The practice of confession is fundamental to some of the most powerful institutions across the globe, from Christian churches and courts of law to psychotherapy consulting rooms and social media platforms.
Prior to the twentieth century, confession was mostly performed by devout sinners and accused criminals. Psychoanalysis and its developments through psychotherapy extended this confessional demographic, first to “hysterical” women, and soon to a broad range of people whose emotions, behaviours, and beliefs have been considered abnormal. In the twenty-first century, social media platforms encourage everyone to make confession a routine practice in our day-to-day lives.
Facebook poses a question habitually asked by therapists, “What’s on your mind?” X (Twitter) is more urgent in its questioning, “What’s happening?!” Bluesky enquires more casually, “What’s up?” Digital activism often embraces confessional modes of communication compelled by these institutions of social media to seek justice through sharing stories of our lived experiences. For activists concerned with lived experiences of the psychiatric system, it seems especially important to recognise and reduce the risks of reproducing confessional dynamics central to these institutions.
Psychiatric service users are often obliged to disclose accounts of the most vulnerable events in our lives to each new worker assigned to our case. Psychiatrists and psychologists document the details of our lives that they consider significant with varying levels of accuracy and use their interpretations to decide on appropriate diagnoses and treatments, which are typically limited to drugs, incarceration, or more confessions. Resisting the obligation to confess risks being judged as “noncompliant” or otherwise “difficult” and labelled with a lifelong personality disorder, from which we are warned we will never recover.
Throughout eight years in Child and Adolescent Mental Health Services (CAMHS), I dutifully recounted stories of historic and ongoing abuse hundreds of times to scores of psychiatrists, psychologists, psychotherapists, and nurses in the naïve hope one of them might eventually act to protect me from the abuse. In the beginning, psychiatric reports recorded details of my emotional responses to my stories and recommended drugs to cure me of my emotional problems. By the end, psychiatric reports noted my stories sounded “glib” and “rehearsed”, considered this to be evidence that I was a manipulative attention-seeker and declared the problem to be my incurable personality. I share these details of my lived experiences to demonstrate that it is not enough to simply tell our stories. Confession requires a performance of appropriate emotion and personality to convince our appointed witnesses of our appropriate suffering. Our lived experiences, which are often the grounds of our suffering, can easily become superfluous to our demonstrable willingness to confess.
The confessional imperative is memorably described in the 1999 film adaptation of Susanna Kaysen’s memoir Girl, Interrupted, set in a psychiatric hospital where a long-term institutionalised inmate instructs the protagonist on its unwritten rule, “You lie down, you confess your secrets, and you’re saved. Ka-ching! The more you confess, the more they think about setting you free.” The film concludes with the promised liberation of Kaysen after she has paid for the privilege with her enthusiastic submission to the rule of confession.
The psychiatric industry is far from the only one that profits from our confessions. Our stories of our lived experiences have been commodified on an unprecedented scale by the billionaire owners of major social media platforms. Elon Musk and Mark Zuckerberg donated large sums of these profits to Donald Trump’s second election and inauguration, whose campaign included a fantastical claim that the US is being destroyed by the masses of psychiatric service users who have been sent there from “insane asylums” across the world. The involvement of social media oligarchs with the US president raises pressing questions about the long-term safety of psychiatric service users disclosing stories of our lived experiences in spaces under their control.
Confession enables institutions to establish and maintain control of their users through isolation and surveillance. They dictate who has the authority to hear and act on the stories of our lived experiences and enclose them within the confines of highly regulated spaces. It seems vital that we continue bringing stories of our lived experiences out from the closed loops of consulting rooms and biased algorithms into connection and solidarity with different kinds of witnesses.
Activist approaches that depend on sharing stories of lived experiences in state-controlled institutions can come dangerously close to the coercive confessional dynamics of the psychiatric system. Social media offers one of many means to establish connections with people who share aspects of our lived experiences and political concerns. Dedicated networks like NSUN offer more autonomous and focused alternatives with options for anonymous participation, making them more accessible to people who are at increased risk from institutional demands for confession, including incarcerated people and psychiatric survivors with related iatrogenic trauma. It seems a critical time to start strategically divesting from institutions that use our lived experiences against us and invest more of our resources into networks that are working to empower us.
Recognising the potential for coercive confessional dynamics in digital activism can be an energising incentive to imagine other ways of raising awareness, which we can pursue alongside sharing stories of lived experience. We can take inspiration from offline activist events like Mad Pride, which pursue strategies ranging from poetry readings and film screenings to psychiatric history walking tours and “bed push” protests. There are abundant possibilities for expanding the future of psychiatric service user activism, which can resist the dynamics of institutions weaponizing and profiting from our confessions and redirect the stories we share of our individual lived experiences toward collective political empowerment.
The Limitations of Lived Experience
This blog is part of our “The Limitations of Lived Experience” series which was open for submissions from NSUN members in January 2025 and published from February 2025. All the blogs in the series are available here.