Sanism is everywhere… and it’s hurting people.

In this episode, we unpack the pervasive ideology of sanism. This ideology frames people struggling with mental health issues as "lacking", “abnormal”, or "less than”, ultimately justifying the application of carceral logic within mental health.

We explore what sanism looks like in practice: from everyday language (e.g., the use of "crazy") and media portrayals (like representations of DID, or characters like the Joker) to the pathologizing language used in psychology (such as "psychopathology" and "disorder").

The perpetuation of "normal" ultimately pathologizes anyone who doesn't conform, giving systems the power to isolate these individuals, who are often historically minoritized and marginalized people, and take away agency and choice in the name of “community safety”. This system also often frames vulnerable people with so-called “severe mental health issues” as dangerous, even though they are more likely to be the recipients of violence. We also discuss the historical and current harms perpetuated by the psychiatric system.

Finally, we look at the history of resistance, including the anti-psychiatry movement, the fight for non-carceral, community-based care championed by Basaglia in Italy in the 1970s, and the Mad Pride movement.

References / People / Topics mentioned in the episode:

Chamberlin, J. (1978). On our own: Patient-controlled alternatives to the mental health system. McGraw-Hill.

Disability Deep Dive podcast episode: History of the Mad Movement with Vesper Moore https://disabilityrightsflorida.org/podcast/story/episode_65

Hart, T. (2023). Mad Pride: Spinning hope from fear by Tamara Hart. Asylum Magazine Accessed on May 6th, 2026 at: https://asylummagazine.org/2023/09/mad-pride-spinning-hope-from-fear-by-tamara-hart

Foot J. (2014). Franco Basaglia and the radical psychiatry movement in Italy, 1961-78. Critical and radical social work, 2(2), 235–249. https://doi.org/10.1332/204986014X14002292074708 Accessed on May 6th, 2026 at: https://pmc.ncbi.nlm.nih.gov/articles/PMC4430803/

Ralley, O. J. D. (2012). The rise of anti-psychiatry: A historical review. History of Medicine Online. Accessed on May 6th, 2026 at: https://www.priory.com/history_of_medicine/Anti-Psychiatry.htm

Rashed M. A. (2020). The Identity of Psychiatry and the Challenge of Mad Activism: Rethinking the Clinical Encounter. The Journal of medicine and philosophy, 45(6), 598–622. https://doi.org/10.1093/jmp/jhaa009 Accessed on May 6th at: https://pmc.ncbi.nlm.nih.gov/articles/PMC7703744/

Tawa, K. (2024). Forced ≠ Treatment: Carceral Strategies in Mental Health. Published by the Center for Law and Social Policy. Accessed on May 6th, 2026 at: https://www.clasp.org/wp-content/uploads/2024/03/Final-Forced-Treatment-Report_final.pdf

Resources on Mad Pride &/or non-carceral mental health approaches:

BEAM - Black Emotional and Mental Health Collective: https://beam.community/

Center for Mad Culture: https://www.madculture.org/

Project LETS: https://projectlets.org/

Feedback? Topics you would like me to discuss? Contact me through my website here! Thank you! Don't want to miss a thing? Subscribe to my newsletter here. Grazie!

