awareness of having a disease, the awareness of the consequences of this disease, and the awareness of the need for treatment. If a patient does not agree with this, the person is alone. Mad Studies put the diagnosis into perspective: it is human work, susceptible to the issues of the day and the dominant theories of the time. In this way it gives the opportunity to escape from constricting psychiatric thinking and creates space for a different kind of dialogue, another discourse. Within Mad Studies, for example, one doesn’t speak of ‘stigma’ but ‘sanism’: discrimination based on mental health. Mad Studies is not about individual psychiatrists in relation to their clients. That relationship can be equal and empathetic. Mad Studies is about generating knowledge, truth and institutional power. Mad Studies give the opportunity to think about insanity, distress and psychosocial complexities together with others who feel they do not benefit from psychiatric diagnoses and to define the definitions themselves. Mad Studies is about swimming against the current, or rather: stepping out of the river.