"You're not making sense": psychiatrization and internal exile
Richard A. Ingram, University of British Columbia, Vancouver, Canada
Abstract
The question of making sense of problems of the mind or the emotions is being re-framed by the international community of psychiatric consumers, survivors, and ex-patients (c/s/x). People who are subjected to various forms of involuntary psychiatric treatment have usually been judged as exhibiting behaviour or communicating in ways that do not make sense in comparison with societal norms. Many of us interpret our experiences differently from individuals whose conditions are not diagnosed on the basis of an alleged hermeneutic deficit. Consequently, we are more likely than others to show scepticism towards the project of making sense.
In order to highlight the specific circumstances of c/s/x, my paper includes a discussion of Jacques Derrida's Monolingualism of the Other. I contend that an analogy can be made between the dis-location of Algerian (or Franco-Maghrebian) Jews whose citizenship rights were revoked during the Vichy régime, and the dis-location of c/s/x whose treatment condemns us to living in a kind of "internal exile." As with the ethnic group to which Derrida belongs, c/s/x are positioned both inside and outside of the state, since we receive "care" according to state-sanctioned psychiatric practices, yet are denied basic civil rights. In both cases, there are obstacles that block the resumption of the narrative continuity that is required to ensure the coherency of a life.
It is the concept of "anamnesis" that provides a focus for my analysis of the personal and political dimensions of psychiatrization. For the psychiatrist, the patient often contributes nothing to an anamnestic outline written on the patient's behalf. Instead, it is the testimonies of a spouse, of friends, relatives, employers, landlords, judges, police officers, social workers, etc., that generally take precedence. In considering a range of examples of autobiographical accounts, my interest lies not in the ways that c/s/x make sense of the event of psychiatrization, but rather in how we articulate that which has prevented and continues to prevent us from making sense.