Mbonde, N., "Wading in Digital Waters" Black Mad/Cripistemologies of Motherhood and 'Mental Illness' in Online Support Groups Amid the Double Pandemic", Disability Studies Quarterly. doi: https://doi.org/10.18061/dsq.6868 

Introduction

I attended my first bipolar support group in 2019 while pregnant. I learned that these kinds of groups exist in my second trimester when I came from a journey through various altered states, which the Diagnostic and Statistical Manual of Mental Disorders (DSM) has termed mania, depression, and psychosis. Alone in my experience of psychiatrized madness since my bipolar diagnosis at 18 and three subsequent psychiatric incarcerations, I found peers for the first time in almost a decade, though they were primarily white. Those of us who attended these support groups have all endured some level of violence from being subjugated by the mental health-industrial complex and by being victims of sanism because of our diagnoses. However, because many of the white people who monopolize these groups cannot perceive how opposing the historical and present structural advantage of whiteness through exclusion and subordination is different from opposing white people, Black people could not receive adequate support in groups where white people were present. This lack of awareness among white people became even more pronounced during what came to be called the “double pandemic,” when the COVID-19 outbreak collided with the global reckoning over anti-Black police violence.¹ As I navigated the racial politics of disclosure, I found a tension in ideas of group unity based on racial identity and psychiatrized madness. Attending my first bipolar support group, I trepidatiously walked into a hospital conference room in Manhattan where the support group convened. After scanning the room full of white people, I sat next to the facilitator, a Black man at the head of the table, who made me feel more at ease.

Opening the Floodgates: Patchwork (Auto)Ethnography and Black Mad Methods

Floodgates regulate the flow of large bodies of water, avoiding flooding and providing productive means for sustenance and hydropower.²

At the onset of the COVID-19 pandemic in March 2020, the intimate digital space of non-clinical online mental health support groups surged in popularity. Groups that previously met in hospitals, churches, and offices migrated to online platforms almost overnight, supporting people confined to their homes. This abrupt shift allowed me to attend groups remotely and be home with my newborn at three months postpartum. From 2019 to 2022, I regularly attended six different support groups: a New York-based bipolar support group (approximately 10 participants per meeting), a New York-based all-Black general mental health support group, a 12-step group for the family members of addicts (up to 200 participants per meeting), and three groups hosted by a perinatal mental health organization—one for Perinatal Mood and Anxiety Disorders (PMADs) for moms (approx. 20 participants per meeting), a Black moms’ group (approx. 18 participants per meeting), and a perinatal bipolar group (up to 10 participants per meeting). I also trained and served as a peer support group facilitator for the New York and perinatal bipolar groups. My deep engagement put me in a unique position to explore these spaces as virtual field sites that would otherwise be inaccessible.

Influenced by the affordances and constraints of the COVID-19 pandemic, I employed “patchwork ethnography,” a method developed by disabled, queer, and feminist anthropologists whose domestic duties and personal lives overlap with their professional responsibilities.³ The groups I attended, even when based in a particular location, transcended geography, attracting participants across state lines and all over the world. My familiarity with perinatal madness immersed me in the virtual world of global maternal mental health during the widespread adoption of digital mental health platforms, including online therapy, psychiatry, medication management, and support groups. Together, these formed a cyber village of pregnant and postpartum people isolated from their families and communities due to quarantines and lockdowns. Online support groups were also spaces where Black people, already disproportionately affected by COVID-19, dying at twice the rate of their white counterparts, had to contend with the collective trauma and national unrest sparked by the televised police killing of George Floyd, Breonna Taylor, and Ahmaud Arbery. Constituting what others and I have called a "double pandemic," the two global crises of COVID-19 and police brutality contributed to Black people's distress and experiences of multiple forms of marginalization, influencing the way they navigated receiving support online.

