What does “authentic” representation mean for psychosis and psychotic disorders in fiction?

Photo by Matthew Henry

Often when analyzing narratives about mental illness, we get caught up in checking off boxes to ensure whether it is a “bad” representation — one that “demonizes” or one that “romanticizes” mental illness, while rarely questioning what constitutes those categories.

Much of the debate seems to center around the sentiment that mental illness should be normalized, but not normalized enough that it’s not considered an illness anymore. While critiquing the seemingly antipsychiatry stance of the show Maniac (which admittedly, I haven’t seen), Katie Dobbs said, “I began to wonder if the show’s creators actually believe in schizophrenia.” This criticism, which comes across as a criticism of the show not taking mental distress seriously, is curious considering that some people diagnosed with schizophrenia are also critical of the label, specifically members of the c/s/x movement, as well as some mental health professionals. Dobb’s review seemed to go back-and-forth between acknowledging the flaws within psychiatry, while also upholding psychiatric assumptions as the only acceptable way of portraying distress.

I’m not interested in pressuring people with psychotic disorders to out themselves; I’m interested in challenging the assumption that we are not worthy of our own stories to begin with.

Some authors will consult “sensitivity readers” regarding books about mental illness. While I obviously think hiring consultants (the bare minimum, in my opinion) is important, it still comes with a host of limitations and potential problems. I can’t help thinking of tokenism when I consider a publisher or author hiring one person from a marginalized group to vet their story for offensive material and authenticity. As I previously mentioned, there is a danger in attempting to use one blueprint for what is good or bad, authentic or contrived, even amongst people who share a lived experience or diagnosis. A multiply-marginalized psychiatric survivor who has had the “schizophrenic” label weaponized against them is going to have a different perspective than an avid supporter of psychiatry who claims it saved their life; someone who hears friendly and comforting voices is going to have a different perspective than someone who has only experienced distressing voices.



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Mel Mallory

Mad, disabled, and chronically ill writer interested in radical perspectives on psychosis.