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Routledge International Handbook of Critical Mental Health

Bruce M. Z. Cohen

Mad studies

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Rachel Gorman, Brenda A. LeFrançois
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Mad studies
Rachel Gorman and Brenda A. LeFrançois

This chapter is written by two mad studies scholars. One of us (Rachel) was a member of
the Coalition Against Psychiatric Assault (CAPA) in Toronto, where she became connected
with the emerging network of mad scholar/activists that later spurred Richard Ingram (2015,
2016) to coin the term ‘mad studies’ in 2008. The other of us (Brenda) was a participant at the
Madness, Citizenship and Social Justice conference organised by Robert Menzies at Simon
Fraser University in Vancouver in 2008, where she became excited by the new Canadian mad
scholarship and took up the invitation to co-edit the book Mad Matters (LeFrançois et al. 2013)
in order to feature that scholarship. Both of these major events – the coining of the term ‘mad
studies’ and the Vancouver conference – collided in ways that have enabled activist scholarship
emanating from the mad movement to find a politicised and theoretical home both inside and
outside of the academy. We come together to write this chapter, bringing in our knowledges of
this emergent ‘in/discipline’ (Ingram 2015, 2016), as well as our experiences as, respectively, a
queer mad mixed-race woman who is a performance artist and disability studies academic and a
queer mad white woman who teaches against the grain to trainee professionals as a social work
educator and critical psychology academic. All this we bring to this joint writing of mad studies,
framed within transnational, critical race and post colonial lenses.
Those who find themselves reading new terrain here might ask: but why mad studies?
Although critiques of psychiatry have been around for decades, from radical and feminist thera-
pists to antipsychiatry activists and critical psychiatrists (to name a few of the most prominent
historic and current sources), none of these critiques have specifically centred the knowledges
and theorising of those who have been deemed mad. Although mad studies scholarship is
engaged in by allies as well as those deemed mad, the mad movement nonetheless remains cen-
tral and intertwined within this scholarship. Given this focus, it is not surprising that, with the
emergence of mad studies, much focused attention has been placed on the retrieving, document-
ing, understanding, revisiting and teaching of mad people’s history (Beckman and Davies 2013;
Burstow and Weitz 1988; Chadha 2008; Davar 2015; Patel 2014; Reaume 2009; Reville 2013;
Roman et al. 2009; St Amand and LeBlanc 2013; Starkman 2013). Indeed, we understand mad
studies as a space of social action and theorising about oppression and psy-violence that centres
the histories of psychiatrised bodies, particularly because those psychiatrised bodies have been

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Rachel Gorman and Brenda A. LeFrançois