Transcript

0:01

Hello and welcome to another live episode of Warm Take Wednesdays with Dr Alex Iantaffi. I'm your host Alex Iantaffi. I use pronouns they/them or he/him in English. I'm a licensed marriage and family therapist, certified sex therapist, Somatic Experiencing Practitioner and a Clinical Supervisor as well as Author and Educator. So May is Mental Health Awareness Month. So for the month of May on Wednesdays, I'm going to really focus on topics that are connected with mental health. And I thought that I would start with talking about sanism because sanism is everywhere and it's really hurting people, you know, and often it's not talked about in the context of mental health. kind of focus on other things. But to start with, what actually is sanism? If you have never kind of heard this word, you might be like, what are you even saying, Alex? So let's start from kind of defining our terms, first of all. So sanism is really an ideology, right? So it's a set of ideas that's very ubiquitous, very baked into kind of our educational system, our legislative system, and so on. And it's an ideology that looks at body minds without any mental health issues whatsoever as normative. Now, I have questions about who gets to decide who has no mental health issues whatsoever, but that's a different question. So sanism basically views people with mental health issues as somehow lacking, deficient, or less than folks who do not have those issues. And by doing so, sets people up with severe mental health as being deemed as less worthy in air quotes of autonomy, right? Because if you are considered to be so impaired in terms of your mental health that you cannot make your own decisions, you kind of have a loss of sovereignty and autonomy. And so, sanism can sound like this very kind of almost intellectual concept in the way they have defined it. And it's definitely one aspect of ableism, right? So the ideas, the kind of the baseline is abled bodies. And so any deviation from the norm, you know, is seen as kind of an handicap, a deficiency, a lack of some kind, right? And so this very ubiquitous ideology is really everywhere. it's even in our everyday language. And so let's start from what does it look like when people say you're being sanist or you're making a sanist remark. What are they talking about? And I'm going to go through some examples in everyday language, in the media, and also in my own field of mental health. I'm a therapist as well as somebody who lives with my own mental health issues such as complex PTSD, for example. And so what kind of sanism looks like in everyday language is actually pretty simple. Sometimes it's in the words we use, um words and I should say content uh note. You know, I am gonna kind of use some sanest language to illustrate some of the points I wanna make. And so please take care of yourselves as you listen to this episode. And so in everyday language, for example, it's very common for people to use words like crazy. That's crazy. That's insane. believe what I've heard. And often this word is used to mean out of the ordinary, right? But we're not saying out of the ordinary in a positive way. When we say that's crazy or that person is crazy or... this behavior is crazy, this new legislation is crazy or insane. What we're really saying is that somehow it falls outside of the norm and that it's negative, right? And so that is harmful for a couple of reasons, right? And we'll talk about why those things are harmful a little bit more in more detail in a moment. But just to begin with, first of all, it's not very precise. When I say this is crazy, what am I talking about? Am I saying this is out of the ordinary? This is unacceptable? In a way, it's a shortcut, but it's a shortcut that really um doesn't give us as much... uh so to speak, in our language to be much more precise about the meaning of our words. And we'll say, we'll look at why that is harmful in a moment. And in terms of language, we also kind of hear a lot of this language in the media, right? And so I wanna talk for a moment about media representation around mental health. And media representation around mental health has definitely gotten better in the past. 20 plus years that I've been a therapist, but it's not great, especially when it comes to what are considered as in kind of mainstream mental health world as severe and persistent mental illnesses, such as schizophrenia, dissociative identity disorders, and so on. For example, often in the media, in movies and TV series, people would kind of what would be considered severe mental health issues uh to kind of a mainstream psychological framework are viewed as dangerous, dangerously violent, as a threat to the community, right? And this links to what I was talking about in the everyday language, right? If we start to equate crazy with bad and dangerous, then when somebody is labeled as crazy or mad or insane, they're inherently viewed as dangerous. So for example, in the DC cartoon and movie world, world of like Batman. figures like the Joker, right, or the insane asylum, right? Those are places where people who are a threat to the community are being confined, right? And this idea of sanism kind of goes hand in hand with carceral logic. And again, we'll talk about that in a moment because it is a pretty complex topic. So I've tried to kind of break it down as much as I could. And so in the media, usually there are not very positive or