Guidelines for participation in mental health support groups demand full membership, sharing the identity and lived experience of the other members in the space. Throughout this article, my deliberate use of the terms “mental illness,” addiction, or other psychiatric labels is not prescriptive. Instead, I code-switch between hegemonic psychiatric labels and mad frameworks to highlight the political tension in the prevalent use of the DSM as the lingua franca for technical discussion of medications, side effects, altered states, and in- and out-patient programs to connect with support group members. My attention to language demonstrates how mad people have undergone various degrees of psychiatrization and exist along a spectrum of (dis)identification with their diagnoses, compliance with psychiatric treatment, as well as perspectives of madness that exist within and outside of a disability identity. This article will show how what I call Black mad/cripistemologies as sites of knowledge production trouble pre-existing categories, labels, and identities, moving away from pathologization, reiterating Toni Morrison’s affirmation, "definitions belong to the definers, not the defined."⁴

Support groups operate in a private sphere due to the strict rules concerning participant confidentiality, to which I am also bound, as an “observant-participant,” fully engaged in giving and receiving peer support while taking mental notes for research purposes.⁵ As gatekeepers of this online community, peer facilitators enforce policies that prohibit audiovisual recording and note-taking and emphasize the importance of maintaining each person’s confidentiality, even if anonymity is not possible. Since no one else was aware that I was conducting research, I used autoethnography to respect the strict requirements for participation and confidentiality in mental health support groups, addressing the blurry boundaries that accompany digital ethnographic research. My decision to participate in online support groups as a point of inquiry turned my digital life into data, allowing me to practice self-reflexivity, glean theoretical insights from my encounters, and respect the privacy and confidentiality of support group participants. A few participants, longing for public recognition and reparations for the profound lack of social support they experienced online and in the “real world,” consented to interviews. I always conducted interviews outside of the group with individual consent based on a shared investment in my research goals.

In this article, I aim to convey my experience of what I observed and how I contributed to the group. As an observant participant, I received a mixed response from support group members who were aware of my research. Some Black people I met in support groups experienced a sense of safety with me. We organically cultivated a community offline because we were in the same struggle together. Meanwhile, others intuited my foreignness and curious comfort in predominantly white spaces. Little did they know I spent my formative years in Switzerland cultivating a “double consciousness” and a “white mask” to navigate my environment.⁶ These perceptive individuals approached me with cautious optimism or careful suspicion. Hence, I acknowledge my bodymind as both the instrument and site of knowledge production within the physical and virtual spaces I occupied, influencing what kind of data I garnered and from whom.⁷ Using pseudonyms, I include these disclosures and refusals where they offer striking examples of “wading through” as mad methodology, part of the legacy of Black resistance and radical creativity in response to an oppressive world order in which “going mad” is the most appropriate response.⁸

Notwithstanding anthropology’s longstanding separation between researcher and subject, my turn to autoethnography to offer myself up for inspection as an “anthropological specimen” is a mad method in and of itself.⁹ Instead of an impediment, my experiences with motherhood, madness, and psychiatric incarceration not only enhanced my ability to navigate and produce knowledge from the virtual field of online support groups, but were the very means by which I gained access. Conducting research and formulating an understanding of the field while Black, pregnant, postpartum, and navigating altered states threatens the academy’s investment in white patriarchal notions of sanity.¹⁰ As a feminist method, which can also be considered mad given the historical depiction of women as witches and hysterics and the overall devaluation of women’s contribution to knowledge production, autoethnography exposes the fictive rationality and objectivity of positivist research.¹¹ Hence, my mad method adopts a “critical” autoethnographic approach, sensitizing me to the power dynamics within the support group space, entrenched in racial capitalism, misogynoir, and institutional racism, that produce Black precarity.¹² Though “a seemingly conceptual impossibility,” I walk a tightrope between my mad liberatory ethic that acknowledges the spiritual, ancestral, and artistic significance and intelligence of my altered states, including those I navigated while pregnant and postpartum, while identifying with my diagnosis to receive care and accommodations, find community, and fend off carceral punishment.¹³

Studying how Black people in online support group spaces navigate the precarity that accompanies being subjugated by the mental health industrial complex, I argue for increased attention to Black mad/cripistemologies, which center Blackness in discourse on crip and mad identities.¹⁴ Like the term “anti-Black sanism,” Black mad/cripistemologies necessarily center Black people and their experiences with sanism, ableism, sexism, and racism.¹⁵ Pickens astutely notes, “Blackness modifies who and what is mad,” making the experience of Black madness qualitatively different and in need of particular attention to grasp the immensity of the challenges Black people have historically and presently faced in efforts towards mad liberation.¹⁶ Not only do Black mad/cripistemologies attend to the various forms of violence Black people experience on and offline, but also how they grapple with and move forward despite the devastation of gendered and racial violence, re-emerge from the wreckage, and re-envision new futures. Unlike racially undifferentiated experiences of time, space, and place shaped by crip and mad subjectivities, I use the term Black mad/cripistemologies to identify mad and disability discourse that addresses the tools Mad Black folk and others involved in anti-racist liberation work use to navigate psychiatric surveillance and policing, which uncannily mirrors systemic problems in today’s world.¹⁷ This article pays particular attention to how Black women maneuver this minefield with the lives of their children in tow.

