Merrick Daniel Pilling is an Associate Professor and Interim Co-Director of the School of Disability Studies at Toronto Metropolitan University. He is the author of Queer and Trans Madness: Struggles for Social Justice and the co-editor of Interrogating Psychiatric Narratives of Madness: Documented Lives.
His new book, Mad Studies: The Basics, introduces Mad Studies as a field that has emerged from community activism and the perspectives of people who have been psychiatrised, institutionalised, criminalised, and otherwise dehumanised by what scholars have referred to as the psy complex. It organises itself around two basic questions: What can Mad Studies help us understand? And what can Mad Studies help us do?
Those questions will guide our conversation today. We’ll begin with Merrick’s own path into this work, then move into psychiatric documentation and narrative, and then spend most of our time with Mad Studies: The Basics—its account of some origins of the field, its critique of psychiatric common sense, and its insistence that Mad Studies is simultaneously a way of interpreting the world and a form of critical praxis.
The transcript below has been edited for length and clarity. Listen to the audio of the interview here.
Justin Karter: I’d like to start with your own path into the field. How did you first find your way to Mad Studies?
Merrick Pilling: I found my way to the field during my doctoral studies at York University, in the Gender, Feminist and Women’s Studies program. I took two courses from the Critical Disability Studies program with Geoffrey Reaume, who’s a well-known Mad Studies scholar. Mad People’s History was one of them, and that was my introduction to Mad Studies. This would have been around 2008 or 2009, before Mad Studies was always referred to as Mad Studies.
But I always like to emphasize that I came to Mad Studies as a queer person, and I’ve always seen Mad Studies through that lens, whether or not that was explicitly offered. When I was in high school, one of my friends, who was a cisgender girl and very femme-presenting, was diagnosed with gender identity disorder. That always stayed with me. I remember being outraged at the time and knowing that it was wrong, but not really having access to the language or knowledge to know that there were other people out there articulating this problem and responding to it.
So when I encountered Mad Studies years later, it took me back to those kinds of experiences where psychiatry was being used against our communities. I felt like finally there was sort of a way into this problem, while also not dismissing the experiences of queer and trans people who identify as mad. I say “sort of” because there really isn’t a huge focus on queer and trans experiences of madness in Mad Studies. But in the time between high school and encountering Mad Studies in graduate school, I had also encountered gender studies, so it made a lot of sense to bring all of those things together. That’s how Queer and Trans Madness: Struggles for Social Justice was born.
Karter: I’m curious about what it was like to encounter Mad Studies explicitly from the angle of queer studies and from your own queer experience. How do you think that changed how you took up the field or what you contributed to it?
Pilling: The first thing I noticed about Mad Studies was, wow, finally there’s this way to understand the tension of how psychiatry has been used against our communities. Mad Studies is, in many ways, a critique of psychiatry and the bigger Psy-complex.
I didn’t encounter Mad Studies specifically bringing that lens to queer and trans experiences, which surprised me because it was the first thing I saw when I looked at it, probably because of my subject position. But that strong critique articulating the harms of the Psy-complex, to me, applies so clearly to queer and trans experiences.
Then, looking back to disciplines like psychiatry, psychology, etc., and the ways madness has been constructed, gender and sexuality and race are at the heart of notions of madness and sanity. So it has always made sense to me that those things are essential to Mad Studies.
Even when we look back to theories of sexology in the late 1800s and early 1900s, people like Havelock Ellis and those sexologists were theorizing “inversion.” That was a way of describing, for example, women who wore men’s clothes and had so-called same-sex desires. You were categorized as an invert, and that meant that something was wrong with you both mentally and physically.
So you can see how notions of mental illness, madness, and insanity are built around these ideas. And those ideas were also heavily imbricated with race science, which was happening at the same time, and ideas of degeneracy. We have to look at how all of those things come together.
