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Jun 14, 2022Liked by Ayesha Khan, Ph.D.

What experiences radicalized your views on psychiatry and mental health/ How did you come to see your mental distress through a political lens?

I've always had a radical understanding of mental health, in the sense that I've always understood my mental health issues to be tied to my environment and born out of the society I lived in. However, I thought that psychiatry would be the 'cure' for me because it was the only thing I encountered that acknowledged these problems as problems. My community was skeptical of psychiatry, but that skepticism led to a denial of abuse and its effects, and an unwillingness to do anything about it. I thought that psychiatry was the only option for addressing these problems and didn't understand that there were solutions to help my suffering outside of psychiatry.

As soon as I got into the psychiatry field I encountered racism and misogyny at every turn. I started treatment in a research study because it was an accessible way to be treated and get paid for it. At that time I was silent in therapy because all of my memories and experiences were too painful to speak of. I literally couldn't get it out. The psychiatrist took my silence as indignance and accused me of not working hard enough. She was licensed to help me but couldn't even recognize my trauma as trauma. When I did speak and explain the deeply traumatic misogyny I was living through, she tried to convince me that I wasn't seeing it correctly, that boys will be boys and I wasn't being positive enough.

The first time I was prescribed medications, my therapist (a new one) sent me to a 24-hour psych ward for suicide ideation - another trick to get me meds quickly. The psychiatrist there prescribed me the highest dose of an anti-depressant to start with. Anybody with a basic understanding of antidepressants knows this practice to be dangerous. Prescribing too high prescriptions to black people is common in medicine. I grew 50 pounds over a few months, felt manic, and stopped taking it. I tried another psychiatrist, who belittled me for being a survivor of sexual assault and prescribed me medicines that she picked out of a pocketbook she kept on her desk. I'd try one for a while and stop taking it, try healing on my own for a bit and struggle, then get back on a different one. Every therapist I had treated my suffering as an individual problem and questioned me whenever I tried to explain it under any other lens. I knew that my suffering was based on the systems that I was encountering. I knew that the way I was being treated was racist, misogynistic and harmful. But I didn't know there were other options to improve my functioning. I just thought I had to keep trying until I found the right person, and that might take years because the system is broken.

When I found a therapist that was a black woman I felt so much better because I finally had someone to confide in who didn't immediately try to convince me my experiences weren't real. She also didn't propose psychiatric or individualized solutions, just allowed me to process my feelings in a safe space, even be silent if I need to be. With that burden lifted I started finding my own ways to improve my ADHD symptoms and live with my trauma. I was the happiest I've ever been during COVID, because I was working from home, making my own schedule, building connections, and able to talk about my experiences without being gaslit. I've gone back to struggling since I returned to an in-office position, but I've gotten a taste of how a change in environment can radically alter mental health, which gives me hope and inspiration for the future.

These experiences helped me come to terms with the racist and misogynistic roots of psychiatry. It led me to find different ways to be, rooted in connections with people who are generous enough to help me with my suffering. I learn the most about my trauma in the arms of people who love and support me and am gradually shifting to a place where I can openly address my pain with the people around me, instead of just my therapist. I'm really concerned about the growing amount of people who believe pain should only be processed with a therapist because it is inherently burdensome to those around you. I feel like that is another commodification of mental health being treated as radical thought.

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"...that is another commodification of mental health being treated as radical thought" <- Real powerful and spot on. I've been thinking and conversing a lot about how Capitalism's aim is to enclose, privatize, and deprive us from everything that has pre-historically been free (land, water, food) and make the market the only point of access, but I had not considered how it does so as well for the most basic forms of company and connection.

Respect and honor to you for sharing your struggles with the supremacist misogynistic encounters with the psych world, very sorry to hear you had to endure that sick level of unconsciousness from organizations and people entrusted as healers. Hope your community and wellness keeps on growing.

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Thank you!!! I think connecting the commodification of mental health to therapy has been hard for me to vocalize too because it primarily comes from the people around me and not from institutions. The way I experience it is socially, with people constantly talking about how therapists need to be mandatory because people with trauma are burdensome on others, or categorizing the needs of people with trauma as inherently harmful to others, so they need to see a therapist to take on that harm and protect the community. To me, it plays on the good/evil dichotomy and keeps us from developing community tools to engage with people we find difficult. It also implies that therapy, an authoritative, monetary service, is a requirement for growth and punishes people socially who can’t get or afford a therapist.

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Jun 20, 2022·edited Jun 20, 2022

Absolutely! It's so isolating and marginalizing socially, emotionally, financially....

