How Bureaucracies Turn Survival into Submission

By JD Goulet

9 January 2025

There is a particular kind of violence in being forced to prove your disability to the very system that helped create it. I find myself caught in this cruel irony now, as the Social Security Administration demands I subject myself to psychiatric evaluation to receive benefits I've paid into my entire working life - benefits I previously received in my twenties due to iatrogenic harm from the psychiatric system itself.

This is not a coincidence. It is by design. The bureaucracies of disability "benefits" and mental health care function as interlocking systems of control, determining who is considered "normal" enough to be worthy of survival in our capitalist society. Those who fall outside these arbitrary boundaries of normalcy face a cascade of institutional violence masked as procedure and protocol.

The Circularity of Systemic Harm

In my twenties, I was labeled with multiple psychiatric diagnoses - major depression, anxiety, OCD, bipolar disorder - and placed on a crushing cocktail of medications that turned me into a shell of myself. This "treatment" qualified me for disability benefits then. The harm didn't stop with the immediate effects of these medications - decades of prescribed psychiatric drugs, a brutal combination of stimulants, anti-psychotics, sleep medications, and anxiety medications, likely contributed to the stroke I would eventually have. In the months before the stroke, I found myself caught between my family doctor, who insisted I needed to stop taking the stimulants due to dangerously high blood pressure, and my psychiatrist, who stubbornly maintained I needed to keep taking them. I had to threaten to quit "cold turkey" before he would finally agree to help me taper off safely.

I’ve written previously in Where unmet needs are called "disorder," that society is sick about the harms visited upon me by the psychiatric system in a society that labels deprivation of resources and support as mental illness. Now, after building a life despite that systemic harm, after serving my community as a non-profit leader and political advocate, after surviving a stroke that significantly impacted my cognitive and physical capabilities - a stroke that might have been prevented if not for decades of psychiatric "treatment" - I must prove my disability anew by submitting to evaluation by the very profession that helped disable me.

This is how the system perpetuates itself - by forcing us to participate in our own pathologization, to accept their frameworks of "normal" and "disordered" in order to access the resources we need to survive. The SSA’s bureaucracy doesn't just deny benefits; it demands ideological compliance. You must believe in their power to define your reality.

Now, I find myself in the audacious position of having to seek validation of my disability from a representative of the very profession that contributed to causing it. I must sit across from someone who, while perceiving themselves as simply a neutral professional doing their job, represents to me the banality of evil - the way systems of harm perpetuate themselves through ordinary people following procedures. How do I explain to this psychiatrist that their profession's "treatment" helped create the very conditions they're now being asked to evaluate? How do I navigate proving I'm disabled enough to deserve support while also being coherent enough to advocate for myself in a system designed to discredit self-advocacy?

This is the double-bind of bureaucratic violence: to access the resources we need to survive, we must subject ourselves to evaluation by the very systems that have harmed us. We must appear simultaneously damaged enough to deserve help and competent enough to jump through the hoops required to get it. Any anger or distrust toward the psychiatric profession - no matter how well-earned through experience - risks being pathologized as further evidence of mental instability. The system demands we smile and nod at our abusers while asking them to certify our pain.

The Bitter Irony of Tech "Solutions"

I must acknowledge here that I am writing this essay with the assistance of an AI chatbot - a fact that fills me with both shame and rage. The stroke that damaged my cognitive functions has made it difficult for me to write the way I once could, a cruel theft of capability for someone who has been a writer and communicator all my life. The words and ideas still exist in my mind, but organizing them into coherent prose has become an overwhelming challenge.

So here I am, forced by circumstance to rely on a technology I fundamentally distrust, created by the same tech authoritarians whose profit-seeking ventures contribute to the systemic violence I'm critiquing. I resent that this tool exists, that it was developed without our consent as part of the endless march of "innovation" that serves capital rather than human needs. I resent even more that I've become so lowered by my life circumstances that with this essay I am caving to dependence on it to make my voice heard, to articulate my resistance to the very systems that have made this technology feel necessary.

There's a bitter irony in using an AI - trained on data harvested without consent, developed by companies that exploit their workers and concentrate wealth and power - to help express my critique of exploitative systems. Yet this is another double-bind created by disability under capitalism: we must often rely on tools and systems we object to because our access to alternatives has been systematically destroyed.

This technological dependency mirrors the broader pattern of how capitalism creates "solutions" that perpetuate the very problems they claim to address. Just as psychiatric medications are offered as the solution to the mental distress caused by capitalist exploitation, AI assistance is presented as the solution to cognitive difficulties that might not exist in a more humane society. The system disables us, then profits from selling us partial remedies to our manufactured difficulties.

These technological "accommodations" come in forms determined by profit-seeking entities rather than disabled people ourselves. Instead of creating a world where cognitive diversity is accepted and supported through human connection and mutual aid, we get algorithmic assistance that further alienates us from our own capabilities and from each other. The push toward AI "solutions" reflects the broader pattern of replacing human support systems with automated processes - the same logic that leads to computerized disability determination systems and automated denial of benefits.

