Neil Gong
Icarus Project Internship
Brad Lewis/ Sascha Scatter
December 18, 2006
My Semester With the Icarus Project
 A key interest of mine in working with the Icarus Project has been to locate the place of theory in Mad Pride activism.  While radical mental health was somewhat new to me at the beginning of this semester, postmodern conceptualizations of identity and politics have been a long standing concern.  In doing this internship in conjunction with Brad Lewis’ Mad Science/Mad Pride I’ve been able to see where theoretical contributions have both enabled new modes of thinking about madness as well as bogged down the discussion.  Through the various events we’ve put on I’ve gained a better understanding of where theory needs to take a backseat, and when a session of academic jargon is appropriate.  There has been a constant tension in Icarus’ pursuit of academic and institutional legitimacy because the project itself is a “radical” approach to mental health support.  The desire to be effective on a larger level means working with the Wellness Exchange and with people who might not necessarily understand where we are coming from.  Another major hurdle I’ve been trying to jump (with mixed results) is to connect with psych majors and pre-med students, who are often turned off by the Icarus Project’s basic tenants, but are precisely the people we need to have on our side.  The first section of this paper will deal with general thoughts throughout the semester, and the latter half will be something like an essay/lecture/workshop I’ve been trying to use on psych and pre-med friends.  (It’s a bit academic and dry, but that’s just how I organize thoughts better. I’m working on making it more audience friendly in a presentation format.)
    I think first of our opening event, “Get Your Freak On.”  Here we had a fine assemblage of alternative healers, including animal trauma specialists, a shaman, yoga instructors, acupuncturists, and more.  Certainly in Brad Lewis’ view of post-psychiatry, this is an aspect of the decentering and democratization of psychiatric practice that the mental health world needs.  The previous day’s theoretical discussion “Open Minds” had shown the defensiveness of psychiatry, as one psychiatrist openly scoffed at social scientists examining it as a discourse and culture.  If he wouldn’t even consider the opinion of academics that hold PhD’s, what would he have to say about shamanism?  The discursive split between the new psychiatry and critical theory, ie the science wars, is big enough, but the split between DSM IV psychiatry and alternative medicine is perhaps even larger.  This is also what Icarus has to contend with in bringing people to our events.  While alternative healers might be appealing to some anarchists, hippies, and postmodern intellectuals, the average college student tends to be dismissive.  This is especially true of psych, and pre-med students, who might not appear to be our target audience (cause honestly, they aren’t nearly hip enough to hang out with us) but are actually people we both need and can help.  To assume that these folks can’t be a part of the movement is to forget that everyone exists in some realm of psychic difference and psychic suffering.  Getting their support and attendance is very tricky but important.   
    An area where I think LGBT has had real success is in allowing people to identify as allies.  This is a very positive way in which people can join the cause without “outing” themselves as queer identified.  Similarly, a language of allies would help the Icarus Project enlist the aid of many students in future positions of power that would not normally want to be associated with the anarchist crazies.  It is the future psychologists and doctors that we need to reach in this capacity, because the further they go in advanced study the more clearly the binary of Dr./Patient is drawn.  If we get ‘em young we have a better chance of creating a new generation of professionals sensitive to differing constructions of madness.  Also, they could all benefit in their personal lives from exposure to Icarus. 
Many of the issues we will need to address mimic the theoretical concerns of LGBT.  For instance, the postmodern argument complicating this “ally designation” is that it allows people to further reinforce and reify binaries of sane/crazy, straight/gay, male/female, normative/queer, instead of forcing us all to recognize how unstable and under erasure these categories are.  For one to be a straight identified queer ally without questioning where any of the gender and sexual normative categorizations have been problematic in one’s own life is in bad faith.  To be a Mad ally without understanding one’s own relationship to madness is to arguably miss the point.  The Icarus view of psychic experience on a spectrum is helpful.  We are all on it somewhere and we change from day to day.  Not only do we change, but the consensus “reality” is ever shifting as well. To take it a step further, madness might be best addressed not as a polarized spectrum, with the two legitimate sides of sanity and madness opposing each other and the various gradations in-between defined in their relation to the “real.”  Instead the language of “psychic difference” seems to best capture the play of madness, where each space along the spectrum is taken on its own terms as legitimate.  (An ever-rotating wheel of psychic experience?)
