J Med Humanit (2014) 35:257–271DOI 10.1007/s10912-014-9293-5 The Icarus Project: A Counter Narrative for PsychicDiversity Sascha Altman DuBrul Published online: 17 July 2014# Springer Science+Business Media New York 2014 Abstract Over the past 12 years, I've had the good fortune of collaborating with others tocreate a project which challenges and complicates the dominant biopsychiatric model ofmental illness. The Icarus Project, founded in 2002, not only critiqued the terms and practicescentral to the biopsychiatric model, it also inspired a new language and a new community forpeople struggling with mental health issues in the 21st century. The Icarus Project believes thathumans are meaning makers, that meaning is created through developing intrapersonal andinterpersonal narratives, and that these narratives are important sites of creativity, struggle, andgrowth. The Icarus counter narrative and the community it fostered has been invaluable forpeople around the world dealing with psychic diversity—particularly for people alienated bymainstream approaches. But, despite the numbers of people who have been inspired by thisapproach, the historical background of the Icarus Project is hard to find. It exists primarily inoral history, newspaper articles, unpublished or self-published Icarus documents, and ininternet discussion forums. As the co-founder of the Icarus Project, I use this article to makemy understanding of that history and its key documents more widely available.
Keywords Community-based practices . Consumer activism . Mad pride . Intrapersonalnarrative . Interpersonal narrative . Cultural studies . Narrative power analysis . Alternativeforms of mental health care . Biopsychiatry . Bipolar disorder Emergence of the icarus project In September of 2002, I wrote an article for the San Francisco Bay Guardian that was read bythousands of people entitled "The Bipolar World" (DuBrul). It was about my personalstruggles in the mental health system, the biopsychiatric model that dominates it, and mydesire for a new way of looking at my diagnosis of "bipolar disorder." I was 27 years old andhad been writing stories and articles for years within my insular community of punks andanarchists, but this was the first time that my words had made it into a more mainstreampublication. It was also the most personal article I had ever written with details about dramatichospitalizations, psychotic delusions, and struggles with suicidal depression.
S. A. DuBrul (*)Silberman School of Social Work, 2180 Third Avenue at 119th Street New York, NY 10035, USAe-mail: [email protected] J Med Humanit (2014) 35:257–271 I wrote about how at times I felt like the entire universe was crawling under my skin, and yet at other times, I felt as though I had been given a divine mission to save the world. Then Iwrote about how the medications I was taking actually seemed to be helping me, but howdistrustful I was of the medical model. I was concerned with how closely it seemed to be tiedto the capitalist system and with how confusing and alienating the whole situation left mefeeling. I ended the story by saying: But I feel so alienated sometimes, even by the language I find coming out of my mouthor that I type out on the computer screen. Words like "disorder," "disease," and"dysfunction" just seem so very hollow and crude. I feel like I'm speaking a foreignand clinical language that is useful for navigating my way though the current system butdoesn't translate into my own internal vocabulary, where things are so much more fluidand complex…In the end, what it comes down to for me is that I desperately feel the need to connectwith other folks like myself so I can validate my experiences and not feel so damn alonein the world, so I can pass along the lessons I've learned to help make it easier for otherpeople struggling like myself. By my nature and the way I was raised, I don't trustmainstream medicine or corporate culture, but the fact that I'm sitting here writing thisessay right now is proof that their drugs are helping me. And I'm looking for others outthere with similar experiences.
Our society still seems to be in the early stages of the dialogue where you're either"for" or "against" the mental health system. Like either you swallow the antide-pressant ads on television as modern-day gospel and start giving your dog Prozac,or you're convinced we're living in Brave New World and all the psych drugs arejust part of a big conspiracy to keep us from being self-reliant and realizing ourtrue potential. I think it's really about time we start carving some more of themiddle ground with stories from outside the mainstream and creating a newlanguage for ourselves that reflects all the complexity and brilliance that we holdinside. (DuBrul, Sascha Altman Within 2 days of the article going to print, my inbox was filled with email from people who had read the story and related somehow to my words. I never would have imagined that my storywould have resonated with so many others from different communities and lifestyles, and it wasan incredibly empowering feeling. For the first time in my life, I learned the important lesson thatwhen you are brave enough to tell your own story, other people often feel compelled to tell youtheir story as well. I learned about the liberatory power of speaking our personal truths and aboutthe power of personal narratives to challenge the power of the dominant narrative.
One of the people who initially wrote to me with a particularly compelling story was a person named Jacks McNamara. We began corresponding over email, met shortly thereafter,and within the span of an evening and a morning decided to create a place for people like uswho had been through the mental health system and were diagnosed with bipolar disorder totell their stories. We started with a website, calling it the Icarus Project. Shortly after meeting,we wrote an initial vision statement: As the ancient Greek myth is told, the young boy Icarus and his inventor father Daedaluswere imprisoned in a maze on an island and trying to escape. Daedalus was crafty andmade them both pairs of wings built carefully out of wax and feathers, but warned Icarusnot to fly too close to the blazing sun or his wings would fall to pieces. Icarus, beingyoung and foolish, was so intoxicated with his new ability to fly that he soared too high, J Med Humanit (2014) 35:257–271 the delicate wings melted and burned, and he fell into the deep blue ocean and drowned.