affirming representation of people. struggle with mental health issues. And that is problematic because already there is such little understanding of mental health issues and generally mental health and well-being in kind of dominant culture that it's even more harmful that we don't have kind of many positive examples. And so often we see figures like the Joker or in movies like Split, I think it is, we see a representation of folks who have dissociative identity disorder as kind of dangerous, right? It used to be called multiple personalities, for example, and often it's either represented almost as a figure of fun, like in United States of Tara you know, there were things I liked about that TV series, but things that were definitely incredibly problematic about the series as well, or in many movies really. folks who have dissociative identity disorder again are often viewed as potentially dangerous and life-threatening. Now those things are non-neutral because then when people have their own mental health issues, right, there is an internalization of there must be something wrong with me and I must be bad and dangerous if I have any of those conditions, right, which then of course increases kind of emotional and cognitive distress. And that is now helped by the fact that the field of mental health traditionally is a very pathologizing field. In psychology, we talk about disorders, psychopathology. Most folks who are trained therapists and psychologists have had to take classes in psychopathology. Even the word pathology means sickness, or the word disorder. Those are not positive, affirming words. is just kind of how the language shows up. And of course, those things also have an impact on our self image. Sometimes when we're being judgmental about ourselves, we say things like, I must be crazy, or I must be insane, or there must be something wrong with me to think this way or to behave this way. And so it can also make it challenging for us to identify where is it that we are just moving from a need for survival, for example, in the face of really oppressive systems and we're trying to do our best to survive and when we may be kind of disconnected from reality a little bit more. But again, usually for survival, very often, unless there are, of course, kind of more physiological roots around brain inflammation and so on. And there's so much to say about this topic that In my brain I've already gone on 10 different side quests, but I will try to stay focused for you listeners or people who are watching on YouTube if you're watching on YouTube. And so there are lots of ways in which sanism shows up in kind of our everyday world. Like I said, it can show up in our everyday language when we use words like crazy or insane and so on. It shows up in media representation as representing folks with of severe mental health issues as dangerous and threatening to the community, know, having to be confined and controlled and not be let loose in the community. And within psychology, of course, where we have developed an old taxonomy, an old way to categorize kind of human experiences according to a model of pathology and disorder. And of course, all of that has an impact on also how we might view ourselves if any of the ways we think or behave falls aside of the norm. And like I said, in a moment we'll unpack why this is problematic. Now... Why does this even happen? Right? As I was preparing for this episode, I was really thinking about why as humans we are very much attached to this idea of madness as being outside of the norm of the everyday. Madness is something that's explored in poetry, in plays, uh you know, and it has been explored in poetry and plays for hundreds and hundreds of years, right? So the concept of madness is not necessarily new, but often traditionally has been more kind of the concern of art or philosophy. But at some point it became the concern of medicine. And we'll talk a little bit more about psychiatry and the anti-psychiatric movement as well in a moment. And so I was asking myself, why is it as humans we are so attached in a way to this idea of madness or insanity, right? And in a way, in a world that can feel uh so out of our control, right, where there so many variables that are not in our control, this myth of normality, the myth that there is such a thing as normality, and normal, in air quotes, human being, can be kind of soothing. It can be reassuring, right? It can give us a sense of safety. containing and it can feel kind of emotionally regulating almost and so it makes sense that as humans we kind of get a little bit attached to this idea of normal but normality is the myth right because who first of all who gets to decide what is normal and what is not right for example if somebody believes in a higher power outside of themselves and they pray to this higher power Is that normal or not normal? Who decides that? If somebody is from a culture that is different from ours and doesn't use uh as much like please or thank you or is much more direct or acts in a different way, who decides whether that is normal or not, right? When we start to talk about normal, What we're really saying is that there is a baseline that we've all agreed is the norm. But who gets to decide that baseline? And that is incredibly problematic because in psychology and in psychiatry, that baseline traditionally in modern culture has really been set by kind of mostly cis, white, straight