Towards Critical Sanity TheoryNARPA 2015 Washington, DCCasadi “Khaki” Marino, LCSW, PhD Candidatecasadimarino@hotmail.com

Theory: the land of the possible and the imagination

•Reality is always outside of our grasp.

•Theorizing allows us to go beyond what is immediately knowable.

•Theory is modifiable; knowledge creation is fluid

•Theory creates the necessity of testing and seeking evidence.

•Theory is where practice grows

Social Model of Disability•Disability not a problem of individual deficit but a social phenomenon or construct.

•Disability located at the intersection of the person and the environment. Difficulties not denied but issues approached in terms of the effects of social exclusion and oppression.

•Avoid biological reductionism•Critical disability theory: disability a matter of politics, power, and human rights

•Disablism, ableism

Mad theory development

•Personal and bodily experiences should be incorporated into theory along with the social and political aspects.

•Madness is an embodied, lived experience with multiple dimensions.

•Mental distress or extreme states understood in relation to life experiences.

•Madness a matter of human diversity

A critical madness•Identity constructed and fluid; social categories not natural.

•Challenge hegemonic normalcy and the sane/mentally ill binary.

•Sane privilege can act to prevent learning from mad experiences.

•Differential opportunities not determined by human variation but by how the differences are understood and responded to.

•Those who are taught to devalue or hate themselves rather than oppressive ideologies are unlikely to challenge the system.

Critical Race Theory (CRT) and Critical Whiteness Studies (CWS)CRT: Centralizing counterstories from people of color in order to decentralize white-normative discourse. Embodied in the imagination: a cognitive library of experiential knowledge; terror at the realities of racism and white supremacyCWS: problematizing the normality of hegemonic whiteness; deconstructing the dimensions of white privilege and the white imagination. Whiteness historically, economically, and legally produced. Whiteness surrounds us and structures daily interaction. Whiteness is often invisible to white people.

How unreasonable•Whiteness tied to rationalist thought. Other ways of being marked as marginal, deviant, or insane.

•The parallel: Race, disability, madness socially constructed. Experiences of fear, discrimination, exclusion

•Categories of disabled and mentally ill enforce the privilege of normality and prevent it from being seen or understood.

•Need to search for diverse expressions of experiences. Expand our understanding of “reason” and include the mad imagination.

Critical Sanity Theory: Who does sanity serve? How is it maintained? How do people come to develop sane identities?Theory Tenets:1)Focus on forces of sanity that operate in neutral

or invisible ways 2)Value multidimensional identities, trouble

singular notions of personhood3)Recognize the material and psychological impact

of being labeled mentally ill4)Privilege voices of the marginalized5)Consider the legal and historical aspects of

mental illness that have been used to deny human rights

6)Recognize sanity as property7)Require resistance and activism

Sane Traitors and AlliesFollow your inner moonlight; don’t hide the madness – Allen Ginsberg

•What is Whiteness without privilege? What is sanity?

•As long as you think you are sane, there is no hope for any of us (Huge nod to James Baldwin)

•Allies: act as a means of self-liberation from hegemonic normativity rather than to be generous towards others

•Engage in a process of learning and unlearning. Be prepared to receive critique for your efforts.

ReferencesAnastasiou, D., & Kauffman, J. M. (2013). The social model of disability: Dichotomy between impairment and disability. Journal of Medicine and Philosophy, 38(4), 441-459.Annamma, S. A., Connor, D., & Ferri, B. (2013). Dis/ability critical race studies (DisCrit): Theorizing at the intersections of race and dis/ability. Race Ethnicity and Education, 16(1), 1-31.Beresford, P. (2002). Thinking about ‘mental health’: Towards a social model. Journal of Mental Health, 11 (6), 581-584.Beresford, P. & Campbell, P. (2005). Madness and mental distress. In Gary L. Albrecht (Ed).Encyclopedia of Disability. (pp. 1049-1053). Thousand Oaks, CA: SAGE.Campbell, F. A. K. (2008). Exploring internalized ableism using critical race theory. Disability & Society, 23(2), 151-162.

