Abstract
“Our visions of a better future are often born from a sense of social injustice, the need for change and an unswerving belief that a different kind of world is possible” (p. 142). Searching For a Rose Garden: Challenging Psychiatry, Fostering Mad Studies is a timely and captivating collection of essays written by twenty–four psychiatric survivors and four allies who have come together to offer insightful analyses of the social injustices ingrained in the fabric of psychiatry, and to share their visions of, and efforts toward, a ‘different kind of world’ based on their personal experiences. This book emerged from the international conference ‘Searching for a Rose Garden: Fostering Real Alternatives to Psychiatry’, held in Berlin, Germany in September 2011, and includes distinctive contributions from others not in attendance. This collection introduces and explores alternatives to psychiatric ways of knowing and practicing, including the many challenges, pitfalls, dangers, triumphs, and possibilities encountered in the efforts to realize such alternatives. I agree with the editors’ contention that each of the contributions to this collection, “raise important questions for the future development of research, theory and social responses to madness and distress” (p. 4).
Content Overview
Searching for a Rose Garden's twenty–four chapters are organized and presented in four sections: (a) Setting the Scene, (b) Survivor–Produced Knowledge, (c) Survivor–Controlled Practice, and (d) Working in Partnership. The book concludes with a set of questions put forth by each of its contributors in a standalone chapter titled, The Search Goes On. The chapters each have separate reference lists, providing highly relevant resources for those looking to delve deeper into the subject matter presented. An extensive index also allows readers to find connections across the chapters as well as locate specific topics and issues. I highlight a few chapters in my description of these sections; however, each of the chapters certainly merits a close reading.
Section I sets the scene, making the case for the need for “radically different approaches to madness and distress” (p. 2) informed by the experiences of psychiatrized individuals (chapters by O'Hagan, Davar, and Filson). This is followed by discussions of the potential contribution of those whose knowledges have traditionally been excluded from the field, and the challenge of co–optation of survivor initiatives by psychiatry (chapters by Beresford, and Penney and Prescott). Beresford considers the important distinction between ‘expert’ and ‘experiential’ knowledge; particularly the marginalization of the latter, and its enormous potential for shared understanding and change. Penney and Prescott discuss the dangers of co–optation of survivor–generated alternatives to psychiatry, presenting co–optation as “a process by which a dominant group attempts to absorb or neutralize a weaker opposition that it believes to pose a threat to its continued power” (p. 35). Additional topics include psychiatric harm and domination, trauma–informed approaches, faith healing and Eastern ‘ways of life’, the social model of disability, peer support alternatives, and identity politics.
Section II focuses on survivor–produced knowledges, or Mad epistemologies, within survivor research and scholarship, and alternative theories and models of madness and distress. Sweeney begins this section with a reflection on what it means to be a survivor researcher, exploring the political underpinnings, inherent challenges, and importance of this role. Russo then proposes an undoing of the biomedical model, and ‘reclaiming madness’ toward the collective development of an alternative framework for understanding madness and distress. Additional chapters address the highly stigmatized issues of self–injury (Shaw) and suicide (Webb), ‘Whiteness’ in psychiatry (King), Community Treatment Orders and the ‘re–branding’ of coercion (Fabris). As a Mad–identified scholar with particular interest in matters of epistemic injustice and the marginalization of Mad epistemologies, I found myself most engaged with these chapters.
Section III (Survivor–Controlled Practice) features concrete examples of projects and service provision models conceptualized and developed from collective first–person survivor knowledges. Lesser–known survivor–controlled initiatives are deliberately highlighted, rather than “well–established alternatives […] such as Soteria, Windhorse or Open Dialogue, which all have one known professional (non–survivor) figure behind them” (p. 3), making this contribution particularly valuable because, as the editors note, it is difficult to find projects started by survivors that are still operating as such. Some of the featured examples include Intentional Peer Support (chapter by Mead and Filson), Women's Independent Alcohol Support (chapter by Staddon), the personal ombudsman service, PO–Skane (chapter by Jesperson), Kindred Minds (chapter by Bhakta), and The Sunrise Project (chapter by Simpson).