For countless generations, the story of Icarus' wings has served to remind us that we arehumans rather than gods, and that sometimes the most incredible of gifts can also be themost dangerous.
The Icarus Project was created in the beginning of the 21st century by a group of peoplediagnosed in the contemporary language as Bipolar or Manic-Depressive. Definingourselves outside convention we see our condition as a dangerous gift to be cultivatedand taken care of rather than as a disease or disorder needing to be ‘cured.' With thisdouble edged blessing we have the ability to fly to places of great vision and creativity,but like the boy Icarus, we also have the potential to fly dangerously close to thesun—into realms of delusion and psychosis—and crash in a blaze of fire and confusion.
At our heights we may find ourselves capable of creating music, art, words, andinventions which touch people's souls and change the course of history. At our depthswe may end up alienated and alone, incarcerated in psychiatric institutions, or dead byour own hands.
Despite these risks, we recognize the intertwined threads of madness and creativity astools of inspiration and hope in this repressed and damaged society. We understand thatwe are members of a group that has been misunderstood and persecuted throughouthistory, but has also been responsible for some of its most brilliant creations. And we areproud.
While many of us use mood-stabilizing drugs like Lithium to regulate and dampen theextremes of our manias and the hopeless depths of our depressions, others among ushave learned how to control the mercurial nature of our moods through diet, exercise,and spiritual focus. Many of us make use of non-Western practices such as Chinesemedicine, Yoga, and meditation. Often we find that we can handle ourselves better whenwe channel our tremendous energy into creation: some of us paint murals and writebooks, some of us convert diesel cars to run on vegetable oil and make gardens that arenourished with the waste water from our showers. In our own ways we're all strugglingto create full and independent lives for ourselves where the ultimate goal is not just tosurvive, but to thrive. Despite the effort necessary just to stay balanced and grounded,we intend to make the world we live on better, more beautiful, and way more interesting.
The Icarus Project Website is a place for people struggling with Manic-Depressionoutside the mainstream to connect and build an alternative support network. We hope tolearn from each others' mistakes and victories, stories and art, and create a new cultureand language that resonates with our actual experiences of this "disorder" rather thantrying to fit our lives into the reductionist framework offered by the current mental healthestablishment. We would like this site to become a place that helps people like us feelless alienated, and allows us, both as individuals and as a community, to tap into the truepotential that lies between brilliance and madness. (The Icarus Project Thus, very early on in our work together, Jacks and I developed a counter narrative to the dominant biopsychiatric narrative. We spoke clearly of our desire not for a reduction of stigma or acure for our disease but for a new culture and language of mental health. We considered themainstream narrative to be a reductionist framework offered by the current mental health estab-lishment, and we emphasized our desire to step outside that framework and into new territory.
We talked about our biodiesel cars and graywater systems, which represented our counter- cultural values and alternative knowledge; our stories about painting murals and writing books J Med Humanit (2014) 35:257–271 highlighted the role art and creativity would play in shaping our work. Our narrative, whichrecognized both lithium and yoga as equally valid means to handling our sensitivities, openedup a much needed space in the dialog about self-care and mental health. We recognized theintertwined threads of madness and creativity as tools of inspiration and hope in a repressedand damaged society. We linked madness and creativity, speaking of them as "tools ofinspiration." Even more powerfully, we flipped the script and pointed our fingers back at thesociety in which we were raised. Furthermore, we expressed an understanding that we aremembers of a group that has been misunderstood and persecuted throughout history but thathas also been responsible for some of its most brilliant creations. It was a powerful beginning.
Narrative strands of our new story Before going further with the Icarus Story, let me step back to provide some context. Ourresponse to the label "bipolar" was not a "normal" response, which is why the Icarus Projectbrought a new perspective to psychic diversity. To create this perspective, we drew inspirationfrom many social movements and subcultural communities that came before us. So eventhough our response was unusual, it did not arise in a vacuum. In creating the Icarus Project,we wove together the ideas and practices in these movements to imagine a powerful newcounter narrative to the dominant mental health narrative that went beyond a questioning of thelanguage around "bipolar" and critiqued the system itself. A review of our cultural, social, andpolitical roots places our work in a larger context and adds to the richness and depth of theIcarus Project as a whole. It also articulates the world views and ways of life from which Icarusemerged. These worldviews are not in the mainstream, they are not "normal," but they have along history of solidarity behind them. Although there are surely more, I have identified eightsocial, political, cultural, and ecological movements that most notably inspired the IcarusProject. Some of these movements were very conscious to us, some were just part of thecultural background in which we lived.