Using the metaphor of wading in digital waters, I explore how Black people have carried forward their mad/cripistemologies, knowledge on how to navigate hostile environments from slavery to segregation, and systemic inequality into the present digital sphere. From the transatlantic slave trade to today, the digital has emerged as another vast expanse of turbulent terrain that Black people must collectively move through. Harkening back to ancestral legacies of fugitivity, we can identify Black mad/cripistemologies to resist, like the Negro spiritual “Wade in the Water,” supposedly used by Harriet Tubman to instruct fugitive slaves to trudge through the water so the dogs chasing them would lose their scent.¹⁸ In the vein of Christina Sharpe’s In the Wake: On Blackness and Being, I use my poetic adaptations of online dictionary definitions of water forms marked in italics as guideposts to meditate on what it means to wade through digital waters and carry the struggle for liberation into the virtual sphere.

Whitewater: The Whiteness of Support Groups

Turbulent. Frothy. Whitewater appears opaque. Deception.
Whitewashing easily conceals the unpleasant, the incriminating
blood in the water.¹⁹

Besides the Black moms’ group and the New York-based all-Black group, each support group claimed to cater to people of all races, though they were “inadvertently white.”²⁰ The groups I attended and facilitated always had a core group of (mostly white) regular attendees who all knew each other from having shared a digital space for significant periods. Despite the best intentions of the group to create a “safe space” – an environment purported to be a refuge from harm, discrimination, or surveillance – there are social biases that pose a risk, especially for Black participants, making these groups (un)safe spaces. (Un)Safe spaces pose the potential for harm precisely because many facilitators and participants consider themselves protected from emotional danger or harmful outsiders and do not examine the risks to multiply marginalized individuals posed by other members of the group.

Attending my first bipolar group, it was a welcome surprise to discover that my idiosyncratic thoughts, feelings, and behaviors are not unique to me, but rather eccentricities that belong to a larger mad community. However, this was nuanced as I saw a clear distinction between the neurodivergence many white people embodied versus Black “neuroexpansiveness,” which diverges from the white construct of able-bodied/mindedness, presenting opportunities for madness and mental illness to be read in new ways.²¹ White people who live with diagnoses of mental illness are distinct from what Barbara Smith of the Combahee River Collective calls “vulnerably oppressed identities,” in which the subject has no privilege under racial capitalism and heteropatriarchy.²² George Lipsitz’s notion of “the possessive investment in whiteness” illuminates the challenges associated with achieving this acknowledgement, let alone divestment from the project of whiteness altogether.²³ He explains how white fragility promotes defensive and dismissive behaviors when confronted with conversations about race, making it challenging to address systemic racism and its impact on Black people.

Mitigating the risks for Black people participating in support groups would allow white people to gain an awareness that having a marginalized identity as a white person has social capital, particularly absolution from all accusations of racism. For instance, I witnessed the cooptation of identity politics unfold as white support group members leveraged their psychiatric diagnoses to their advantage to claim their experience with ableism or sanism is equivalent to racism. In the context of white people claiming a disabled identity as a result of being diagnosed with a mental illness, Reyma McDeid’s concept of “white disabled fragility” demonstrates how white people cling to their victimization from living with a diagnosis without reflecting on their learned privilege, namely, the ability to be oblivious to who does not have the same level of access to the spaces they occupy.²⁴ This disposition is particularly damaging to the Black participants who encounter this “oppression Olympics” because they may feel the need to take on the responsibility of educating the “oppressed” white people in the room, or deal with racist remarks in silence. Hence, Black people with vulnerably oppressed identities do not benefit from disclosing them, particularly in white support group spaces, which tend to erase their distinct experience of anti-Black sanism.