Karter: Thinking about debates around psychiatric language and the DSM, the depathologising of homosexuality is often pointed to as a moment that was liberating in some ways, but also revealing of the ways psychiatric classifications normalise and pathologise behaviors that society deems acceptable or unacceptable, rather than mapping onto some natural underlying distinction between what is healthy and what is not.
But it sounds like what you’re saying goes much deeper than that. Can you talk about this connection between madness and queerness and how they continue to show up together, even after the depathologising of homosexuality?
Pilling: Maybe I’ll focus on the intersection of madness and transness because it is being used so heavily right now in dominant discourse, especially in the United States. I just saw yesterday some headline along the lines of Trump putting an end to “transgender insanity.”
Even the language there—“insanity”—is being used in this effort to eliminate trans people, often by positioning transness as a mental disorder. They’re so tightly tied together.
I’m always surprised that Mad Studies doesn’t take this up more than it does because it’s everywhere, especially right now with the rise of right-wing ideologies and fascism, and the way that transphobia and sanism are used together to bolster fascism, to bolster right-wing ideology. It’s right there.
But I often don’t see that taken up by predominantly cisgender mad scholars and other people. I’m not throwing mad scholars or Mad Studies under the bus here, but I am sometimes surprised not to see it taken up more than it is.
Karter: Is a critical disability perspective and a Mad Studies perspective similarly needed as a complement within queer studies?
Pilling: Yes, it’s needed on both sides. That was one of my goals in writing Queer and Trans Madness, because there is that same kind of mirrored problem on the other side, where a Mad Studies critique is widely unknown in queer studies,trans studies, and gender studies.
That critical perspective about psychiatry does come into play in feminism in some ways. But when it comes to queerness and transness, we sometimes see widespread acceptance, or just no questioning, of the biomedical model within both the community and sexuality studies, queer studies, etc.
Karter: Especially when the medical system or psychiatry can act as a gatekeeper for access to services or medical procedures, is there a resistance to questioning its authority or the distinctions being made through the biomedical model? What do you attribute that lack of engagement with the critical perspective to?
Pilling: To be clear, there is definitely a critique of gatekeeping of transition-related medical procedures. There is also a strong critique of the psychopathologising of both transness and queerness.
But sometimes it feels like the critique is isolated to things like gender identity clinics, for example, which are psychiatric clinics. The critique can be limited to that without stepping back and looking at the whole thing and saying, oh wow, the whole Psy-complex here is implicated. It’s not just the gender identity clinic. I get into this in more detail in my chapter in the new edition of Mad Matters: A Critical Reader in Canadian Mad Studies.
Karter: Thinking about the clinic brings me to your co-edited book, Interrogating Psychiatric Narratives of Madness: Documented Lives. It reminded me a bit of Jonathan Metzl’s The Protest Psychosis, looking at psychiatric documentation and how Black men in the United States were increasingly construed as having psychotic disorders during the Civil Rights Movement.
What did your investigation of psychiatric documents reveal about the populations you were studying?
Pilling: This was based on a study led by Andrea Daley, and we looked at over 160 psychiatric inpatient charts from one institution in Ontario. We were looking at the charts to see what kinds of narratives or stories were being told, specifically about things like gender, race, class, and madness. We challenged the notion of the chart as an objective or neutral text.
We looked at how patients’ lives, appearances, mannerisms, and ways of being were constructed through the lens of the biomedical model, as well as other dominant ways of thinking. It gave us the opportunity to examine psychiatric narratives—in other words, the stories that psy professionals tell about their patients—and how dominant oppressive worldviews are woven into those stories.
Karter: Are there any charts that come to mind as particularly telling of the way lives get translated or filtered through biomedical models and hegemonic narratives?
Pilling: It’s so hard for people to express an understanding of their lives and experiences in a way that is not through a biomedical lens. Or rather, it seems hard for psy professionals to understand or validate patient self-understandings that do not align with the biomedical model.