Also directing people to therapy seems to have become "THE right thing to do" or the standard course of action (something I've been guilty of as well), almost carrying a hip, faddy, virtue-signaling flavor. The deeper problem I see with this is our society's widespread emotional ineptitude and terror of emotions. Nobody teaches us how to deal with other's strong emotion, let alone our own, so it becomes an awkward at best and terrifying at worst. Recommending a suffering person to go to therapy provides an easy exit where the person giving the advice can wash their hands off of any real concern and leave their conscience intact.

On the other hand of this experience, in moments I reached out to friends or relatives when I was suffering, I was often met with damaging or dismissive messages that felt even more isolating and re-traumatizing. This made talking to a therapist very relieving in some aspects, but nowhere near filling the void of a supportive community. Seems like a third path emerging as an alternative to it is to reclaim, de-institutionalize, and cultivate the emotional intelligence of our communities...?

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Yes!! I honestly associate with mental health institutions and our cultures larger understanding of mental health with patriarchy. The lack of understanding, demonization, and pathologization of emotion has roots in white cis-masculinity patriarchy where being stoic and detached from emotions is the dominant way to be. We demand it in schools we demand it in jobs we demand it in our government leaders. So much of my suffering is tied into not understanding my emotions because the community I grew up in associated emotions with being weak and childish and taught me to stifle them in order to be heard.

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Spot on!! Yes, yes, yes. Making emotion a feminine trait and then building a mysoginistic society where we are humiliated for feeling, smh. Reclaiming our emotions is a brave act of rebellion in this world!!

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Jun 28, 2022Liked by Ayesha Khan, Ph.D.

I’m a survivor of multiple instances of psychiatric neglect and now do my own crisis intervention work at public events, linking them to holistic treatment options in my network they may not be aware of.

My story:

Out if nowhere during my marriage, my husband became constantly angry and unable to cope with anything. Not seeing any external factors and thinking it was a relationship problem, I read a dozen marriage self help books before giving up on not finding a solution. Eventually I threatened to leave his behavior and was able to get us to marriage counseling. At our first session, we didn’t get past his medical history. 10 minutes in, the therapist said to him, “either your condition is misdiagnosed or you are severely mismedicated.—with possible brain damage because of how long you were on one prescription”. He expressed how he addressed it rationally with his doctor several times and asked for different medication but it was casually dismissed. I felt myself fall into neurosis on the spot (soul loss) as I realized a psych’s negligence ruined our marriage. I was also deep in postpartom depression with a four month old infant with colic. Things continued to decline for my mental state as he immediately reverted back to his normal self once the medicine was changed. I then couldn’t cope. How could I trust a psych to fix me—especially since my husband’s old psych was reputable.

I eventually depleted to a point where I was nonfunctional and psychiatrically disabled. I lost my job and people were convinced I didn't WANT to work and that I was avoiding help, though I was constantly seeking it. I had done my own research and knew my desired treatment but could not find help that would provide it to me. I was recommended to inpatient care and saw the utter HORRORS that occur there. To say it was repulsive is an understatement. I fought for my and my floormates patients rights (as a trained union organizer) and got nowhere. They then threatened to keep me at the hospital by custody of the state if I didn’t rescind my voluntary withdrawal from the facility—and immediately backpedaled when I threatened to call my lawyer. My grievance of 12 violations was rejected by the hospital board. I basically learned the hard way that once you seek facility psych care most states void your autonomous rights as a patient and psychs try to make money from insurance by keeping you there for 29 days.

I had to agree to outpatient group treatment in order to leave the hospital. I addressed my horror story to the group in my first session, and to my shock, another member of the group shared her own similar story about the same facility. Therapists are required to report abuse, and it was not reported or taken seriously. When I eventually met the head doctor of the clinic, he was condescending and used circular conversations to avoid my legitimate objections to his treatments and lack thereof. It became apparent that he had an established script he was using. When he got frustrated enough he looked me in the eyes (for the first time) and told me that my trauma didn’t happen. Literally tried to brainwash me. I was eventually escorted out of the building kicking and screaming in outrage. When I followed up with management for the next few days, they avoided me at all costs. Including the director closing the door in my face without words as I stood outside of their office asking questions. They quickly found a reason to kick me out of the program.

In addition, to this day, I have not been able to obtain most of my psych records. In Maryland, at least, psychs personally hold medical files. Basically if the psych dies/disappears or creates a maze where you can’t reach the right person, you can’t get your records. Both instances were true for me. All the doctors discussed were enabled to get away with everything because they knew their power and apathetically didn’t care.