men. And so it's deeply impacted by systems like... patriarchy, systems like race that were really constructed to kind of other and control people and justify oppression and violence such as slavery and genocide and colonialism. And so when we start to unpack this idea of normality, hopefully we can start to understand how problematic it is to even think that any one person or any group of people can reach consensus out of context about what is considered to be normal. And yet this myth of normal continues because like I said it can help us feel some sense of agency and uh rule and order which is something that we can aspire to sometime especially if we're experiencing a lot of distress. However, when we kind of perpetuate this idea, this myth of normality, which by definition, as to include uh an idea of madness, of insanity, something that is outside of normal, right? That is deviant from normal. We're also really reinforcing a lot of harm. And often the harm lands on historically minoritized and marginalized folks, right? Often the people who are defined or seen as being, deviating from the norm are folks who do not fall. um kind of under categories that within dominant culture have been considered as normative categories. So for example, at the beginning of the Third Reich, there was a lot of targeting of disabled people, trans and queer people, as well as Jewish people. And the targeting of trans and queer people and disabled people was very much rooted in the myth of normality, in this idea that there is such a thing uh as the norm, right? and norm, anything that falls outside of that in terms of the way we think or the way we act and behave, then it is crazy, in air quotes, or insane. And psychology and psychiatry are disciplines that are really built on this myth of normal and that often pathologize very human experiences and responses. So for example, even experiences like grief, grieving, somebody. um have been pathologized but being given a deadline, right? If people are still grieving after three months and there are other criteria in the DSM, the Diagnostic Statistical Manual, that many therapists, psychologists, and psychiatrists use to categorize um pathology, again, in our quotes, and disorders in our quotes, right? um If anybody falls in those criteria, their grief is seen as uh abnormal, outside of the norm. right? Kind of closer outside of the norm and therefore closer to kind of madness, insanity, disorder, lacking, deficiency, whatever language we want to use. And yet in most culture there is an understanding that when we're grieving of course we are going to be outside of the norm. Having somebody close to us die for example is something that is going to be emotionally upsetting and dysregulating and destabilizing. And that is actually a very human response. For example, I was brought up in Italy and especially in southern Italy, you would wear black to indicate that you were grieving. And that wearing black is not just about mourning, but it's also signaling to the community that at this point in time, you're in a cognitive and emotional state. that is outside of the norm because you are grieving and therefore you need a level of community care that is different than if you weren't grieving, right? And so in a way, under colonialism and white supremacy, we have lost so many rituals to hold ourselves and one another during moments and states of distress and instead we have ended up with this very medical taxonomy that categorizes many of our thought patterns, emotional responses, and behaviors, including relational behaviors, has kind of disordered in some ways. And so, you know, this myth of normal really is foundational to the idea of like psychology, psychiatry, and mental health. Paradoxically, this idea that some very human experiences, responses, behaviors, ways of thinking are abnormal, in air quotes, outside the norm, kind of uh impact our mental health negatively, I would say, right? Because often it means that we are measuring ourselves in ways that may or may not be congruent um with what we are experiencing. What do I mean by that? For example, if we are, you know, disabled in some ways and we cannot be as productive under capitalism as the world expects us to be, we might feel kind of that we have less worth, we might feel more depressed because our experience is being categorized as being outside of the norm and as such being somehow lacking, inferior or deficient to the experience that abled folks are having, right? And when we bring that to the field of mental health, right? If we're experiencing uh hearing voices uh in our own mind or kind of even voices around us, that is usually categorized as abnormal outside of the norm and yet... many spiritual traditions, many cultural traditions have a history of being able to hear the voices of the ancestor or voices of spirit or being able to talk to plants and trees and animals. But under kind of colonial-wide supremacist frameworks, all those things are seen as, in air quotes, crazy, mad, insane, and abnormal, right? And so if we're adding some of those experiences, rather than becoming curious about those experiences, we might shut down in shame and we might really start to look at ourselves as somehow less human, less worthy, more deficient than other people who do not have those experiences. And this is important because increasingly even Western kind of... em modernist science, so to speak, has