Compulsory Able-Mindedness II

CW for sexual violence, psychiatric violence, suicidality.

If you have experienced the suicide of someone close to you, it might be best not to read this post.

In my last post with this title, I talked about the nature of compulsory able-mindedness and how there is a ubiquitous expectation in our society that we all will pursue this, do our best to achieve this. I pointed out that this expectation is sanist/ableist and that Mad and neurodivergent people should not have to conform to normative ideas about how we should or should not behave/move/think/act. Beyond this, I suggested that ‘care/treatment’ in its current manifestation is designed for the benefit and improved wellbeing of able-minded people, not for Mad and neurodivergent people.

A lot of people had strong reactions to this; it was clear that many disagreed with me. As far as I could tell, virtually none who disagreed with me identify as Mad/neurodivergent/otherwise non-neurotypical. As far as I could tell, it was able-minded people rejecting my stance that Mad/neurodivergent people should be free to be/live/die as we wish. As far as I could tell, the people most adamantly protesting my view that non-Mad people should not define, prescribe, and administer (without consent) care/treatment of Mad people are not, themselves, Mad. It seems to me that the people who find the idea of Mad/neurodivergent self-determination most offensive are able-minded people. In other words, the neurotypical people who were angry at my rejection of ableist/sanist ‘care’ were enacting the kinds of normative expectations I mentioned within the concept of ‘compulsory able-mindedness.’

Here’s a thing: no one disagreed that our society expects Mad/neurodivergent people to (want to) seek care/treatment.

Here’s another thing: Most people agreed that ‘care/treatment’ of Mad/neurodivergent is often implemented without consent. Most people agreed that some Mad/neurodivergent people cannot consent, at times. On this point, we all agree: non-consensual ‘care’ of Mad/neurodivergent people is normal in our culture.

I must say that it surprised me that neurotypicals readily agreed that some Mad and neurodivergent people aren’t capable of giving consent at times. It surprised me, in part, because many (especially progressive/liberal) Americans subscribe to a ‘rights’ model of humanity: human beings are special and our rights should be protected; we should have individual liberties; we should have bodily autonomy (a concept foundational to the anti-rape movement); and so on. Rights-based thinking leads many Americans to accept that, in most cases, it is wrong to do something to someone who has not consented to that thing (be it sexual contact, medical treatment, etc.).

This is not the case for Mad/neurodivergent people. When we venture into certain territories—in particular, ‘A Danger to Myself or Others’ territory—we suddenly lose many if not all of our rights. I suspect this is because, to some degree, we lose our humanity. Neurotypicals can expect to hold onto their rights until they have actually harmed someone or something. Mad/neurodivergent people, though, can have our rights taken away by neurotypicals if we are suspected of being ‘a danger’—that is, before we’ve harmed anyone or anything. There is a chicken-egg dilemma here in that it’s hard to know if our rights are being taken away because we are seen as less human, or if we are dehumanized because neurotypicals have seen ‘the need’ to take our rights away. Either way, ‘It’s for our own good.’

All of these thoughts on bodily sovereignty, rights, humanity, and so forth have been leading me to a particular realm of thought: suicidality. It is possible that I’m drawn here partly because of my own morbid inclinations, but more likely that conversations of bodily sovereignty inevitably turn to ‘the most extreme’ beliefs about the body and our entitlements.

There are books to be filled (and that have been filled) about bodily sovereignty. I don’t want to write a literature review here. I want to talk about the everyday effects of neurotypicals casually accepting the violation of the Mad bodymind while vehemently rejecting assertions of Mad autonomy and self-determination.

Before I delve into the connections between suicide and bodily sovereignty, I want to say a few things about perceptions of suicidal people.

One paradox of suicide is that thinking and talking about it makes one crazy and irrational, yet avoiding or preventing it (and healing from ideation) often hinge on our ability to discuss it. In the neurotypical imagination, to admit that I’m thinking about killing myself precludes me from partaking in potentially life-saving discussions about suicide.

Perhaps stemming from this, another weird thing is that if I don’t mention suicide/suicidal ideation, neurotypicals assume that I’m ‘not extreme’ or even that I’m ‘on their side.’ But the minute I do mention suicide/ideation, suddenly my opinion is crazy, irrational, and devoid of merit. This is evidence of the ways that Mad people are alienated from discussions of our own needs, problems, desires, and strategies for (not) living with Madness. The void created by the absence of Mad voices is filled by sanist and non-Mad voices telling us ‘the facts’ about suicide and sane-splaining how to prevent it. David Webb discusses the striking absence/exclusion of Mad people from suicidology (the study of suicide) in the piece “Thinking (Differently) About Suicide.” Webb explains that because suicide and suicidal ideation are heavily pathologized in our culture, neurotypical suicidologists assume that Mad people who think about, plan for, and/or attempt suicide are irrational have nothing to contribute to the study of these topics, which is primarily science-based.