For nearly three centuries, anarchists were at the forefront of contending undemocratic,unaccountable forms of power. From the Spanish Civil War to the 1960s counterculture,anarchist ideas and actions have played an important role in political and social movements(Marshall Since the end of the Cold War in 1989, there has been a resurgence inanarchist organizing, most notably during the protests against the World Trade Organization inthe streets of Seattle 1999 (Graeber 2002). Many early Icarus participants identified with theanarchist political tradition and its emphasis on prefigurative political ideals, mutual aid, anddirect action. Our original organizing vision was based on Food Not Bombs (Butler andMcHenry ), an anarchist project which began as part of the anti-nuclear movement and isa type of direct action and mutual aid: acquiring free food, cooking it as a group, and serving itin a public place.
Though we did not fully understand it in the early days, we were walking in the footsteps of alarge body of knowledge and thought from the 1960s, grouped under the category of Anti-Psychiatry (Cooper ). Anti-psychiatry is a term used to refer to a configuration of groupsand theoretical constructs that question the fundamental assumptions and practices of J Med Humanit (2014) 35:257–271 psychiatry, such as its claim that it achieves universal, scientific objectivity. In the UnitedStates, the body of ideas known as anti-psychiatry were passed down and put into practice inwhat became known as the Psychiatric Survivors Movement by organizations such asMindfreedom International based in Eugene, Oregon (Glasser While the Icarus Projecthad much in common with this project, we tended to have a more nuanced relationship topsychiatric medications than many in the survivor movement. Also, we were younger thanmost in the survivor movement and had never experienced long-term hospitalizations orinstitutionalization. That set us apart and made us more appealing to many of our generationwho had emergency room and short-term hospital run-ins with the psychiatric establishmenttypical of today.
From the beginning, the vision and spirit of the Icarus Project drew a great deal of inspirationfrom the worlds of sustainable agriculture and the body of knowledge collectively referred toas Permaculture (Mollison Within the first months of its formation, both Jacks and Iwere working on Community Supported Agriculture (CSA) farms, understanding that oursensitivities (labeled by society as "bipolar disorder") could be kept in check by keeping closeto the earth and prioritizing the cultivation of food in a community context. Both an economicfarming model and an international movement, CSA re-prioritizes the relationship betweenfarmers, the food that they grow and the families that consume their products. Icarus hasalways had a culture that prioritizes and celebrates food. Many of the most powerful metaphorsin the Icarus Project are drawn from ecology and sustainable agriculture: from roots and seedsto the comparison of monoculture fields with monocultures of the mind.
Permaculture refers to a set of principles for developing sustainable human systems by mimicking systems that occur in nature (Mollison ). Among the useful ideas in permacultureare: using and valuing diversity, using small and slow solutions; integrating rather than segregat-ing, understanding the important relationship between the wild and the cultivated, understandingthat the problem holds the keys to the solution, catching and storing energy, and stepping back toobserve patterns in nature and society. Like the Icarus Project, Permaculture has gone from a set ofideas and principles gathered from a diverse group of people and places to an action orientedinternational signifier for a thriving movement.
The Lesbian/Gay/Bisexual/Transgender/Queer (LGTBQ) movement is large and diverse;within it there is an incredible amount of outsider and resistance stories that have inspiredthe work of the Icarus Project. The watershed event for both the radical and mainstreamLGBTQ community was the 1969 Stonewall riots in New York City where, for the first time,an LGBTQ community publicly reacted militantly in the face of oppression in a way that waswidely reported (Duberman 1994). Until 1973 homosexuality was on the American Psychi-atric Association's official list of mental disorders. (Bayer In the 1980s, an organizationcalled ACTUP (AIDS Coalition to Unleash Power) coordinated an incredibly successfulcampaign to raise awareness about government complicity in the AIDS crisis and build asuccessful movement based around direct action activist culture and queer identity (Shepard &Hayduk, Icarus has drawn a lot of inspiration from the success of the radical portions ofthe Queer Pride movement.
What we have in common is the focus on personal politics, looking at a marginalized identity and reclaiming it as a point of pride. Icarus members' common shouts of "mad pride" J Med Humanit (2014) 35:257–271 (Glasser have much in common with the loud and vibrant articulation of gay pride orqueer pride. It helps that many of the early (and contemporary) Icarus organizers identify assome shade of queer. At the heart of our connection is the utilization of pride around anoppressed identity to inspire political action and the understanding that when we stop beingafraid of being exposed for a shamed identity, there is nothing that can stop us.
The harm reduction movement is centered in the experiences of drug users, sex workers,people involved in street economies, and criminalized communities. There are many ways toframe the war on drugs in the United States and many ideological angles from which to viewit; one angle is that it has been a massive and successful propaganda exercise to demonize drugusers and destabilize Black and brown communities. Drug users are first criminalized for usingoutlawed substances, and then, as a result of how they must obtain drugs, forced to engage inadditional criminal behavior in order to maintain their habits and addictions. Thus, a drug userbecomes a deviant - a transgressor who is incompetent and selfish, destined for jails,institutions or death. The message is that drug users do not care about their own health, thehealth of their friends or colleagues and certainly not the greater public health. The harmreduction movement challenges these ideas.