actually shown how as a human species, we are neurodiverse. And so we are going to be experiencing the world in a range of ways. And one of those ways might be to not have an individual sense of self, but rather to hold a plural sense of self within ourselves. And if that's our experience, of course we're going to hear some voices, right? Again, having, or if we come from a kind of spiritual tradition where we do hear the voices of spirit or our ancestors, right, but that spiritual context has been erased or oppressed or forbidden by kind of dominant powers. then we might feel really disconnected from the lineage and not have the guidance that we need to, for example, kind of set boundaries or function while we are kind of hearing those voices. And so in a way, of that uh pathologizing, that categorizing according to those pathological categories also shuts down curiosity, inquiry, and really makes self-compassion so much harder for a lot of folks to achieve. experience falls outside of what is considered the norm, which again, like we said, the norm only applies to a small number of people who have enough power to decide what is the norm to begin with, right? And in a way, it also disconnects us from ourselves and from trusting our own experience, right? Because if I feel like I'm having a moment where I can really connect to a tree, you know, or another greenblatt, like a plant or an animal, I might start thinking to myself, am I mad, am I crazy, am I really having this experience? So in a way, it also undermines kind of the trust that we might have in the concrete. um rootedness of our experience and paradoxically increase mental distress. This is supposed to help us with our mental health according to Western traditional standards uh set by psychiatry and psychology, but paradoxically I think it harms our mental health more than it helps more often than not. And historically, the folks who have been mostly harmed by the psychiatric and psychology systems particularly are folks who are historically marginalized and minoritized, such as minoritized genders. usually women, trans folks, non-binary folks, gender expansive folks, disparate, Indigiqueer folks, um and also folks of the global majority, folks of color, immigrant folks, uh and so on, right? And we see that that's been represented in some books and some movies and the way that those folks have been harmed has been by experiencing carceral logic, being confined, being pathologized, and also often being treated medically in ways that had no foundation in actual uh evidence, but... there were just theories that people were trying out and therefore even kind of... damaging physiologically some of those folks. And honestly, historically, folks who were put in uh psychiatric institution were unwed gestational parent, for example. If a teenager or a young person would get pregnant and they were married, especially if they were very sexually active or if they were viewed as being, in quotes, sexually promiscuous, having multiple sexual partners, and that was something that is kind of condemned in the culture, they might end up in a psychiatric institution. Often people who had undiagnosed neurodivergences, right? We know a lot more about neurodivergence now, but even up to a decade ago, we couldn't even... uh Diagnosed autism and ADHD at the same time. We believed there was one or the other now We know that it's not one or the other right? Kind of the way we understand our body minds has grown so much but so a lot of kind of undiagnosed neurodivergent people would end up in psychiatric institution a lot of people would rebel to kind of the norms Dictated by dominant culture which included like trans folks as well or sometimes immigrant folks who maybe had spiritual and religious traditions that were not really well understood by mainstream psychology and psychiatry would end up uh in kind of psychiatric institutions. And of course, trans and queer people too, because that was seen as a form of madness in air quotes and abnormality. uh I remember one of my friends as a teenager kind of disappearing in a psychiatric institution just because they were queer. uh neighbor going into a psychiatric institution, this was before the legge basaglia in Italy, which I'll talk about in a moment, was uh passed, the law 180, uh going into a psychiatric institution, into impatient and coming back and really looking like a shadow of themselves, right? While I can have empathy for the family, they really struggled and that was really the only thing that doctors would do in the 70s. uh I remember the heartbreak of seeing this young person come back and pretty much being like a zombie, not talking very much, not having very much affect. You know, and now as an adult, because I was a child at that time, I understand that they were likely subjected to various forms of cure in air quotes that probably caused some significant level of brain damage at the time. And so people, know, I'm not talking about those things because on a theoretical level only, I care about those ideas, ideas like sanism because people have actively been harmed by the psychiatric system. And like I said, the people who have been historically harmed by this categorization of pathology by the psychiatric system are generally folks who are minoritized and marginalized within dominant culture. Because in a way the psychiatric system works very much through control and containment