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Book Review   |    
Nothing About Us Without Us: Disability Oppression and Empowerment
Judi Chamberlin
Psychiatric Services 1999; doi:
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by James I. Charlton; Berkeley, University of California Press, 1998, 197 pages, $27.50

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In Nothing About Us Without Us, James Charlton, a disability rights activist for many years, describes the development and underlying philosophy of the disability rights movement worldwide. He brings to this task his own background as well as the experiences of many other activists, primarily from third-world countries, whom he has interviewed and whose words appear throughout the book.

Although he focuses almost exclusively on physical and sensory disabilities, Charlton makes the connection with psychiatric disabilities, noting that "the absence [from his discussion] of people with mental and cognitive disabilities is especially notable because these disabilities combine to make up the largest disability 'category.'" His sources agree "that people with mental illness are the most discriminated against and the most isolated in their respective countries." It is doubly unfortunate that Charlton fails to include representatives of the mental health consumer-psychiatric survivor movement among his interviewees, as both movements have developed along strikingly similar lines.

Nonetheless, this is a valuable book both for people who work in the mental health field and for people with psychiatric disabilities because it so clearly lays out the facts about disability oppression, which Charlton describes as a "human rights tragedy of epic proportions." By taking a global perspective, Charlton illustrates clearly that although the lives of people with disabilities in developed countries are difficult, those of people in the third world are almost unimaginably so. And yet, as his examples from countries as diverse as Zimbabwe, Thailand, Brazil, and others show, people with disabilities are everywhere organizing to demand the same basic things: freedom, self-determination, empowerment, and liberation.

As people with disabilities have taken over theorizing about disability from professionals, the emphasis has changed from seeing disability as a tragic personal condition in which a person needs the services of (primarily medical) professionals to one that sees disability in a cultural, political, and economic context. (Charlton's emphasis is particularly on neo-Marxist economics.) Charlton vividly describes how a professionally dominated disability organization invited a small contingent of people with disabilities to an international conference in Singapore in 1980, and how this "token effort" led directly to the development of a new international organization run and controlled directly by people with disabilities and their national organizations. Many of his informants had their first experience of meeting other disabled activists at this conference, which galvanized their organizing efforts when they returned home.

Professionals who work in the disability field have been slow to accept the changes in power and control that disability rights activists promote. Despite 20 years of activism, people with disabilities are still segregated and discriminated against. This is particularly true in the field of psychiatric disabilities; most professionals continue to believe that the nature of the disability precludes, or vastly limits, the extent to which self-help, empowerment, integration, and freedom are possible, despite the ongoing efforts of the psychiatric survivor-mental health consumer movement to develop services and programs based on these ideals.

Nonetheless, the work of disability activists, and the growing cooperation between activists with psychiatric disabilities and those with other disabilities (although not reflected in Charlton's book), will continue to, in Charlton's words, "explode the mythology of people with disabilities as passive nonpersons and confirm for us that people do and can make their own history and that the struggle of survival is a triumph of life."

Ms. Chamberlin is affiliated with the Center for Psychiatric Rehabilitation in Boston.

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