suppressed and erased within other disciplines and bodies of knowledge, including those bodies
of knowledge that critique psychiatric oppression.
In addition to this innovative way of studying and teaching mad people’s history, mad studies
provides a systemic critique of psy-violence, epistemic injustice (Donskoy 2015; LeBlanc and
Kinsella 2016) and sanism (Fabris 2011; Poole et al. 2012) that includes, for example, reading
psychiatric charts (that is, the daily notes that hospital personnel make about patients) against
the grain (Daley et al. 2012) and exposing psychiatric violence through other forms of writing,
research and social activism (see, e.g. Ben-Moshe et al. 2014; Burstow et al. 2014; LeFrançois et al.
2013; Russo and Sweeney 2016). Infiltrating academia, either via critical disability studies or as
its own separate transdisciplinary field, we understand the progression of consciousness raising,
social activism, peer-run services and psychiatric survivor research within the mad/psychiatric
survivor movement to have moved beyond a social movement alone to one that now has its own
in/discipline. Given its immergence within the mad movement, crucially, we see that mad stud-
ies takes place in a variety of spaces within or without academia, but never without community
(LeFrançois 2016). Moreover, transnational, critical race and post colonial understandings have
been integral to mad studies from its inception (Gorman 2013; Gorman et al. 2013; Gorman and
Udegbe 2010; Haritaworn 2013; Kanani 2011; Mills 2014; Nabbali 2013; Patel 2014; Tam 2013;
Voronka 2013), working to subvert the erasure of racialised and colonised mad bodies as well as
their targeting and over-representation within psychiatric institutions.
Mad studies understands itself as an evolving project, where no one person or group carries
authority over what it is now and what it might become over time. In addition, it has been
envisioned as a collective project that has begun and will evolve primarily out of the politi-
cal discussions and theorisings taking place among members of the mad community (Ingram
2016). Infused by mad cultural production (Dellar et al. 2000; Diamond 2013), mad studies aims
to celebrate community and positive aspects of altered states of mind, without pathologising
those experiences or glamorising or effacing what may be experienced as deep and unbearable
distress.
Also of importance within mad studies is the focus on what Finkler (2014) refers to as a psy-
chiatry survivor analysis or what Wolframe (2014) refers to as a mad reading or the maddening
of text. Here we see the central issue of moving beyond consumer narratives (Costa et al. 2012)
to honouring the knowledge production and theorising of those deemed mad (Finkler 2014;
Sweeney 2016; Wolframe 2014). Not only does this theorising hold importance in terms of
looking in and exposing the violence of the psychiatric apparatus, it opens up the many possibili-
ties surrounding mad standpoints looking outward, as mad readings of the wider world (Ingram
2015; LeFrançois 2015). That is, the mad gaze, the maddening of text and the mad analyses of
non-psychiatry-related social policy issues or on literature, the arts, politics, philosophy and so
on, all have a home within mad studies.

Emerging debates
With this introduction to mad studies and its possibilities, we move now to a discussion of
some of the emerging debates currently taking place within this in/discipline. In the remain-
ing paragraphs, we will outline what we consider to be emerging theoretical debates that are
made possible through the emergence of mad studies – and by interventions into mad studies
by indigenous, critical race, queer/trans and feminist theories and theorists. At stake are ques-
tions of ontology/epistemology and debates over essentialism. Also up for discussion is whether
mad studies can present us with a robust enough analytic framework that it can be understood
as a critical social theory in its own right, through potentially grasping social relations beyond

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Mad studies

a narrow study of psychiatric systems and the people who have been most directly subjected
to them. Through an assessment of recent scholarship at the intersections of mad studies and
settler colonial studies, critical race theory and queer and trans of colour studies, we will argue
that there are important stirrings that may lead us towards a thoroughgoing mad theory that can
help us understand the central role that ideologies of ‘mental health’ play in ongoing processes of
colonisation, labour exploitation, racism and state violence.
We start with the premise that mad theory emerges at least in part from (and/or as a part of)
mad studies. While there is no consensus about what mad studies is – or perhaps more impor-
tantly, no consensus about who can do mad studies – we will say broadly that ‘[m]ad studies
takes social, relational, identity-based, and anti-oppression approaches to questions of mental/
psychological/behavioural difference, and is articulated, in part, against an analytic of mental
illness’ (Gorman 2013: 269). We must attend to the fact that mad studies’ emergence in the aca-
demic industrial complex creates a specific set of conditions for knowledge production, even as
mad studies itself emerges from scholarship connected to mad movements.Therefore, in order to
query an emergent mad theory at this historical juncture, we must understand it in relation to
identity-based social movements that emerge in Western capitalist contexts and that are simulta-
neously contested by majority world and indigenous activist communities.