The stark inequality of this system was made painfully clear to me when Senator Mitch McConnell, one of the primary architects responsible for gutting America's social safety net, experienced a stroke-like medical incident on camera. As I wrote about previously in Liberty for thee, but not for we, McConnell received immediate, comprehensive care and support - the kind of response that those of us without power can only dream of. I too had my stroke on camera, during a work web conference I was leading. It's a horrifying experience, but it's difficult to feel any sympathy for him, because while McConnell returned to his position of power with full institutional support, I found myself struggling through an endless bureaucratic battle just to access life-saving healthcare and the disability benefits I need to survive. With perfect clarity, I saw how the system reserves care and accommodation for those who maintain it while forcing the rest of us to prove our worthiness for even minimal support.

The Compounded Violence of Diagnostic Authority

This technological colonization of disability support parallels how psychiatric diagnosis itself serves to alienate us from our own experiences. The diagnostic criteria in the DSM read like a catalog of behaviors incompatible with capitalist productivity and social control:

• "Excessive" movement and difficulty remaining seated in classrooms and workplaces designed for neurotypical bodies

• "Inappropriate" emotional responses to oppressive conditions that we're supposed to accept as normal

• "Defiant" rejection of arbitrary authority and meaningless tasks

• "Impaired" ability to maintain consistent work performance under exploitative conditions

• "Disordered" sleep patterns that don't align with capitalist time discipline

• "Irregular" eating habits that don't conform to standardized meal schedules

These "symptoms" become even more weaponized against multiply marginalized people. A Black person's justified anger at racism becomes "oppositional defiant disorder." A trans person's disconnect from their assigned gender becomes "identity disorder." A poor person's anxiety about survival becomes "generalized anxiety disorder." The same behaviors that might be seen as quirky or eccentric in privileged people become grounds for institutionalization or criminalization when exhibited by marginalized people.

The psychiatric evaluation process the SSA demands reproduces these intersecting oppressions. As a queer, gender non-conforming neurodifferent person, I must carefully modulate my self-presentation - appear disabled enough to qualify for support while not seeming so distressed that I might be deemed a threat to myself or others. I must demonstrate my neurodivergence while hiding any trauma responses to the psychiatric system itself. I must perform my disability in ways legible to neurotypical authorities while suppressing the natural expressions of my embodied experience.

This performance becomes even more complex given my history with psychiatric harm. How do I communicate to an evaluator that their profession has been a source of trauma without having that very truth used to discredit me? How do I express my understanding of how psychiatric frameworks perpetuate oppression without being labeled as delusional or non-compliant? The system demands both absolute honesty and careful self-censorship, total compliance and convincing authenticity.

The cruel irony of these bureaucratic barriers became apparent from the very beginning of my SSDI application process. The application form itself requires such complex cognitive processing to complete that I had to use an AI chatbot just to help me articulate my disabilities - the very cognitive deficits that necessitated my application for benefits in the first place. This perfectly encapsulates the perversity of the system: you must prove you're disabled enough to need support by successfully navigating complex bureaucratic processes that are themselves inaccessible to many disabled people. It's like requiring someone to climb stairs to prove they need a wheelchair.

When we speak of bureaucratic violence, we often think of dramatic denials of care or explicit discrimination. But the deeper violence lies in how these systems construct and enforce "normalcy" itself. The bell curve I described in my essay Are you or a loved one suffering from Internalized Social Construct Disorder? isn't just a statistical tool - it's a weapon, determining who deserves to live and who can be left to die.

The people within the normal range of distribution are the most useful to the Masters in maintaining their grip on power. Note that all of the categories in that middle range are social constructs.

The psychiatrist's office becomes a checkpoint, a border crossing between the kingdoms of "normal" and "disordered." Those of us who are queer, gender non-conforming, neurodivergent, or otherwise different must perform our deviation from normalcy in exactly the right way to be granted passage. Too "high functioning" and we're denied support; too "low functioning" and we risk institutionalization.

Refuge and Resistance

I was fortunate enough to find refuge in Portugal, where universal healthcare and a lower cost of living provide some buffer against this systemic violence. But this option isn't available to many trapped by the very benefits system meant to support them. As I’ve mentioned previously in The American Diaspora, the SSA's rules prohibiting recipients of SSI (the most economically disadvantaged disability benefit recipients) from leaving the country create a form of bureaucratic imprisonment - you must stay within reach of their disciplinary apparatus or forfeit your means of survival.

The recent public response to the murder of the United Healthcare CEO reveals a growing recognition of how these systems enact violence. While I cannot condone individual acts of violence, we must understand this reaction as a symptom of the profound rage these bureaucracies produce - rage born from watching loved ones suffer and die while administrators hide behind policies and procedures.

