Nicole Luongo

The Becoming is a brutal account of mental illness by a woman who doesn’t believe in mental illness. A lifetime of addiction, eating disorders, and trauma culminates explosively after the author begins a PhD at the University of Oxford, and while in hospital she is liberated through psychosis. Her journey from terror to self-acceptance is grueling, and she makes meaning of it by weaving reflexive narrative with classic and nascent scholarship. Part phenomenological recounting, part social critique, the text disrupts bio-medical approaches to altered states by exploring their emancipatory potential. It also illuminates how conventional mental health treatment pathologizes human suffering. In doing so, The Becoming contributes to anti-psychiatry and Mad studies projects, each of which asks, “what does it mean to be sane?” 

Excerpts from The Becoming, forthcoming via Inanna Publications in 2021.

THREE

ONE

I have flashes from my first night at The Priory. I remember screaming (and screaming and screaming) as the alcohol left my system, begging for diazepam, quetiapine, anything that would reduce the pain and knock me out. I remember screaming (and screaming and screaming) when I was denied. I was completely bed-ridden, and was too weak and sick to walk, let alone communicate. Every few minutes I was breathalyzed, and I was told by a Doctor that my blood alcohol level was excessive – that to take benzodiazepines while still so drunk would kill me. I no longer felt drunk (I was no longer obliterated, anyway), and at that point, death would have been welcome. 

I didn’t know it at the time, but The Priory has what is called an observation schedule. Each patient is categorized by level of perceived risk upon arrival. Those of us who are skeletal, who need to be carried to the door, and who reek of blood, vomit and urine, are watched twenty-four hours a day. That night, I could not process this. I was unable to understand why there was a large woman seated at the foot of my bed, nor could I make sense of why she refused to leave even as I screamed (and screamed and screamed) for her to fuck off. I could have had a withdrawal “fit,” as the Brits call them, and I was being watched, I eventually realized, in case I began to seize. I also learned – again, eventually – that the observation schedule has many functions.     

Another memory from that night is of trying to eat. I have no idea how long it had been since I had done so, and I see in hindsight that concerns about food had been superseded by alcoholism. Never before has substance use eliminated bulimia, but then again, never before have I drunk with such ferocity; such vigor. In the days prior to admission my stomach had been volatile. It had been filled with so much bile and acid and pain that I must have eschewed binging and purging in favour of vodka – just vodka. At The Priory, I was given a sandwich. I ate it in the fetal position, willing it to stay down, and I was told after being wheeled to a medical room and placed on a seated scale that at sixty-four inches tall I weighed just eighty-eight pounds. A few minutes or hours later, I asked for another sandwich. I picked at it still coiled in a ball, felt remorse, then asked the woman to bring me to the toilet where I purged and she watched, soundlessly, from the bathroom door.

TWO

I sense it was on day three that I began to speak in sentences. My memory from this time is shattered; crudely stitched together by revisiting social media messages that I don’t recall sending and by reviewing my writing. There are also the people. I am still in contact with patients from The Priory. I still rely on them, in my darker moments, to remind me who I am; who I was; who I could be.

Michael, who arrived the same day I did, has told me that I introduced myself to him by asking him for a cigarette. The Priory has a gazebo-style smoking hut adjacent its side door, nestled on the lawn beside a paved area furnished with wooden tables. Smokes are shared here, as are secrets. I’m assuming that I showed up empty-handed because I vaguely recall the same woman wheeling me outside on one of my first nights and staring at me with disdain as I dug through an ashtray, shakily seeking hits of discarded nicotine. Michael has said that I couldn’t sit upright during our first encounter. Instead, I slumped sideways in my chair, the woman hovering over me in case I fell, clutching my abdomen. I have no recollection of this, but according to Michael I said that I needed a cigarette and that he should give me one because I was about to die. Again, this is secondary information, but given what happened after my first days (and what continues to happen, now), my words still frighten me. Michael obliged.

In addition to Michael, I would meet people who would unintentionally but irrevocably alter the course of my life. Before they were people, though, they were simply patients – a group of Brits to whom I was an outsider. I was a mistake, an import who had taken a wrong turn and landed in a mental hospital. At least, this is how I saw myself. I know that after those first two days, I became semi-capable of talking. I know that whenever someone introduced themselves, I name-dropped Oxford and then stopped, pained, and began to weep instead. All I could say, over and over, was that I wanted my life back.