I do take issue with an aspect of Webb’s piece, though, which is its focus on the notion of ‘prevention.’ Thinking about the Western obsession with ‘prevention’ guides us back to the links between suicide and bodily sovereignty.

‘Suicide prevention’ is a collocation in English, indicative of anti-Mad and anti-suicide beliefs that run deep in Western cultures. If I’m suicidal, it’s assumed that I am crazy and also that I should get ‘treatment.’ If I discover that someone else is suicidal, it’s assumed that I should prevent it. This prevention should happen regardless of the suicidal person’s wishes; intervention and prevention should happen by any means necessary, up to the point of violating the suicidal person’s bodily autonomy and forcing ‘treatment’ upon them.

Here is another paradox of suicide: sometimes feeling suicidal means simultaneously feeling out of and in control. Suicidal ideation is empowering for some us precisely because it is a means of taking control, even when we feel out of control.

Violating a suicidal person’s bodily autonomy can have the effect of reinforcing that person’s feelings of disempowerment. Forced ‘care/treatment’ reifies our experience of not being in control.

Even for those of us for whom suicidal ideation is never empowering or does not make us feel in control, non-consensual ‘care’ is rarely empowering. Feelings of being out of control are often accompanied by feelings of disempowerment, fear, hopelessness, and worthlessness.

There is a connection between violation of bodily autonomy and subsequent depression and suicidal ideation. This is not remotely surprising to anyone who has experienced and/or studied sexual violence (i.e. experiencing sexual violence is a risk factor for suicide), medicalized trauma, imprisonment, or other instances in which a person experiences bodily violation or loss of control over the self.

Considering this, it seems antithetical to frame intervention/prevention as ‘caring’ when it entails a lack of consent. It seems odd to take for granted that we must intervene on the suicidal person, and that we do so under the guise of ‘care.’

So we live in a sanist culture where non-consensual ‘care’ of/intervention on Mad people is normalized (even when Mad people experience it as harm), while Madness and the exercise of Mad autonomy is pathologized. Not choosing treatment is a non-option; ‘treatment’ is narrowly defined within the range of the neurotypical imagination (and obviously does not include suicide). The very rejection of treatment is, itself, pathologized: when we are told something is ‘wrong’ with us yet we do not choose ‘treatment,’ the neurotypical assumption is that such rejection is symptomatic of our ‘mental illness.’

If Mad people reject treatment, we do so because we are crazy and this opens the door to non-consensual enforcement of ‘care.’ Therefore, not only is able-mindedness a standard expectation in our culture but ‘treatment’ is mandatory.

I think I should make it really clear that I do not think suicide is wrong or bad. Sometimes it is sad, devastating, angering, terrifying— suicide pings the range of human emotions. Suicide is also extremely personal and context-dependent. I will probably write more about this some day, but I don’t want readers to get the impression that a) I’m over-the-moon happy about suicide all the time or b) all suicidal people are the same. In fact, that is a sanist perspective: all suicidal people are the same, which is why there are only a tiny handful of approaches for dealing with us. Suicide and suicidal people are complex, and the sanist temptation is to boil us down into the least complex terms imaginable. The sanist imagination strikes me as a lack-thereof. If you are reading this as a binary (“they didn’t say suicide is 100% bad, therefore they are saying suicide is 100% good”), then you hold a sanist perspective.

One of my goals with writing about this crazy stuff is to try to imagine new ways of thinking about and approaching Madness and Mad people, and to get sane people to be more imaginative about life, death, in/sanity, un/wellness, care, and community.

In that vein, mine is not the only perspective. If you feel like you have something to say about this stuff (madness, mental illness, suicide, bodily sovereignty, psychiatric care, disability, sanism/ableism, etc. etc.), I would love to give you a platform for talking about it—this blog could be a place to start. If writing appeals to you, I am happy to serve as an editor if you so desire. If you want to post something here on my blog, you can do so under your name or anonymously. Consider this an open invitation. ^_^

 

References and Further Reading:

Webb, David. “Thinking (Differently About Suicide.” Searching for a Rose Garden. Edited by Jasna Russo and Angela Sweeney. UK: PCCS Books. 2016. Link: https://thinkingaboutsuicide.org/thinking-differently-about-suicide/

“Victims of Sexual Violence: Statistics.” RAINN. June 22, 2016. https://www.rainn.org/statistics/victims-sexual-violence

The Icarus Project. http://theicarusproject.net/

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Compulsory Able-Mindedness

CW for sanist/ableist BS and a reference to suicide.