Psychiatry and scientific racism

Foundational epistemological and methodological contributions to a potential mad theory have
emerged through mad studies projects of analysing and re-historicising histories of madness
and psychiatry. Mad studies historiographies of psychiatry and the psychiatrised have been hard
fought struggles, which began in the early days of mad and psychiatric survivor organising. It
is through the perseverance of activists and scholars who have struggled for a mad people’s
historiography and through the strength of anti-racist and anti-colonial contributions to mad
historiography by black and indigenous people and people of colour, that we are in a position to
speculate on possibilities for mad theory. Despite the over-representation of racialised bodies as
subjects of psychiatric violence, overarching social relations of racism and colonialism mean that
we nonetheless witness the suppressing and erasure of the experiences of racialised mad people
even more so then those of white mad subjects. This becomes, then, not only the erasure of
psychiatric violence and sanism, but also the erasure of racism within this same dynamic. Centring
the histories of psychiatrised bodies therefore requires interrogating and exposing the intercon-
nections between the history of racism and the history of biomedical psychiatry.
Psychiatry and scientific racism share a common history of emergence and ongoing articula-
tion. The scientific elaboration of the ‘normal curve’ can be historically traced as central to the
constitution of mad and other disabled people as different and abnormal, reproducing a hierarchy
of power, privilege and subordination (Campbell 2009; Chapman 2014; Davis 1995) that inter-
sects with other markers of race, gender, class, sexuality and age, crafting the unmarked white
mind and body as superior (Butler 2016). This casting of the superior–inferior dichotomy and
the scientific racism through which it was codified was a central pillar in the colonial project
(Césaire 1972; Fernando 1992; Tuhiwai Smith 1999). At the same time as colonial regimes and
slave traders propagated racist ideologies and claimed their projects as benevolent – whereby
primitive peoples with smaller brains who lacked self-control and advanced reasoning skills were
helped by their superior masters – psychiatry was developing in the context of these socio-
scientific epistemologies (Fernando 1992).
The contradictions of human science in its study of ‘[m]an’s human others’ (McKittrick 2013)
meant that colonial scientists found very low incidence of what psychiatry was now calling

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Rachel Gorman and Brenda A. LeFrançois

‘mental illness’ within colonised populations (Cohen 2014; Fernando 1992). Uncivilised people
were declared immune from bourgeois neuroses and psychoses, and some argued that slaves
were only free of madness when in captivity (Fernando 1992). Indeed, psychiatry at the time
bolstered the slave trade by classifying the ‘running away behaviour’ of slaves as a mental illness
known as drapetomania (Fernando 1992; Kanani 2011).Within relatively little time, the marking
of unruly racialised and colonised bodies became more pronounced in psychiatry, to the point
where racialised and indigenous peoples were (and are) over-represented within mental health
systems within the Western world (Cohen 2014; Fernando 1992; Fernando et al. 2012; Metzl
2009;Voronka 2013).

Epistemology and ideology in mad theory

In our consideration of mad theory as emerging from mad people’s analytic perspectives, we
must grapple with mad movements as social movements. Emerging from a social movement that
is based on principles of self-identity, mad theory also contains at its kernel a tendency towards
essentialism – the explicit or implicit argument that mad people have essential characteristics and
are, therefore, identifiable as mad people. Ontological claims inevitably lead to epistemological
ones – if we are trying to centre thinking that emerges from mad experience, it matters whose
experience we are most interested in. Broader social relations of gender, race, class, sexuality and
gender identity play out in Western-based liberal social movements, including mad movements.
As mad movements are appropriated into the academic industrial complex as mad studies, radi-
cal antipoverty and antipsychiatry movements are both appropriated and de-emphasised. As a
result, emergent mad identity tends towards dominant subjectivities. In similar ways, claims about
the experience of being psychiatrised can be based on the imputed experiences of dominant
subjectivities – for example, the longstanding claim by some activists that being psychiatrised
is ‘like being colonised’ (Gorman 2013; Tam 2013) solidifies a mad subjectivity that erases the
experiences of black and indigenous people and people of colour who are simultaneously resist-
ing psychiatry and legacies (and ongoing violences) of colonialism.
Nor can we understand cultural ideologies of mad ‘essences’, or their social movement refrac-
tions, in the absence of psy-complexes and white supremacist sanism. Emerging mad subjectivi-
ties also must struggle against the ongoing institutionalised reproduction of psy-ideologies. This
ideological struggle is perhaps most apparent in the so-called consumer perspective on the role
of stigma in the oppression of psychiatrised people. In the ongoing competition for state and
charitable funding, psychiatric hospitals and research complexes are recast as ‘helping’ institutions
through massive anti-stigma campaigns and through the appropriation of patient testimony of
‘changed lives’ (see Costa et al. 2012). Through these campaigns, psychiatrised people, as well
as the not-yet-diagnosed, are enjoined to confess our essential (chemical) differences or to be
informed on by co-workers and loved ones.
These contemporary psy-techniques of forming and coming to know mad identity are in
dialectical opposition to ex-patient and antipsychiatry consciousness-raising groups, where
people deconstruct and critique experiences of distress and violent interventions and imagine
alternative modes of support. While ‘stigma’ flags the ideological realm of psychiatric hospitals
and service organisations, concepts like ‘sanism’ that emerge from mad studies fora (Fabris 2011;
Poole et al. 2012) may provide more robust explanatory power than ‘stigma’. ‘Sanism’ has the
potential to account for both discrimination against those perceived as mad and for psychiatric
violence, while ‘stigma’ only accounts for the former. Indeed, in contemporary mental health
campaigns, the ‘problem’ with stigma is that it causes delays in ‘getting help’ from what are, ulti-
mately, oppressive systems.