THREE

While my first week in hospital is piece-meal, I did retain some information. For instance, I was told that my stay was a sort of emergency favour. I had by-passed The Priory’s lengthy waitlist, and Nuffield was paying $1,500CAD a day for me to be there. I also learned that no one had my medical records. I was a total stranger; an anonymous foreigner who, other than needing to be monitored while receiving pharmaceutical assistance, would be fit to pack up and ship off within the week. What no one realized, me included, was that in the coming days, weeks, and months, I would need a lot more than pharmaceuticals.

The Priory Woking, which is the nearest of the network’s brick-and-mortar facilities to Oxford, has three streams. First is general psychiatry. It treats those who struggle with anxiety, depression, bereavement and the like. I’m not sure whether those with more “serious” and stigmatized mental illness labels are welcome, but based on my experience, I can’t imagine people who enter alter states receiving the care they need. Next is alcohol therapy (ATP, for short), which is twelve-step and abstinence based. Finally, there is eating disorders. This program tends to have only a few patients at a time, and its main focus is weight restoration. Members of each stream also engage in individual and group-based therapies, most of which pertain to motivation for change, relapse prevention and post-discharge aftercare. The majority of The Priory’s patients are funded by England’s National Health Service (NHS), which means they receive little information about when they can expect to be admitted, to which locale they will be admitted, and, strangest of all, when they will have to leave. In the coming days, I would learn more about this infrastructure and I would become enraged by its limitations. Initially, though, I was confused. In theory, I belonged in all of the streams. As a patient who been admitted only to detox, though, I was excluded from all of them.

The more I heard about The Priory, the more mystified I was. I had been to eating disorder treatment once, I had been to addiction treatment thrice, and I had been involuntarily committed (or “sectioned,” as the British call it) more times than I could count. In Canada, it is rare for a facility to operate as a catch-all institution.Usually, those who have been diagnosed with eating disorders will not be admitted to treatment if they disclose concurrent addictions, while those who are admitted to addiction treatment with eating disorders are instructed to self-manage the latter or are encouraged to apply twelve-step modalities such as praying to their eating. However, despite claiming to treat all conditions, The Priory still operated much like the centres I had already been to. Each stream was siloed, and patients completed a pre-intake interview so they could be divided based on their most salient concern. In practice, this meant those who had been labelled with substance abuse disorder rarely interacted with those who were general psych or eating disorder patients, that general psych patients rarely interacted with those who had eating disorders or substance abuse issues, and so on. As someone who was label-less, I would eventually float between the streams, converse with whomever I wished, and see the absurdity of reducing people to a single identity. At first, I was just distraught.

FOUR

It is important to relay that I was profoundly disoriented. Trying to reconstruct events henceforth as though they occurred sequentially feels incorrect, disingenuous, because for most of my stay, time and space were disturbed. I am restricted by western temporal and spatial orders that conceive of both as objective, constant, and “real” – Newtonion absolutes that are independent of consciousness and are at once fixed (space) and ceaselessly marching forward (time). In other words, I would lack coherence if articulating myself aloud, my body-mind unsure what is present, what is future, and what is recurring, devastating past.⁵ My intention while writing, then, is not to recount a consecutive summary of what happened at The Priory. Rather, it is to construct a consecutive summary – all of which will be true, but some of which may be only true to me – and, in so doing, demarcate boundaries, however contrived, around this opaque event. Otherwise, I may never leave.

(CONT’D)

---

FOUR

ONE

The phrase, “it gets worse before it gets better,” as trite as it is, holds some truth. At The Priory, it would eventually get better. First, though, as bad as it was already, it had to get much worse. After writing, I sat back and took in my surroundings. My room consisted of a desk, a standing closet that I had yet to populate, a garbage can and bedside table that perpetually overflowed with food wrappers, a pile of clothing that had been given to me by another patient, a bathroom with a toilet, mirror, and shower, and a small, sterile cot. I knew the walls were beige, but at some point, they had stopped looking beige. Instead, an iridescent spectrum of colours bled into one another, their movement synergetic with my short, shallow gasps. I got scared again, and I went for what felt like the millionth time for help. The confidence and clarity I had possessed moments earlier (“I will find the exit myself”) was gone, and in its place was the conviction that I was psychotic (or dead, or both) and that I needed medication. Quickly.

