Mirages And Hopes in Mental Health

— Tristano Ajmone —

The present speech was delivered by Tristano Ajmone at the meeting IL GRIDO NEL DESERTO
DEI MALATI INDIFESI (The outcry in the desert of the defenceless sick), organized by the no-
profit association Tutela diritti malati indifesi, in the city of Bologna the 10th of March 2006, at
the Sala Conferenze Baraccano.
This text is not subjected to copyright and can therefore be freely distributed, reproduced and
quoted, without need of further approval from the author, on the condition that its source is
mentioned.

Bruna’s invitation to participate to this meeting fills me with joy. Bruna and I know each other
through a brief and sincere email exchange, and we both share the will to make changes in the
mental health system, we both engage in action moved by the spirit of solidarity and sense of civic
duty, and our work is charitable. Premises like these — premises shaped on human qualities — are
the ground on which even differences can find affinity.
The title of this meeting, The outcry in the desert of the defenceless sick, is strongly evocative to
me, not so much as a linguistic artifice, but as a metaphor capable of exhuming very intense life
experiences. I find myself in the peculiar condition of being a survivor to the abuses of psychiatry
and, today, I am president of OISM1, a no-profit association which deals with the subject of mental
health by providing correct information, mainly by criticizing psychiatry. But I have been also a
relative of a psychiatric user: my childhood was permeated by the invasiveness of a coercitive
psychiatry which, through forced hospitalizations, constantly abducted my mother from me, exiling
me to the darkest form of solitude and abandonment that a child can get to know.
Personally, I belong to those people who don’t believe in the existence of mental illness as a
medical concept, but I fully grasp the context of human sufferance which the title of this meeting
wishes to address. Human sufferance exists, and there are types of sufferance of the soul so intense
that they “translate” into alienation, in disharmony with the surrounding world, in extreme grief, in
despair, in reality-visions which can’t be shared… This is what people understand when reference is
made to «mental illness».
Truly, this type of sufferance, which is the subject matter of this meeting, is a sufferance which
society has since long renounced to manage — exiling those who experience it to the total institutes
of psychiatry. Obviously, this scenery is non all back and white, there are intermediate shades of
greys which make the difference between the inhuman treatments and the less cruel ones; but the
point is that we are nonetheless speaking of a reality which holds no space for colour.
A psychiatric internee’s life is today — like in the past — an existence relegated to the shadow, to
the scales of grey, and this indeed happens because for those who suffer in similar ways — which
are considered unmanageable by society — the only possible destination is that of deportation into