Section IV (Working in Partnership) is the only section written from the perspectives of both survivors and allies, who share personal reflections on the “meaning, hardships and potentials of collaborations” (p. 4) in research (chapters by Sex and Sexton, Faulkner), education (chapter by Landry and Church) and practice (chapters by Brown and Stastny, Roper, and Maglajlic). Specific survivor/ally collaborations such as the Mental Health Recovery Archive, the Peer Specialist Project, and the Consumer Academic role at the University of Melbourne's Centre for Psychiatric Nursing are featured. In an engaging ‘partner dialogue’, Landry and Church also discuss the notion of “teaching (like) crazy” (p. 172) in a Canadian university, and the survivor/ally “partner relations that nurture this emergent practice” (p. 181). The section concludes with Maglajlic, who with her ‘ally’ hat on, shares insights from her experiences of supporting the development of survivor–run initiatives, stressing the need for survivors and allies to “carry each other” as co–researchers and co–activists (p. 215).
Evaluation
Searching for a Rose Garden makes an undeniably important contribution to the emerging field of Mad Studies, particularly in the way that its composition – written almost exclusively from the perspective of psychiatric survivors – reflects “what Mad Studies is all about” (p. vi). As the editors rightfully suggest, Mad Studies provides a ‘home’ for this groundbreaking work, as well as a powerful framework for connecting and situating the authors’ voices. Mad Studies can be understood as a “space of social action and theorizing about oppression and psy–violence” (Gorman & LeFrancois, 2018, p. 108) that “centers the knowledges of those deemed Mad, bolstered on the periphery by the important relationships, work and support of allies – or by those who comport themselves as mad–positive” (p. v). This work contributes to Mad Studies’ systemic critique of psy–violence, epistemic injustice and sanism; addressing the important issue of moving beyond consumer narratives and highlighting survivor–produced knowledge and theories (Gorman & LeFrancois, 2018). In her introduction to Searching for a Rose Garden, Brenda LeFrançois, co–editor of the book Mad Matters: A critical reader in Canadian Mad Studies, describes the book as fundamental to the evolution of Mad Studies, and says that she foresees the book being taken up as foundational in the field.
One of the strengths of this book is in its strategic offering of a range of perspectives and experiences from survivors and allies with multiple, intersecting identities, who attend to issues related to gender, race, disability, and other dimensions of difference present in psychiatry and Mad activism. Some notable examples include: King's examination of the impact of post–colonial forms of institutionalized racism, and the influence of the unconscious performance of ‘whiteness in psychiatry’ on the diagnosis of schizophrenia in African men (p. 69); Bhakta's highlighting of the under–representation of Black survivors in survivor–led organizations, in a discussion of her involvement in Kindred Minds, a project designed to address the concerns of mental health system survivors from ‘Black and minority ethnic’ (BME) communities” (p. 142); and Staddon's presentation a social model of alcohol use in her discussion of Women's Independent Alcohol Support, which acknowledges “alcohol problems principally as gendered social issues with multiple causes” (p. 121).
The contributors’ perspectives also diverged in their stances on central concepts, with some contributors asking challenging questions about the search for alternatives, the role of identity in researching madness, and the desirability of partnership. Davar troubles the very notion of ‘alternatives’ in a discussion of the widespread use of Eastern healing techniques (or faith healing) as a ‘way of life’ in India, and the “erasure of cultural ways of life” that results from our tendency to divide all approaches to madness into ‘psychiatry’ and its ‘alternatives’ (p. 18). Fabris suggests we consider looking “outside the garden” (p. 105), as any promised roses “would be psychiatric” (104), and that “the perfect treatment may not be treatment at all” (p. 98). Penney and Prescott, Roper, and Stastny, raise important questions regarding the possibility of genuine partnerships with allies, pointing to the challenges that survivors face in trying to protect their identities, voices, values and experiences from co–optation.
Recommendation
Searching for a Rose Garden is well written, easy to understand and enjoyable to read. Its accessibility and comprehensive overview of international survivor activism and scholarship, should appeal to a wide–ranging and diverse audience from discerning academics to those without any academic expertise. These may include: university students, researchers, and educators interested in Mad Studies; critical health and social care professionals seeking to become Mad–positive allies, or who are interested in challenging their current understandings and responses to madness and distress; or psychiatric consumers/survivors/ex–patients, and all others, looking to support the collective efforts of the Mad movement. I recommend that Searching for a Rose Garden be integrated into existing Mad Studies, and related, courses; as well as used to help guide, as a handbook or set of examples, newly forming alliances and partnerships in survivor–led research, scholarship and practice.