foreword: what is THIS?
and other commentary on organizing

joseph sexton

(Sometimes I talk or reflect to myself. I put that in parentheses.)

If one considers this collection of blogposts as an edited text, then the foreword should accomplish a couple of things. First, it should introduce the purpose of the whole text. To what degree – and how – was this purpose met? Did it change over time? Second, the foreword should introduce what the pieces accomplish. What do the different authors talk about? By reading this edited text, what will readers find? (Though, some people might suggest I actually call this Chapter 1, or an Introduction. I couldn’t care less; I already typed out “FOREWORD”, so that’s what I’ll call it.)

In an attempt to answer the above, I recall the single greatest thing I have learned from organizing and my reading in general. All things are blurry, including the success of this collection. So I invoke “queer theory”: which is not (just?) calling upon gender-expansive, same-sex romances, but recognizing that questions rarely possess single answers. In clinical science, people are classified out of convenience. But in reality, it is not so easy as “depressed” or “not depressed” – depression doesn’t exist in material space. It’s just a label we prescribe to symbolize some imprecise, correlated phenomena. Just as well, I don’t think the purpose of this text is a discrete or defined object. It has always been dynamic, and it has never been totally known. (Heisenberg, as it turns out, was quite the trailblazer for queer theory.) Regardless, there is substance to cc:Psychiatry. It is a product of people, their circumstances, and their impression of “critical psychiatry”.

I ramble a lot. What I am trying to say is: this foreword aims to capture purpose and content, even as these things have always been turbulent. And, in fact, I think as people distribute the text or view it now or later, purpose and content might change. The blogposts are static, but their implications may well vary by circumstance. Here is my observation of the text and, inevitably, the conference at large. (Joseph, your foreword begins with a three-paragraph prelude. This is not good writing.) (“Good” is such an impossible standard to begin with. See above. Good/bad; it’s just another false dichotomy.) (That’s like saying we should abandon language in general because the prototypical meaning deviates from what we actually intend. Should no one say “good” anymore?) (Joseph, you miss my vision.) (No, I just think it’s silly. All this talk about semiotics – you ought to actually read about semiotics first.) (You’re excused. Maybe I’ll regret this later. For now, I keep writing.)


The purpose of the edited text mirrors that of the conference at large. As stated in the “master document”, the Conference on Critical Psychiatry (CCP) aims to convene people “across disciplines and professional backgrounds for thoughtful critique and discussion of mental health care”. As the director, I hoped that this might help address certain bottlenecks in the movement for mental health reform (or abolition, depending on who you ask). Though there is a growing number of critical academics and activists, it felt to me that there was a dearth of cross-talk. People trusted either academics or activists – even as some people occupied both roles – with further splits in any class. There are critical neuroscientists, clinicians, anthropologists, students, psychiatric survivors, and so forth, but I wanted to imagine a space where these critiques could be placed in conversation with one another. This would be accomplished through, hypothetically, “panels, roundtables, digital content, and other events to highlight diverse perspectives”.

I had organized the first Conference at Vanderbilt in January 2022. Despite a last-minute switch from in-person to online, the event was a “success” (if labels like that are truly possible). Yet, it didn’t feel critical enough, and it was lacking in terms of lived experience and even academic expertise. (The Vanderbilt press team’s coverage for 2022 is here, though nowadays I find that article a bit disagreeable.) For 2023’s conference, I recruited help online, hoping this would catch attention from more radical parties. In September I fielded applications for an organizing “board”. The application was open to everyone, and there were ultimately ten of us that slated to meet every other week, though a couple dropped off over time due to time constraints. I was excited that the board included undergraduate and graduate students, research assistants, and a practicing counselor among others. All of us considered ourselves activists and were passionate about the critical space, and between us we held a variety of lived experiences with mental health care. (Note also that some more experienced academic and clinical folks also volunteered advice at a few points.)