and confinement, right? And when we do that, we can perpetuate this myth of normality because we constrain and contain and isolate anybody who falls outside of the norm according to the system. Right. And this is one of the reason why Franco Basaglia was a psychiatrist in Italy in the kind 60s and 70s fought so hard for the end of kind of psychiatric hospital, especially psychiatric hospitals were completely outside of other hospitals. Right. The psychiatric institutions used to be completely separate. And so the law 180, which is often referred to as the Legge Basaglia in Italy that was passed in 1978, if memory serves, and if I'm wrong, please forgive me, uh really posited that it was healthier for folks to be part of the community and to receive mental health care within the community rather than have them kind of isolated, overly medicated, and cut off from relationship and from community. Basically, Franco Basaglia was really advocating for what nowadays I think we would call a non-carceral approach to care. And what happened in Italy was also kind of foundational for the creation of community mental health, some of the ways in which our National Health Service works. And it was so revolutionary at the time that it was studied by other countries such as France. The British also studied it, but they didn't like it very much. And I'm not saying that there weren't challenges, of course. Of course there were challenges. because we didn't have the level of community care that was really needed and training and understanding and support that was really needed to support um this really beautiful kind of dream of not isolating and cutting off folks who were kind of labeled as mentally ill, again in air quotes, by kind of normative powers. And so traditionally this idea of madness from a psychiatric perspective, the psychological perspective, has really been used also to pathologize difference. And pathologizing difference, of course, is very harmful, right? Because if you have an identity or a behavior that is not well understood by people around you, it can be very easy to then see yourself and be labeled by others as somehow, you know, in air quotes again, defective, wrong, as having something wrong with you and having to be controlled. And in fact sometimes people... who are categorized as having severe and persistent mental health issues, such as folks who live with schizophrenia or folks who live with dissociative identity disorders, even even view themselves as dangerous, even though they've never engaged in actual harmful or dangerous behaviors. And in a way, the psychiatric system, you know, traditionally and still through things like mandated reporting and so on, really reinforces compliance with the dominant systems of power. And I think we're seeing this in actual time in the so-called United States right now, where certain diagnosis or certain identities are being viewed as outside of the norm and therefore being pathologized, confined, controlled, demonized as well through a of a sensationalist media reporting and so on and so forth. so, you know, the anti-psychiatry movement, which we'll talk about a little bit more in a moment, which Basaglia was definitely part of, was also a pushback against the control of the diversity of our human experience, right? And the reality is that while kind of the media and dominant culture depicts folks with mental health issues as dangerous to the community, the reality is that folks who live with mental health issues are vulnerable and they're much more likely to be abused within their family, within their system, including within the medical industrial complex, including within kind of psychiatric care, right? And so there is this paradox where labeling folks um were viewed as having some level of pathology, again in our quote, or being labeled as outside of normality, being labeled as as mad, insane, crazy, as dangerous when the reality is that they're much more likely to be on the receiving end of violence, whether that's abuse within the family, within the educational system, or even within the psychiatric system in itself. And we see this again on a day-to-day level when there are things like mass shootings, for example, in what is colonially known as the United States, often the first thing that we go to in the media and social media or in the mainstream media is looking at somebody's mental health and yet we don't seem to look at the fact that statistically most mass shooters are cis white men for example overwhelming overwhelmingly so and we don't start asking ourselves systemic questions such as what is it that we're doing as a society that is so alienated to cis white young men that the only way that they can express themselves is through mass shooting, right? Instead, we fall back on this idea of we must have more mental health uh care available. Now don't get me wrong, I think we do need to have more mental health care available for all of us, but the reality is that those kind of extreme moments, such as mass shooting, are not a result of a lack of mental health care, but rather they're the product of a uh dominant system of power, privilege and oppression that is really kind of creating the conditions for this to happen. And as long as we put this on an individual level as like this is a mental health issue, this is an individual mental health issue, that kind of excuses us from looking at the systemic commonalities. Like