This is not to say that I am against the idea of “allies.” It has only been within this semester that I have begun to understand the complexity of postmodern identity/identification politics, and their real life limitations.  I am definitely aware of the fact that most folks will scoff at my last paragraph.  I think the concept of the ally is something that will be very helpful for the Icarus Project, even if it is problematic ideologically. During our meeting with Todd Smith from NYU LGBT I was really impressed with the way safe zone training is set up on different campuses across the nation, and how it has become a training that is required in some jobs.  Perhaps our version would become the kind of thing pre-med and psych students would list on their grad school apps and resumes.  (That’s how we lure them in, and then we get educate them.) 
During our last event, a screening of the film The Devil and Daniel Johnston, I was really impressed with the level of discussion we had afterwards.  During our intro to the film we brought up both dangerous gifts and the idea of the schizophrenics as shaman, and it seemed that a number of people understood the idea of multiple truths coinciding.  Even on a simpler level it was clear that people saw the impact an informed, caring community would have had on Daniel Johnston’s life.  Though this is certainly an accomplishment, I have to remind myself that this is a roomful of mostly Gallatin kids.  They are much more amenable to things like multiple truths and accepting difference in general.  Reaching mainstream future doctors and psychologist means dealing with scientists who believe that there is one, stable world that they can view through a microscope.  This is their world, and the world of the sane.  I think that LGBT has a much easier time finding kids to be their peer ed leaders because gender and sexuality studies students are taught to question normative categorizations right off the bat.  The history of queer studies is one of progressive politics and refusal.  The kids in CAS psychology, however, are about as establishment as they come.  (Ok, I’m stereotyping, but this has been my experience, even with friends.)  They are the future movers and shakers of the mainstream mental health world, and we need them on our side.
How we accomplish this, and what concessions we make, is a complicated issue.  To some degree it will be nearly impossible to convince a physician or psychologist that they are part of the problem.  Years of investment, both time and monetary, leave little room for taking down the system.  Way too much cognitive dissonance.  I think at best we can convince medical health professionals to be more sensitive to the experience of those in their care.  It is unlikely that we will get them to make a wholesale turn away from their profession.  Students who are currently dropping $40,000 a year in order to become doctors are very much in the system.  Bringing them to our events is probably not the hardest part.  We do need to start advertising in non-Gallatin venues, but gaining access to CAS psych networks is just a matter of legwork when we are ready for it.  The difficulty will be convincing people that we are, ahem, not crazy.      
I was recently debating with my friend Mike, a premed junior, about the “truth” behind a person’s psychic experience.  When I introduced the idea of the shaman and the schizophrenic, he agreed that it is ethnocentric for the western doctor to go and pathologize what he or she does not understand in an unfamiliar cultural context.  This is certainly a progressive reading, but Mike consistently returned to a master narrative explanation: the person may appear to be a shaman, but science will provide the real truth of whether or not the shaman is schizophrenic.  Perhaps we misinterpret at a given time, but there is undoubtedly a stable truth to the situation.  With enough scientific inquiry we will reach the conclusion.  Even if it’s good for the person to think they are a shaman, it is wishful thinking and inevitably a lie.  This was pretty much what I expected, so when we hit this point it seemed we had to scale back to a more ontological discussion and we turned to the old zen koan about the tree falling in the woods.  I argued that there may be something that happens when that tree falls, but without human interpretation it need not be sound.  Indeed, the thing falling need not be a “tree,” and it may not be “falling.”  I then tried to explain that his concept of language assumed that there is a referent to which “tree” refers, a stable thing that is “tree.”  Instead I asked him to consider that the amorphous blob of matter making up the tree has no essential truth to it outside our meaning assignments, and that tree only gains resonance through linguistic relations and classifications.  He got frustrated, and so did I.