Cherney, J. (2011). The rhetoric of ableism. Disability Studies Quarterly, 31 (3), 1-15.Costa, L., Voronka, J., Landry, D., Reid, J., Mcfarlane, B., Reville, D., & Church, K. (2012). “Recovering our Stories”: A small act of resistance. Studies in Social Justice, 6(1), 85-101.Gentle-Genitty, C. S., Gregory, V., Pfahler, C., Thomas, M., Lewis, L., Campbell, K., Ballard, K., Compton, K., & Daley, J. G. (2008). A critical review of theory in social work journals: A replication study. Advances in Social Work, 8(1), 62-80.Ginsburg, F., & Rapp, R. (2013). Disability Worlds. Annual Review of Anthropology, 42(1).Harper, D., & Speed, E. (2012). Uncovering recovery: The resistible rise of recovery and resilience. Studies in Social Justice, 6(1), 9-26.Hiranandani, V. (2005). Towards a critical theory of disability in social work. Critical Social Work, 6(1), 1-10. Leonardo, Z., & Broderick, A. (2011). Smartness as property: A critical exploration of intersections between whiteness and disability studies. Teachers College Record, 113(10), 2206-2232.

McDonald-Morken, C. A. (2014). Mainstreaming critical disability studies: Towards undoing the last prejudice (Doctoral dissertation, North Dakota State University).Matias, C. E., Viesca, K. M., Garrison-Wade, D. F., Tandon, M., & Galindo, R. (2014). “What is Critical Whiteness Doing in OUR Nice Field like Critical Race Theory?” Applying CRT and CWS to Understand the White Imaginations of White Teacher Candidates. Equity & Excellence in Education, 47(3), 289-304.Miller, E. T. (2015). Discourses of whiteness and blackness: An ethnographic study of three young children learning to be white. Ethnography and Education,10(2), 137-153.Morrow, M., & Weisser, J. (2012). Towards a social justice framework of mental health recovery. Studies in Social Justice, 6(1), 27-43.Mulvany, J. (2000). Disability, impairment, or illness? The relevance of the social model of disability to the study of mental disorder. Sociology of Health & Illness, 22 (5), 582-601. Munro, E. (2002). The role of theory in social work research: A further contribution to the debate. Journal of Social Work Education, 38(3), 461-471.Peters, S., Gabel, S., & Symeonidou, S. (2009). Resistance, transformation and the politics of hope: Imagining a way forward for the disabled people’s movement. Disability & Society, 24(5), 543-556.Schrader, S., Jones, N., & Shattell, M. (2013). Mad pride: Reflections on sociopolitical identity and mental diversity in the context of culturally competent psychiatric care. Issues in Mental Health Nursing, 34(1), 62-64.Schriempf, A. (2001). (Re) fusing the amputated body: An interactionist bridge for feminism and disability. Hypatia, 16(4), 53-79.Shakespeare, T. (2008). Disability: Suffering, social oppression, or complex predicament? International Library of Ethics, Law & the New Medicine, 39, 235-246.

Sherry, M. (2004). Overlaps and contradictions between queer theory and disability studies. Disability & Society, 19(7), 769-783.Sleeter, C. (2010). Building counter-theory about disability. Disability Studies Quarterly, 30(2).Smith, P. (2004). Whiteness, normal theory, and disability studies. Disability Studies Quarterly, 24(2).Stienstra, D., & Ashcroft, T. (2010). Voyaging on the seas of spirit: An ongoing journey towards understanding disability and humanity. Disability & Society, 25(2), 191-203.Thomas, C. (2002). Disability theory: Key ideas, issues, and thinkers. In Colin Barnes, Mike Oliver, & Len Barton (Eds.), Disability Studies Today. (pp.38-57). Malden, MA: Blackwell Publishers. Thomas, C. (2006). Disability and gender: Reflections on theory and research. Scandinavian Journal of Disability Research, 8(2- 3), 177-185.Tooth, B., Kalyanasundaram, V., Glover, H., & Momenzadah, S. (2003). Factors consumers identify as important to recovery from schizophrenia. Australasian Psychiatry, 11(s1), S70-S77.Williams, C. C., & Collins, A. A. (2002). The social construction of disability in schizophrenia. Qualitative Health Research, 12(3),297-309.Wolframe, P. (2013). The madwoman in the academy, or revealing the invisible straightjacket: Theorizing and teaching sanism and sane privilege. Disability Studies Quarterly, 33 (1).