These thoughts signal mental illness. Certainly, no sane person would entertain such ideas (and no sane person would see their walls melt), and at least according to the DSM, I am highly “mentally ill.” I do not dispute this. To reduce my experience to just pathology, though, to chalk it up only to sickness, would be doing myself a disservice. My purpose with writing is to highlight that mental illness labels are not always useful, in that the more labels one accrues, the less one is trusted and the less one will trust themselves. I simply wish to offer alternate paradigms through which others may view my (and their own) experiences. These paradigms are unconventional, but they acknowledge that mental, emotional, physical, and spiritual distress may not just be “disease.” As I see it, the DSM is just one option, one version of materiality among many, and I have learned through trial and error and exquisite suffering that materiality is malleable.Of course, on my seventh day at The Priory, this hadn’t fully resonated. I was drawn towards anti-psychiatry and Mad discourses, yes, but these were belief systems I had dabbled in, not ones I had adopted as my own. What was certain is that Phil the psychiatrist had taught me that in this particular state I was “psychotic,” and psychosis, says common-sense, is dangerous.

My bedroom at The Priory was at the end of the upstairs hallway, directly opposite a woman’s-only lounge. I sped into the lounge with a renewed sense of urgency, pulsating with righteous anger, and yelled at staff to listen. A nurse reminded me that I didn’t have an appointment, and that I couldn’t demand to see a consultant just because I felt like it. She then exclaimed, as though this required immense effort, that she would go find Ivan. I did not trust Ivan, I did not want to speak with him, and after the nurse fetched him anyway, he sat across from me at a table. I told him matter-of-factly that I was psychotic, and he said that he was not intelligent enough to help me. Those were his exact words: “Nicole (shrug) I do not think that I am smart enough to help you” and while I agreed, his insouciance in light of my claw-my-skin-off-pull-my-hair-out horror was maddening independent of my underlying symptoms. I plead to be sedated, and I was told by Ivan and the staff members I spoke to after him that I should calm down; that I was overreacting. I was not overreacting, and it would be two more weeks of agony, two more weeks of shouting, kicking, begging to be heard, before I found solace within myself.

TWO

For the rest of day seven, I was frantic. I stormed the hallways and screeched at care aids, nurses, and fellow patients, my disbelief growing with each rebuff. Staff members were apathetic, directing me to someone else or explicitly stating they didn’t know who I was (and implicitly, that they didn’t really care). When a person believes they are psychotic – when they are hearing chanting, singing, and screaming they know is in their mind – this is a very cruel approach. I found myself in The Priory’s main entrance surrounded by patients, staff, and visitors who were greeting their loved ones or saying goodbye. Sights, sounds, smells; the stimuli were acrid, invasive, overwhelming, and they overcame me as I sank, sank, sank, the plush carpet engulfing me and transporting me elsewhere (“I have been in this meadow before”) while I shrieked.

I don’t know how long I was on the floor, how loud I was, or if anyone noticed, because I clearly remember screaming (into the void) but very little else. My presence went unacknowledged until I glimpsed Jeremy, a middle-aged care-aid. His was a familiar face, and seeing it oriented me enough to remind me that I wasn’t only frightened, I was also furious. Leaping from the carpet, I snatched a newspaper and waved it at him, barely registering that the paper unraveled and cascaded to the floor. “What is WRONG with you people!?” I yelled. “You British FUCKS!” and a small smile played at the corner of Jeremy’s mouth. He thought this was funny. Unable to breathe and needing to move, I ran toward the door.  

I sped through The Priory’s corridors (after seven days, I was still lost) and out the side entrance. I ran past the gazebo, where a group of patients huddled, smoking to distract themselves, smoking to kill time, and I kicked a bench. Hard. “I am psychotic!” I screamed, “I have been psychotic for days, and no one here cares; this is FUCKED!” The world tilted and turned, the grass pulsating in tandem with my heartbeat and the rhythmic squeeeeezing in my head. As though my legs belonged to someone else, I continued to the edge of the grounds where I howled inconsolably, fell to my knees, and wept. I didn’t know exactly why I was weeping but doing so was vital, lustral, and good. I cried for what felt like hours, until I looked up from my crouched position to see three staff walking toward me. Confused but earnest, one offered me her hand and said she’d find me a cigarette. My body recoiled, but I saw no alternative and so I rose, begrudgingly. The grass stopped moving, I could see straight again, and for the next few moments, I felt almost “normal.” These periods of calm, blessed but brief, would come and go for the duration of my stay. Appreciated as they were, pain, I would learn, is the most fertile soil for growth.

