Again/st the Mad Subject 1.

Abstract

Although widely contested, psychiatry continues to function as a dominant governing framework for mental distress within contemporary healthcare. While critiques of psychiatry have proliferated across survivor movements, mad studies, neurodiversity advocacy, and critical nursing scholarship, much of this work remains tethered to humanist assumptions that seek recognition, inclusion, or rights for a stabilized subject. This article argues that psychiatry functions not merely as a contested medical specialty but as a structural determinant of harm that systematically produces hierarchies of the human through diagnostic legibility, coercive care, and moralized governance. Focusing on mental health nursing, the article examines how nursing knowledge and practice are entangled with psychiatric classification, risk frameworks, and legislative authority, implicating the discipline in the reproduction of psychiatric power even when care is benevolently and ethically motivated. Rather than positioning psychiatry as simply helpful or harmful, the analysis reframes it as a humanist apparatus of capture that stabilizes subjects in order to render them governable. While identity-based critiques and activist movements have achieved crucial reforms, this article contends that such strategies risk reinscribing the very ontological conditions psychiatry requires to persist. Drawing on posthuman and poststructural theory, the article advances an alternative orientation for nursing grounded in becoming, imperceptibility, and relational ontology. Madness is theorized not as an identity to be recognized, but as a destabilizing force that exposes the limits of the humanist subject. The article concludes by proposing posthuman figurations of nursing care that move beyond subject-centeredness toward practices attentive to assemblages, processes, and lines of flight-forms of care that do not oppose psychiatry directly but render it increasingly irrelevant by exceeding its capacity for capture.