One of the fallacies in some peer support philosophies espoused in these online spaces is that we all share the same identity of oppression. Scholars working at the intersection of incarceration and disability identify that Black people can gain some advantage from proximity to whiteness and have a spectrum of experiences at the intersection of class, gender, sexuality, religion, and colonial oppression affording privilege or marginalization. However, their inability to become white means they are always vulnerable to slipping into stigmatized categories, whether or not they are formerly diagnosed with a mental illness.²⁵ Helena Hansen, Jules Netherland, and David Herzbeg demonstrate how “technologies of whiteness,” social strategies of erasure and exclusion to maintain white dominance, have whitened the face of opioid addiction, indicating that the faces of recovery from mental illness and addiction in support groups and 12-step programs can be whitened too.²⁶

Framed as apolitical, the structure of 12-step groups functions as a technology of whiteness as it reproduces white supremacy, maintaining the status quo of class and racial hierarchies. Twelve-step groups often refrain from discussing topics such as race, politics, religion, and careers, to create “safe spaces” or “healthy” meetings, where the focus is on unity and group cohesion. Though I only discovered 12-step programs in the post-George Floyd moment, I wonder how people in these meetings, which are aggressively asserted to be “apolitical,” might have found a way to talk about this moment of racial injustice without violating the group guidelines. Dissent and resistance against hegemony get coded as political, creating the potential for the dominant group of white participants to feel threatened or uncomfortable. To continue participating in these 12-step meetings, I felt like I needed to check my Blackness at the proverbial door. I quickly realized the first step is for all members to claim the same identity while forsaking all others in the name of unity. In meetings, we are one, meeting solely for the benefit of the family members of addicts to find peace and serenity through a supportive community and working the Twelve Steps. We do not share our religious affiliations, announce our political alliances, declare our die-hard sports fandom, discuss the therapies we partake in, or even mention our professions. Through a seemingly mystical process of identity transformation, these groups make self-proclaimed addicts. “Addict” becomes the common last name, making each group member part of a chosen family. In this way, the defined become the definers, reclaiming a pathologizing label to build community and find recovery, which 12-step programs define as the pursuit towards ceasing addictive behavior. For the family members of addicts, our addiction supposedly takes the form of toxic co-dependency and enabling the substance-using addict in our lives.

One of the well-intentioned but misguided promises of online support groups is that they are safe spaces because they avoid certain subjects. While the bipolar support group did not have stipulations against talking about politics and race like the 12-step group, there is an unspoken agreement that these subjects are best avoided. Most white members in the bipolar group did not know how to address race when George Floyd was killed. People tripped over their words as they tried to express their solidarity with the few Black participants who shared their grief, anger, and frustration. Some white participants made overtly racist statements as they expressed their ignorance about the Movement for Black Lives and the Black Lives Matter protests. Others communicated their bewilderment about how the news stories about police brutality against Black people were relevant to the group discussion. Despite the group being a “safe” space where people can discuss their distress and daily struggles, there was no explicit effort in the group facilitator training to create an environment where people could discuss race, politics, and religion in a supportive manner, even if not devoid of conflict or friction.

Treading Water: Navigating (Un)Safe Spaces

Tread: to walk in a specific way. Moving one’s legs and arms in a forward motion without moving forward. Stagnation. Keeping one’s head above deep water. Expending effort just to maintain the status quo.²⁷

Attending the bipolar support group for almost a year in-person and then online inspired me to train as a peer support facilitator because I saw few facilitators who looked like me. Even when I didn’t feel like attending the group, I was always excited every time a Black person joined for the first time. I felt relieved I could be a friendly face and offer moral support, given the difficulty of coming out to a room full of white strangers with a diagnosis seldom discussed in one’s community. My desire to attend groups and hold space for other Black people was borne out of a mutual understanding of our shared lived experience of how systemic anti-Black racism and sanism impacted us. While the use of digital platforms, such as Zoom, facilitated greater connection among people who did not live in the same vicinity, the nature of videoconferencing technologies also impeded connection due to the ubiquitous challenges with equity in internet access and the adverse experiences Black users have with the technology. I noticed a greater racial disparity in attendance when the groups migrated online compared to when they met in person. Group guidelines and the specific support group culture are “technologies of whiteness,” part of the social infrastructure that make these platforms inaccessible and, at times, dangerous for Black people, requiring careful navigation of virtual space.²⁸