I said, we're not really looking at the fact that how is the patriarchy, how is white supremacy kind of creating the condition for those things to occur. So when we perpetuate this idea of normal, ultimately, we run the risk of pathologizing anyone who doesn't fall in line with the dominant system, whatever the dominant system is, right? And the way we perpetuate that idea of normal is by the system having the power to isolate people, confine them, take away agency, choice, and even destroying parts of their body minds, like I was describing with the example that I've witnessed of my neighbor when I was growing up as a child. Now, this is not the only way to look at mental health though. So just like there is sanism, which is so ubiquitous in kind of our day to day, there's also Mad Pride. And Mad Pride is really a survivor led movement. And it starts kind of officially in the early 90s uh in Toronto, Canada, as well as in London in the United Kingdom. And then it's kind of spread out globally, but it has much older roots. and it does have some roots also connected with the antipsychiatric movement and folks like Franco Basaglia and our delaying and other folks. so, Mad Pride is really this idea of kind of uh reclaiming this idea of madness. And so sometimes survivors uh of the psychiatric system, so people who maybe had been hospitalized against their will uh or have kind of experienced harm through the mental health and the psychiatric system in particular, reclaim words like mad, crazy, insane as a way of reclaiming power and agency, just like queer folks and trans folks have done that with words that were created to kind of slurs and to harm us and they were used to harm us and then kind of we reclaim them in a similar way. Those of us who are kind of survivors of psychiatric systems or mental how systems have sometimes reclaimed words like mad, insane, crazy, and so on, um really as a way to take back our power. And like I said, the Mad Pride movement, you know, starts in the early 90s. I believe the first official kind of survivor pride march, Mad Pride March was 93. But again, please fact-check me if that is not correct. But it has a much longer history. For example, the book on our own patient controlled alternatives to the mental health system by Judy Chamberlain was published in 1978. And the seventies were really a alive moment for the antipsychiatric movement. And even though the antipsychiatric movement starts in the early 1900s, uh really the kind of the sixties and the seventies is when we see a lot of different movement, they're pushing back against oppressive systems, right? In the 60s and 70s, we're seeing the sexual liberation movement, the gay pride movement, and the anti-psychiatric movement is also kind of uh really gaining momentum, even though it had already existed for a few decades. It's really gaining momentum and we see things like the Legge Basaglia being passed in Italy and so on and so forth. And Lange, for example, was part of the also of the anti-psychiatric movement, stated that Psychiatry was founded on a false epistemology, a false way of looking at science, right? Because illness, so to speak, again, was diagnosed according to how somebody was behaving, but then was treated biologically, right? There was no biological testing, right? Psychiatrists were looking at behavior, and then they were diagnosing that illness for behavior, but then often they were treating it biologically through things like... you know, electric shock or insulin therapy and so on and so forth. so Lang posited that this, you know, the whole field of psychiatry was really perpetuating this kind of epistemological error in some ways, right? And I've already talked about how low 180 in Italy... usually familiarly known as the Legge Basaglia abolish psychiatric hospitals altogether in favor of shifting to community mental health center and really the foundation of kind of community mental health care kind of nationally and really influence things internationally. I think that nowadays we're in an interesting moment because MedPride uh is very alive still, but interestingly is usually not taught in grad school for folks who are training to become psychologists or MDs who are training to be psychiatrists or people who are training to be counselors and psychotherapists. I've been really surprised to notice here in the colonially known United States how many people are kind of mental health providers have no idea what MedPride is, for example, right? And so the movement is very alive, but seems to be very separate from providers. And yet paradoxically, many providers are also consumers of mental health services. And what's interesting is that currently we're seeing a resurgence in the interests of things like... um psychoactive medication assisted therapy, so things like ketamine therapy, cyborgine, you know, so the use of drugs that enable us to reach altered state of consciousness, something that some of the folks in the antipsychiatric movements were also really advocating for in the 60s and 70s. And now we're seeing that really gain some traction. And uh I'm saying that it's ironic in the context of talking about sanism because often folks who are labeled as crazy, in air quote, or insane or abnormal, again, all in air quote, are actually experiencing those altered states of consciousness that we are advocating to induce through psychoactive medication and or plans, right? And