Excuse me, but how do I get out of here?Graduating from a doctoral clinical psychology program with dignity intact

Melissa Schroeder, M.A., BCBA

To be or not to be?

•The value of authenticity

Gains

Risks

• Premium on hiding

Dilemma:•Veil one’s true beliefs in order to gain the credentials needed

•Disown personal experience, friends, community

• Change minds and perspectives with honesty

• Personal growth in processing one’s experience through sharing

The Internship

•1-year training position required for graduation ▫Accredited vs. non-accredited

•Leads to licensure

•Accreditation by the APA▫Concerns▫Benefits▫Training based on organizational philosophy

•Is there really another option?▫Non-accredited training programs

The Essays•Autobiographical

•Diversity

• Case presentation

• Research

Self-disclosure dilemma• Not to be narcissistic or grandiose about it, but how much self-disclosure is needed and justified?▫Between faculty and student▫Students, peer to peer▫Student/therapist and client▫Cycle of trauma

•Fiduciary responsibility vs. room for growth▫The reflective-practitioner training model

▫Practice makes perfect

So is there a way out?The power of sharing•Removing the stigma

•Bridging a gap with lived experiences▫Lived Experience Research Network

▫Discrimination in Higher Education project

• The Johari Window

The future of graduate study•Students partnering with advocacy agencies▫Didactic trainings and colloquia▫Closed-door peer discussions

•The International Network of Integrative Mental Health (INIMH)▫http://www.inimh.org

•Integrative Mental Health for you▫http://imhu.org/courses/

Copying is the highest form of flattery•Oxford•Melbourne

Resources2015 APPIC Match Statistics Combined Results: Phase I and Phase II. Report Prepared by Greg

Keilin, Ph.D. and National Matching Services, Inc.Berger, J. (Nov. 7, 2011). Intern Gap Frustrates Clinicians in Training. The NY Times. Retrieved from http://www.nytimes.com/2011/11/08/health/views/internship-shortage-frustrates-psychology-students.html?_r=0Cohen, D. (Oct. 21, 2014). It’s the Coercion, Stupid! Retrieved from

http://www.madinamerica.com/2014/10/coercion-stupid/ Council of Chairs of Training Councils. (November 14, 2013). Psychology Internship Development Toolkit.

Retrieved from http://www.apa.org/education/grad/internship-toolkit.pdfDe Victoria, S.L. The Johari Window. Retrieved from

http://psychcentral.com/blog/archives/2008/07/08/the-johari-window/Ruthie (2011). Scientist/reflective/critical practitioners - you what?! Retrieved from

http://www.clinpsy.org.uk/wiki/article/scientist-reflective-critical-practitioners-you-what Scattergood Foundation:

http://www.scattergoodfoundation.org/innovideas/lived-experience-research-network#.VdNKlyxVikoUnger, R. (February 21, 2012). Personal Steps toward a Revolution in Mental Health Care. Retrieved from

https://www.madinamerica.com/2012/02/personal-steps-toward-a-revolution-in-mental-health-care/

A Harm Reduction Approach to the Mental Health System

Noel Hunter, MA, MS

Mental health reform or demolition?•Many agree there is a need for change▫Murphy Bill▫Anti-psychiatry calls to demolish

•Peer-led alternatives and independent funding▫Harmful dynamics can still arise▫Does not answer the problem of what to do now

•Reducing harm

History of Family DiscordProfessional “Patient”

High socioeconomic Middle-low socioeconomic

External support Lack of support

Helper Scapegoat

Participant in triangulation Object of triangulation*

Please authority figures Rebellious, anti-authoritarian

*(West, Zarski, & Harvill, 1986)