For example, there was a chart of a woman who was partially understanding her experience through Kundalini energy, which is a concept from Hinduism. This was pathologized in the chart as being delusional, as evidence of psychotic illness. We can also see how this is racialised, and it made me wonder how much experience the clinician had with Hinduism when they were writing these things about this woman’s self-understanding of her experiences.
There was another woman who had been living on the street and in shelters, and she was refusing to give up her bag to staff. It was written in her chart as if she was very paranoid and delusional. Again, this is a person who had been living on the street and in shelters. Maybe she had experiences of having her stuff stolen. Maybe this bag was the only bag of things she owned in the world. How much experience does the average clinician have with this one bag being everything you own in the world? Do you want to give it up to someone? Probably not.
Another example would be the chart of a Black trans woman who was experiencing street harassment, multiple apartment break-ins, etc. Her experiences, again, were written up as delusions and evidence of psychotic illness.
This is why I say it shows us more about the clinician than it does about the person who’s being written about. Of course a Black trans woman can experience street harassment. This was a woman who was also living in poverty, so her accounts of her apartment being broken into were very credible. But they weren’t seen as credible, and she was seen as a so-called “unreliable narrator,” which is language that comes up quite a lot in the charts.
Karter: This seems like a good example of what you were speaking about earlier—bringing these perspectives together, or a multitude of perspectives. In Interrogating Psychiatric Narratives, your chapter on sexual violence and psychosis brings rape culture, sanism, and anti-Black sanism together in the analysis. What does it look like to bring those different lenses together?
Pilling: In my chapter, I focused on the charts of people who had either experienced sexual violence or perpetrated it. Clinical language was used to minimize and dismiss experiences of sexual violence and, in some cases, to normalize perpetrating sexual violence.
This was particularly visible for people who are already less likely to be believed about experiencing sexual violence because of racism and anti-Black sanism. For Black women and Black trans-feminine people, this was highly visible in their charts. Again, people’s experiences of violence were taken up by clinicians as being delusional, as evidence of their mental illness.
There was even one case where, earlier in the chart, somebody had documented some corroborating evidence. There was a medical record number for a potential perpetrator. There were notes that this potential perpetrator had a history of sexual violence. Then, as the chart gets longer, that information just fades into the background, and what comes to the foreground are these narratives about this woman being delusional.
This was a Black woman, so we see that confluence of anti-Black racism with sanism and misogyny being used to dismiss this woman’s experience of violence.
Karter: For the benefit of our readers and listeners, I wonder if you could unpack some of these terms for us—sanism in particular, and then what anti-Black sanism adds to that analysis. It also brings to mind epistemic injustice as a related concept that seems to play out in psychiatric charting.
Pilling: I think it’s useful to think about sanism in contrast to something like stigma, because people are probably more familiar with that term.
Stigma, and especially a term like “self-stigma,” is often used in a way that’s really individualizing. The problem, as articulated through stigma, is that you view yourself in a negative light and other people view you in a negative light. And this, in turn, inhibits somebody from seeking biomedical treatment. That’s articulated as the problem when we think about stigma.
Of course, there are other theorizations of stigma, but this is how it’s used in anti-stigma campaigns, for example. What that misses, and what sanism brings to the table, is that biomedical treatment can sometimes be really harmful. Sanism articulates the harms of the psychiatric system.
Sanism is an oppression, a form of oppression that is similar to and also inextricably bound up with things like racism, transphobia, and homophobia. So sanism offers a much more comprehensive way of looking at oppression than something like stigma.
And then anti-Black sanism is something that has been Idil Abdillahi, Sonia Meerai, and Jennifer Poole. They brought into this what was missing from white-centric understandings of sanism: that anti-Blackness is at the heart of this as well, both in terms of how mental illness and sanity are constructed and how Black people are understood and treated.
There are all of the examples of police violence against Black mad people. You mentioned Jonathan Metzl’s work earlier about the overdiagnosis of Black men with schizophrenia. Suman Fernando talks about that as well. Anti-Black sanism gives us a lens to understand that more fully.
