Mad in America: Rethinking Mental Health

• Why Psychosis Is Not So Crazy: A Conversation with Stijn Vanheule

  Stijn Vanheule is a clinical psychologist, psychoanalyst, and professor of psychology at Ghent University. Trained in the Lacanian tradition, he has written widely on the structure of psychosis, the limits of psychiatric diagnosis, and the importance of attending to the subjective logic of mental distress. His books include The Subject of Psychosis: A Lacanian Perspective, Diagnosis and the DSM: A Critical Review, and most recently, Why Psychosis is Not So Crazy, which offers a reorientation of how clinicians, families, and broader society might understand and engage with psychotic experience. Drawing on psychoanalytic theory, case studies, and contemporary cultural examples, Vanheule treats hallucinations and delusions not as meaningless symptoms but as creative responses to existential disruptions. He emphasizes the importance of listening—clinically and socially—not for coherence imposed from the outside, but for the structure and logic within a person’s seemingly incoherent world. His approach challenges dominant psychiatric models that prioritize symptom suppression, calling instead for a therapeutic attitude grounded in humility and collaboration. In this interview, Vanheule discusses the role of hallucinations in restoring a shattered sense of meaning, the necessity of admitting one’s limitations as a clinician, and the importance of everyday practices—gardening, conversation, shared meals—in building connections that can anchor recovery. Using a depathologizing lens, he discusses that to overwhelming existential challenges that make us all vulnerable, psychosis might not be a crazy reaction after all. *** Find a full transcript of the interview here: https://www.madinamerica.com/2025/06/why-psychosis-is-not-so-crazy-a-conversation-with-stijn-vanheule/  Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. https://www.madinamerica.com/donate/ To find the Mad in America podcast on your preferred podcast player, click here: https://pod.link/1212789850 © Mad in America 2025. Produced by James Moore https://www.jmaudio.org

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• “Progress Only Occurs when People Make Demands” Paolo del Vecchio Reflects on a Life of Federal Service

  Paulo del Vecchio is a person in long-term recovery from mental health and addictions, who has been a leader in the peer recovery movement for 40 years. He recently completed a 30-year career at the U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, where he served in multiple roles including the director of the Center for Mental Health Services and the founding director of the Office of Recovery. Paolo is now an independent advocate, working to advance recovery-oriented policies and practices on national and international levels. In this interview, he speaks with Mad in America’s Leah Harris about his roots as a housing justice activist to his decades of public service at SAMHSA, what worries him most about mental health in today’s America, and where he sees hope in the recovery movement that he helped create. *** A full transcript of this interview can be found here: https://www.madinamerica.com/2025/06/progress-only-occurs-when-people-make-demands-paolo-del-vecchio/  Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. https://www.madinamerica.com/donate/ To find the Mad in America podcast on your preferred podcast player, click here: https://pod.link/1212789850 © Mad in America 2025. Produced by James Moore https://www.jmaudio.org

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