The meaning of survivor….

A friend told me that she thought the term “psychiatric survivor” was widely misunderstood, that it was much more than a political label and that people who self identified that way were normally unfairly marginalized and dismissed as extremists who had little of value to say. “Psychiatric survivors” were she said unfairly dismissed as people who were against everything and unwilling to work with anyone who did not agree with them about everything.

She said it was more about identity than ideology and we talked for a while that night what it meant for her…. A couple of nights later I was part of a phone conversation with Sarah Knutson, Marty Felker, and Sharon Cretsinger. The same subject came up and some of the same points were made. Much of the rest of this post springs from that conversation.

I have a friend who is a remarkably good person. Life has been lucky for him. He has not known distress in the same way so many other people have.

We were talking about recovery and I read him part of something I had wrote a long time ago. “…. Do good things every day that build your strength and capability. Try to anticipate and prevent any problems you can. Cope with what you can’t prevent. Survive what you can’t cope with or control …”

He wondered why for so many people life was so hard and seemed to think people should just be more focused and try harder. I told him that he didn’t know very much about survival.

For some people life is a lot about survival. It is not about education or skills although that may be very important. It is not about motivation or support although that may be very important. As much as anything else it is about tragedy. Bad things happen to people who don’t cause those bad things to happen. Bad things happen that people have little or no control over. For many people bad things impact what they think of themselves, of others, of life and many other things.

Sometimes life is not simply changing life events but fighting like hell to survive the assault of life events on you. For some people survival is about saving themselves in circumstances that conspire to make that seem impossible. It is about trying to survive with some degree of integrity and capability the injustices that seem to determine the parameters of life.

For some people mental health issues and their exposure to the mental health system is about survival more than anything else.

Distress and difficulty are very real. Many things may seem out of control or very difficult. The “treatment” they are offered may add to injury. The short term side effects of many drugs and their long term consequences may be life altering and impossible to live with. Even if you can live with them they often don’t make it easier to live. For many people they don’t help nearly as well as advertised or hoped for. For many people the experience of inpatient treatment is demeaning and traumatic. They are asked to accept a definition of themselves that says life will never be better, that their “disease” will be chronic and life long. They are told they can never have, will never have what others have. And they are told to be “realistic” and accept a life always limited.

But the issue of survival goes far past these things. It is not just the experience of distress or treatments that may make things worse that must be survived but the social experience of what all that means. The labels attached to you matter. They have impact. Discrimination and prejudice are real. Psychiatric diagnosis is not a simple morally neutral medical act. It consigns you to a social group and standing. If you belong to that group you are more likely than other people to:

Be poor…
Be unemployed…
Face issues of homelessness…
Lack access to the help you need or want….
Have a history of lousy medical care…..
Die considerably earlier than the larger population….
Have your civil rights be abridged or denied….
Plus many other things…..

To survive what it means to be “mentally ill” in this society with any kind of integrity, belief in themselves, hope for the future, and recognition of their own strengths and abilities requires a daily courage and commitment that even survivors don’t always know they have or give themselves credit for.

“Psychiatric survivors ” are often dismissed as people chronically complaining about what the system has done to them. It is so much more than that. It is about courage and victory and making real better life. It is about, in a very real sense something good happening.

Many people know what it means for life to be about survival. In tragedy sometimes we find the capacity to reach out to others and to support and be supported and to find out even in the worst of circumstances more is possible, that we can survive and find better life.

(Psychiatric survivor is also a political term but that is the subject for another post.)


5 thoughts on “The meaning of survivor….”

  1. Many of the folk who identify themselves as “survivors ” that I have spoken with seem to be filled with rage and viciously attack any perspective different than theirs. If you claim to have met psychiatrists and therapists that are respectful, that listen well and work collaboratively, they, well for lack of a better phrase, “freak out”. It’s like they consider me to be collaborating with enemy and the moral equal to the Jewish capos who worked in the death camps and were often described as being more brutal than the Nazi guards. The complete intolerance of other perspectives regarding recovery than theirs is the most frequently encountered quality they share, at least to me. I do agree with many of their critiques of the whole mental health world, so I am not a priori against talking with them; I just wish the courtesy was more oftentimes reciprocated.