THREE

Now, with The Priory behind me but still very much inside me, it is difficult to reconcile my reflections with that which seems “reasonable.” If they were to be asked about this day or the days that followed, staff would undoubtedly challenge my recall. Surely their version of events wouldn’t (couldn’t possibly) include ignoring a distraught woman; blatantly dismissing her when she clearly needed aid. But this is what I remember. Above all else, my time at The Priory is characterized by an abstruse, almost otherworldly sense of alone-ness. Without formal programming, I was physically separate from both patients and clinicians. More importantly, for the next two weeks I would inhabit a distinct psychic realm. I had forayed into this realm in 2015 – I had dipped my toes in, so to speak – but I had been wrenched out via tranquilizers, proximity to authority, and the logistics of addiction. This was similar: It was the first term of a graduate degree, I was driven by the need to be “exceptional” without having considered whether I actually cared, and I had lost it almost immediately. Unlike in 2015, however, a literal and metaphorical ocean separated me from my peers, my family, and psychiatry. I had no school to return to, no medical professional was interested, and the ramifications of this breakdown were far more severe than before. In other words, I had dived into unchartered waters, and now I needed to swim.

Swimming, however, would take some time. Initially, I wasn’t sure that I knew how, or that I wanted to try. Instead, I looked for “logical” causes for my condition, reasoning that when I arrived in England I hadn’t been drinking, I wasn’t binging, and I ingested a mood stabilizer and anti-psychotics before bed. I had been more level, but I was still starved, smoking pot, and hyper-vigilant. Then, for nearly a month, I had ceased eating and consumed only alcohol. I likely experienced medication withdrawal when my neuroleptics were confiscated by the cops, but I didn’t notice because my thirst had been insatiable. I also started hearing things, and it was difficult to keep from screaming. Then, when I arrived at The Priory, the alcohol’s sedative effects wore off and my physiology would have rebounded. I became over-stimulated and over-excited because I was filled with adrenaline, cortisol, and other stress hormones, which culminated in an abrupt escalation into “psychosis.” I was merely hallucinating (“merely” in the sense that I knew there were medications to fix this), and I could find reprieve if prescribed them in the right combination of dosages.  

I found comfort in this interpretation. It was biomedical, it was “rational,” and parts or all of it may have even been “correct.” However, this was not just “psychosis,” and even if it had been, Ivan and Dr. Bristow had been clear that beginning new prescriptions wouldn’t be an option. I was thus left with…myself. With no groups to attend, no schedule to adhere to, and rather oddly, at least to staff and Eleni, a sudden inability to travel, I was told that while Nuffield had paid to extend my stay past the weekend, I would be expected to leave come Monday. Given where things were at, this was a lofty goal. After more yelling and more tears, none of which elicited response, my seventh day at The Priory concluded with me sitting on my bed, my thoughts churning at a rate they never had before, hearing “Morning! Ello! You alright!?” as I watched the ceiling vibrate.

FOUR

By now it was late October, either the day-of or the day before Halloween. I wasn’t conscious of this, but the festivities infiltrated my subconscious and impacted my impressions. Maybe. It is also possible that the encounter I am about to describe would have occurred irrespective of season, because it ended up being meaningful.

After dozing briefly, I woke during my eighth night to see a witch at the foot of my bed. She was a stoic shadow figure, her features amorphous but wicked, and though she hadn’t moved, I sensed she was about to. I screamed, leapt from my bed, and fled to the upstairs lounge where I was greeted by Agnes, a care aide. I had met Agnes before, and I had admired her delicate features and amiable demeanor. However, in this moment Agnes was not Agnes. Agnes was also a witch, and as she sneered, her eyes, nose, and cheeks crawled with insects. I was too frightened to speak, so I curled into the fetal position and cowered on a couch. Agnes peered over me, asking what was wrong, not aware as I sobbed that her face was rotting off. My depth perception was also distorted, so while Agnes likely maintained an appropriate distance, I felt as though she was not just adjacent me but was entering me from above. I couldn’t watch her flesh decay and her skull emerge, her putrid breath mixing with mine, so I tried to go outside.

I made it to the downstairs corridor, but I froze once I reached the side door. The mist (the perpetual mist) that enveloped the patio and the gazebo repulsed me. It seemed to be a harbinger, a warning that should I penetrate it, it (The Priory) would never let me go. Utterly panicked, I kept screaming and I collapsed onto a bench. As I did so, a young woman walked toward me. She paused for a moment, averted her gaze, and retreated. Still screaming, I ran back upstairs and re-entered the lounge, where Agnes the witch was waiting. Then, something remarkable happened: As I screamed, she chastised me: “Keep it down,” she said snidely; “Have some self-control and think about your fellow patients! Some are in a great deal of distress, you know, and they only have sleep to look forward to!” and with this, Agnes transformed again. She stopped being a witch, and as she instructed me dispassionately to take personal responsibility for my actions, she turned into the spitting image of my Mother.

