Power Relations, Social Order
and Mental Distress
Although the connections may not always be straightforward, mental distress may often link to experiences of power and powerlessness. It is a theme which underpins many of the topics covered in this book – for example, understanding the impact of trauma and abuse (Chapter 6), and making sense of the different experiences of mental distress (and levels of incidence) encountered by subordinated social groups, such as women, Black people, or lesbian and gay people (Chapters 7–9).
Factors such as oppression, injustice, social exclusion or abuse at the hands of powerful others may be implicated in the sequences of events that lead up to many people's experiences of mental or emotional breakdown. Power issues may also shape the reactions that people receive from professionals and the wider community – for example, evidence suggests that African-Caribbean people may be more likely than many 'white' groups to be dealt with more coercively (Browne, 1997; see also Chapter 7).
Indeed, the very form taken by experiences of distress may reflect issues of power. For example, many psychotic experiences would appear to have a somewhat metaphoric quality and may be characterised by images of power and powerlessness – such as believing that one's mind or body is being controlled by strange external forces, or that one possesses special forms of influence and is able to determine external events in unusual ways. People with eating disorders have talked of being stuck within a paradoxical power struggle: that they have come to feel that their only remaining area of control by which to assert their existence is through the refusal of food; but this desperate assertion of power may threaten to end their biological existence