At the core of the harm reduction movement is the belief that everyone has the right to determine the circumstances of his or her own life, including care (Inciardi & Harrison This principle is also at the core of the Icarus Project. Early in our visioning, we embraced thecomplexities of our individual members' relationship to psychiatric medications, use ofrecreational substances, life style choices and outsider identities. One of our first websiteforums was titled "Give Me Lithium or Give Me Meth," and it was a place to share storiesabout members relationships to illegal drugs. The Icarus Project embraced the spirit of theharm reduction movement in its publishing of the Harm Reduction Guide to Coming OffPsychiatric Drugs (Hall which gathered the best information and valuable lessons wecould find about reducing and coming off of psychiatric medication.
Global justice movement From the beginning, the Icarus Project viewed itself in terms of a larger political context, as onepart of a struggle for mutual liberation. The Global Justice Movement describes the loosecollection of individuals and groups—often referred to as a movement of movements— placinga significant emphasis on transnational solidarity uniting activists in the global South and globalNorth. Usually traced historically to the Zapatista Uprising in Chiapas, Mexico on January 1,1994, the Global Justice Movement is an anti-capitalist movement that weaves together thestruggles of many movements, including an emphasis on grassroots organizing, populareducation, and strong critique of capitalism (Notes from Nowhere, ). Our original webdesigner was from Indymedia, one of the key online activist networks in the early part of the21st century and a hub of the Global Justice Movement. Not long after we published our firstbook, Navigating the Space Between Brilliance and Madness, we learned that it was being readwidely in the Zapatista activist community of San Cristobal de las Casas, Chiapas, Mexico.
In 1968, Theodore Roszak coined the term "counterculture" to refer to the intersection ofVietnam War protesters, dropouts, and rebels of various stripes who had an effect on the larger J Med Humanit (2014) 35:257–271 dominant culture (1968). In the 1960s, the counterculture was strong in numbers and culturalinfluence. Today, many of the most powerful ideas have either been co-opted in the service ofcapitalism or marginalized. Countercultural ideas are transmitted through music and art, andthey offer creative ways of disseminating ideas, connecting with allies and realizing goals. Thefollowing is a brief mention of some of the countercultures that have inspired the Icarus Projectvia their ideologies, practices, approaches and goals.
The Beat Generation is a term used to describe a group of American post-WWII writers who came to prominence in the 1950s, as well as the cultural phenomena that they both documentedand inspired (Charters Central elements of Beat culture included experimentation withdrugs and alternative forms of sexuality, an interest in Eastern religion, a rejection of materi-alism, and the idealizing of exuberant means of expression and being (Charters ). Howl,written by Allen Ginsburg in 1956, chronicles the repressive culture of America in the 1950s. Itreads as a transmission from an earlier time in a language that has clearly influenced the natureof our modern slang-filled English. Howl was dedicated to Carl Solomon, whom Ginsburgbefriended in a Rockland County psychiatric hospital. The following excerpt captures an aspectof the Beat culture that has influenced the Icarus Project in major ways: "I'm with you inRockland/where there are twenty five thousand mad comrades all together singing the finalstanzas of the Internationale…" (Ginsburg 18) The weaving together of madness and thehistory of leftist politics is familiar. The words are not mainstream but are transmissions fromthe underground to the underground—now in the mainstream for everyone to see.
Jack Kerouac was the archetypal beat writer – the explorer of the open roads of America.
One of the most famous quotes from his influential book On the Road articulates the feeling ofthe Beats and their relationship to the "mad": The only people for me are the mad ones, the ones who are mad to live, mad to talk, madto be saved, desirous of everything at the same time, the ones who never yawn or say acommonplace thing, but burn, burn, burn, like fabulous yellow roman candles explodinglike spiders across the stars and in the middle you see the blue centerlight pop andeverybody goes "Awww!" (1957, 21) We consciously resurrected this Beat language in the Icarus Project, referring affectionately to one another as "mad ones," the nod to earlier times and cultures that contributed to theartistic foundation of our project.
As one of the founders of the Icarus Project, I can safely say that the culture of punk rock helda critical and important role in our project's tone and vision. Emerging in the 1970s in Londonand New York before spreading to cities over the globe, punk rock was initially a reaction tothe sterile conformity of commercial rock and roll and disco culture. It inspired a lot of creativeprotest music during the Reagan and Thatcher era of the 1980s. An emphasis on questioningauthority, rebellious distrust of government, and an anti-materialistic DIY (Do It Yourself)ethic. The British version of punk had direct influences from the Situationists, a cleverrevolutionary student movement from the 1960s in Paris (Marcus The Situationistswere proto-punks, inspired by the ideas of breaking down barriers imposed by moderncapitalist society and creating "situations" where new visions might emerge. Woven into theideology of punk is an understanding that society is sick and that acting crazy is totally natural.
Growing up immersed in the punk scene in New York in the 1990s, I learned how to be proudof sometimes feeling crazy and, if anything, learned to revel in it while celebrating differenceand nonconformity.
