Wednesday, July 22, 2009

What's on the Wall WEDNESDAY

I've completed 15 blocks for my Lucky Stars quilt. It seems like I cut enough for a total of 33 blocks. What the heck was I thinking?!?!?! Since they are 15" blocks, I think I'll quit at 30 - so I'm half finished.
I gave another speech this morning. I happened to catch a story about "Mad Pride" on CBC Radio show "Current" yesterday on my way in to school. One of the guests on the program was Geoffrey Reaume. I thought the kids in my class would be interested in this, so I worked my butt off yesterday to do the research and write my speech.
Happy “Mad Pride” Month!

A series of events are taking place this month, all over the world to help people with mental health issues—psychiatric survivors-- celebrate who they are as a means of conquering stigma. Supporters of Mad Pride say that psychiatric labelling leads to segregation, discrimination, and poverty.

Mad Pride is a project of Mind Freedom International, a coalition with local and regional affiliates all over the world. Their mission is to put an end to what they see as a truly global emergency: human rights violations in the mental health system. They believe that countless numbers of people are imprisoned in psychiatric institutions without adequate advocacy, where they endure solitary confinement, restraints, electroshock, experimentation and other forms of inhumane treatment.

One supporter of Mad Pride is York University health ethics professor Geoffrey Reaume. His doctoral thesis was published as a book in 2000: Remembrance of Patients Past: Patient Life at the Toronto Hospital for the Insane, 1870-1940. Just as his book was coming out, Dr. Reaume and a collective of other psychiatric survivors founded the Psychiatric Survivor Archives of Toronto, which is dedicated to preserving the history of people who have experienced the psychiatric system.

Reaume was diagnosed with paranoid schizophrenia when he was 14. Now, any mental disease, including schizophrenia, is difficult to diagnose. Unlike other diseases that have physical manifestations, schizophrenia is diagnosed by relying primarily on the patient's behaviour and history. There is no blood test, no x-ray, no empirical evidence at all.

Under the DSM IV-TR—considered the psychiatric bible: the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders--a person must exhibit two or more symptoms in order to be diagnosed with schizophrenia. These symptoms include extremely disorganized behaviour, and a decline in motivation. Do you suppose any of us here in this room today could meet that criteria –past, present or future?

Canadian physician Susan Rosenthal recently wrote “the DSM lists and categorizes symptoms outside of any social context” and that “most of the symptoms listed in the DSM describe human responses to deprivation and oppression (anxiety, agitation, aggression, depression) and the many ways that people try to manage unbearable pain (obsessions, compulsions, rage, addictions). “ Dr. Rosenthal believes that most of the psychiatric symptoms listed in the DSM are actually reasonable reactions to social conditions, and blames our capitalist system for pathologizing such reactions to create a profitable and self-perpetuating industry.

Now, myself? I’m on the fence about my beliefs regarding psychiatric illness. I’ve always believed that psychiatry as a science is in its infancy. On one hand, I’ve seen remarkable, even miraculous improvement in a patient’s quality of life when pharmaceutical treatments work. On the other hand, I’ve often seen psychiatric diagnosis and treatment arbitrarily dealt out - - considerations of age, sex, social class, and social connectedness seeming to be most important factors in how the patient was treated, rather than their actual suffering, behaviour, or symptoms.

Others have been a little more explicit in their position. For example, Dr. Thomas Szasz. Professor of psychiatry at Syracuse University denies that there is any such thing as “mental illness”, that it is a man-made myth. In his book “The Manufacture of Madness”, he explains:

“Psychiatry is conventionally defined as a medical speciality concerned with the diagnosis and treatment of mental diseases. I submit that this definition, which is still widely accepted, places psychiatry in the company of alchemy and astrology and commits it to the category of pseudoscience.”

Okay, so, maybe you haven’t heard of Dr. Reaume, Dr. Rosenthal, or Dr. Szasz. But I’ll bet you’ve heard of Michel Foucault. In Madness and Civilization Foucault similarly argued that mental illness must be understood as a cultural construct, sustained by a grid of administrative and medico-psychiatric practices.

Let me cite a few examples of how social and historical context has changed how we as a society have thought about mental illness.

In an 1851 article by American physician Samuel Cartwright, the diagnosis of “drapetomania” was described. In those days, science argued that blacks were psychologically suited for a life of slavery, so naturally runaway slaves were crazy. It may not surprise you that the treatment for the prevention of drapetomania recommended by the good doctor was “whipping the devil out of them”.

In “Making Us Crazy” – Kutchins & Kirk write that soldiers’ reactions to combat situations have been described throughout recorded history. As early as the Battle of Marathon in 490 BCE, Greek historian Herodotus described a case of hysterical blindness in a soldier with no physical injury. In more recent times, soldiers have had the same stimulus of exposure to combat, but each generation re-invents these psychological symptoms.
Civil War: nostalgia
WW1: shell shock
WW2: battle fatigue
Vietnam: PTSD – posttraumatic stress disorder
1st Gulf War: Gulf War Syndrome
2nd Gulf War: acute combat stress reaction

Women in particular should be concerned about how psychiatric illness is viewed, managed and stigmatized by society and science. In her book “Women and Madness” Phyllis Chesler writes: Since clinicians and researchers, as well as their patients and subjects, adhere to a masculine standard of mental health, women, by definition, are viewed as psychiatrically impaired—whether they accept or reject the feminine role—simply because they are women.”

The DSM (remember? The psychiatric bible?) listed homosexuality as a mental illness until 1986. Is it just me? Or does that seem crazy?? Clearly what was at issue was a value judgment about heterosexuality, rather than a factual argument about the nature of homosexuality.

Now, we’ve learned a little about the Psychiatric Survivor movement, questioned whether psychiatry is a science or not, and considered how social and historical context changes society’s view of mental illness. What I’d like to do now is to back up a smidge and tell you a bit more about York professor Geoffrey Reaume.

After a diagnosis of paranoid schizophrenia at age 14, he was twice admitted to psychiatric facilities. He dropped out of high school after only six weeks in grade nine. Eventually, he enrolled as a mature student in history at U. of Windsor, and was very successful, despite having no high-school education, graduating in 88 with a BA in history. He went on to complete his Masters and PhD at the University of Toronto. Now, as a professor at York, among other courses, Dr. Reaume teaches the History of Madness.

And, as part of his interest and commitment to psychiatric survivor activism, Dr. Reaume leads tours of the brick wall surrounding the Queen Street Mental Health Centre in Toronto built by psychiatric patients more than 100 years ago. He believes that the wall preserves the history of mistreated patients, and gives psychiatric survivors a sense of their own history. “It is a symbol of prejudice, confinement, and oppression. By preserving it we can liberate their stories and ensure that the men and women who lived, worked, and died behind the wall are remembered and respected as worthwhile human beings.”

This seems to sum up the objective of the psychiatric survivor movement and Mad Pride - - to promote the idea of mental diversity, so that all people can be respected and treated as worthwhile human beings, and not simply a psychiatric label.


  1. that new quilt is delightful......what's happening with your " Pick and Choose"?

    You certainly write well....are you enjoying the class? I see an A in your future for this one!

    Happy sewing

  2. Oh, this is a wonderful quilt, too! Very happy.