“Evil” behavior, not “evil” people

•Pressure to conform to societal expectations

•Power of authority

•Role expectations

Asch Experiments

• Verbal response most often that of the group

• Written response correct 98%

• More people in the group = increased conformity

• Social support = decreased conformity

Milgram

"The social psychology of this century reveals a major lesson: often it is not so much the kind of person a man is as the kind of situation in which he finds himself that determines how he will act." –Stanley Milgram, 1974

Milgram

Zimbardo: Stanford Prison Experiment

Human response to accusations•When confronted with accusations of harm, response often to assert hardships

•Exposing privilege self-protection

•Denial▫No personal responsibility▫Trauma▫Threatens privileged status

•Justification▫Assert how privilege has been earned or deserved

*(Lowery et al., 2007; Phillips & Lowery, 2015; Rosette & Tost, 2013; Tyler & Smith, 1998)

Example: Jeffrey Lieberman•Psychiatry has the dubious distinction of being the only medical specialty with an anti-movement. There is an anti-psychiatry movement. You have never heard of an anti-cardiology movement, an anti-dermatology movement, or an anti-orthopedics movement.

•It is very disturbing that we still live in an age when the stigma of mental illness and the lack of interest in trying to present medical science as it deserves and needs to be for an informed public, is still preyed upon by this kind of journalistic opportunism.

•I tried to write a serious, responsible, and constructive letter to the editor, which I submitted within 24 hours. Seventy-two hours have elapsed since the article’s publication. I haven’t heard from the Times about their interest in publishing my response, so I assume they won’t publish it. The name that I publish under is my own. My credential is the Chairman of Psychiatry, Columbia University College of Physicians and Surgeons, one of the leading departments of psychiatry in the country, past president of the American Psychiatric Association, and the author of the forthcoming book for the lay public called Shrinks: The Untold Story of Psychiatry.

Can the system change?•Overt corruption and abuses easy to identify and alter

•Subtle nuances of harmful dynamics inherent in the foundation, not so much

•Diffusion of actions and identity

•Powerful ideology that serves a cultural purpose

•People are invested in maintaining the status quo(Jost & Hunyady, 2002)

What about those who are “different”?•No one becomes a professional without becoming part of the problem

•“I” am not “bad”

•Often justified, minimized, deflected▫“It was necessary”▫“It was for his own good”▫“The system made me do it”▫“she was being manipulative and attention-seeking”

“Shallow understanding from people of good will is more frustrating than absolute misunderstanding from people of ill will.

Lukewarm acceptance is much more bewildering than outright rejection.”- Martin Luther King, Jr.

What to do?•Harm-reduction

•British Psychological Society

•Take back power and build community

•Egalitarian, trauma-informed, humanistic therapeutic experiences can be extremely healing!

References•Bowen, M. (1978). Family therapy in clinical practice. New York: Basic Books. •Burger, J. M. (2009). Replicating Milgram: Would people still obey today?

American Psychologist, 64, 1-11.•Jost, J. T., & Hunyady, O. (2002). The psychology of system justification and the palliative function of ideology. European Review of Social Psychology, 13, 111-153.

•Lieh-Mak, F. (2010). Psychiatrists shall prevail. World Psychiatry, 9(1), 38-39.•Lowery, B. S., Knowles, E. D., & Unzueta, M. M. (2007). Framing inequity safely: The motivated denial of White privilege. Personality and Social Psychology Bulletin, 33, 1237-1250.

•Phillips, L. T., & Lowery, B. S. (2015). The hard-knock life? Whites claim hardships in response to racial inequity. Journal of Experimental Social Psychology, 61, 12-18.

•Rosette, A. S., & Tost, L. P. (2013). Perceiving social inequity when subordinate-group positioning on one dimension of social hierarchy enhances privilege recognition on another. Psychological Science, 24, 1420-1427.

•Tyler, T. R., & Smith, H. (1998). Social justice and social movements. In D. Gilbert, S. Fiske, G. Lindzey (Eds.), Handbook of Social Psychology (Fourth Edition). New York: McGraw-Hill

•West, J.D., Zarski, J.J., and Harvill, R. (1986). The influence of the family triangle on intimacy. American Mental Health Counselors Association Journal, 8, 166-174.