Some guidelines, such as the bipolar group’s requirement for participants to be on camera, even when they are not speaking, may pose a problem for people concerned with being watched. In the DSM-5, paranoia is a symptom associated with psychotic disorders, such as schizophrenia. However, it is common for Black people to be sensitive to the real and actual threat of surveillance in their engagement with digital platforms like Zoom. Rather than merely a symptom of mental illness, what often gets referred to as “paranoia” is an understandable reservation given the historic surveillance of Black people in all sectors of white-dominant society, including law enforcement, employment, the medical establishment, the education system, and social services.²⁹ From stop-and-frisk practices against Black pedestrians and the policing of natural hair in schools, surveillance is a routine part of Black life, dating back to the antebellum period when enslaved Africans had to develop fugitive communication practices to abscond from the ever-looming white gaze.³⁰ Recent FBI surveillance of “politically suspicious” groups, including members of the Black Panthers and Black Lives Matter, illustrates how governmental surveillance is still prevalent in ongoing Black liberation movements.³¹ Black mad/cripistemologies contend with these realities and theorize vigilance, what psychiatry considers paranoia, to be a justifiable means for Black people to protect themselves in an antagonist anti-Black world.

Mental health support groups are supposed to be spaces where individuals can share their struggles and experiences. Irrelevant conversation about the minutiae of everyday life robs members of precious time to share or hear something valuable for recovery. Small talk is discouraged. As I shared how addiction devastated my life with over one hundred strangers on Zoom, I began examining what Jenny Kennedy refers to as “transgressive sharing.”³² In essence, this type of sharing interrogates the boundaries of social acceptability as it pertains to intimate disclosure of taboo subjects, such as hearing voices and suicidal thoughts. Instead of beginning with surface-level introductions, support group participants are invited to “start from a place of steel vulnerability” without apology or justification.³³ Outside of the support group space, people may consider this kind of exchange “oversharing,” an inappropriate divulgence of personal details, especially when in conversation with strangers. Within the support group space, transgressive sharing gets reframed. What is transgressive outside the group is pedestrian within the group.

Though transgressive sharing in support groups can be liberating, it also comes with sizable risks for Black people in white spaces. In most mental health support groups, there is a dicey guideline delineating the course of action for facilitators if a member expresses a desire to act on thoughts of suicide or self-harm. The organization’s stance is to intervene when members’ shares veer in this direction. In the bipolar group, the standard procedure is for the facilitator to speak with the individual privately in a Zoom breakout room and then follow up with a phone call after the meeting to monitor the situation and help connect the individual with professional mental health support. Notably, support group facilitators are peers with lived experience rather than licensed mental health providers. When the bipolar support group met in-person, they escorted suicidal group members to the ER. However, when groups moved online during the pandemic, the course of action involved law enforcement in the form of a wellness check at the group member’s home.

Though participants do not have to provide their home addresses to support group facilitators, the friendships among the tight-knit group of peers allow facilitators to obtain information, such as phone numbers and addresses, to facilitate wellness checks. Often undesired by the group member, this intervention provides security for the organization and facilitators rather than safety for the person in crisis. This protocol is part of what Lisa Stevenson would call “murderous care,” making it such that mostly white peers participate in policing Black people who are often harmed, if not by law enforcement, then almost always when they undergo psychiatric incarceration.³⁴ Thus, Black people are caught in the double bind of needing support and simultaneously having to do without it because the help may be lethal.

When I began attending the bipolar support group during the late stages of my pregnancy, there was only one other Black woman present, whom I will call Sadie, an industrious Southern 49-year-old mother and grandmother. I developed a rapport with Sadie from the bipolar support group because she was the only one who shared my identity as a Black bipolar mother. In an interview, she shared how the trauma of losing her third daughter five months after she was born triggered Sadie’s madness and postpartum-onset bipolar diagnosis, which she struggles with into her menopausal years. Concerned about her worsening suicidal thoughts, white members from her bipolar support group contacted a mental health crisis team to check on her. The support group members did this without regard for the risks this would pose for a Black person, since police are first responders at wellness checks.