FIVE

Based on conceptions of mental illness, it would be easy to assume that I fabricated this. Parts of it I did, but it is worth noting that Agnes later apologized; that she acknowledged having been harsh, and said she regretted lecturing me when I was under duress. My recall is not solely influenced by insanity, then. I am not a crazy woman (not just a crazy woman, anyway), who was cognitively and emotionally disintegrating. I prefer to see this event, as well as those that followed, as the origins of a break-through of sorts; one that was astonishingly powerful, irrevocably transformative, and above and beyond all else, excruciatingly dark.

The belief that my journey at The Priory was neither arbitrary nor pathological has been theoretically explored. Thirty years ago, transpersonal psychologists Stanislov and Christina Grof introduced the idea that unusual states of consciousness accompanied by emotional, perceptive, and psychosomatic manifestations surface due to the intrinsic pursuit of wholeness.¹ They suggested that these“non-ordinary states” are “spiritual emergencies,”² not psychosis, with the potential to catalyze healing. In their words, possible indicators of a spiritual emergency include dramatic death and (re)birth sequences, archetypical phenomena, incidence of synchronicities or extrasensory experiences, and intense energy.¹ During this era, pioneering investigator on mythical states Arthur J. Deikman also coined the term “mystical psychosis” to denote accounts of psychosis that align with reports of mysticism.³ Deikman believed that these experiences are prompted by “de-automatization” (undoing) of “habitual psychological structures” that “organize, limit, select, and interpret” perceptual stimuli.³ Much like the Grofs’ indicators, the features of mystic psychosis include realness (or, “stimuli of the inner world becom[ing] invested with the feeling of reality ordinarily bestowed on objects”⁴), unusual percepts (“sensations and ideation that do not seem to be part of the continuum of everyday consciousness”⁴), unity (experiencing one’s self as one with the universe) and ineffability (the inability to aptly express what one has experienced, because said experiences are rooted in primitive memories and nonverbal sensations ⁴), all of which arise out of extreme circumstances and disrupt the subject’s relationship with the world.⁴

By now you know that I am not a strict empiricist. Mental health won’t always conform to standards of systematic observation or falsiability of hypotheses because there are things we can’t and shouldn’t know.⁶ However, I take scholarship seriously, I appreciate rigour, and because of this, I loathe new age woo. I will thus issue this caveat before proceeding: The text is about to undergo shifts in tone and form. These will include references to literature that I don’t use in my academic work, mostly because it requires suspending all I have been taught about deriving conclusions from the senses. It is not scientific, and even more egregiously, it is individualistic. The theories I introduce situate the loci of responsibility for health and illness in the body-mind, whereas I have been trained to see these phenomena as socially and culturally constituted. The suggestion that one can “self-heal” or is “responsible for their healing” is used to sell products to people who lack the analytic tools required to know better, and in case this isn’t obvious, neoliberalism is deadly. Yet in this context, none of the sociological, anthropological, feminist science, public health, epidemiological, or critical drug scholarship I studied prior to writing suffices. I have found no better way to conceive of my Madness than through fringe psychology, even as it implicitly claims that “betterment” is a personal task or project. Please remember that it’s not, even as you read about how in this instance, it also kind of was.   

SIX

The Grofs’ typology of spiritual emergencies has been evaluated, contested, and amended,⁷ but a recurrent theme in their work and the work of their contemporaries is that spiritual emergencies are evolutionary crises – they are born of restricted emotional development and can emancipate “vitally needed” psychic functions.⁸ Related, clinical (anti-)psychiatrist R. D. Laing proposed that psychoanalytic “defense mechanisms” (repression, denial, splitting, etc.) that unconsciously alienate one from themselves needn’t stay unconscious.⁸ Rather than remain oblivious to our defense mechanisms (or become aware of them but stay powerless over them) “the patient” can, through “a psychedelic voyage of discovery”⁸  “progressively realiz[e] that these are things [they] ha[ve] done to [themselves]” and, in so doing, once more become an agent.⁸

I now interpret my encounter with Agnes to have been one incident among many that occurred during a rapid, self-directed trajectory toward integration. This had started in 2015, but it had been too visible and strange, and had thus been thwarted by psychiatry (and my own embarrassment). Then, upon arrival at The Priory, I was met with the same admonishment when in in distress that had characterized my childhood, my adolescence, and my tentative (and mostly unsuccessful) forays into adulthood. In many ways, staff at The Priory mirrored how I have been treated by my parents every time that I’ve sought help. I have been told that I’m a nuisance, I have been scolded for attention-seeking, and I have always responded with intensive self-destruction. This is why The Priory was so critical. I would soon realize, with stark, stunning clarity, for the first time in over twenty years, that this was not OK.

