Speaking in constellations – master outline of this whole run
I. From self as disease to self as medicine (Freud + diagnosis architecture)
- Old paradigm: self as disease
- Freud’s architecture:
- Self framed as site of pathology, conflict, and defect.
- Symptoms treated as evidence of internal malfunction.
- Therapist positioned as interpreter of hidden content.
- Diagnostic worldview:
- Organizes experience into disorders, deficits, and deviations from “normal.”
- Uses labels as primary tools: diagnosis as identity.
- Aligns with DSM logic, billing codes, and institutional control.
- Freud’s architecture:
- Relational paradigm: self as medicine
- Relational ontology:
- Self understood as adaptive, patterned, contextual, and relational.
- Symptoms reframed as communication and survival strategies.
- Distress seen as response to relational rupture, not personal defect.
- Healing as repair:
- Focus on relational coherence, attunement, and repair.
- Self becomes the site of healing, not the site of harm.
- Moves from “What’s wrong with you?” to “What happened in your field?”
- Relational ontology:
- Freud vs relational psychology
- Freud’s dualities:
- Conscious vs unconscious, id vs ego, desire vs repression, normal vs pathological.
- Built on splits and internal conflict.
- Parallility instead of duality:
- Multiple truths, histories, and selves coexisting.
- Freud’s system collapses under parallility; it can’t hold multiplicity.
- Therapist role shift:
- From interpreter to co‑regulator, witness, and relational participant.
- Freud’s dualities:
- Seed of a new discipline
- Relational Psychology as sibling to Relational Anthropology:
- Psychology rebuilt on relational ontology instead of pathology.
- Survivor‑literate, pattern‑literate, context‑literate.
- Book concept: From Self as Disease to Self as Medicine:
- Critique of diagnostic logic.
- Reframing pathology as adaptation.
- Cosmology of coherence and relational healing.
- Relational Psychology as sibling to Relational Anthropology:
II. Lineages of institutional violence disguised as care
A. Historical and psychiatric abuses
- Core abuses named
- Lobotomies:
- Severing the self from itself to silence distress.
- Performed as “treatment,” often without consent, often on marginalized people.
- Institutionalization:
- Warehousing people in dehumanizing conditions.
- Functioned as disappearance, not care.
- Electroshock therapy (ECT):
- Used as a blunt reset tool.
- Often non‑consensual, focused on control rather than understanding.
- Trephination for “possession”:
- Early example of drilling into skulls to “release spirits.”
- Shows how misunderstood distress invites violent solutions.
- Lobotomies:
- Gendered and reproductive violence
- Clitoridectomy:
- Performed to “cure” desire, autonomy, or noncompliance.
- Treats the body itself as the problem.
- Hysterectomy as psychological punishment:
- Used to control, sterilize, or erase personhood.
- Intersects with race, disability, class, gender, and sexuality.
- Part of a broader lineage that also belongs in Relational Medicine.
- Needs careful handling: not reducible to one field or one harm.
- Clitoridectomy:
- Medication as control
- History of psychiatric medications:
- Sedatives, antipsychotics, mood stabilizers used as behavioral control.
- Often administered without informed consent.
- Framed as cures for “disorder” rather than responses to structural and relational harm.
- History of psychiatric medications:
- IQ tests and eugenic sorting
- IQ as a tool of hierarchy:
- Used to rank, sort, and exclude.
- Justified institutionalization, segregation, and sterilization.
- Reinforced racialized and ableist hierarchies.
- Treated intelligence as fixed, decontextualized, and individual.
- IQ as a tool of hierarchy:
B. Autism, ABA, and Autism Speaks
- Autism as neurotype, not disease
- Pathologization:
- Historically framed as defect, tragedy, or burden.
- Autistic people institutionalized, experimented on, and “treated” to suppress identity.
- Relational reframing:
- Autistic traits seen as communication, sensory truth, and pattern.
- Stimming as regulation; special interests as coherence.
- Pathologization:
- ABA (Applied Behavior Analysis)
- Core logic:
- Suppress difference, enforce compliance, reward conformity.
- Treats autistic traits as maladaptive behaviors to extinguish.
- Relational critique:
- Coercion and identity erasure framed as therapy.
