Whose voice? Whose choice? Whose power?

Coercion in psychiatry stems from the historic inequality between the psychiatrist and the person who is designated as the "patient," even though he/she may not have chosen this role, and may not see him/herself as needing psychiatric attention. The psychiatrist has the power to define an individual as mentally ill, and then to confine and treat the person based on that definition. The user/survivor movement sprang from the desire of those coerced by psychiatry to escape the patient role, and to redefine their experiences in ways that are personally meaningful. Psychiatry's medical model explanation of the users' experiences is often an obstacle to such understanding. The user/survivor analysis of the power relationship brings into question everything about how psychiatry is conceptualized and practiced. In this presentation, the voice will be those of the users, and a historical approach will highlight the analogies between psychiatry and other forms of oppression, particularly those that claim to be "for their own good." Only when the users have equal rights, and can choose or reject psychiatric involvement in their lives, can psychiatry become an honest and ethical enterprise.