J Med Humanit (2014) 35:257–271 The story of punk, and of countercultures generally, are useful in explaining an important aspect of the cultural vision and strategy of the Icarus Project. In 1994, punk went through arevival in the mainstream with the rise in popularity of bands like Nirvana and Green Day. Iwatched the subculture in which I had been immersed suddenly become currency for massculture with both positive and negative results. One positive result was that more people hadthe opportunity to be exposed to the alternative political and social messages by which punkrock music is characterized. On the negative side, capitalist consumer culture's process ofmarketing a product required that many of the themes of social change be toned down oraltogether removed from the music (Frank ). As a result, the counternarrative associatedwith punk rock culture was somewhat diluted. For Icarus, this history meant that importantcultural work can start in the underground, but at the same time, this work can easily becomeco-opted.
Navigating the space between brilliance and madness Pulling these many strands together, the Icarus Project initially focused on the identitynarratives of bipolar disorder, and much of our language was geared towards radical politicalactivists. But it quickly became clear that our message was reaching people outside of thecounterculture from which we were born. Shortly after the website went live in November2002, I embarked on a cross-country tour in a beat-up 1982 Toyota pickup truck, facilitatingworkshops in community spaces and collective house kitchens. I had never organized mentalhealth discussions, but I had facilitated a lot of meetings and taught permaculture and seedsaving workshops. I was used to public speaking and creating space for dialog, but nothinglike this. I started with a basic set of questions which evolved into some incredible discussions.
An example of the way in which we used our words to carve out a space in the psychic architecture of the community around us is illustrated in the following passage, an excerptfrom the original flier used to advertise the meetings and gatherings of the Icarus Project: Walking the edge of insanity Navigating the world of mental health as a radical in the 21st century As creative folks skeptical of the conventional social system, what does it mean within ourextended community for someone to be "mentally ill" or struggling with traditional labels suchas "clinical depression," "bipolar disorder," or "schizophrenia?" How helpful is the modernpsychiatric paradigm that revolves around medicine and mental disorders and how much of itis really just a function of powerful pharmaceutical corporations, public funding cuts, and asociety that equates productivity with health? Are there other frameworks for understandingwhat it means to be "crazy?" Are there alternative ways to heal? How do we begin the process? Chances are pretty high that if you're reading this, you or someone you care about has been grappling with these questions for years. Come join an open discussion and learn more aboutThe Icarus Project, a radical support network by and for people struggling with the dangerousgifts commonly labeled as mental illnesses. The Icarus Project envisions a new culture andlanguage that resonates with our actual experiences rather than trying to fit our lives into aconventional framework. By joining together as individuals and as a community, we hope tocreate space where the intertwined threads of madness and creativity can inspire hope andtransformation in a repressed and damaged world. (The Icarus Project ) J Med Humanit (2014) 35:257–271 The following season, Jacks and I were both apprenticing on organic farms, she in California and me in the Hudson Valley of New York. The Icarus Project website was upand running, and a virtual community began to evolve around the discussion forums. We wereattracting interesting people, creating discussion forums with names like "Alternate Dimen-sions or Psychotic Delusions" and "Experiencing Madness and Extreme States." There was noplace else where people who used psych meds and people who did not, people who identifiedwith diagnostic categories and people who did not, could all talk with each other and sharestories. Because of the outreach in the anarchist and activist community, there was a highpercentage of creative people with a radical political analysis. And with the (seeming)anonymity of the Internet, people felt comfortable being honest and sharing intimate storiesabout their lives. Our website served as a refuge for a diverse group of people who werelearning the ways in which new narratives could be woven about their lives.
After a generous and serendipitous donation (from a wealthy woman whose daughter was diagnosed with bipolar disorder) in the winter of 2003, Jacks and I reunited and spent twointense months compiling the writings of people on the website with our own writings into abook that we self-published under the title: Navigating the Space Between Brilliance andMadness – A Reader and Roadmap of Bipolar World. Here is a passage from the introduction: The two people putting together this reader you hold in your hands have been diagnosed with "Bipolar Disorder," the most recent medical language for what was once known as ManicDepression. It is considered a disease of the mind. The statistics are that 6 million people in theUnited States have some form of the disorder, and that 1 out of 5 people left untreated willeventually kill themselves. But this "illness" is more than a bunch of statistics, or a set ofsymptoms. For those of us who live with this awkward label, the phenomenon it describes issomething fluid and hard to pin down, yet none of us can escape its effects on our lives. Weshare common patterns and eerily common stories, some devastating and some inspiring—andso few of them have actually been mapped… In this little book we've assembled an atlas of maps, back and forth through the subcon- scious and consciousness, from hospital waiting rooms to collective house kitchens, from thedesert to the supermarket. The pages we are giving to you chart some of the undergroundtunnels beneath the mainstream medical model of treatment, tunnels carved by brave andvisionary people before us, and tunnels we're helping to carve ourselves with our friends. Theygo beyond three dimensions. They are maps made up of ideas and stories and examples frommany people's lives. They are maps of our souls as well as the world outside. Some of thesemaps will help you to navigate through the existing architecture of the mental health estab-lishment; some of them might help you figure out for yourself where you stand in relation tothe larger ecosystem of the earth and the people who inhabit it.
