I was recently on an episode of The Radical Therapist, talking to Dr. Chris Hoff about youth mental health activism, radical visions of alternative mental healthcare, and the harms of Big Tech. He asked me a question during that interview which has stayed with me ever since.
Do you think diagnoses can ever be liberating? Or are they always entangled in systems of control?
On the one hand, the answer is simple. Yes, of course diagnoses are entangled in systems of control. You cannot disentangle diagnoses from their oppressive history, the colonial imperative to be able to identify, categorise and police madness. You cannot ignore the power dynamic that the medical model imposes between the person diagnosing and the person being diagnosed.
On the other hand, diagnosis can be a doorway to support, community, and validation. A diagnosis is often necessary for someone to be able to access appropriate care, whether in school, at university, or the workplace. I don’t think it should be this way, I think anyone should be able to access care in whatever form that takes, but often a diagnosis is the first step to accessing care. In a very immediate, tangible sense, then, it can be a liberating thing.
My own experiences of being diagnosed were incredibly negative, and strewn with harmful power dynamics. I have friends who felt relieved, empowered and liberated when they received their diagnoses.
But the reason this question has stayed with me isn’t because of the myriad answers I could have given about the complex history of the DSM, the relationship between capitalism and suffering, or the colonial power dynamics between a psychiatrist and a patient.
This question has stayed with me because I think it’s actually the wrong question to ask.
I think it’s a distracting question.
Spending hours pondering over whether diagnoses are ‘good,’ or ‘bad,’ is like a dog chasing its tail. Entertaining, but directionless. There is no one answer to that question because everyone has a different relationship to their diagnosis.
The more important question is, what are the material conditions that are causing people to suffer in such enormous numbers?
For example – as an inpatient on a CAMHS ward when I was 17, I was diagnosed with Borderline Personality Disorder. It felt completely inaccurate, the stigma attached to it felt tangible, and I felt like a specimen given a label. I am still angry about the flippant application of that diagnosis.
But I don’t think the diagnosis itself is the site of struggle I want to give my energy to. Because, BPD or no BPD, I was suffering. I was debilitated. I was seriously and chronically unwell. Spiritually, physically, mentally (however you want to conceptualise mental illness) I wasn’t well. I wasn’t living. Not really. Why? That’s the question that I’m more interested in. What were the material conditions that were causing me to suffer?
I believe it’s really important to remain focused on these material conditions. Because the discourse on diagnosis has been co-opted by neo-liberalism to justify cuts to state-funded mental health care. It is a topic that has been turned, as Micha Frazer-Carroll puts it, into an economic argument, rather than a moral one.[1] Just this past year, Wes Streeting’s statement of an ‘overdiagnosis,’ of mental health conditions was used as a justification for the devastating cuts made to the benefits bill.[2]
This isn’t anything new. In the 1970s, Margaret Thatcher capitalised on the growing anti-psychiatry movement, by closing down residential units (asylums) across the nation, promising instead to implement care in the community. Shocker, this never materialised. It was a funding cut. It left mad people with nowhere to live, no-one to care for them, and no prospects.[3]
So yes, it is important to acknowledge and resist the power struggle in who is giving the diagnoses, and who is at the receiving end. Yes, it is important to resist the medicalisation of our human experience, and yes, psychiatry is a carceral system that needs to be abolished. But diagnoses are descriptive terms. They are words used to describe our experience. They are useful for some people and harmful for others. It is a distraction to be spending our time debating whether they are ‘good,’ or ‘bad.’
We must remain focused on dismantling the material conditions that create this suffering in the first place.
References
[1] https://www.instagram.com/p/DSpR56LDGP9/
About Chloe Yates
Chloe is a landworker, activist, and psychiatric survivor. She is a Patient Leader with Mad Youth Organise.