These instances of surveillance and intervention illustrate the association of Black madness with danger, pathology, and criminality, which have long resulted in the inhumane treatment of Black people diagnosed with mental illness at the hands of law enforcement.³⁵ Unequipped to de-escalate mental health emergencies, police often injure or kill the person in crisis. Despite the image of Black men killed by the police, many Black women with mental health diagnoses have been murdered, including Miriam Carey, Sonya Massey, Sandra Bland, Tanisha Anderson, and Deborah Danner. These women all navigated non-normative ways of being in the world. They were either shot during a wellness check while they were in distress or died in police custody, demonstrating how police brutality is an issue at the intersection of sexism, racism, and ableism/sanism. Cognizant of this, Sadie states, “I was pleasant with [the police officers], but they remained with their hands on their guns the whole time. And because I had a nephew here who’s Black, I didn’t want anything to happen to him. Because he started coming out to my aid, I went [with the officers] voluntarily because I didn’t want . . .” Sadie’s voice trails off, omitting the possible outcome of her nephew’s death at the hands of the police. Sadie was involuntarily committed despite the threat of COVID-19 on the psych ward, medicated against her will, and discharged in a worse mental state with a large medical bill she could not afford to pay.

Sharing in the context of support groups for pregnant and postpartum people is particularly transgressive and can have negative consequences because it almost always implicates an unborn or small child. For instance, while airing one’s suicidal thoughts in a support group can cause concern, the stakes are magnified when the person sharing is pregnant or taking care of children. I realized the limits of confidentiality outlined in the support group community guidelines when I trained as a facilitator for a bipolar moms’ group. The trainers instructed me to keep people’s shares confidential unless it seemed that imminent severe harm could come to the person who shared or other people in their lives, with suicidality and homicidality requiring the most urgent intervention.

The organization that hosts the bipolar support group offers resources to facilitators for participants who may need them. These include scripts on how to talk to someone in crisis and hotline numbers for suicide prevention, domestic violence, and child abuse. Despite equipping facilitators on how to handle issues that arise during the group session, the organization requires facilitators to report these incidents to the support group manager, adding an extra layer of surveillance long after participants exit the support group space. Since organizations have concerns about being liable for being complicit in child abuse or neglect, once facilitators consult the manager, more consequential reports can take place. The organization endorses facilitators, both regular volunteers and therapists, who are mandated reporters, to activate carceral responses from the police and child protective services that can result in irreparable harm, separating children from their families.³⁶ The organization codes actions involving the carceral state as in the group members’ best interest or for the safety of the children, rather than liability protection for the organization and support group facilitators.

This treatment of Black madness fits into Christina Sharpe’s formulation of contemporary Black life more broadly as “in the wake,” in perpetual proximity to death.³⁷ Simone Browne identifies the slave ship as the original blueprint for the panopticon, a design proposed initially by Jeremy Bentham, which Michel Foucault later developed as a metaphor for contemporary carceral surveillance and governmentality.³⁸ While ignoring structural violence and the generational trauma of reproductive oppression in “the afterlife of slavery,” medical and state authorities attribute Black maternal mental illness to personal failure and innate flaws of Black mothers because of their race.³⁹ As a result of the multiple jeopardy of being Mad, Black, and female, the processes of marginalization through racism, sexism, and sanism combine to justify involuntary intervention in Black motherhood.⁴⁰ Consequently, punitive and carceral logics are mobilized to protect children from their mothers and save Black mothers from themselves, making them targets of intervention and robbing them of the right to raise their children.⁴¹

While some Black people take the risk of sharing in the presence of white support group members, others practice what Simone Browne calls “dark sousveillance.”⁴² Adapted from Steve Mann’s term “sousveillance,” dark sousveillance captures tactics Black people have used since escaping enslavement to surveil their environment and protect themselves from the white gaze.⁴³ Dark sousveillance is an active inversion of the power relations embedded in racial surveillance, granting Black people access to data about their surveillance and, thus, the ability to neutralize it. Ambivalent support group attendees do not disclose but surveil the room to assess the level of threat. They ask questions about other people’s experiences to see if they measure up to their own. They take note of how members and facilitators perceive them and whether they agree with this perception. If they sense danger, they leave, never to be seen again.

