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Coming to Terms with Madness, Illness, and disabilities of mind: Margaret Price, “Defining Mental Disability”

In this article, Margaret Price examines a range of different terms that are used to refer to “mental disability.” Her aim is to examine the different context in which each of the terms is used, examining the social and cultural function of each of the following: madness, consumer/survivor/ex-patient, mentally ill, neurodiverse, mental disability, and psychosocial disability. Price sees the business of examining names in this way to be integral to disability studies politics, as the names might often signify of inequality or oppression or alternately fuel coalition building and activism. Names teach us a great deal about the culture of our “here and now,” as much as they have potential to direct the future.

“Mad” offers the same kind of blanket appeal as “queer,” taking in huge diversity but also providing a coalition-building power, as in MindFreedom International and the Mad Pride movement. Emerging from this movement have come terms like “psychiatric system survivor” and other iterations that identify a person as a current or former recipiant of psychiatric medical “care.” Here people identify that they now or once held a patient role, and it is from this postition that they often argue agaisnt the oppressive treatment of the medical establishment.

The medical industrial complex (including doctors and insurance providors) use a definition of “mental illness” to conceive of madness, wherein individuals are seen as mentally unwell and in need of treatment to return them to a state of “mental health.”The mental illness paragigm is especially powerful because the mad person must comply with their diagnosis and submit to prescribed “care,” “which may include medication, incarceration, or electroscock.” One faction of doctors and activists, the postpsychiatry movement, have rejected this paradigm as inherently oppressive and argued instead argued for establishing a psychiatric care system that would serve the desires of c/s/x folks as well.

Mental illnesses don’t seem to fit within the paradigm of disability, since under this definition they are temporary and potentially curable. For instance, it seems as if the interests of c/s/x people and those in the neurodiversity movement may be incompatible. Price draws on the work of Cyntia Lewiecki-Wilson to offer the term “mental disability” to unite these disparte groups under one theoretical frame: as disabilities perceived to reside in the mind, these conditions, she believes, share a similar rhetorical disenfranchisement. Those believed to be mad or autistic or otherwise mentally impaired are disempowered as rhetors.

Price offers a final term that may be especially useful to my own discussions of cognitive difference in higher education. She argues that these disabilities are not “invisible” in the traditional sense, but instead “apparitional,” in that they appear through behavior and in specific circumstanses. This is essentially what I was trying to get at in my last post on stigma of mental illness in universities. She calls these conditions “psychosocial disabilities,” mental disabilities that emerge in relation to particular social conditions. It acknowledges that the experience of mental difference is embodied, but that it’s also rendered as disability not through inevitability but through social convention. While Price finds this last term most theoretically useful, she acknowledges that it is too theoretically complex for much coalition building. In the end, she settles on mental disability as the most practical and powerful term available for conceptualizing mental difference.

* * *

Price’s work continues to prove important to my thinking. The concept of mental disability may work well for helping me define academic disability, which is essentially a specific iteration of psychosocial disability. I’m aware that definitional distinctions like these work at an untennible level of abstraction without some kind of real-world applicability. What good is it, really, to fuss around with terms like this? Price claims that the terms we use have impacts on the power dynamics that end up surrounding the labled person. So, if the terms we accept are “mental illness” and the like, it–what? causes?–requires that those so labled accept their role as patient and submit to normalization under the guise of cure. Or, if we use terms like “mental disability” we are more prone to see these conditions for their social and cultural components, motivating those so labled to seek coalition with other disabled people.

I’m not sure I fully comprehend the relationship between terminology and change. That is, I’m curious about the connection between the discourse Price identifies and the contexts in which she sets it. She shows how the language we use to define mental disability often matches the social structure in which it has meaning, but I wonder if she’s saying there’s causality. That is, does using the term “mental illness” really perpetuate the system of psychiatric discrimination? Is the problem discursive, and thus best addressed through a discursive critique?

To be clear, Price states early on that she’s not trying to advocate one term over another. She only claims that the terms we use right now show us something about the social contexts in which they exist. That they explain, in some way, the workings of the psychiatric establishment or the mad power movement or disability activism. Still, I find the connection between the discourse and the social context as it’s actually experienced to be difficult to untangle.

Price spends a great deal of this essay modeling her own idea development process as she moved from one term to another; it’s pretty hard not to read her progression of terms as a development toward the most empowering and politically effective term. There’s a politics of activism behind this search, and experiences of activism and coalition building throughout the rhetoric of personal narrative used in this piece. ¬†Indeed, this is one of the most admirable things about the piece, which I now realize I omitted completely from my summary. Price employs her personal experiences to walk us from her history of medical treatment, to seeing herself as a survivor as a possible participant in the s/c/x movement, to a moment of claiming disability at the end. It tracks her own journey for definition.

I was leading toward this method myself in my paper on learning disabilities I have been working on for Joe. This article might provide a useful model, since my work was trying to lead up to a definition of terms in this same way. I could explore how my own self definition of dyslexia, LD, and academic disability have evolved, and consider some of the contextual implications of each.

*** Up next¬†from the Disability Studies Reader: Liat Ben-Moshe, “‘The Institution Yet to Come’: Analyzing Incarceration Through a Disability Lens”

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