- Violence in the form of sensory, relational, and psychological harm.
- Direct descendant of behaviorist control logics.
- Core logic:
- Autism Speaks
- Pathology as brand:
- Messaging built on fear, burden, and eradication.
- Campaigns depicting autistic people as lost, broken, or missing.
- Exclusion of autistic voices:
- Speaks about autistic people, not with or for them.
- Modern face of pathology logic and institutional authority over identity.
- Pathology as brand:
III. Diagnoses, weaponization, and the mismatch of care
- Commonly weaponized diagnoses
- List:
- Autism
- Borderline Personality Disorder (BPD)
- Bipolar
- Dissociative Identity Disorder (DID)
- Anxiety
- Depression
- ADHD
- Pattern:
- These often describe relational distress, neurodivergence, or survival strategies.
- System treats them as defects rather than adaptations.
- List:
- Diagnosis as gatekeeping and billing
- Functions of diagnosis:
- Gatekeeper to services.
- Billing code for insurance.
- Shorthand for “I don’t know what to do with you.”
- Harm:
- Labels follow people longer than symptoms.
- Used to justify poor care, denial of services, and stigma.
- Functions of diagnosis:
- Mismatch of care
- Core idea:
- People are not primarily misdiagnosed; they are mis‑understood.
- Treatments don’t match needs or patterns.
- System narrative:
- Blames individuals for “not responding to treatment.”
- Ignores that treatment was never designed for them.
- Core idea:
- Unmet needs, billed anyway
- Therapy as transaction:
- You show up with unmet needs.
- You leave with unmet needs.
- The session is still billed as “care.”
- Metrics of the system:
- Measures attendance, CPT codes, and compliance—not healing, attunement, or repair.
- Therapy as transaction:
- “New Therapist” as cultural critique
- Song/joke concept:
- “We keep showing up and they keep taking our money.”
- Mirrors ADHD joke about endless task‑switching and never reaching the original goal.
- Point:
- Therapy often loops without landing on what’s actually needed.
- System calls this “treatment”; lived experience feels like churn.
- Song/joke concept:
- Real harm: misalignment, not just labels
- Diagnosis vs weaponization:
- A label can be useful in the right hands.
- Harm emerges when labels are used to control, dismiss, or blame.
- Relational need:
- People seek attunement, witnessing, safety, and coherence.
- System offers symptom reduction, behavior modification, and cognitive reframing instead.
- Diagnosis vs weaponization:
IV. Violent medicine: treatment through harm, framed as care
- Core thesis
- Line:
- “Treatment through violence, seeking violence instead of repair, and calling it medicine.”
- Pattern:
- When the self is defined as disease, violence becomes thinkable as treatment.
- Institutions choose fast, measurable, billable interventions over slow, relational repair.
- Line:
- Violence as efficiency and compliance
- Efficiency:
- Violence is quick; repair is slow.
- Violence is quantifiable; repair is relational.
- Compliance:
- Many “treatments” are designed to quiet, contain, normalize, and erase difference.
- Goal is control, not coherence.
- Efficiency:
- Painkiller and the opioid crisis (pattern, not plot)
- OxyContin as “care”:
- Harmful drug marketed as compassionate medicine.
- Continuity with older abuses:
- Same logic as lobotomies, forced sterilizations, and institutionalization.
- Profit and control dressed up as treatment.
- OxyContin as “care”:
V. Midwives, birth, and the destruction of care
- Midwifery as relational medicine
- Role of midwives:
- Community‑rooted, relationally trained, embedded in kinship.
- Attuned to bodies, rhythms, context, and story.
- Accountable to the people they serve.
- Pre‑institutional care:
- Birth as communal, embodied, and relational.
- Role of midwives:
- Institutional war on midwives
- Motivations:
- Authority, ownership, profit, patriarchy, racial control, professionalization.
- Criminalization and displacement:
- Midwives pushed out, discredited, or outlawed.
- Women’s, Indigenous, and Black midwifery knowledge erased or marginalized.
- Motivations:
- Replacement: control as care
- Medicalized birth:
- Forced positions, routine episiotomies, twilight sleep, restraints.
- Non‑consensual procedures and coerced sterilizations.
