Dr. Sue E. Estroff: Subject/Subjectivities in Dispute

Subject/Subjectivities in Dispute: The Poetics, Politics, and Performance of First-Person Narratives of People with Schizophrenia

I've had my brain and what it has produced, admired in the past, then questioned before being invalidated, and ticked off as being the diseased organ of a "schizophrenic". It has been messed up with drugs and electroshocks, so called "treatments" in which I had no say. It has suffered much that was unnecessary. Mainly, I've had to struggle alone with it in order to explore and conquer the inner and outer dimensions of my reality.

Tomecek, in Susko, 1991

I have spent years of my life existing as a footnote, a case note, a clinical note, clinging to the understanding that I was a defective biological unit. Somehow time, matter, and the joke of genes and enzymes had exiled me to the sidelines of being. This may truly be a valuable perspective for those who observe mental illness, but for me, as subject, this tree bore only a dry and tasteless fruit.

- I have a chemical imbalance; it wasn't really me who did those things.
- I have a chemical imbalance; I really didn't feel those things.
- I have a chemical imbalance; I didn't really experience those things.
- I have a chemical imbalance: I didn't really think those things.
- I am a chemical and I don't really think.

Here is an insight! The entire human drama of love, suffering, ecstacy and joy, just chemistry.

Granger, 1994

In these excerpts, Granger and Tomecek, two very different people with schizophrenia, convey a less felicitous view of the "Decade of the Brain" than the neuropsychiatric research community and advocates such as the National Alliance for the Mentally Ill (NAMI) who laud the vocabulary and progress of this brain-besotted era. Tomecek juxtaposes his lonely struggle, lack of autonomy and agency, and sense of damage via treatment with brain-based language. He is invalidated as a diseased organ, referring to his brain as "it". Granger, who had his first experience with schizophrenia during his first (and last) year of medical school at Harvard, is similarily unrepresented by his identity as a defective biological unit -- a dry and tasteless fruit. He mocks the reduction of subjective experiences to chemisty.

These excerpts are but two of many written and spoken statements by consumer/survivor/ex-patients that work the same territory -- sometimes mocking, angry or despairing of the absence of themselves as recognizable subjects in the current neuropsychiatric renaissance. These narrations epitomize the competing dualities that make up what I abbreviate as the subject/subjectivity problem in schizophrenia.

First, there are disagreements about the subject-as-person. C/s/x experience themselves as diseased brains and essentialized into chemicals rather than acknowledged as the perhaps enigmatic, but nonetheless sentient, persons they know themselves to be.

Second, there is disagreement about the subject-as-topic. That is, c/s/x may hold entirely different views of what schizophrenia is than many who diagnose, treat, and study them and thus, are also at odds about what, if anything, afflicts them and what should be done in response.

There is then, disagreement about the subject (as topic) at hand, schizophrenia and the subject (as person) -- whether one has it and who defines what it is.

The lack of common ground and understandings, of intersubjectivity, extends to the subject (the person and schizophrenia) and their subjectivities -- their experience with and understandings of schizophrenia and its treatment.

Scientific formulations of schizophrenia do not account for, indeed, often exclude the illness experiences of people so diagnosed. C/s/x narratives of schizophrenia protest this absence, representing experimental scenarios that cannot be accomodated by the prevailing paradigms of clinicians and researchers. What is at stake here is authority and authenticity concerning identity, definition, meaning, and experience in schizophrenia -- and ultimately what happens to and about people with schizophrenia.

Source: Schizophrenia, Culture, and Subjectivity

See also: The Far Side of Madness

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Schizophrenia, Psychosis, Recovery, The Recovery Based Model, Hope for Schizophrenia Sufferers