Karter: This seems like a good transition to Mad Studies: The Basics. In Interrogating Psychiatric Narratives, you raise the question of who gets to speak, who gets to create discourse, who gets to create narratives around people’s experiences. There’s the way people get charted, the way their stories get translated through the Psy disciplines. Mad Studies seems positioned in opposition to that, foregrounding first-person accounts and first-person theorizing.
How did your work on psychiatric narratives lead to the idea for an introductory text on Mad Studies?
Pilling: Of course, the books are all interrelated. But between Interrogating Psychiatric Narratives and Mad Studies: The Basics, I wrote Queer and Trans Madness: Struggles for Social Justice. After I published Queer and Trans Madness—and to this day—I found that, in general, there wasn’t a strong understanding of queer and trans experiences in Mad Studies.
I talked already about how that has always seemed like this weird mismatch to me. So I wanted to write an introductory text to Mad Studies that would not center whiteness or cis-heterosexuality in the ways that the field sometimes does.
I also started writing it right before my first year of my tenure-track position at Toronto Metropolitan University. I was newly off the job market. I’d had some interesting experiences trying to make myself and my work intelligible to search committees who, for the most part, had never heard of Mad Studies, with the exception of my current workplace, of course. That served as inspiration for the book as well, alongside wanting a really concise resource to share with students to help them understand what Mad Studies is.
Karter: It strikes me that when you’re speaking to people in different fields about what Mad Studies is, you can end up framing it quite differently. You can tell a version of Mad Studies through the lens of sociology, disability studies, or comparative literature. You could tell its story through first-person accounts of madness. Mad Studies can then end up appearing as an outgrowth of whatever discipline people already use to understand the world.
You seem very conscious in Mad Studies: The Basics not to do that—not to give an origin story that positions any particular disciplinary heritage as leading to Mad Studies. Can you talk about the pressures involved in telling the story of Mad Studies and the different directions that story could be pulled?
Pilling: There are so many different possibilities for writing about the origins of Mad Studies. I do tie it to Disability Studies and women’s and gender studies. But as you said, you could write any number of disciplinary histories that might come into play.
I was very specific about saying some origins rather than the origins of Mad Studies. I really wanted to challenge this idea that there is only one origin.
Vanessa Jackson pointed out more than 20 years ago that the origin story of psychiatric survivor movements is very white. The more we tell white-centric origin stories, the more they solidify and the harder it gets to break into them and think, okay, where else did some of these ideas come from?
So the language of “some origins” versus “the origins” opens that door. It allowed me to bring in histories of queer and trans organising, LGBT organising, as well as Sami Schalk’s work on the Black Panther Party and how they resisted psychiatric oppression. And I’m sure there are other stories still waiting to be told.
Karter: Can you share some of those origin stories, knowing that they’re not totalizing or the only origins? I’m particularly curious about resistance to psychiatric oppression within the Black Panther Party and some of the other histories you bring into the book.
Pilling: I would really direct people to Sami Schalk’s Black Disability Politics. Anyone interested in Mad Studies should read that book, and absolutely the chapter on the Black Panther Party.
In terms of queer and trans or LGBT organising, there are examples from the ’60s and ’70s. Of course, there were the direct actions against the APA trying to get homosexuality out of the DSM. But there were also mutual-aid groups like STAR, Street Transvestite Action Revolutionaries.
They were focused on mutual aid for people who were living on the street or street-active, focusing on things like housing, food security, community, etc. Those are all forms of mad activism as well.
Karter: A central point you seem to make in the book is that Mad Studies isn’t primarily or exclusively about critiquing a particular biomedical narrative or a particular historical form of psychiatry. It is also about building alternative forms of care and support and ways of knowing each other, which don’t necessarily define themselves in opposition to psychiatry.
Can you say more about the relationship between community building and mutual aid on the one hand, and academic critiques of existing structures on the other?