 

I have noticed this trend lately where people talk about Madness (or usually they’re calling it ‘mental illness’) as a thing that obliges treatment. That is, if you have mental health struggles or neurodivergence of any kind, you are expected to seek treatment once you recognize that you ‘have a problem.’ Almost as if care/treatment is compulsory.

There is a theory in feminist studies known as ‘compulsory heterosexuality,’ forwarded by Adrienne Rich circa 1980. According to this theory, as Americans we live in a heteropatriarchal society that assumes human sexuality is hetero and binary, and thus our baseline of understanding is heternormativity: intimate relationships are (or ought to be) between ‘men’ and ‘women’ only; this is what is normal/natural/good. This understanding is so pervasive that anything contrary to heteronormativity is framed negatively or rendered invisible altogether (Rich was particularly concerned with the erasure of lesbian identity and existence).

More recently (2006), disability studies scholar Robert McRuer has identified a parallel phenomenon that he calls ‘compulsory able-bodiedness,’ which he ties in with the erasure of both queer and disabled existences. In our ableist society, the norm is ‘able-bodiedness’ (or as others of us call it, able-bodymindedness); if you are in any way outside the norm, the expectation is that you will seek to fix it in order to become as able-bodied as possible. For some of us, our ‘unwellness’ or disability or disfigurement is such that it cannot be ‘fixed’ or ‘cured,’ and in this case this means such bodies (or bodyminds) should be hidden away from public view.

“Like compulsory heterosexuality, then,” McRuer explains, “compulsory able-bodiedness functions by covering over, with the appearance of choice, a system in which there actually is no choice”(2006, 92). This lack of ‘choice’ arises from the fact that our ableist culture defaults to a question with an assumed answer: Wouldn’t you rather be normal? Able-bodied people (aka ableds) tacitly enforce the question (“[W]ouldn’t you rather be more like me?” [McRuer 2006, 93]), and assume the answer— everyone wants to be able-bodyminded, no one wants to be disabled/crazy/neurodivergent.

As an extension of critical disability studies theory on compulsory able-bodiedness, it seems logical to me that our culture is also infused with a tacit assumption of compulsory able-mindedness. Now, I am partial to Mad Studies scholar Margaret Price’s use of the phrase ‘bodymind’— which points to the intrinsic interconnection between body and mind (that is, they’re really one and the same, there is not one without the other, GTFO Descartes). However, I wanna write a bit about the notion of un/wellness in relation to the ‘mind’ to show how, for many of us, living with a ‘different mind’ is stigmatized and pathologized in particular (albeit parallel) ways from living with a physical or bodily disability. Of course, many people experience both because they have various Madnesses, disabilities, and/or neurodivergences; and/or because one affects the other (whoa, interconnectedness!)— for example, some people with physical disabilities (e.g. cerebral palsy) experience cognitive impairments (e.g. ‘delayed language development’) as a result of their physical disabilities, and some people with mental health issues (e.g. depression) experience physical disability (e.g. chronic pain) as a result of their mental health issues.

I want to focus on our culture’s particular disdain for differences of the ‘mind,’— there’s even a word for this disdain, it’s called sanism (or saneism). Sanism is beliefs and practices predicated on the idea that there is such a thing as a ‘sound mind,’ leading to harm of all kinds being directed at those determined to be of ‘unsound mind.’

Sometimes, this harm takes the form of ‘treatment’ or ‘care.’ How can care be harmful? you may be wondering. Care is frequently harmful when it is a response to something perceived as a deficit, disorder, or deviance. This is often true for those of us who are Mad/experience mental health struggles or neurodivergences: non-Mad/neurotypical folks view our lives as suffering, and the ‘natural’ response to suffering is to end it. Do they necessarily inquire of Mad folks if we are, in fact, suffering? Nah. Do they necessarily get our consent before initiating ‘care?’ Not always.

