Walking in the Psych Ward: The Democratization of Healing Space
Michelle Bach, MD, PhD, St. Louis University
In his renowned essay, “Walking in the City”, philosopher Michel de Certeau illuminates two, very different experiences of New York City. There is the panoptic view from atop skyscrapers, which implies grid-like order and control. But at street level, we find the democratizing, meandering footsteps of unruly pedestrians and their million little rebellions. In this presentation, I invite the audience to go “walking in the psychiatric ward” with me. For Foucault, psychiatry is the exemplar of panoptic power. Indeed, modern psych wards often have a “fishbowl” room from which clinicians can survey the entire ward. Yet de Certeau shows us that the panopticon is not the final word on post-modern life. Upon close examination, we see that people “poach” power from the panoptic gaze by manipulating existing structures to make their own meaning. Drawing from clinical experience, I explore how psychiatric patients live and innovate within the rigid control of medical panoptic space. I describe the ways in which I’ve seen patients take sterilized medical space and turn it into a personal, particularizing sense of place. This journey raises two vital questions: First, how do we resist the urge to pathologize behaviors that may be adaptive to a pathological space? In other words, how can we honor the ways in which people create their own meaning within technocratic space? Second, how ought we balance controlling space for safety’s sake with the creative and sacred chaos of the healing process? Healing, particularly mental health healing, requires a sense of ownership and potency. It is worth asking how we might safely empower psychiatric patients to “poach” power in the psychiatric ward for their own healing.