Pilling: I don’t know if I see it as a tension. I see them as very complementary. There is maybe a tension between academia and community, of course, but Mad Studies comes from community knowledge in a lot of ways.
Nothing about Mad Studies, at this point anyway, really strikes me as being only theoretical. It’s always integrated with changing the material conditions of mad people’s lives, with making mad and other oppressed people’s lives more livable.
Karter: That makes me think about the context-dependent, hyper-local politics of that project. Efforts to materially improve people’s lives through mutual aid can lead to different ways of knowing depending on what’s happening politically, what resources are available, the particular form psychiatry takes in that place, and what avenues exist for peer participation.
How do you tell an overarching story about Mad Studies when so much of the community work has developed forms of knowledge and care that respond to specific local contexts?
Pilling: I think it should stay that way. It needs to be contextual. It needs to be very specific to be relevant to wherever it’s being used.
So if it’s growing in the Global South, it’s going to grow in a way that’s relevant to things happening in the Global South—which is obviously itself a very homogenizing and huge term.
But for Mad Studies to remain generative and not prescriptive, it needs to be relevant to the local context. And I think that’s a good thing, rather than trying to provide some unifying or prescriptive narrative about what Mad Studies is and saying it’s going to be the same here as it is somewhere else.
Karter: That makes me think about the distinction between anti-psychiatry and Mad Studies. How do you see those histories as connected, and where do you see important distinctions between them?
Pilling: There’s this body of work referred to as anti-psychiatry that is not Mad Studies, created mainly by white men who were some kind of psych professional in the ’60s and ’70s—people like R.D. Laing and Thomas Szasz.
These men could actually be pretty dismissive of mad people. I remember seeing somewhere in Diana Rose’s work that she wrote about Thomas Szasz calling her a malingerer because she didn’t work at the time. That’s obviously a really ableist, sanist thing to say.
Thomas Szasz was also extremely transphobic. There are a couple of really great pieces about Thomas Szasz and his transphobia that I wish had existed when I was writing Queer and Trans Madness.
But I want to tell you what I think is happening when people use the term “anti-psychiatry,” because I don’t think they’re necessarily familiar with that work from the ’60s and ’70s. They’re not actually referring to that.
Someone will hear a critique—any critique of psychiatry—and say, “That’s anti-psychiatry.” There can be a range of critiques of psychiatry. Some might be anti-psychiatry, and some might not be. I think that’s why anti-psychiatry and Mad Studies often get conflated: it’s based on this wrong assumption that any critique of psychiatry—and Mad Studies does critique psychiatry—is anti-psychiatry.
It’s often a way of dismissing Mad Studies critiques by just saying, “This is anti-psychiatry.” And it’s often used by people who aren’t actually trying to make a good-faith effort to understand what Mad Studies or what anti-psychiatry is. They may be heavily invested in the biomedical model because they work within the Psy-complex, or maybe they’ve had really great experiences with psychiatry or the Psy-complex.
I really wish there were more understanding that a systemic critique of the Psy-complex is not an individualized critique of someone’s choice to make use of the Psy-complex, to take psychiatric medication, etc. It’s a systemic critique.
It doesn’t negate the possibility that someone has a positive experience of psychiatry or the Psy-complex. Hopefully you could say, “I had this positive experience,” and still understand that not everybody has that positive experience. You can still see the critiques of the system and the harms perpetuated by it, even if you personally had a positive experience. And you can ask what conditions allowed you to have that positive experience.
Because if the system is working for you, there’s usually something there like whiteness, cisgenderism, able-bodiedness, class privilege, coming from wealth. But the larger point is that this is a systemic critique, not a critique of an individual’s choices.
Karter: This gets into some of the politics within Mad Studies and the larger world of psychiatric critique, because there are people in the psychiatric survivor community who embrace anti-psychiatry as a label. There was the Bonnie Burstow Scholarship in Antipsychiatry there in Toronto, for example.