Sadly, that’s only the preface for the rest of the things I’ve endured. My prayers are constantly with clinical psych trauma victims. Nobody knows unless they’ve experienced it. I wouldn’t wish it on my worst enemy.

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Jun 27, 2022Liked by Ayesha Khan, Ph.D.

I was forcibly admitted to a psych ward when I experienced severe psychosis for the first time. I realized I had to lie to the professionals for them not to treat me a certain way. As psychology was my minor for my degree, I was aware that I had started experiencing symptoms of schizophrenia during the pandemic but due to my withholding information, they diagnosed me as having Bipolar I and told me I needed to take medication for the rest of my life. This didn’t sit well with me but it made me realize that diagnoses are really subjective and they don’t even try to understand the traumas that a person may have endured that could lead to psychosis. I worked through my traumas without antipsychotics and as I did, the symptoms were allayed, thus proving that if mental health professionals only took the time to care, many persons could heal naturally. Mistreatment by professionals made me realize that persons with mental health issues need love and care the most, but keep getting retraumatized by the system.

I started seeing my mental distress through a political lens when I realized that most symptoms of “mental illness” that I displayed were really my mind’s way of trying to survive and understand existence in a messed up society. I then understood that the longer they are framed as symptoms of biological issues instead of spiritual and social ones, harmful structures designed to keep people mentally enslaved won’t lose power.

I found it extremely annoying that I got depressed while awakening to the fact that church, state and capitalism are causing all the environmental and mental health issues we are suffering from but people thought that my problem was that I was unmedicated.

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Jun 21, 2022·edited Jun 21, 2022Liked by Ayesha Khan, Ph.D.

What experiences radicalized your views on psychiatry and mental health?

I got the whole package - shrink dad, psychoanalyst mum, gaslight before I could talk. No, really. I had to crack their code before I could crack psychiatry's. It took 45 years, a thesis on the topic, and a heap of de-gassing. I was a fawning CPTSD machine and neurodivergent AF and I didn't waltz into authentic friendships, at least not with people who could help me process this. Shrink-dad installed the "everything that doesn't look like it descended straight from Freud or Darwin is dangerous woo woo" module and thus I never strayed from the paradigm. Somatics came to the rescue: Pete Walker, then Bessel Van Der Kolk. My palm struck my forehead firmly when the penny dropped.

How did you come to see your mental distress through a political lens?

I got hit by the gender bus and went full trans anarchy a couple of years before I saw the colonial threads tying psychiatry to other forms of state control. I coincidentally ended up in a psych ward where the nurse in charge over-reached her job description by some margin in order to cause me harm. That's the moment my indignation sparked. I read the entirety of the NSW (local) Mental Health Act in a rage that night and I've not stopped hissing since.

What’s the most annoying misconception about psych abolition that you’ve encountered?

I'm going to answer answer a slightly different question that also has the word "annoying" in it. The most annoying misconception about psychiatry, perpetrated by abolitionists and defenders alike is that at least "some" parts of psychiatric taxonomy are made by carving nature at it's joints. The unreality of the 19th century's "hysteria", or "neurasthenia", were (like all knowledge) built-for-a-particular-purpose. And the structural purpose of psychiatric knowledge in the 19th century wasn't vastly different to its structural purpose today. It was and remains - to make perfect workers exemplary, to maintain all the supremacies (the patriarchy, white supremacy, ableism, etc) and to disappear people and behaviours that appear different from the perfect worker, father, mother, student etc...

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Last thing - of course any individual psychiatrist (even a really nice one) is going to spit chips at every part of abolition and particularly the structural analysis that theoretically grounds it. I studied the history, philosophy, and sociology of science at uni and if there's one thing I learned during that time its this: the people least willing to acknowledge the structural forces driving a science are its practitioners. The next least willing? It's "clients".

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As a kid I was always really into science, and I always had trouble understanding the motivations of others (suprise, suprise). So I decided to study a degree in psychological science. It was a struggle, and extremely triggering because of my own mental health difficulties and experience of othering. I was taught that psych was the gold standard, and any other approach to treating mental health was just snake oil. I didn't believe in a more radical approach until I started working in a queer organisation with a bunch of social workers and gestalt psychotherapists. I couldn't deny the successes that came with Learning to look to external factors that contribute to mental ill health. It helped me understand and respect my own brain as well. I've interacted with a lot of psychologists and psychiatrists in my career, and I find that it teaches one to be disconnected, cold and rigid in their thinking. I was reading John Bowlby's attachment lectures when I came across his idea that psychology is constantly trying to "prove itself" as a natural science, when our concious experiences are far to complex to achieve this, which felt like a light bulb moment for me. This is when I really started to see all of psychiatry and psychology as fundamentally flawed in it's ideology.