Even when consent is supposedly present, we have to remember how consent truly functions: we cannot assume that a ‘yes’ is, in fact, a ‘yes’ when there is a power differential, when there is fear of retaliation, when (a history) of coercion or violence exist, when internalized ableism/sanism exists, etc. We need to be critical of that ‘yes.’ When I first consented to take medication to ‘remedy’ my madness, I was guilted into doing so. They called up my history and reminded me of how scary things could become, how much of a failure I had been, and how I had (at times inadvertently) hurt people. I didn’t start taking medication because I believed it would help me feel better or improve my overall wellbeing, I started because I was afraid of the consequences of not taking it— which, the psy folks assured me, would be devastating (joblessness, friendlessness, maybe even homelessness or, lolz, lifelessness).

The funny thing about ‘care’ of Mad and neurodivergent people by able-bodyminded people is that it often exists to make the latter feel better. Many psychiatric meds, cognitive control meds, and even some non-pharmacological therapies exist to mediate Mad/neurodivergent behavior. Perhaps those behaviors are deemed disturbing (the silences of a depressive), disruptive (an ADHD person not ‘following directions’), frightening (a schizophrenic person hearing voices), or frustrating (an autistic person not making eye contact). Whatever it is about a neurodivergent person’s way of being that is considered ‘atypical’ or ‘disordered,’ the treatment of that thing is regularly mandated by neurotypicals whose discomfort comes from being in proximity to that person. It’s less about the Mad/neurodivergent person being disturbed than it is that we are disturbing to neurotypicals. If there is one thing I hope we clarify about ‘care’ of Mad/neurodivergent people in the near future, it’s that much existing ‘care’ is intended to tamp down on Mad and neurodivergent ways of being, doing, moving, and thinking in order to help neurotypicals feel better. I’ll say it again: most ‘care’ of neurodivergent people is actually intended for the comfort and peace of mind of non-disableds and neurotypicals.

That is not to say that care and treatment are never helpful for crazy/neurodivergent people. I, myself, have found some forms of care tremendously helpful— most of them outside mainstream care, though. But a great deal of care/treatment is developed and implemented without including us, the recipients, in the creative process. Until care/treatment is reimagined and regenerated with the consent and inclusion of Mad/neurodivergent participants, it is going to continue to harm many of us. It doesn’t matter how ‘well-intended’ it is.

A final comment, for now: Mad, disabled, and neurodivergent people— including manic depressives, OCD people, autistic people, addicts/substance users, people with PTSD, depressives, borderline people, and all the rest of us— have the right to seek care and/or treatment on our own terms. We have the right to help shape what that care/treatment looks like. We have the right to refuse care/treatment. Others do not have the right to say we ‘must be treated.’

References:

McRuer, Robert. “Compulsory Able-Bodiedness and Queer/Disabled Existence” in Disability Studies: Enabling the Humanities. Edited by Sharon Snyder, Brenda Jo Breuggermann, and Rosemarie Garland Thomson. The Modern Languages Association of America: New York, 2002. Read it here: https://www.academia.edu/16338241/Compulsory_Able-Bodiedness_and_Queer_Disabled_Existence

Rich, Adrienne. “Compulsory Heterosexuality and Lesbian Existence” in Feminism and Sexuality. Edited by Stevi Jackson and Sue Scott. Columbia University Press: New York, 1996. PDF here: http://www.weldd.org/sites/default/files/Compulsory%20Heterosexuality.pdf; read Rich’s reflections (2004) here: https://muse.jhu.edu/article/53008

 

Reblog: On the Medicalization of Donald Trump, via crippledscholar

There has been quite a bit of discussion around whether it is appropriate to speculate about whether Donald Trump has a mental illness. The rhetoric and armchair diagnosis of Trump is already happening and it’s important to look at the arguments for why people are doing that and perhaps more importantly whether people should. I […]

via On the Medicalization of Donald Trump — crippledscholar

Reblog: Why Are You Complaining? Some People Actually Feel That Way: A Critique of Me Before You

Important stuff. Digs deep and makes you think. Check it out.

crippledscholar

Warning: This post includes comprehensive spoilers for the book Me Before You, a book that deals with disability and assisted suicide. It also deals with sexual assault.

It has taken me months to get all the way through Jojo Moyes’ 2012 novel Me Before You. This protrated reading can be explained by two things. I’m a PhD student and don’t have a lot of free time for reading anything that isn’t directly related to my studies and the fact that this book made me feel violently ill. I hated it, well before I got to the ending. The only reason I finished it is because the movie adaptation is coming out next month and I felt the need to thoroughly explain why it is so problematic and why I find the excitement over the movie adaptation so troubling.

I only became aware of the existence of this book after the…

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