Many people come to Mad Studies after having endured a difficult relationship with psychiatry. This can come in many forms, often involving an explicit experience of being subjected to violence as one’s liberty is denied, but can continue in more subtle forms, such as a lack of credibility to know oneself. What all these experiences have in common is that they require the utilisation of power to make an individual feel at best uncomfortable, if not retraumatised. Any consideration of Mad Studies therefore needs to begin to conceptualise power, no easy undertaking with debates having been raging for centuries but one we will look to dip into as a starting point for offering a potential guide for wider Mad narratives.
This is because whilst typical conversations tend to see it as something wielded down upon people, it can also be thought of as something that can be built from below in order to challenge unjust ways of currently doing things. This is rarely a simple one-directional process but involves a complex interplaying of different ideas and interests. Service-user involvement for example whilst being on face value a positive development for diversifying perspectives within the mental health system has faced charges of co-opting survivor voices and using them as a form of legitimising tokenism instead of a way of bringing about meaningful change.
A Strategic Model of Power
John Gaventa has used an idea of a ‘power cube’ which considers how power operates on different levels (local, national, global) and in different spaces (closed, invited, claimed/created) and forms (visible, hidden and invisible). This allows for a multidimensional understanding of power, which sees the ways in which it operates, both from above and below, changing depending on the specific context. Consequently we can be encouraged to reflect on how different arenas may pose different possibilities and challenges so we can direct the ways in which we want to most appropriately bring about change.
The ideas of different forms of power are developed from Steven Lukes’ analysis. It encourages us to dig deeper than the visibly apparent facts, for example the powerful can set the agenda and decide who attends, but can also steer discussion and outcomes and on the invisible level shape the ideology of conversation. Ideology is a complex term but impacts on the psychological boundaries of participation, affecting the norms of entering into a space and contributing. It often limits what people are able to bring to a given table. All these forms of power operating together have the effect of deciding on the ultimate perceptions of a social body, both around what is happening and what can be done to change it in the future. This has been conceptualised in relation to the mental health field in regards to medication for example.
This shows the importance of creating and claiming spaces, as they can give people the resources to gain their own ‘power within’. This is defined as creating a sense of self-identity, confidence and agency that can increase resilience and lead to political actions which challenge the powerlessness felt in more contested spaces. Ideally this can also lead to a ‘power with’ in which people can collectively begin to organise to bring about change.