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Firstly, thank you so much to both of you for this deeply impactful work. I feel so seen in Disorderland in a way that I didn't know I needed. Carthatic sighs and tears present when listening.

Learning about Polyvagal Theory as a health practitioner was my intro to realising how I had been conditioned (and isolated) to believe my mental distress/diagnoses were 1. biological to me as one-dimensional existence and 2. they were in fact the result of having many traumatic experiences compounded over my lifetime without resources or safety to heal.

For me, it followed on reflecting on my own pscyh treatment having been about "fixing my thoughts" and nothing else. Not even speaking about the systems we all exist in that contribute to those thoughts. And I see that in the work I do every single day where folks blame themselves for behaviours that are survival skills, and that blame is sanctified by society at large. "Yes this behaviour is wrong and in isolation so just correct it."

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What experiences radicalized your views on psychiatry and mental health?

Psilocybin+ the beginning of the pandemic + end of a LTR broke me open. Started doing a lot of research. Learning about the nervous system, self healing, behavioral change. Realizing my “Major depressive disorder” was actually childhood trauma and chronic stress.

How did you come to see your mental distress through a political lens?

I think psychedelics definitely aided in this. It’s been a very non-linear back and fourth process. Eventually I came to see that the entire system has been responsible for the intergenerational trauma in my family that has manifested in variety of mental health disorders.

What’s the most annoying misconception about psych abolition that you’ve encountered?

Not sure tbh. I am in my second year of my MA for mental health counseling. I am facing some distress and disappointment. I am ultimately not sure if I can help people in the way I want within the system. Sure I want a career that provides for me and great subjective well-being. However I want to work in such a way that gives. Not to charge others $150 for nervous system healing. I’m not 100% sure how to do that. A vision I had recently involved providing safety, authenticity, and vulnerability to everyone I come into contact with. I don’t think the thing that is going to heal the world is in the commodification of the vulnerable relationships that this system took away. I think it’s ultimately being the change we want to see in the world. To me this involves changing my conception of work.

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I witnessed poverty often in my upbringing in Mexico and was blessed with radical elders who would talk candidly about colonialism and exploitation, so I always had the sense that the ways of global society were horribly wrong and that people's suffering and maladjustment were just a symptom of that.

Still, when we migrated to the US, I definitely internalized the pressure of performing well in school, assimilating, and being a 'hard worker.' I started coping through binge eating and other compulsions to sustain focus and developed a lot of shame, insecurity, and major depressive episodes for having so much difficulty completing tasks.

I sought a counselor and talking about my feelings and unraveling early traumatic episodes was helpful, but pointing to capitalism as the source of chronic anxiety felt completely out of the question, not only because I was applying for citizenship at the time and had become paranoid around being picked out as a 'red', but also because it seemed clear to me that the thought had never occurred to the practitioners treating me and that the suggestion could invalidate my judgment or even be used as a way to misdiagnose me. This sounds like a far-fetched thought to me now, but at the time the fear was very real and very isolating. The 'therapeautic' approach centered on 'fixing' me also exacerbated my feelings of shame and inadequacy, something that a decade later is still tripping me up, even through the crystal clear clarity that the forced labor and threat of destitution is the real problem here (amazing how deeply-ingrained those things become).

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I feel like immigrants especially have to internalize being hard workers in order to appear worthy to our larger society. Then it’s harder to critique the issues with capitalism and the hard worker rhetoric because it becomes a source of community pride and honor. I’m so sorry you’ve experienced that and I’m glad you have a place to name how capitalism has harmed you!!

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What experiences radicalized your views on psychiatry and mental health?

We have been in therapy since 2009 and *trying* to get help much earlier. I guess growing up in an abusive family just made us assume that the pain and confusion we were experiencing was our fault. We remember that even the first times we told our parents that we were suffering mentally, we phrased it as "I think there is something wrong with my head".

We have been in mental hospital ~25 times, for crisis interventions and long term DBT therapy. Even though we understood that the way we were treated was horrible, we blamed a lot of it on ourselves or thought of it as isolated incidents...

It wasn't until our DID diagnosis in 2020, that we learned about complex trauma and understood that it wasn't some bad therapists and nurses, but a fundamentally traumatizing system at play.

It was also the first time we understood the amount of medical trauma we suffered through therapy.

How did you come to see your mental distress through a political lens?