At an in-person bipolar meeting in 2019, I met a Haitian woman whom I will call Ines, who disagreed with her diagnosis, but she was curious to see if the support group could provide any clarity. Upon arriving at the in-person support group I frequented before the pandemic, Ines entered the conference room, surveyed the space, and chose to sit at an empty seat next to me, the only other Black woman present. She never shared. Instead, Ines occasionally glanced at me throughout the meeting to gauge my response to a member’s remarks. Eventually, she leaned toward me and commented on how few Black people were at the meeting. Afterward, in a one-on-one conversation, Ines revealed more about why she attended the group. Ines had four children and had experienced what she was told was postpartum psychosis on more than one occasion. She rejected her bipolar diagnosis because she felt she only experienced postpartum psychosis and did not experience bipolar symptoms before giving birth to her first child. Even though her fourth pregnancy was unplanned and unwanted, Ines carried through with it. It was that fourth postpartum period that caused the most disruption in her life. After giving birth, Ines thought the hospital was trying to kidnap her premature baby. In her altered state, Ines hitched a ride to the hospital, found her baby in the NICU, and began disconnecting the tubes. Hospital security arrested her for trying to “steal” her own baby. During the conversation, Ines expressed her discomfort at the whiteness of the support group and asked why I attended. I could tell she was unsatisfied with my answer. I never saw her again.

The Hadal Zone: Black Mad Intimacies

Black water. Womb of the ocean. Against all odds,
in the immense pressure of these sunless, near-freezing depths, life still flourishes.⁴⁴

Black women’s lack of participation in mental health support groups is a prime example of mad alterity that breaks with apolitical notions of group unity to survive. An early Black feminist disability framework, Leith Mullings’ “Sojourner Syndrome,” is a useful analytic framework for explaining the unique challenges Black women face both on- and offline.⁴⁵ It describes Black women’s resilience in response to the unique set of challenges they face due to the compounding effects of racism, sexism, and classism, and the enormous toll this takes on our short-term ability to cope, overcome, and even appear as if we are thriving, at a high cost to our long-term well-being. Physically disabled by the hard labor and violence of slavery, Sojourner Truth nevertheless maintained “an ideology of ability” to evade stigma and undermine social hierarchies based on race, gender, and ability, breaking with the dominant medical model pathologizing disabled individuals.⁴⁶ This ideology echoes sentiments I’ve heard from Black women already teetering at the precipice of multiple forms of marginalization that to claim another oppressed identity of mad or crip would be “excessive,” as Schalk phrased it.⁴⁷

Though it is intended to highlight the health consequences of the superhuman strength Black women are assumed to possess, as illustrated in Truth’s “Ain’t I a Woman,” the Sojourner Syndrome might be viewed as a parody of a diagnostic category intended to highlight the limitation of diagnostic categories to pathologize rather than demonstrate the function of the so-called impairment.⁴⁸ Truth’s approach was successful as she freed herself, her son, and daughter from slavery, listening to the voice “a God of her own making,” and became a formidable abolitionist, amplifying the call for women’s and others’ civil rights.⁴⁹ Her health did indeed decline significantly throughout her life, as she suffered from severe ulcers and loss of hearing and vision.⁵⁰ Similarly, sustaining a traumatic brain injury in her youth, Harriet Tubman escaped slavery. She returned to the South at least 13 times between 1850 and 1860 as a conductor of the Underground Railroad, leading an estimated 70 enslaved people to freedom, all while experiencing seizures, fainting spells, headaches, and chronic pain.⁵¹ Tubman’s disability may have provided the tools for her liberation work, as her mad sensibility allowed her to follow divine guidance through supernatural visions, learning how to free herself and others.⁵² Comparable to the spiritual emergency one may experience in altered states or the notion of “dangerous gifts,” articulating the powerful but precarious potential of madness, it is clear that many Black women do not see themselves accurately represented in the psychiatrized identity and language of mental illness used in support groups.⁵³

On the other hand, other Black women recognize that though our resilience is a vital resource that enables us to make a way out of no way, it is also weaponized to deny us rest and care. In Letters to My Bipolar Self, one interlocutor, Glenda Lezeau writes, “While it is great that you have such mental strength, you have to balance your strength. In some ways your strength blinds you from the intensity of your symptoms. You push yourself so far that you don’t realize how much you are going through… your strength can actually hinder you from fully recovering.”⁵⁴ From the lived experience of psychiatrized madness, Glenda acknowledges the “syndrome” in the exorbitant racial health disparities and structural barriers that hinder Black birthing people and families from thriving.⁵⁵ It is for this reason that it was significant to witness how Black people lean into the protection that all-Black support groups offer.

