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/