How do you navigate the politics around whether anti-psychiatry is a term to embrace or one that we should contextualize within a particular historical moment led by figures who themselves had significant limitations?
Pilling: I think it’s great if people want to take on the moniker of anti-psychiatry and think it really describes their work. That’s wonderful. There’s room for that in Mad Studies. It’s part of Mad Studies. It’s just not the same thing as Mad Studies, so it’s important not to conflate the two.
Even thinking about abolitionism—is abolitionism anti-psychiatry? Is that accurate? I don’t know. It seems to flatten things to me.
Abolitionism is more than just anti-psychiatry. Mad Studies is critiquing more than just psychiatry. Abolitionism is imagining and creating new worlds. So those things aren’t the same either.
Karter: One of the issues you identify in the book is the tension between critique and co-option. Can you say more about that back and forth within the history of Mad Studies and the groups that have led both critiques of existing systems and alternative life-building or world-building projects?
Pilling: In terms of co-option, I think that’s always a risk for any area of critical study or social movement. It is and will be a problem for Mad Studies. There have already been aspects of mad organising that have been co-opted.
Lately, I’ve seen more than a few examples of people saying that anything to do with lived experience of psychiatric systems is Mad Studies. That, I think, is a profound misunderstanding of what Mad Studies is.
That’s one of the many ways Mad Studies can get watered down, depoliticized, and neutralised. It’s one way of neutralising critical politics.
Karter: How does defining Mad Studies as anything having to do with lived experience defang the politics of the movement?
Pilling: It washes away that critical edge. It washes away any abolitionist critique.
Mad Studies is, in some way, a critique of the Psy-complex. You can have accounts of lived experience that have nothing to do with Mad Studies. So if you reduce Mad Studies to any account of lived experience, you’re missing that critical edge. You’re missing the articulation of sanism. You’re missing the articulation of the harms of the Psy-complex.
Karter: So there are theoretical commitments within Mad Studies, even if the way they are understood varies by context. It’s not simply lived experience for lived experience’s sake. Lived experience can illuminate something about systems or power relations that is worth challenging or changing. Would you say that’s fair?
Pilling: Yeah. It’s about disrupting power relations as they stand. It’s about disrupting oppression—sanism, anti-Blackness, transphobia—and the ways those things come together.
If you just have any old account of lived experience, it’s not necessarily disrupting any of those power relations.
Karter: That speaks to the first question of the book: What can Mad Studies help us understand? Another question you ask is: What can Mad Studies help us do?
What do you think Mad Studies enables us to create in the world that might otherwise be harder to imagine or put energy toward?
Pilling: If the response to madness and distress—not that those things are always the same—is in the hands of people who have experienced it and people who are trying to disrupt harmful power relations, then we see something very different from a psychiatric system.
I’m thinking about examples such as Project LETS, where they are trying to build non-carceral responses to distress, or Trans Lifeline, which is a distress hotline for trans people where they do not use non-consensual active rescue.
In other words, they’re not going to call the cops on you if you say you’re thinking about suicide, because they know that can actually inflict more harm on trans people, especially trans people of color and Indigenous trans people.
These are very different ways of responding to madness and responding to crisis.
Karter: In the book, you take up resistance to some of the most coercive elements of current psychiatric practice. You discuss coercive care, but also ECT, or electroconvulsive therapy.
What does a Mad Studies lens reveal about these everyday forms of psychiatric practice that otherwise become normalized within institutions?
Pilling: I think Mad Studies names coercion as coercion.
Police responses to distress, involuntary hospitalisation—all of those things are coercion, and Mad Studies names them as such. Whereas you’ll see them named as care. You’ll see them named as treatment.
Mad Studies names it for what it is. It says this is coercive. It’s responding to distress with violence. And responding to distress with violence creates trauma and is maddening.
Mad Studies illuminates that instead of simply saying, “This is treatment, and this is care.” Locking somebody up against their will, giving them ECT against their will, holding them down and injecting them with drugs against their will—all of that is coercion.