Ocean Oasis: Currents of Solidarity

Ocean oases are areas where life flourishes amidst a barren or harsh marine environment, taking the form of thriving coral reefs, underwater springs, kelp forests, estuaries, and seamounts.⁵⁶

Attending my first all-Black support group provided a glimpse into what a more liberatory world for Black people could look like. In March 2020, at the outset of the COVID-19 outbreak, a prominent mental health organization in New York launched an all-Black online support group. Initially receiving pushback when their idea was first proposed a year prior, Black employees of this organization succeeded in starting a support group for Black people who identify with having mental illness, with funding from a prestigious grant. Claiming their diagnoses by attending biweekly Zoom meetings to commune with folk who share similar experiences, Black people seeking recovery created social bonds across ages, genders, and state lines. The conversation allowed participants to share tips for managing triggers and symptoms and exchange notes about medication, virtual therapy, and psychiatry. It also provided a safer space to process the disproportionate effect of COVID-19 infections on Black mortality and the national unrest in response to police brutality.

I also frequented a Black perinatal mental health group, which was starkly different from the mixed, but predominantly white PMAD group that purported to welcome mothers and birthing people of all races. I witnessed what Mia Mingus calls “access intimacy” among the participants of the all-Black moms’ group; namely, an intrinsic sense of belonging.⁵⁷ Instead of discussing psychiatric medications, they favor discussions about herbs and homeopathic remedies. Participants avoided the use of terms from the DSM. Still, they were well-versed in verbal and nonverbal affirmation, acknowledgement, and understanding when mothers shared their stress, fear, anxiety, pain, or sadness. There is a tacit understanding rooted in the shared experience of life at the intersection of multiple oppressions. In addition to words of encouragement, nods, sustained presence on the screen, and heart emojis, this practice involved not just observing and responding, but also the compassionate act of bearing witness. Here, small talk and crosstalk, directly addressing individual speakers, is a form of profound care and recognition. Laughter and jokes are balms that ease the weight of transgressive sharing. This form of sociality renders psychiatric explanations unnecessary.

The benefit I received from being in an all-Black virtual space was the ability to connect in spoken and unspoken ways that are legible even through muted Zoom squares as members listened to a person sharing. Unlike the majority of predominantly white groups where participants take access to affordable mental health social services and support for granted, the members of all-Black groups were familiar with the systemic barriers, including delays in receiving a diagnosis, long periods of psychiatric incarceration, difficulty finding culturally-competent mental health professionals as well as increased mental health stigma and cultural barriers in the Black community. While I felt bonded to other Black group members because of our shared experience of oppression and survival, sometimes I missed the sense of familiarity that came with being in a Zoom room with people who had a similar experience of diagnosis-specific navigation. While our Blackness united us, our experiences living with the distinctive diagnoses of depression, bipolar, borderline, and schizophrenia were vastly different.

For the first time, I questioned which identity was more important in the online support group space – my race, my psychiatrized madness diagnosed as bipolar, being the family member of an addict, or becoming a new mom. As I separated my experience of psychiatrization from my mad identity, I could not identify with group members in any of the groups as much as I did when I began attending in 2020. Years later, I had gained a richer understanding of my madness: the spiritual and sacred nature of intuition and altered states, the creativity and generativity of riding highs and lows, the profound empathic ways to experience unity, oneness, and belonging, interacting with humans as well as the material and immaterial world.

Between 2022 and 2025, I gradually stopped attending and facilitating support groups altogether. I did not abandon my bipolar diagnosis, but I found ways to reclaim my psychiatrized mad experience through artistic expression, repurposing psychiatric vocabulary, and making subversive decisions on how I comply with treatment to navigate the family regulation system and keep my child safe from carceral interventions. My time in support groups showed me that they are not a refuge from systems of oppression but are sites in which digital technologies can become a conduit for these harmful dynamics to replicate themselves if we are so naïve as to think of them as safe spaces. As diasporic peoples whose ancestors walked through the Door of No Return, we traverse “antiblackness as a total climate,” black water, a vastness beyond imagination, acknowledging “chattel slavery and its afterlives, which are still unfolding.”⁵⁸ Hence, we wade through digital waters.