Establishing first-person knowledge of madness: Must This Undertaking Elide our Differences?

It is encouraging that, in their commentaries, Sarah Carr (2016) and Timothy Kelly (2016) do not bring the discussion back to the conventional treatment of personal narratives in psychiatry and mental health, but rather take the ideas presented in my paper forward. We seem to agree about the need to disrupt the ultimate interpretative authority of the researcher. This is the point from which both commentaries depart, taking off in their own directions through the thorny questions of how—and indeed whether—any of this can be achieved. This sense that we share at least a point of departure complicates the task of writing a reply, because I would much prefer to engage in a conversation about some of the key issues that these two authors raise. My thoughts expressed here are therefore not meant as any kind of final response, but rather as an invitation to continue and expand the debate beyond this special journal issue.

In trying to prioritize the questions that these commentaries open up, I have come up with three topics that I would like to focus on: The use of personal narratives as resources, intersectional analysis versus the pursuit of a unifying narrative, and the role of second-person (you) address in responding to madness.

Personal Narratives as Resources

It was never my intention to say that published personal narratives of madness should not be at everyone’s disposal as powerful resources to “think with” (Frank, 2010, p. 47) or that these texts’ reception and consumption—basically their life—should be limited or controlled in any way. What Kelly accurately identifies as my “insistence that survivor narratives be analyzed only together with a survivor who ‘owns’ the narrative” (2016, p. 231, original emphasis) refers strictly to the use of personal narratives in psychiatric and mental health research. My paper focuses on the further processing of our stories as part of the official production of knowledge about madness within a field that may be seen as a competitive academic enterprise. I fully agree with Kelly that “public narratives become resources and do work beyond describing a single person’s experience” (p. 231). However, despite their value and their vast number, diversity, and availability, first-person perspectives are still far from being resources that inform the dominant understanding of madness and resulting policies. My certainly overemphasized call to engage with the owners of these stories and with their understanding of their experiences speaks to the typical absence of this kind of engagement in the discipline of psychiatry, both in its practice and in its underlying ‘science.’ Many survivors have powerfully described the meaning and possibilities opened up by telling their own stories:

There’s magic in words, and instead of allowing people who haven’t had these experiences to form the language around it, discussing it with other people who’ve dealt with these emotions has allowed us to claim ownership of the ways of living our lives and moving with them.

(Shive, 2008, p. 182)

Our stories are already doing their work in a multitude of ways, including their primary job of “making the earth habitable” (Frank, 2010, p. 46). But if our truths are ever to become part of the shared knowledge base about madness in the societies in which we live, then we first need to figure out the ways that this may happen. Research is one of these ways, but its many failures and injustices, including those of narrative analysis, give rise to legitimate concerns and skepticism.

Intersectional Analysis Versus a Unifying Narrative

Central to both commentaries is a discussion of the opposition between intersectional analysis and a unifying survivor narrative. Although they pursue this question to different ends, both authors remind us of the dangers of imposing a unifying narrative and urge that we recognize ‘heterogeneities of experience’: “Can we be confident that in creating a ‘community’, we do not exclude, essentialize and homogenize, as Hill Collins warns (2000)?” (Carr, 2016, p. 235).

How do we develop situated knowledge as an analytic in our methods...