As a board, we endeavored to create an equitable and in some ways (particularly in its construction) revolutionary conference. It was not academic, or it was never intended to be, yet it would ideally still carry the weight of hard-hitting scholarship. We hoped to platform people usually unseen, like youth and young adults, psychiatric survivors, and people with “serious mental illness”, alongside those with normative epistemic power: people with PhDs and MDs who can get taken seriously even when others are discounted. A panel with a high school student and a full professor provides an opportunity for collaboration that is by some measures academic but by others not at all. I find that quite dreamy. (This is why as the conference approached, I suggested it be rebranded as an unconference. That was well-received, and should this happen again, it will definitely be situated as such.) (And that way we’d avoid the acronym “CCP”, too.) (If we called it “CPU”, that would be so great. Can you imagine the commentary on algorithmic bias, precision medicine, et cetera?)

The mission to platform diverse voices, of course, is one that goes beyond profession. And it is not a simple pursuit. How do you reject proposals for symposia, for example, without engendering issues of class (and race, and gender, and any other social force that might influence how one writes or speaks or thinks)? If you accept every proposal, what if you get far more than you can handle? This is partly why we took proposals for blogposts but not panels/roundtables. Blogposts – essays, modified to include virtual media as the author desires – would not require moderation the weekend of the conference, and were therefore less restricted. The ability to accept virtually all blogpost submissions (and we did) appealed to us. Submissions were recruited via Twitter and word-of-mouth in January and February.

In accepting virtually all blogpost proposals, cc:Psychiatry emerges as a collection of varied positions and backgrounds. It seems to even question what “critical psychiatry” means to begin with. Though a definition and some revisions were provided by myself, Alma Ionescu, and Shannon Pagdon, the degree of critique in a blogpost varies considerably. Regardless, the collection is a product of some stimuli: we provided definitions of critical psychiatry, and these are topics the authors found to fall under that umbrella.

With regards to rhetoric, some readers may also find some blogposts more well-written than others. I am forced to reckon with the fact that both critique and “eloquent” writing constitute their own kinds of privileges. Not everyone has been afforded the time to read Hegel. For some people, clinical terms are the only ones available; maybe I can cast critiques in a way that seems more “well-spoken”, but then I also had the time and resources to do so. Finally, not everyone was born or raised or taught or incentivized to write the way that you might like. (But what, Joseph, of knowing your audience?) (That’s a moot question. I decline having a single target audience at all.)

Thus, in characterizing the purpose of cc:Psychiatry, I would say the following. This collection, like the CCP generally, hopes to bring together critical perspectives on mental health care from a diverse group of authors. Precisely how “critical psychiatry” manifests in each blogpost is at once inspired by the approaches we suggested for submissions as well as the author’s own understanding of “critique”. I would not call the collection cohesive. I would not even call the collection uniformly great by whatever meaning “great” carries. I would not say I agree with every point raised. Yet, this is partly what makes the project so interestingly mad in the first place. (In the future, I [we] might do things different. But I won’t say I have regrets.)


A conventional foreword would not have spent so much time just situating its purpose, but I hope this also captures the sentiments of the conference at large. Unfortunately (for you, reader) (or maybe you are interested) (don’t be so hard on yourself, Joseph!), the contents of cc:Psychiatry are just as complex.

Here I’ll also identify the shortcomings that I induced. When I was a college freshman, I wanted to fix my issues with time management. Then I graduated in May, and it’s difficult to say what progress I made. (I do make a lot of lists now.) (And I take Adderall.) (In all seriousness, it’s somewhat better now, but it still leaves much to be desired.) By one measure, this signifies my “executive dysfunction”. On another count, though, it makes me a real pain in the ass to work with. There were meetings I would cancel thirty minutes beforehand, and there were several deadlines I both set and missed. Further, none of the organizers was compensated, and we were all full-time employees or students. I imagine several of us – myself included – were working in excess of 40 hours a week before any conference commitments. It was a challenge to have the blogposts (and many other things) collated for the CCP.