So maybe my approach here needs work.  One suggestion Brad Lewis has made is to focus more on the relation of disability activism to mad pride.  For disability activists it is important to move away from individualizing and medicalizing approaches that seek to “cure” the abnormal body.  Instead a social model should be adopted that adjusts societal environments for different bodies.  As Brad writes, “…much of the suffering of different bodies comes from social exclusion, isolation, and lack of opportunity, along with the pernicious side effects of a medical industry bent on aggressive intervention to achieve “normal” bodies.”  Similarly, much of the suffering of psychic difference might come from social exclusion, isolation, and lack of opportunity, along with the side effects of a psychiatric industry bent on achieving mental “health.”  Perhaps through this lens doctors could become more sensitive and start to relax on the normalizing processes.  I believe that this might be a space for doctors to work in that doesn’t call their deepest held beliefs into question, while still highlighting the negative effects they have.  It is certainly a start in the move from the scientific desire to “know,” to the sometimes more important desire to “care.” 

Mad Science/ Mad Pride for Those from the Dark Side:
Turning Bill Nye into a Mad Ally
A Primer on Sociological Theory and Madness

In 1972 the sociologist David Rosenhan conducted 2 major studies on the validity of psychiatric diagnosis, published as “On Being Sane in Insane Places.”  In it 8 healthy experimenters went to a psych ward complaining of hearing voices.  Upon entrance they proceeded to act as normally as possible, and claim that the voices had stopped.  Once labeled schizophrenic or bipolar, however, all of their behavior became considered pathological.  For instance, one researcher/patient’s note taking was regarded as an unhealthy compulsive “writing behavior.”  Each claim to one’s sanity was disregarded.  The average stay for the researcher/patients was 19 days, with some there as long as 52.  The next study occurred at a major psychiatric hospital that considered its diagnostic procedures fool proof.  Rosenhan agreed to send a few pseudo-patients through their doors over a three month period.  Out of 193 patients, the hospital concluded 41 were imposters, and suspected another 42 despite the fact that Rosenhan actually sent no pseudo-patients to the hospital.  The publication of this research created much controversy in the psychiatric world.
One response was to agree that psychiatry was too lax, and to make diagnosis more scientific.  This attitude can be seen in the highly codified DSM IV.  The “new psychiatry” is one of increased neuroscience research and medication use, and a move away from the soft humanities practices like psychoanalysis.  Though many psychiatrists accepted the social science critique of diagnostic procedures, they clearly missed out on what the sociologists were saying.  It was not simply that diagnosis needed to be refined.  Instead, the sociological research points to the complexity of how language and labels filter our perceptions of the world.  Sociological labeling theory argues that the labels placed on individuals affect their behavior profoundly, as well as the reception of that behavior.  In criminology, for instance, many studies have found youth offenders labeled “deviant” return to crime in higher rates than those not so labeled.  It is the result of a self-fulfilling prophecy, meaning that a false definition of a situation can elicit behavior that makes the originally false definition come true.  This is taken from the Thomas theorem, which states “if men define situations as real, they are real in their consequences.”  In the Rosenhan case, this can be seen in a healthy researcher’s diagnosis as schizophrenic.  Though the pseudo-patient may not be suffering, the consequences produced are much the same as if he or she had been.  The hospital staff’s refusal to see anything but pathology and schizophrenia led to a closing of their own critical minds.  For the pseudo-patient, a long enough stay with constant reinforcement of schizophrenic expectations might be enough to produce behavior similar to schizophrenia. 
Bio-psychiatrists have attacked this mode of thinking repeatedly.  They argue that mental illness is a clearly documented, empirically verifiable fact.  Since the symptoms exist prior to labeling, the disease is there with or without social definitions.  This is, unfortunately, where the dialog tends to stop between sociologists and bio-psychiatrists.  Many in the mental health field regard sociologists to be working against science and the best interest of patients who need to be diagnosed.  This is symptomatic of the larger “science wars” occurring in academia today. 