1
Osservatorio Italiano Salute Mentale: http://www.oism.info

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the institutional deserts of psychiatry where people are often devitalized and pushed in an abyss of
solitude in which any request of real help is traduced into an unheard outcry.
During my years of coercive psychiatric detention I have crossed this desert. It’s a desert in which
solitude takes on the unusual shape of forced and monitor cohabitation. It’s a narrow and
claustrophobic space which forces you to escape inside, to create alternative worlds of fantasy in
which to seek refuge from the wretchedness of a highly institutionalized daily life, articulated by
rituals which are typical of total institutions such as prisons and military barracks. It’s like if the
person, while stiffening on the outside, transforms his mind in an harmonic box which amplifies in
the inner world every exterior sound and silence thousands of times, distorting them, transfiguring
them, moulding them into nightmares or hopes…
I have chosen to employ this chance offered to me by Bruna to introduce the autobiography of Ken
Steel, The Day the Voices Stopped: A Memoir of Madness and Hope2, a book to which I have
contributed to it’s Italian translation. Ken is probably the most famous psychiatric survivor in the
USA, undoubtedly a person highly esteemed both from the users in favour of psychiatry as well as
from those who criticize psychiatry, not to mention the various activists’ group for civil rights.
The life of Ken Steele — his experience, his person! — is unique and unrepeatable. All that he has
gone through might seem to us, toady, a remote reality, psychiatric stories of the old times — times
of reform now outdated — but it’s not so! We can agree with his opinions and choices, or we can
criticize them, but none of all this grasps the essential point of the legacy which Ken has left us.
Ken Steele has been a person gifted with extreme courage. The anguishes of the soul which brought
him to be what is considered one of the most enigmatic and hope-bearing psychiatric cases of
USA’s psychiatry in our times are intense anguishes, real anguishes! Ken’s life has been an
existence messed up by mental sufferance. From his narration emerges the inability of his alienists
— and of his companions — to penetrate his inner world of sufferance, understand it, making sense
of it and offer him a friendly hand which might bring him back to the point of his youth where he
got off the rails of what he considered to be his own life — as it’s considered by every teenager who
aspires to build a future according to his own dreams.
At the end, Ken found his point of equilibrium, an existential rail along which he could live in a
non-alienated way, managing to have his own humanity recognized through a solidarity campaign
which knows few equals in contemporary history, especially if we bear in mind that Steele has been
mostly the victim of a totalitarian system of exclusion which proved itself cruel toward him. Ken
Steele had the courage to break the chains of the diagnosis, the courage of imposing himself as a
man in a society that stigmatized him and condemned him as mentally sick. He did not achieve this
by refusing the diagnosis or the concept of mental illness, but by refusing to indulge in a life
pampered by the institutions, by struggling unceasingly against the voices that persecuted him and
against his sense of helplessness and overwhelming.
He faced an hostile world in an age in which being homosexuals was still cause of strong out
casting, but he found the courage to narrate of his own homosexual adventures, of the rapes which
he suffered in psychiatry, of his resorting to prostitution in order to survive economically during his
runaways from psychiatric institutes. All this he accomplished it by finding the courage to expose
himself by narrating his life — by denouncing the degrading humiliations that psychiatry forced on
him, by speaking of his madness without sense of shame.
Having I crossed psychiatric institutes in which the decay described by Ken is still taking place, and
having I suffered in the soul that alienating sufferance which is madness, I understand the many

2
For further details on the books: http://www.perseusbooksgroup.com/basic/book_detail.jsp?isbn=0465082270

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difficulties that Ken had to face, and for this reason I hold him in high esteem as a man, beyond
every ideological divergences over the issue of psychiatry that separates us.
Exposing oneself publicly, narrating one’s own psychiatric story, entails strong penalizations. For
me, since I come from a judiciary psychiatric path, penalization is double. Those who recognize me
or encounter me after having visited my website3 generally approach me wearing the shield of
stigma, keeping «due distances». Having told my story in a non anonymous way has barred me
many job chances. The truth is that I am motive of embarrassment for many people. And it is
exactly for this reason that many people end up in the existential desert of psychiatry: because they
are motive of embarrassment (they act in bizarre way that make their family or society feel
uncomfortable). But it is exactly for the same reason that many people can’t manage to escape the
psychiatric desert: they don’t find a society ready to accept them after it has «excommunicated»
them.
Madness is a form of heresy: when the person gets to the point of expressing thoughts, feelings or
actions which are intolerable or incomprehensible it’s deported and abandoned in this existential
desert, entrusted to the «experts» and often forgotten by friends and acquaintances. The diagnostic
label, charged as it is of negative traits by the media, is an easy pretext for shaking off one’s back
personal responsibility toward friends and relatives which are in existential difficulties — “what can
we do… he’s gone crazy, he’s sick! Let the doctors take care of him…”
Often I wake up in the middle of the night overwhelmed by the nightmares of memory: I dream of
the tortures to which were subjected the people in psychiatric forensic facilities, I hear their
desperate screams. Even though years have gone by, at times it still happens that I wake up
frightened, screaming for the help of a security guard or a nurse. Then I resurface from the maze of
dreams and realize that I am in my flat, alone, and that there is no longer any security guard or nurse
in the corridor… I’m alone, alone with my fears.
The only cell that now restrains me is that of the alienation that follows the dehumanization which I
underwent in psychiatry. The experiences of Ken Steele are overtly dehumanizing — they consist in
beatings, four-point restraints, padded cells — not that these things don’t happen today! — the point
is that the dehumanization process is grounded on more subtle points: the rituals which scan the
daily life of the internee — bodily punishments still are, today, exceptional remedies; they are more
or less spared to those who blindly obey.
Institutionalization is a gradual process and — allow me to say it — a refined one. The type of
psychiatry which I experienced was based on seizing individual responsibility: we could not handle
our money, we could not plan our daily life, we were denied our own freedom, we had to justify
ourselves for every action or movement we took. With the excuse of cure and treatment they forced
us to accept that every personal need was to be satisfied by the institute — obviously needs such as
sexuality or love were not an issue worth of consideration because they did not fall into the
therapeutic needs, at the most they could constitute a threat to the «rehabilitation» project.
Returning to freedom has been an immense effort. After years of desert, the noise of the city’s daily
life is deafening, oppressive. Ken felt exactly like this when, all of a sudden, he ceased to hear
voices: he was overwhelmed and threatened by the small noises of daily life — the dripping of
water from the tap, voices from the streets, the wind’s whiffles… all sound that he had forgotten
because they had been covered by the voices that he heard continuously for thirty years.
I experienced similar sensations when they brought me back to the free world from the institutes of
psychiatric cure and custody. I had dis-learned to relate myself in a «normal» way, I was
accustomed to the artificial world of the total psychiatric institutes, I was attuned to the standards of