According to the transpersonal psychology, which literally translates to “going beyond and/or through the personal boundaries of ego/identity,”⁹ and emphasizes the interconnectedness of all beings, spiritual emergencies necessitate therapeutic intervention distinct from that which is derived from “the pragmatically successful but simplistic worldview of mechanistic science.”¹  While traditional psychiatry relies on suppression while engaging with altered states, transpersonal psychologists claim that in lieu of diagnosing or medicating the patient, the “facilitator’s” task is to forge a nurturing, trusting relationship.¹ By allowing the patient to experience the symptoms of what appears to be “psychosis,” and by helping them find meaning in the content of their experiences, the facilitator can support the patient in resolving their spiritual emergency.¹⁰ Otherwise, should one’s altered state be severe enough to interfere with daily functioning, and should they be institutionalized because of this, the result will be “sad compromises”¹ via reductive scientism. The irony of course is that my “spiritual emergency” (or “mystic psychosis,” or “spiritual awakening”) may have been triggered because my history of abandonment was replicated at The Priory. While it was this that propelled me into a necessary and life-affirming state, it was also the factor that prohibited me from seeing my state as life-affirming because I didn’t have a “facilitator.” All I had Phil’s were words reverberating in my ears (“You are psychotic; You are psychotic”) and the sincere belief that I could stay that way forever. Fortunately, however, because no one particularly cared, I would move toward resolution (the exit) myself.

My approach to mental health (and illness) is transient. The language I use to discuss it has evolved as I’ve engaged with the psy disciplines, twelve-step programs, and academia, each of which I’ve left (for now) and each of which has taught me that the frameworks we rely on to make sense of our experience are, above and beyond all else, informed by one’s access to power and privilege. They are also optional. I spent many years cycling through homeless shelters, psychiatric hospitals, and addiction and eating disorder treatment centres, and in so doing I learned that relative “the norm,” I am very sick. That said, between institutionalizations I also acquired a few degrees, and I gradually realized that when it comes to mental health, identity is a choice. “The Becoming,” then, details a process of unlearning (and, eventually, re-learning who and what I am outside of illness). I wrote the text after my attempt to begin a PhD at Oxford went awry, and I crumbled quickly under the weight of suppressed memories and unaddressed trauma. Coming-to in a British psychiatric hospital after a month of black-out drinking originally felt like the worst outcome imaginable, but the profound existential journey that followed was, though terrifying, overdue and emancipatory.

Fundamentally, “The Becoming” is an identity project. Throughout I grapple with the relative importance of certain paradigms over others when describing my inner world, and while I draw liberally from theory to do so, I also emphasize that theory is just that – theory; systems of ideas whose purpose is to explain phenomena that may, at times, be ineffable. My hope is that readers will be similarly empowered to challenge the ways they’ve been taught to view themselves, and to discard “facts” that no longer serve them. I invite those who are uneasy with how they’ve been categorized by psychiatry to explore alternate ways of being/knowing, and though I have included my own roadmap, I don’t expect our paths to be the same. Rather, I provide sufficient information (made manifest in the form of classical and contemporary research on trauma, disordered eating, substance abuse, and Madness) for one to make their own informed decisions. Ultimately, I propose that mental health is a resource: It is available to each of us, but our opportunities to acquire and keep it, as well as how we discuss it, will vary based on the social locations we inhabit.

Nicole Luongo grew up in Vancouver, British Columbia. She has condensed multiple lives into her thirty-one years, and her various identities – homeless, drug addicted youth, psychiatric inmate, college lecturer, Oxford scholar – have been confusing and contradictory. These days, she is passionate about disrupting dominant narratives about “mental illness,” and she focuses on de-medicalizing addiction, disordered eating, and all forms of Madness in and outside of academia. Her inspirations range from Michel Foucault to Bonny Burstow to the comrades who live, die, and love on the streets of Vancouver’s Downtown Eastside. Members of this latter group have been instrumental in radicalizing her, and they have taught her that meaningful change comes not from pandering to authority but instead requires direct action against policies (and politicians) that are death-dealing. When not reading, writing, or protesting, Nicole can be found in the forest or the ocean.