outside of a spiritual tradition. And so that really reinforces this idea that what is considered normal, again, or acceptable, in air quotes, really is connected to who holds power within dominant culture. And you know, because for example, being able to access alter states of consciousness for healing is something that has been alive in many indigenous traditions for a very long time. And yet now is being taken and put into this kind of medical industrial complex setting where It's taken out of a cultural and spiritual context and put into this context of pathology where we are advocating for inducing states that some people are already experiencing just through having access to their own body mind. And there is all other conversations to be had here as well around cultural appropriation within psychology and psychiatry as well as classism, poverty, and all of that, but we maybe will do that for another episode, even that all of May is Mental Health Awareness Month. In conclusion, because I could talk about this for a long time and you might not want to listen to me talk about this for a long time, what can we do if by this point you're like, oh, sanism really is not a good thing and it is very pervasive in our culture and I want to do something different? Well, first of all, I really encourage you to learn more about MedPride and I'll put some links in the episode description so that if you want to look for more resources connected to this, you can. But we could also do things in the day-to-day. So, for example, we can shift our language. Now, is shifting our language enough? Absolutely not. But it is a start. So for example, I've been really working on challenging myself for years now to uh reduce and ideally eliminate ableist and saneist language from my vocabulary. And I'm starting with reducing because sometimes I don't even know the roots of certain words. But we can do very simple things like when we feel like saying like, this is crazy or that's crazy. What are we really meaning? Are we meaning That is wild. I never expected that. Wow, that is not something I expected. That is, that feels really oppressive or upsetting, right? So we do need to get a little more specific in our language, not to use kind of those shortcuts, which are really harmful and reinforce this kind of idea of sanism. And like I said, know, shifting our language, it's not the be all and end all, but it's a start. And I think that as we start shifting our language, hopefully we start shifting the way we think about ourselves and one another and we can start to become gently curious. What do I mean by that? If we are... hearing a voice within ourselves, so we have somebody in our life who hears voices. Rather than maybe uh panic, we can start getting curious and be like, what is this voice inside of me? Or tell me more about your experience of hearing voices, right? because those experiences are non-neutral. Again, another topic that could take another 45 minutes. And so we can really start to question this whole myth of normality by asking ourselves, who decided what is normal and what is not? Who decided why we see certain things as being pathological, again, in air quotes, from a mental health perspective, and some things as not? And really, you might find as you do this, you realize that a of what falls under the category of pathology or psychological abnormality is often really a survival response to oppressive systems or impossible situations right? as well as other factors, of course. You I don't want to be overly simplistic, but I think that shifting our language is really helpful and hopefully that brings kind of a change in the way we think. And as we change our language and as we change the way we think, hopefully, ultimately, we can also change systems. you know, system change is not uh a utopia, right? Like Basaglia had a beautiful dream with the law 180 and there's also issues, right? Both ends. But I'm still very glad that in Italy, Basaglia really campaigned so fervently for the closure of psychiatric hospitals because I've seen firsthand when I was very young the harm that that was doing to people. And also, like I said, how that is weaponized against folks who are historically minoritized and marginalized, such as immigrant folks, trans and queer folks, disabled folks, so on, neurodivergent folks, and so on, right? And so ultimately, we want that system change. But let's start from kind of the everyday language, let's start from the way we think and also let's start by educating ourselves about you know the survivors movement and the MedPride movement, especially for those of us who are therapists, counselors, psychiatrists, work in the mental health field. I would love for you to kind of if you never heard about MedPride really do some research about MedPride, like I said, I'll put some links in the episode description. There are some wonderful kind of organizations as well, uh where you can really learn directly from survivors of psychiatric harm. So I hope this episode was useful or gave you something to kind of chew on and think about. Please let me know if there are other topics you would like me to cover in the future. Like I said for the month of May, I will likely really look at mental health, given that it's mental health awareness month and that I am a licensed therapist myself. And until we meet again, please take care of yourselves and each other. Ciao, e alla prossima.