We were very politics apathetic before we knew about trauma. I guess we were just caught in learned helplessness, without being able to name it.

Understanding on a deeper level that the sexual abuse and gaslighting we went through in our family was deeply traumatizing and not our fault organically lead to also understanding that the systems we're living in are traumatizing. We see the ways that our parents justify themselves and their cruelty mirrored in the wider society. The same kind of gaslighting used in therapy, the same kind of punishment and control based thinking.

What’s the most annoying misconception about psych abolition that you’ve encountered?

That psych abolition is only possible for people who have a not-so-serious (whatever that means) form of mental illness.

We see so much talk about how when you have DID, you *have* to work with a mental health professional and you should absolutely not try to work through your trauma without professional help, because you'll just make it worse.

Guess what? Most mental health professionals have 0 clue about DID. We have been in specialized hospitals for years and no one even recognised the clues.

I'm not advocating for people to heal alone, but frankly we do not feel comfortable recommending therapy anymore. Not without a warning.

The DID community online has helped us a lot more than 11 years of dealing with "mental health professionals". It is by no means perfect, there are a lot of problems within the community, but we got so much valuable information and found our little subspaces where we feel comfortable and accepted. A feeling therapists could never give us so far.

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My views of psychiatry were radicalized in undergrad, where I studied neuroscience. At the very beginning, I experienced intimate partner violence that nearly killed me. Due to this experience, I (reasonably) had some agoraphobia and paranoia. Instead of being met with empathy by my provider, I was put on anti-psychotics and (incorrectly) diagnosed with psychosis (yes, psychosis!). I went about my education as normally as I could (despite extreme sedation) and even had aspirations for improving pharmaceuticals for people with PTSD. My provider went on maternity leave and I went to the closest therapist I could find for temporary care. As luck would have it, he was an abolitionist. Instead of being met with pathologizing normal behaviors under stress and capitalism, I was met with empathy and given tools to survive. I finished off my education with an ethics of neuroscience class by Peggy Mason (check her out!!!). We tackled a lot of issues with disability and mental health, and a lot of my classmates who had aspirations in psychiatry and counseling were challenged to think about material conditions in the context of mental health.

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1. What experiences radicalized your views on psychiatry and mental health?

(UK white woman perspective) That the ‘help’ I was offered wasn’t genuine, real or even appropriate. Any and every time I was offered counselling I was interrogated as to WHY I felt I needed it: I could barely string two words together or remember any vocabulary to speak let alone make life changing decisions.

As a woman I felt belittled, even by other women, case in point; psychiatric nurse came to my home and told my parents to ignore me when I cried as “they always do this”. Scenario being, I was offered help and then it was taken away within that same week, so my retired parents had to ’deal’ with me.

From that moment on I decided to ‘fuck off’ the NHS and any psychiatric help and, after 8 years of trying to get help, decided to do it on my own. I recognise the privilege of having parents that would and could help me while I was jobless and essentially homeless. I also have a PhD and could research as much as I was able into what drugs they’d given me… to which I had bad reactions to.

This system in place was supposed to help, but only the statistics and not the person!!

2. How did you come to see your mental distress through a political lens?

Everything is just a protocol and statistics. They say there are programs for you and there is help, but accessing it is one thing and then there is quality!!. There is little tailoring and a lot of white-washing of programs that just don’t work or fit anyone! I got trainees giving their presentations on what an anxiety attack is to a group of people, some of whom ran out the room cuz it was like reliving the trauma. It’s just a bunch of ill-managed, pass-the-buck, bullshit. Lots of people who work in the system care but the system isn’t working for the people who care to work in. Again, it’s all about protocol and no-one is to blame or too scared to get sued for doing the wrong thing.

3. What’s the most annoying misconception about psych abolition that you’ve encountered?

Don’t feel I can answer this being a white person.

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What’s the most annoying misconception about psych abolition that you’ve encountered?

That there will be all these “crazies” running loose in society. The people who say this do not want to know about the stats on how we are more likely to be victims of crime, than to perpetrate it.

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1) what I said to the doctor in the psych ward was not sacred, got put in my return to work letter and caused me loads of hassle in my job. Then the psychiatrist had the nerve to suggest I get a lawyer, that my employer's reaction to his information was wrong but he didn't have to put it in the letter. It is so arbitrary their diagnosis was meaningless and beyond getting medicated enough to get sleep for a few days in a row and start getting my head on straight they did not help me at all. 3) the contradiction of the real world situations where if people don't have a Dx they can't get care/support. Not a misconception just the most comment retort to abolition arguments.

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