After this publication, The Icarus Project grew in earnest. Our website became increasingly well know; our book was in its third printing; and we had completed threeincredibly successful tours. Our Icarus discourse of dangerous gifts was becoming audibleamong the larger community around us, despite our subcultural backgrounds and unor-thodox messages, we were onto something that people found compelling. We had tappedinto a desperate need for a more creative look at mental health and wellness. Thebiopsychiatric model, though incredibly profitable for some, left many of us out in thecold as far as understanding our mental health issues and how they related to the rest ofthe world.
Through contacts in the non-profit funding world, Jacks and I met with Anthony Wood, Executive Director of the Ittleson Foundation, and talked over ideas for a proposal to partnerwith an older, more established organization in New York named Fountain House to dooutreach on college campuses. A radical mental health organization when it was founded in J Med Humanit (2014) 35:257–271 the 1940s, Fountain House became the parent of an international network of mental healthClubhouses (the International Center for Clubhouse Development.) Like most mental healthagencies, Fountain House uses the traditional language of mental illness, but also, like mostmental health agencies, they were desperate for ideas that could attract young people. Below isa section from our proposal to the Ittleson Foundation: Community support is a vitally important part of the healing process no matter what form of treatment an individual chooses. While there are numerous conventional support structuresavailable for adults, family members, and those who are comfortable with the medical modelof mental illness, there are very few peer-based support structures created by and for youngand creative populations. Most of the support structures currently available in this country havebeen established by institutions, mental health professionals, and large bureaucratic organiza-tions like NAMI, the National Alliance for the Mentally Ill. While these groups haveindubitably helped thousands of people suffering from mental illness, they have also alienatedcountless individuals who do not "identify with the conventional paradigm of the "mentalhealth consumer." The majority of our members have indicated that they did not consider anyof the participants in traditional support groups to be their peers, and subsequently felt evenmore alone in their struggles to understand the extremes of their experience.
Traditional support organizations frequently speak in terms of "psychiatric disability," "disease," and "eradicating mental illness" (the first objective in NAMI's mission statement).
The members of The Icarus Project, by contrast, have consistently expressed that our project –with its unique conception of mental illness as a potential gift of great vision, creativity, andcompassion that must be harnessed and respected, as well as an incredible hardship – is one ofthe only places where they can find meaningful support from true peers. The archetype of themythical Icarus, who uses the gift of wings to fly to places of incredible beauty but crashesafter recklessly flying too close to the sun, has proven a much more resonant metaphor for ourmembers' extremes of experience than the paradigm of disease…(The Icarus Project ) The day we found out we had received the grant from Ittleson, we were hanging the first Icarus Project art show at a radical community center/art gallery on the Lower East Side ofNew York known as ABC No Rio. It was surreal; not only were they giving us $80,000 towork on our dream project, but we had also stepped suddenly into a world of legitimacy towhich we never expected to gain access. Within 6 months of receiving the grant, we recruited ahandful of amazing organizers, collectivized our organization, and revised our mission andvision statements to reflect our evolving political and social analysis. In short, this was thestatement, not just of a non-profit but of an aspiring movement: Icarus project mission statement (2005) The Icarus Project envisions a new culture and language that resonates with our actual experiences of 'mental illness' rather than trying to fit our lives into a conventional framework.
We are a network of people living with and/or affected by experiences that are often diagnosedand labeled as psychiatric conditions. We believe these experiences are dangerous giftsneeding cultivation and care, rather than diseases or disorders. By joining together as individ-uals and as a community, the intertwined threads of madness, creativity, and collaboration caninspire hope and transformation in an oppressive and damaged world. Participation in TheIcarus Project helps us overcome alienation and tap into the true potential that lies betweenbrilliance and madness.
J Med Humanit (2014) 35:257–271 OUR VISIONTogether, we seek new space and freedom for extreme states of consciousness. We support alternatives to the medical model and acknowledge the traumatic legacy of psychiatric abuse.
We recognize that we all live in a crazy world, and believe that sensitivities, visions, andinspirations are not necessarily symptoms of illness. Sometimes breakdown can be theentrance to breakthrough. We call for more options in understanding and treating emotionaldistress, and we advocate for everyone, regardless of income, to have access to these choices.
We respect diversity and embrace harm-reduction and self-determination in treatment deci-sions. Everyone is welcome, whether they support the use of psychiatric drugs or not, andwhether they identify with diagnostic categories or not. To ensure we remain honest anduntamed, we do not accept funding from pharmaceutical companies. We invite anyone whoshares the Icarus vision and principles to join us, and choose "The Icarus Project" or any othername for the independent efforts that inspire them.
Beyond the medical model While we respect whatever treatment decisions people make, wechallenge standard definitions of psychic difference as essentially diseased, disordered, broken,faulty, and existing within the bounds of DSM-IV diagnosis. We are exploring unknownterritory and don't steer by the default maps outlined by docs and pharma companies. We'remaking new maps.