 Perhaps the biggest leap for a scientist is accepting multiple truths.  The important thing here is to recognize that the critique isn’t simply about neuroscience being right or wrong.  It is about seeing the multiple, coinciding realities to every situation.  Yes, “symptoms” may be there, but they only gain resonance when humans add meaning to them.  Meeting someone with a different perception of reality can have many different interpretations.  To pathologize this person as crazy is certainly one interpretation, but it is not necessarily the best, most accurate, or only “true” one.  Take for instance, the experience of hearing voices.  Some cultures believe that a person hearing voices is having a shamanistic experience.  Indeed, this person might become a spiritual leader.  Using the lens of bio-psychiatry, we could go into that other culture and spot what looks to be textbook DSM schizophrenia.  On the other hand, using the lens of shamanism, we could go into a mental hospital and find a group of people in touch with the divine.   Now it may seem obvious to bio-psychiatrist that all shaman are really schizophrenics, and that the cultures they live in simply haven’t been exposed to modern mental diagnostic procedures.  The other way of looking at this, however, is to understand that truth is unstable and is intimately shaped by the language we use.  There may be an experience that the “schizophrenic” or “shaman” has, but as human beings we can only describe that experience by imbuing it with language and subjective meaning.  There is no objective acquisition of it.  The meaning we choose to give it creates consequences that will affect the life of the “schizophrenic” or “shaman.” Returning to self-fulfilling prophecy theory, the person hearing voices can be made to experience each way of life through the very labeling and social reinforcement of terms like shamanism or schizophrenia.  This is to say that the experience of and reaction to shamanism and schizophrenia are socially constructed. 
This does not mean, however, that schizophrenia and shamanism do not exist.  To call these lived identities socially constructed labels does not mean that the frameworks don’t explain some peoples’ lives quite well.  Instead, it means that each is one way of mediating the reality people experience.  When we recognize something as a construction we are reminded that it is one of many possible ways to understand the world, and that the seemingly “bare facts” can only be understood through these different mediations. Mental illness is one way of understanding a set of symptoms, but there is nothing inherently ill about those symptoms.  They might be understood as creating dysfunction, but under whose definition of functioning?  The social context of a person’s life determines whether hearing voices is better understood as illness or divinity. 
In diagnosis medical and psychological practitioners hold an important tool for shaping the consequences of a patient’s life.  The power of the self-fulfilling prophecy in labeling should not be underestimated.  This is more than simply the placebo effect, in that a diagnosis such as schizophrenia or shamanism has the power to completely reorganize a person’s life, sense of self, and future.  The next generation of doctors and psych experts will have a role in shaping whether the mental health industry continues down a purely scientific path, or if it opens itself up to other forms of knowledge.  Though the science wars rage on, some questions to consider include: What are the manifold consequences of a diagnostic label in a person’s life, beyond that of “curing” a sickness?  What are the political implications of a mental health system that can only see difference in terms of pathology?  Is the scientific desire to “know” the “truth” of a person’s psychic condition more important than the desire to care for that person?  Upon which criteria do we define a baseline “health” across varying cultures and times?  These and others are important questions that cannot be answered satisfactorily in the scientific world alone.
To provide one more example, the Icarus Project has changed the definition of madness from “illness” to a “dangerous gift.” Again, the scientific skeptic might argue that this is just wishful thinking for the crazies, who want to believe they are special.  But upon closer examination we must understand that the truth of calling them “crazies” is manifested in that labeling.  Calling them dangerously gifted can take on its own kind of truth, and the consequences of that name are far different, and for some people, perhaps better.  As one leader from Icarus has said, a person can certainly take their meds because they are sick.  They can alternatively take their meds because they are a superhero learning to control their powers.  Though this is something of a comical statement, it reflects the power framing has on a situation.  The work this social activist has done throughout his life was made possible by dangerous gifts.  Had he remained convinced he was ill, his options would have been far more limited.  What the next generation of mental health professionals needs to do is focus more on empowering and caring for those suffering psychically than chase after an illusory “truth” to their condition.  This does not mean a turn away from science, but an embracing of other forms of knowledge that will hopefully result in a mental health industry prepared to deal with people in all of their complexity.