Karter: You used the word “maddening” there. It seems like that word is also increasingly being used to talk about bringing Mad Studies into institutions and other forms of practice. What does it mean to “madden” something? What might it mean, for instance, to madden our universities?
Pilling: I think “maddening” can be used in so many different ways.
There’s the way I just used it, in terms of social conditions that are maddening—highlighting that someone is experiencing distress and that its origins are in our social conditions.
But it’s also a term that is increasingly being used in a way that’s analogous to queering or cripping: bringing mad knowledge to bear on something. So maddening any field of study, maddening any practice, or, as you said, maddening universities—bringing the knowledge of Mad Studies and the knowledge of mad people into those contexts.
Karter: So it’s about more than inclusion and participation. If we take the example of universities and think about student well-being, student distress, and student “mental health”—with all the different narratives that get brought in with that term—what would it mean to madden a university’s response?
Pilling: First, I’ll say that I don’t necessarily see it as inclusion, because inclusion can sometimes just serve the status quo. I would see it more as disrupting inequitable power relations rather than inclusion.
In terms of our universities, I think postsecondary institutions as we know them would have to change quite a lot, in tandem with society more broadly, to really madden anything. We need a collective reimagining of what that would look like.
I can tell you the things that need to go.
We need to see an end to putting students in handcuffs when they’re in distress. We need to see an end to calling police and campus security on distressed students. We need to see an end to punitive policies such as mandatory leaves of absence for students in distress. We need real financial support for students who need it.
In a recent project led by Lori Ross, our team created Mind the Gaps: A Survival Guide for Graduate Students. But of course, that doesn’t actually solve any of these issues. It just provides a small form of support in navigating them.
Karter: The same tension seems to run through any institution. We’re trying to create ways of supporting people and resisting existing power relations, narratives, and oppressive structures, while also trying to change those structures themselves. Sometimes those projects can even work at odds with one another: a form of individual support can become a release valve for something that ultimately needs to be addressed collectively or structurally.
I’m curious about the relationship between Mad Studies and the Psy disciplines. There is a critical psychiatry movement within psychiatry and, of course, critical psychology within psychology.
Where do you see possibilities for integration, collaboration, or productive tension between Mad Studies and those disciplines? What are the risks? What would you hope to see from critical psychology or critical psychiatry, and what would make you wary?
Pilling: It’s a really good question. I am wary of some of these turns (toward the critical) in psychology and psychiatry because I have a hard time believing that there isn’t still a vested interest in continuing the power relations as they are and maintaining that hierarchy with psychiatry at the top.
Are people who are really firmly located within those systems truly working against their own interests? I don’t know.
That said, there are really interesting things happening in critical psychology that I’m not dismissing whatsoever. However, I am wary, particularly when it comes to thinking about marginalized groups like trans people and the violence that has been done and continues to be done to trans people.
And I’m not just talking about psychiatry.
Psychology has played and continues to play a huge role in gatekeeping, in pathologizing, in trying to maintain its power over dictating who gets to say they are trans and live as a trans person, and who has access to the technologies of transition.
What are psychologists doing? What are they doing there? They don’t belong there.
No cisgender psychologist should be in a position where they are deciding whether a trans person is trans or not. I am very wary when there has been historical violence, and there is continuing violence against our communities, coming from these disciplines.
Where do you see the points of possibility for Mad Studies right now? Where can we create possibilities for resistance on a smaller scale, and where can those projects come together to disrupt larger systems that are themselves maddening?
Pilling: It’s such a big question. It’s also a big question for an individual to answer because I think the answer needs to be collective.
I will say that we’re in a time of rising right-wing ideology and fascism. And we’re in a time where we’re seeing increased political support for involuntary mental health and addiction treatment, for locking people up against their will.
There’s this continuing need to push back on that, to resist carcerality in all of its forms. I think Mad Studies and mad activism are highly relevant and really needed in this moment of rising fascism.
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This article first appeared on Mad in America