3
http://tristano-ajmone.oism.info

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institutes in which violence and intimidation are the means by which order is maintained. The
difficulties that I had to face were frustrating and they introduced me to new types of alienation:
stigma and social rejection.
If today I have gradually taken the reins of my life back in my own hands, in an autonomous way, I
owe it to the few people who trusted me and kept by my side, people who did not feel ashamed of
me and my personal story, that accepted me in they world confiding that I would eventually find my
path — and, I feel obliged to stress, amongst them are also psychiatrists and mental health
professionals who have been able to enter my life-context in a non-invasive manner, nor limited by
a «just-clinical» vision of life.
I don’t know if I’ll ever overcome the feeling of separation and solitude which grieves me. Maybe
I’ll never manage to rebuild a family and have next to me a person who can understand what I’ve
really gone through. But surely, the thing which I’ll never regret is having fought, having tried to
make it happen, and in many ways having managed to succeed in it, and most of all: having
exposed myself in the frontline by narrating the atrocities which I have witnessed. This choice has
been an expensive one to myself, because I became cause of embarrassment for many people who
were associated to me in sentimental life and working context, and many of them abandoned me.
On the other hand, it gave me the chance of getting to know new people, better people, who
accepted me the way I am, understanding that every human life is a constant evolution, and that for
some people personal evolution passes though dark zones. I therefore belief that with this choice of
exposing myself I have gained in quality: I’ve got rid of many people polluted by prejudice and I
found myself surrounded by people who are receptive to human nature.
This is the true message of Ken Steele’s book: those who suffer should not hide, they should accept
denigrating labels and stigmatizing processes. I, like Steele and Bruna, fight in order that things will
change, so that there can be a future in which people will not have to endure that which I suffered or
I have seen my companions of misadventure suffer, a future in which human beings will no longer
be socially outcasted by a medical stereotyped and distorted vision that wants them incompetent,
dangerous and unpredictable.
The very fact that I am speaking here, today, is the proof that I do not belong to the «defenceless» to
which this meeting is titled. I have fought, and I survived, and I managed to reconquer my freedom.
Many of my companions of misadventure will never see freedom again, other simply did not make
it since they died along the path.
Until psychiatry will be rooted on environmental-, bodily- and chemical-control of the person, our
consciousness will have to cohabit with the outcries of those who suffer from the strangling of
psychiatric «cures». And as long as we are not willing to face the inner contradictions of the mental
health system, we’ll have to accept that for many people deported in the existential deserts of
psychiatry the only true alternative to a denied existence is the fatal freedom: exiting the stage of a
world which has proven to be indifferent and hostile toward, or scared by, diversity.
In psychiatry there are professionals who act in a conscientious and human manner, and Ken Steele
at the end found who gave him the right push in the right direction. Even I, at the end, have found
supportive people who managed to address me toward a path of personal growth. Regardless of how
rotten psychiatry is, we must not forget that those wearing the white coat are, after all, men —
who’s qualities and shortcomings transcend their clinical roles and specializations.
But often the efforts of these conscientious professionals are rendered vain by a cruel society which
oppresses the mentally distressed, penalizing them and rendering their life unliveable. I really wish
that here with us, today, I could have my mother, and the she could be proud of the battles that I’ve
fought against psychiatric cruelty, against those inhuman practices — like electroshock and forced
hospitalization — which devastated her life. Unfortunately, since many years my mother is no