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Mad studies

Mad theory and/as critical social theory

As with the development of women’s standpoint theory (with its onto-epistemological problems
of the ‘essential woman’) and its relationship to broader feminist theory and gender studies, so
too can we imagine a mad theory that goes beyond a focus on critiquing, abolishing and/or
reforming psychiatry. Recent scholarship in mad studies reveals psy as an expansive overarching
system that permeates and interlocks with other ruling relations – for example, settler colonial-
ism and social work (LeFrançois 2013). A mode of critique becomes far more powerful when
it can be integrated with other critical social theoretical positions and fields of study. Critical
race theory scholar Sherene Razack (2015) and critical native studies scholar Dian Million
(2013) have uncovered fundamental ways in which psy-technologies are co-constitutive of set-
tler colonialism and reproduce white supremacy in the Canadian context.These scholars did not
deploy mad studies concepts per se in order to develop their critiques; however, these authors
are aligned with mad studies scholars and are committed to social justice. The insights of these
authors reveal important possibilities for the future of mad theory and the scope of mad studies.
The most important potential sources for mad theory continue to be collective interventions
into ways of knowing that come from outside the academic industrial complex, or that chal-
lenge its boundaries and authority. There are fundamental lessons to be learned from antipov-
erty and anti-violence politics that emerge from mad perspectives (see Psychiatric Disabilities
Anti-violence Coalition 2015) – these voices have always been anchors in mad and psychiatric
survivor organising, yet they may be displaced as mad studies engages in the academic industrial
complex. In addition, we must learn the painful lessons of anti-black racism in broader social-
movement organising (Garza 2014) and consider the ways in which anti-black racism emerges
in mad movement organising. For example, in the Toronto context, anti-racist organisers like
the Urban Alliance on Race Relations (2002) and Black Lives Matter (Ross 2016) have been
front and centre in the fight against police killings of black men with psychiatric labels, while
many white-identified mad organisers have failed to recognise and grapple with the centrality of
racism in cases of violence against people with psychiatric labels.
From the historic and ongoing significance of periodicals such as Pheonix Rising, Asylum and
Our Voice/Notre Voix to the embodied theory produced through artistic sites such as Gallery
Gachet and Friendly Spike Theatre Band, as well as the recentring of important historic contri-
butions of anti-colonial writers such as Bessie Head (1974; Onyinyechukwu Udegbe, personal
communication) and Meri Nana-Ana Danquah (1998; Mollow 2006), there are many important
sources for a more thoroughgoing mad theory. Taken together, these interventions may help us
gain a more concrete understanding of the ways in which psy, as a ruling relation, is a co-con-
stitutive of patriarchy, settler colonialism and anti-black racism, among other logics of raciality
(Kanani 2011). At its best, mad theory may help to elucidate and address some of the specific
contours of broad concepts like ‘settler colonialism’. At its worst, mad theory may reinforce white
middle-class identity politics by valorising and recuperating less dominant white subjectivities.

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