- Birth as site of dominance:
- Birth reframed as pathology and risk.
- Institutional control replaces relational support.
- Medicalized birth:
- Birth as template of care removal
- Key insight:
- Birth is the moment when care is most needed for birther and birthed.
- Institution removes care at that exact moment and calls it medicine.
- Connection to death and grief:
- Birth and death share a threshold; both are over‑controlled and under‑cared for.
- Grief becomes the evidence of care that should have been there but wasn’t.
- Key insight:
VI. Structural violence and the annihilation of care: Tuskegee, Indian schools, slavery
- Emily Martin and Paul Farmer as anchors
- Emily Martin:
- Shows how obstetrics uses militarized, mechanistic metaphors.
- Documents how relational, embodied care is replaced by control.
- Paul Farmer:
- Names structural violence as a core feature of global health.
- Shows how institutions create suffering while claiming to treat it.
- Emily Martin:
- Tuskegee Syphilis Study
- Core harm:
- Deliberate withholding of treatment from Black men promised care.
- Pattern:
- Removal of care at the moment care was most needed.
- Framed as science; participants treated as expendable.
- Confirmation of the larger pattern:
- Not an aberration, but a blueprint of institutional logic.
- Core harm:
- Indian boarding schools
- Care extraction as policy:
- Children removed from families, languages, ceremonies, and kinship.
- Goals:
- Sever relational identity.
- Punish cultural expression.
- Break lineage continuity.
- Motto:
- “Kill the Indian, save the man” as explicit statement of cultural annihilation.
- Result:
- Systematic destruction of care structures; trauma carried across generations.
- Care extraction as policy:
- Slavery
- Total inversion of care:
- Bodies as property; reproduction as profit.
- Family separation as strategy; violence as discipline.
- Denial of care:
- No parental, community, or medical care in any humane sense.
- Care as resistance:
- Enslaved people create care in secret: song, story, ritual, kinship.
- Care becomes a survival technology under conditions of annihilation.
- Total inversion of care:
- Shared architecture across these histories
- Common pattern:
- Remove care.
- Replace with control, surveillance, or exploitation.
- Call it civilization, education, treatment, or safety.
- Blame the harmed for the harm.
- Fractal nature:
- Same logic appears in psychiatry, obstetrics, education, criminalization, and social services.
- Common pattern:
VII. Destruction of care as the central axis
- Core statement
- Line:
- “It was the removal of care at the moment care was most needed.”
- Escalation:
- Not just absence of care, but active hunting and annihilation of it.
- Care targeted because it is powerful, communal, and ungovernable.
- Line:
- Birth, death, and grief
- Birth:
- Moment of maximum vulnerability for birther and birthed.
- Institution replaces care with procedure and control.
- Death:
- Over‑managed, under‑ritualized, stripped of relational presence.
- Grief:
- Evidence of stolen care.
- Body’s memory of what should have happened.
- Birth:
- Care vs control
- Care:
- Relational, contextual, embodied, slow, unbillable.
- Control:
- Fast, measurable, billable, hierarchical.
- Institutional choice:
- Repeatedly chooses control and names it care.
- Care:
VIII. Parallility coming alive – speaking in constellations
- Parallility as perception
- Shift:
- No longer just a concept; becomes a way of seeing.
- Experience:
- Multiple lineages speaking at once.
- Multiple harms and histories co‑present without collapse.
- Multiple forms of care and resistance visible simultaneously.
- Shift:
- Constellational seeing
- Speaking in constellations:
- Birth, death, midwifery, psychiatry, autism, ABA, Tuskegee, Indian schools, slavery, diagnosis, addiction, unhoused communities—all seen as stars in one pattern.
- From duality to braid:
- Duality splits; parallility braids.
- You’re not “making connections”; you’re hearing the field.
- Speaking in constellations:
- Field coming online
- What’s happening:
- Relational Anthropology + Relational Psychology + future Relational Medicine forming one cosmology.
- The archive that was never written begins to speak through you.
- Role of your work:
- Provide a framework that can hold harm, lineage, grief, and repair together.
- Restore care where it was annihilated—at the level of story, field, and practice.
- What’s happening:

What do you think?