When April 1st arrived, cc:Psychiatry was not ready. To be clear, failures like this are chiefly due to my own ineffective leadership. (And, as false as dichotomies are, this really does seem to be a failure.) I left holes in communication and failed to patch them up.

This is necessary context for interpreting the blogposts. Our timeline did not just inhibit careful writing and revision; rather, my disorganization made these things impossible. Authors submitted blogpost proposals in February, and their first drafts were due on March 10th. We got revisions back to them overnight and asked for final drafts by March 15th. Of course, this ended up being for naught since cc:Psychiatry is only just now being published.

In any case, a foreword should first and foremost provide a description of what authors contributed. (For a section titled “content”, I’ve been quite neglectful of the text’s actual words.) It seems to me there is no convenient, overarching message in cc:Psychiatry. The conference’s theme was pluralism in anti-oppressive praxis. Put another way, how can different ways of knowing – invoking varied kinds of evidence or rhetoric – help us forge a less oppressive system of “mental health”? The arguments included in cc:Psychiatry are on several (different) wavelengths, but they do all call for change. This is true even as central claims and approaches to critique vary considerably. Some write about their lives; some others write critical reviews. Some blogposts hardly seem critical to me, but every piece was critical insofar as the authors saw it as such. (Is this what Wittgenstein was talking about? “Critical” to who? Maybe it isn’t enough, nowadays, to simply be “critical”. The term feels increasingly pragmatic, and not necessarily for the better.)

Final remarks

Sorry again to everyone who was left behind in one way or another – whether because I just couldn’t bring myself to answer your email or Instagram DM for one month, or because I went radio-silent for three weeks in November, or because I was busy otherwise. (I mean, I was.) (Literally everyone is busy. That’s a shitty excuse.) (Okay. Well, to be more straightforward, I don’t know why I struggle to initiate things, or finish them, or switch from one task to another. I finished 95% of this website and then had to go get dinner with someone. In the days that followed, instead of finishing that last 5%, I watched TEN hours of lectures and documentaries on YouTube. And I didn’t need to do that. (In fact, if someone had asked me to watch those lectures, I wouldn’t have done it.) Through this entire process, I watched commitments go from next week to today to a week overdue. It’s been like this for as long as I can remember, including with virtually all the conference organizing. Why is this so difficult?) (I don’t know.) (I wish I could figure this out.) (For someone who knows how blurry everything is, you’re quite preoccupied with finding a discrete fix, or assuming there’s an alternative “cured” state.) (I know. It’s like my relationship with labels. I disagree with it in theory. But as atheoretical as I might want life to be, the world – or society, at least – is in fact theory-laden. It is bound by a certain physics, even if my bodymind keeps rejecting that physics as inadequate.) (This feeling, of course, sucks. I hurt so many people. I make false commitments and fall shortly constantly. It’s almost compulsive.) (Well, philosophy is compulsory once you believe it.) (I said compulsive, not compulsory.) (There’s not much of a difference. It just changes everything – even if it damns you in practice. You couldn’t forget “the” philosophy if you tried.) (Deleuze becomes radically less appealing when you have to do things like shower, pay taxes, and communicate with other humans.) (Just be friends with Laing, he would get it.) (Maybe. He was probably on time for his meetings.) (You’re okay.)

I learned a lot. Until next time, take care. And enjoy the collection, I hope 😽😽😽

(So you’re going to do this again?) (Probably, but maybe not. I think yes though. And it would be better. Because I learned a lot.)

Joseph Sexton directs the Conference on Critical Psychiatry. He finished his undergrad degree at Vanderbilt University in May 2023 and situates himself as a service user – someone who is not only identified and treated as disordered, but who furthermore protests clinical frameworks that “other” him to begin with. More broadly, as a young person, Joseph is concerned with what Bruce Cohen called psychiatric hegemony. His other interests are in suicide, movement building, and bringing back “anti-scientism”. He’s on Twitter if you want to follow him @josephfsexton.

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