  2. @Clint. “If you claim to have met psychiatrists and therapists that are respectful, that listen well and work collaboratively, they, well for lack of a better phrase, “freak out”. ” Sure as long as you do exactly what you are told most mental health professionals will behave like that for the most part. Try telling them you are not interested in what they have to offer. Thats when they get nasty. And it gets nasty, very nasty very fast.

  3. Excellent. I have struggled with labels for 40 years. Though I appreciate your blog’s treatment of the difficulties of surviving whatever is “mental illness,” my survivor side would say those struggles are based more on the social reaction and interpersonal relations than the internal struggle with trauma and diversity. The friend you are mentioning who struggles less, he and others in his group were probably lucky (?) to have had less trauma and more supports. Even more he may have been born and developed neurotypical, i.e. his make up fits with the status quo. This is not ideology this is fitting into the expected role and station in life that you are assigned usually at birth but certainly consolidated in the industrial incubator we call school. If you don’t fit in and either cannot or will not conform, you most likely will receive one or more of the 900 labels of illness in DSM V. Then either you comply and survive or find a community that accepts you for who you are and thrive. Gradually you can hope or make happen a change in the cultural values so your way of being in the world is accepted. Being gay or queer as young people say, is a good example. Being gay was considered an illness and a subculture of accepting persons developed, the gay community. Then after years of activism for gay rights to be accepted by society, in 1973, the APA, the arbiter of normality, struck gay from its bible of deviance, the DSM, and was no longer considered an illness. So I think the question of surviving after being labeled mentally ill is primarily a social/political/cultural issue. I conclude that mental illness is not primarily due to s biological defect in the individual’s brain but a cultural defect in society. Instead of a rigid rule bound society that maintains the status quote at the expense of diversity, based on xenophobia (fear of difference) we need an adaptive society, that embraces diversity, practicing xenophillia (love of difference). This takes a continuous cultural evolution. Clearly our choice of president will either help or hinder this cultural evolution. Any candidate who denies the rights of others, who practices xenophobia, and/or denies the importance and existence of evolution does not deserve to be president.

  4. The psychiatrists I’ve had were respectful to me, and I toward them. One psychiatrist (who I had never seen before) stepped in to speak to me when I was on a ward and another psychiatrist was being disrespectful to me and dismissive of what I said had occurred. I realize how rare that is. I don’t disagree with the survivor label – much of the system is abusive – and surviving the abuses is something to be grateful for. Much of the abuse, as I see it, is deliberate – a way to force individuals into a subservient position – and accept the abuse as normal. This is not acceptable – Taking the non-violent communications course by Marshall Rosenberg should be required for all staff. Neither Republicans nor Democrats are, in my opinion, generally conscious of the disrespectful behavior they tolerate within the mental health, criminal justice and social service systems. Blissful ignorance yields callous indifference – which I see as a major reason for the problems in society today – which much of those in government service seem unaware. “According to the social model, disability is not an attribute of the individual, but rather a complex collection of conditions, many of which are created by the social environment: the approach to disability requires social action and is a responsibility of society.” ( Neurological disorders: public health challenges, World Health Organization © 2006, pg. 10) Much work needs to be done.

  5. The psychiatrist and those that work for him/her are figuratively killing people with poisons, electroshock and Bilateral cingulotomy (lobotomy).
    Usually before someone gets executed we have a trial by jury, Usually 8 to 12 people who must discuss the facts of the case and arrive to a conclusion by reasonable means.

    One person is given this power.

    The poisons, electroshock and lobotomy prevent the “patient” from defending themselves.
    Then afterwards if the person/patient has no inherited wealth, they then have their skills impacted ( coming from their damaged brain), and without skills can not acquire an income of significance. Further dis-empowered/disenfranchised.
    Putting the patient in a hole they can not climb out of, and the psychiatrist profits and the drug manufacturer profits.

    So yes the analogy of a room full of Nazis and Holocaust survivors is a good one in my opinion.

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