Mental Health, Madness, and Psychiatry: An Annotated Study Guide

Fully aware that 2020 is the year of reading lists, I offer here an introductory study guide for those who are familiar with some ideas, images, or theories of madness or “mental illness” (and perhaps also psychiatry), but feel a lingering skepticism and doubt about what they mean.

The critique of psychiatry has long been relegated to a niche position by the public and characterized as a fringe reaction by the medical establishment, despite the increasing prominence and scale of psychiatric modes of thinking and methods of intervention into the never ending climate-driven, economic, and political crises we face year after year. The psychiatric field is enormously complex: it has been contested at every point throughout its history by its patients and has been subjected to numerous heresies and splits by its practitioners. Despite its internal instability, psychiatric ideas and treatments have been increasingly touted as the natural and obvious responses to a diverse assortment of problems, some of which it traditionally handled (emotional/psychic crisis, suicide, disruptive or problematic individuals) and some of which it has only recently gained authority over (performance/productivity enhancements, palliative treatment for sadness or anger below the threshold for inpatient treatment, adolescent securitization and screening for potential pathological development). This guide is about developing critical tools for questioning these interventions and ideas for other approaches.

This is the second edition of this reader (download link at the bottom of the page), which was first put out (and can still be accessed) on the now inactive website of the Minneapolis writing collective The Underbelli. The second edition was updated in August 2020; changes include fixing broken links, swapping out some articles for more relevant new ones, and correcting some typos. Feel free to reach out with any feedback at unsoundmind@protonmail.org.

All the articles linked in the study guide are free and generally on the shorter end. The reader is organized into 10 units. One could either study a little bit from each unit, focus entirely on a unit of particular importance to you or your group, or do the entire thing. At the beginning of each unit, I wrote summaries of the articles and the themes and questions they explored, and, at the end, a couple questions you can use as a note-taking device or conversation starters. Most units will have a primary text to introduce the themes and ideas in a general way. This will be followed by a few optional texts, podcast episodes, films, or other media that go deeper into the themes. There will be hyperlinks for all the texts, podcasts, and more on the pdf (with the exception of the films, which you will have to find on your own). As a rule, the main text and materials will be shorter and more like a survey of the problem/question of that unit. The optional texts will either be primary documents or somewhat denser secondary texts illuminating one or two aspect of the general theme. In many cases, the primary texts are interviews or surveys of a theme.

The LISTEN, SEE and WATCH sections offer podcast, song, art, and film recommendations for opportunities for learners of different types to use what they feel most comfortable with to approach the questions at hand. A general warning for what is to come: I have not excluded texts which discuss many unpleasant and challenging topics including child abuse, suicide, self-harming, and rape. Please use your own discretion as you continue.

Every section will feature at least one text or work by a person who feels they have passed through/live with “madness” or has had a psychiatric label forced upon them. This is necessarily a difficult category to pin down, as you shall see. I let the writers themselves define what it means to them to be mad, and did not use any diagnostic system or nosological schema (classification system for defining and organizing diseases) to decide who warranted inclusion or not.

I’ve designed the guide in three parts with a particular narrative structure in mind, even though the parts as I’ve conceived them will blur into one-another. The first part is largely negative, in that it is meant to challenge dominant beliefs about mental health. Sometimes this is done through critique, other times it is done through illuminating alternatives to the normal, accepted ideas. The present is over-saturated with ideas and facts about mental health. This “ever more facts” model serves above all to bury the essential problems related to madness under a mountain of detail. So first, this guide will challenge beliefs already held by most people in the West, and since most of these beliefs come from psychiatry (directly or indirectly), the first half will largely be about psychiatry and the process of labeling and treating someone as “mad” (roughly units 1-5); the second cluster of units (units 6-7) will then offer up unique perspectives on “madness,” will outline some reform and harm reduction efforts of the past and present within psychiatry, and potential alternatives to our practices of “mental health;” the last part (units 8-10), will focus on the experiences of those who have experienced something they’ve called madness, and will look outwards, to try to draw connections and remove the question of madness from its imposed isolation in medicine, connect it to other political movements and ideas, and draw new lessons from it.

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