Educating ourselves about alternatives A lot of what the media, medical establishment, andinstitutions tell us about "mental illness," psych drugs, and how we have to live our lives is justnot true. We educate ourselves and each other. We question what we hear on TV and read indoctor's office brochures. We explore holistic and spiritual approaches to handling our extremestates of consciousness. We learn as much as we can about any medical treatments, andencourage each other to make informed choices. Icarus is a sanctuary for people thinkingoutside the mainstream and creating their own definitions of health and wellness.
Balancing wellness and action Icarus is a place for supporting each other in practicing realself-care. This includes but is not limited to: making sure we don't neglect our personal basicslike food, rest, exercise, and community; encouraging each other to commit to the amount ofwork we can actually do, and not push ourselves past our limits; and challenging ourselves tofind daily routines and projects that help us live out our dreams and have enough structure toget by.
Access We don't need more alternatives that only rich people can afford. All Icarus gatheringsfollow the policy that 'no one is turned away for lack of funds.' We work to create options andchoices that are available to all.
Non judgment and respect for diversity We welcome people who support psych drugs andpeople who do not, as well as people who use diagnostic labels and people who do not identifywith those terms. We do not exclude people on the basis of politics, lifestyle choice, diagnostichistory, recreational drug use, "criminal" behavior, or other outsider identities. We all have a lotto learn from each other, so we respect each others' choices. While the current social systemand medical model have the tendency to divide us, we want our understanding of andexperiences with madness to unite us.
J Med Humanit (2014) 35:257–271 Non-hierarchy and anti-oppression Local groups need to be anti-authoritarian, inclusive, andworking against racism/classism/sexism/homophobia and other oppressions. As a radicalmental health support network, our affiliated groups create safe and challenging spaces whereoppressive behavior is not tolerated.
Nonviolence We believe that we will bring about lasting change in the world through dialogue,compassionate listening, mutual aid, and grassroots networks of support. We hope theseapproaches contribute to forming viable alternatives to the current system of government,bureaucracy, domination, and corporate culture.
Transparency We believe in public access to information about how we are making decisions,spending money, distributing responsibility, and otherwise delegating the work of organizingtogether. (The Icarus Project, These are revolutionary words and acknowledge our relationship to history and our debt to the movements and cultural workers that have comebefore us. These words put us outside all the other organizations working in our field, affirmingto everyone our radical stance in the true meaning of radical: from the roots to the extremes. Noone else in the field of mental health was talking about non-hierarchy and transparency in thisway. We were bringing the radical narratives and models into the door of the mainstream.
Later that year we created a collective document which we called Friends Make the Best Medicine: A Guide to Creating Community Mental Health Support Networks that peoplearound the world download from our website and use as a guide for starting local IcarusProject support groups. Here is part of the introduction.
Underground roots and magic spells Visions for resisting monoculture and building community You can see it all from the highway: enormous monocrops of identical corn plants that reach formiles bordered by an endless sea of strip malls, parking lots, and tract housing. You can see it on ourkitchen counters and in our classrooms: the same can of soda on the table in Cairo and Kentucky,the same definitions of "progress" and "freedom" in textbooks around the world. Monoculture – thepractice of replicating a single plant, product or idea over a huge area– is about the most unstable,unsustainable, unimaginative form of organization that exists, but in the short term it keeps thesystem running smoothly and keeps the power in the hands of a small number of people. In thelogic of our modern world, whether it's in the farmer's field or in the high school classroom,diversity is inefficient and hard to manage. Powerful people figured out awhile time ago that it's alot easier to control things if everyone's eating the same foods, listening to the same music, readingthe same books, watching the same TV shows, and speaking the same language. This is what wecall the monocult, and while everyone is supposedly more and more connected by this new "globalculture", we're more and more isolated from each other. Things feel more and more empty, and somany of us end up lonely and rootless, wondering why everything feels so wrong.
Out in the wild things are very different. In old forests everything is connected, from the moss and lichens to the ferns and brambles to the birds and beetles. In our human minds weseparate all the parts of the forest into separate pieces when a lot of the time it can be morehelpful to view the forest as one giant organism with separate parts all working together. Thetrees of a forest intertwine their roots and actually communicate with each other underground.
You see it most visibly along ravines and creek beds where a cut-away hillside reveals totallyasymmetrical tangle of roots that no scientist could ever have imagined or planned out with allhis laws of physics. Something in that tangle explains how those trees can lean out at all kinds J Med Humanit (2014) 35:257–271 of gravity-defying angles and hang their necks into the strongest winds and still survive,bending but not breaking, adapting with unpredictable curves and angles to the way the worldbreathes and shines and rains and burns. Concrete can't do that. There are a lot of lessons to belearned from the way life evolves and gets stronger in the wild. Something about the livingarchitecture of chaos and time, multi-tiered forests and microscopic algae, outlasts any of thestraight lines and square institutions we're told to believe in.
We believe that people do not belong in grids and boxes of rootless lonely monocultures.