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longer amongst us… but I respect her choice of having taken the emergency exit of fatal freedom. I
think that, after all, that which most embittered her was the hostility of a world which proved to be
indifferent to human sufferance and individual fragility.
If today we live in a society in which people are starting to demolish the myth of dangerousness of
the crazy, is also thanks to people like Ken Steele, people who had the courage to reveal themselves
to the world in the fullness of their humaneness, demonstrating that even those who suffer mentally
— to the point of social alienation — can eventually make it… if they find their own path, if they
find people who believe in them and support them in a loving way.
Our society is mainly rooted on superficial relationships, guided by stereotypes, and human
relations are generally determined by the medias’ jargon. In such a society, for those who can’t
manage to give voice to the jargon of their own sufferance, there is no other choice than
screaming… and if their outcries are not understood they’ll end up being motive of further out
casting.
Here, today, we can debate ad nauseam on the clinical, social and technical aspects of human
sufferance, but the crude and brutal reality is that the deserts which we are about to examine are the
metaphorical projection of a society which has divested itself of the flourishing vegetation of its
humaneness: a world in which families are swift in handing their children over to psychiatric
institutes at the first sight of a dark adolescential cloud is, ultimately, a desertic world in which
there are no longer secular trees offering shelter. It is not all psychiatry’s fault: I have met
psychiatrists who are exasperated by the continuous and pressing requests of parents who want to
have their sons and daughters hospitalized. If, on the one hand, the axe of psychiatry has worked
with zeal to knock down the secular institution of the family, it is also true that if the tree has fallen
under its blows is because it had, anyhow, weakened.
My hope, in having exposed you my experiences and opinions, is that this book of Ken Steel might
be a stimulus so that people who have ended up in psychiatry might find in it an example and the
courage to speak out their experiences. The editors of the Italian translation of Steele’s book, Dr.
Tibaldi and Dr. D’Avanzo, would like to produce a book that gathers various experiences of Italian
psychiatric users. This could be a great occasion for many users, not only because society in general
would benefit from their testimonies, but mainly because this would allow them to grow inside and
outwardly through individual self-affirmation.
No human life can be summoned in a diagnosis, nor in a hundred clinical charts. The
autobiographical value of those who suffered in the soul is inestimable to those who sincerely desire
to understand the psychic sufferance of others. Stigma is also, in some ways, the existential gap that
separates those who live ordinary lives from those whose inner sufferance has reached such peaks
as to preclude them from an ordinary life. Autobiographical narrations are bridges that those who
have overcome or tamed sufferance of the soul can build above this abyss, so that one day these
shores might be brought close to each other, healing the fraction between normality and folly by the
cement of human solidarity, thus making obsolete the necessity of alienistic interventions
I therefore hope that all of you might gain benefit from reading Ken Steele’s autobiography.
Thank you for the attention you have granted me.

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