The Sunday Magazine·Essay

The crushing power of psychiatric labels

For Sarah Blackstock's mother, being labelled led to a tragic outcome. Blackstock's personal essay is called Lunatic.

Warning: This story contains details of self-harm and sexual abuse

Sarah Blackstock's mother, who struggled with mental illness, described herself as a 'lunatic.' Blackstock wonders, as she writes in her essay, how her mother's life may have turned out differently had she been defined differently. (Submitted by Sarah Blackstock)

"Lunatic?" Miss Campbell repeated.

"Yes," I confirmed to my Grade 3 teacher.

Miss Campbell looked at me with surprise. Hesitantly, she spelled out L-U-N-A-T-I-C, and then wrote it on the small, pink index card where we listed new "L" words for our classroom dictionary.

I couldn't yet spell L-U-N-A-T-I-C on my own, but I knew its meaning. It's the word my mother used to refer to herself. It was how she explained her distress and the unpredictable, devastating ways in which she wounded herself and wounded us. But even then, I had a sense that there was more to my mother's anguish than this single word could hold.

While my mother didn't name the abuse until I was an adult, I had known about it for a long time, although I cannot remember how I came to know.

Maybe I came to know as I was scouring the blood-stained cracks in the bathroom tiles, frantic to finish before my younger siblings saw the traces of my mother's most recent cutting. Or perhaps it was as I tried to explain the latest crisis to the emergency workers who were often called to our home. Perhaps it was in the stories my mother told or in the way she told them that I started to realize that her so-called "lunacy" was the product of wicked betrayals and cold, vicious touch. Her father had sexually abused her.

We had no other words to articulate the chaos and pain. No vocabulary to explore it.- Sarah Blackstock

The language my family relied on to refer to the mayhem that dominated our lives was filled with the crass terms used to avoid the messiness and complexity of mental illness and trauma. Lunatic. Nuthouse. Loony Bin. We had no other words to articulate the chaos and pain. No vocabulary to explore it.

And, there was the equally unhelpful language of the psychiatric system.

The 'lunatic' label erased my mother's experience, and gave her abusers an escape chute, Sarah Blackstock writes. (Submitted by Sarah Blackstock)

For the majority of her life, my mother saw psychiatrists both in and out of the hospital. The two she saw regularly for several decades gave her drugs and labels. "Obsessive Compulsive." They changed the labels as often as they did her medication. "Manic Depressive." They gave her new drugs, more drugs. "Clinically depressed." "Bipolar." "Borderline Personality Disorder." There was never a shortage of pills or labels — none of which diminished her agony.

If the abuse was even acknowledged, it was deemed insignificant.

As I got older, my world got bigger. My desperation to understand my mother led me to people and books that offered a different vocabulary. My patience and compassion for my mother began to swell.

Her hurt and hurtfulness were omnipresent and inescapable but when I could see and feel them as a consequence of abuse, I could better understand and cope. I could also imagine that there could be some healing — there could be another way of living.

I now saw that the 'lunatic' label erased my mother's experience, and gave her abusers an escape chute.- Sarah Blackstock

For years, I pleaded with my mother to believe she was not a "lunatic." In soft, quiet moments, in late night, tearful conversations, in frantic outbursts, in careful letters, in every way I could think of, I tried to create an opportunity for my mother to at least catch a glimpse of herself as a survivor.

I now saw that the "lunatic" label erased my mother's experience, and gave her abusers an escape chute. There was no one to whom the wretched pain my mother lived with could be traced.

But nothing I could do seemed to help her get closer to who she wanted and intended to be.


As Sarah Blackstock grew older, her 'patience and compassion' for her mother 'began to swell,' she writes. (Submitted by Sarah Blackstock)

My hope, my patience and my compassion began to erode.

Eventually, I withdrew from my mother. I was terrified of losing myself.

In the gaping space I forced between my mother and I, there is immense guilt and grief.


In the spring of 2016, my mother was unusually unsteady. Her body was blackened from falls. Her weakness and confusion were extreme. The doctors said these symptoms were the result of long-term use of antipsychotic drugs.

Look more carefully, we insisted. There is more going on.

The doctors' language was polite and sanitized, but the message was unmistakable: your mother is a lunatic, and this is what happens to lunatics.

Only weeks passed before my mother died of brain cancer.

The cancer was missed. As a result, neither she nor we, her family, had a chance to know she was dying.

In the final moments of what had been a very difficult life, there was no chance to acknowledge the myriad of ways in which we had all tried so hard.

There was no chance to trace the scar tissue and notice the survival.

There was no chance to soften the calluses that had allowed us all to endure.

There was no chance to acknowledge, together, that all of our efforts might not be the failures we deemed them to be. There was no chance to see that those efforts were fuelled by love, by people who knew she was more than any single word could hold. There was no chance to say goodbye.


I can't recall now what it was I was writing back in Grade 3 that required the spelling of L-U-N-A-T-I-C. But I do I wonder what it would have meant if I'd had access to a more accurate, compassionate vocabulary that allowed me to express confusion, to name abuse, to build power, to tell the truth. What would I have written with a different vocabulary?

And I wonder about my mother. How she might have lived — and even died — had the words that defined her been different.

Click 'listen' near the top of this page to hear Sarah Blackstock's essay, Lunatic.

Where to get help:

Assaulted Women's Helpline: 1-866-863-0511
Attorney General's support services for male survivors of sexual abuse: 1-866-887-0015

The toll-free National Suicide Prevention Lifeline at 1-800-273-TALK (8255) is available 24/7.