Humans are adaptable creatures, and while a lot of people learn to adapt, some of us can'thandle the modern world no matter how many psych drugs or years of school or behaviormodification programs we've been put through. Any realistic model of mental health has tobegin by accepting that there is no standard model for a mind and that none of us are singleunits designed for convenience and efficiency. No matter how alienated you are by the worldaround you, no matter how out of step or depressed and disconnected you might feel: you arenot alone. Your life is supported by the lives of countless other beings, from the microbes inyour eyelashes to the men who paved your street. The world is so much more complicated andbeautiful than it appears on the surface.
There are so many of us out here who feel the world with thin skin and heavy hearts, who get called crazy because we're too full of fire and pain, who know that other worlds exist and aren'tcomfortable in this version of reality. We've been busting up out of sidewalks and blooming allkind of misfit flowers for as long as people have been walking on this Earth. So many of us haveaccess to secret layers of consciousness you could think of us like dandelion roots that gatherminerals from hidden layers of the soil that other plants don't reach. If we're lucky we share themwith everyone on the surface―because we feel things stronger than the other people around us, alot of us have visions about how things could be different, why they need to be different, and it'spainful to keep them silent. Sometimes we get called sick and sometimes we get called sacred,but no matter how they name us we are a vital part of making this planet whole.
It's time we connect our underground roots and tell our buried stories, grow up strong and scatter our visions all over the patches of scarred and damaged soil in a society that is sodesperately in need of change. (The Icarus Project ) With this statement, we attempted to define ourselves in opposition to the cold logic of the DSM-IV. The same way that monoculture corn fields are horrible for the environment butprofit a few, the monocultures of the mind are a disaster to our planet, our communities andpersonal lives. The Icarus vision, a weaving of multiple counternarratives, throws the coldDSM narrative on its head and grows a new world with the broken pieces.
A dandelion conclusion Biopsychiatry remains the dominant narrative of mental health despite the fact that it has facedtremendous resistance. Indeed, over the same years that the Icarus Project developed,biopsychiatry has become the focus of widespread critique (Whittaker Tamini and,Cohen Lane , Morrison ). New approaches to mental health focus on storiesand narratives echoing many of Icarus Project perspectives and emerging from a variety ofsources (Stastny ). Yet, despite widespread critique and alternatives, biopsychiatry re-mains the invisible common sense on our television screens and in our medical culture. It is theoverwhelming option that is available to us when we and our loved ones are in distress, and itis the language in our mouths when we try to talk about our most intimate struggles with ourminds. Biopsychiatry is the mainstream that we all drink from and, for many of us, the storythat keeps us feeling trapped in psychic boxes like we are sick and diseased, rootless and alone.
J Med Humanit (2014) 35:257–271 In the preceding pages I have shared with you the attempts of my community to actively and creatively counter the biopsychiatric narrative and way of life. Early on in our struggle, wecame up with a metaphorical symbol, an image that carries a story which best conveys ourresilience in the long battle to redefine how our culture understands mental health. This is thesymbol of dandelion roots and their relationship to soil.
It is a rule of nature that the ground does not stay bare for very long. Wherever soil has been disturbed, there are always seeds that come along which grow into plants with roots and leavesthat cover the bare soil, providing homes for all kinds of creatures and enriching the earththrough their cycles of life and death. These plants are called pioneer plants because they laythe groundwork for the inevitable successions that follow. Many of the most common pioneerplants are the ones we are trained to see as weeds, plants like the dandelion whose strongtaproot extends far below the depleted topsoil to the deep layers of subsoil that hold hiddenminerals underground. The dandelion pulls these minerals up and incorporates them into itsleaves and flowers; when it dies all the nutrients that were locked underground join the upperlayers of soil, making them available to the next generation of plants growing in the soil.
We have learned, in the Icarus Project, to see the dandelion–this wild and unpredictable plant that reaches into the fertile darkness of underground places–as a symbol for our work.
Many of the ideas from the Icarus Project are taken from the cultural and political under-ground, from important stories and wisdom that are not so easy to find in the topsoil ofmainstream culture. Many of our visions for the future emerge from the depths of our ownexperiences as the mad ones whose roots reach down into the darkness but whose voices openup into the light.
Pioneer plants tend to create thousands of tiny seeds that are lightweight, sometimes with fine hairs that act like parachutes, keeping them afloat in the wind and preventing them fromsuccumbing too quickly to gravity. We see the Icarus Project setting seed and releasingmessages from hidden worlds that just might travel far and wide and colonize patches ofdamaged soil all over the planet, slowly transforming old stories into new, laying thegroundwork for inevitable changes. In this spirit, the dandelion serves as an organic metaphorfor our strategy and our vigilant hope going into the future.
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Comparative efficacy of inhaled albuterol between two handheld delivery devices in horses with recurrent airway obstruction

EQUINE VETERINARY JOURNAL Equine vet. J. (2011) •• (••) ••-••doi: 10.1111/j.2042-3306.2010.00313.x Comparative efficacy of inhaled albuterol between twohand-held delivery devices in horses with recurrentairway obstruction F. R. BERTIN, K. M. IVESTER and L. L. COUËTIL* Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Purdue University, Indiana, USA.

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