Beyond Reform

The solution isn't simply to reform these systems but to fundamentally question why we accept their authority to define normalcy and determine who deserves to survive. We must recognize that disability itself is largely socially constructed - not by the impairments we live with, but by a society that refuses to meet human needs unless they can be justified through elaborate processes of proving our suffering.

We need a complete paradigm shift that starts by acknowledging every person's inherent right to have their needs met, without having to perform their pain for bureaucratic validation. Until then, we remain caught in this machinery of harm, forced to seek permission to exist from the very systems that threaten our existence.

The violence I experience now at the hands of the SSA is the same violence I experienced in psychiatric offices years ago - the violence of being told my reality is invalid unless validated by their authorities, of having my survival contingent on compliance with their definitions of normal and disordered. It is a violence that continues to claim lives while hiding behind the sterile language of policy and procedure.

The extension into our educational institutions and workplaces of the perversity of this system becomes even clearer when we consider neurodiversity. I am what the medical establishment would label as "autistic" - though I reject their authority to pathologize my natural way of being. My children and their father share this neurotype and have also faced the brutality of this supremacist society as a result. But the label "autism" itself is merely a medical construct used to categorize and control forms of human diversity that don't serve capitalist productivity. The space my bodymind occupies in the nebulous constellation of human neurodiversity has been medicalized and pathologized by the eugenicist priests of this supremacist capitalist religion, transforming natural human variation into "the sin of disorder" requiring professional managerial exorcism.

This creates another cruel paradox: to access needed support and resources, we must submit to having our natural ways of being labeled as psychiatric disorders. We must accept their framework that defines our differences as deficits rather than valid forms of human diversity. The system demands we internalize our own oppression, accepting medical labels for our identities while performing disability in ways that validate psychiatric authority.

The psychiatric establishment's role in maintaining capitalist power structures becomes clear when we examine its historical roots in eugenic ideology. One of the most stark examples is the 19th century psychiatric "diagnosis" of drapetomania - a supposed mental illness that caused enslaved people to flee their enslavers or resist enslavement. This medicalization of the natural human drive for freedom established a template that psychiatry would follow for centuries: pathologizing resistance to oppression as mental disorder.

This pattern continues in the modern DSM, though now cloaked in clinical language. "Oppositional Defiant Disorder" pathologizes children who question authority. "Conduct Disorder" medicalizes resistance to social norms. Depression and anxiety diagnoses often center on inability to maintain consistent work performance or conform to social expectations. The criteria for ADHD essentially describe behaviors incompatible with capitalist productivity - difficulty sitting still for long periods, struggling to focus on tasks you find meaningless, speaking out of turn, remembering to be on time for work and meetings, recalling details someone else says are important, and planning and organizing around goals that are assigned to you.

I learned firsthand how threatening this analysis can be when I naively shared with my manager at Harvard Business Publishing that I was reading Marx's "Capital" and tracing connections between his critique of alienated labor and how ADHD is pathologized in corporate settings. My intellectual curiosity about systems of control and my willingness to question business as usual marked me as a liability. My freshly renewed contract was abruptly canceled just two months in - a reminder that We must still fight for Diversity, Equity, and Inclusion and never forget that even prestigious institutions claiming their devotion to the principles of DEI in business education will quickly excise those who dare to examine the foundations their power rests upon.

The intersection with law enforcement reveals how psychiatric authority serves as another arm of state control. My own experience of being placed in solitary confinement based on a bipolar diagnosis shows how police readily defer to psychiatric labels to justify their violence. When cops arrive at a scene, a psychiatric diagnosis becomes a weapon they can use to discredit the person labeled as "mentally ill" - particularly if that person is also from another marginalized group. The psychiatric establishment provides a veneer of medical legitimacy to the criminalization of disability, poverty, and racial oppression.

For neurodivergent people seeking support, this creates a particularly cruel trap. We must submit to having our natural ways of processing information, sensing the world, and communicating labeled as "disorders" to access basic needs. The psychiatric evaluation process itself is often inaccessible - requiring us to communicate our experiences in neurotypical terms, maintain eye contact, suppress self-soothing movements, and perform other behaviors that may be actively harmful to us. As I argued in my article in Harvard Business Review, Stop Asking Neurodivergent People to Change the Way They Communicate (republished here without the paywall), these imposed communication standards serve to maintain power hierarchies rather than facilitate genuine understanding. The trauma of existing within this capitalist system - of having our bodies and minds broken by its demands, of watching our communities destroyed by its greed, of being forced to participate in our own oppression - runs deep in all of us. Yet we must carefully hide this understanding, must conceal our rage and fear and grief, must perform acceptance of the very systems destroying us, lest we be deemed too "unstable" or "non-compliant" to deserve support.

The SSA's insistence on psychiatric evaluation reveals this underlying ideology. I must prove to a psychiatrist that my differences render me sufficiently unprofitable to deserve support, while simultaneously demonstrating enough compliance with psychiatric authority to be deemed worthy of help. This process isn't about determining need or ability - it's about maintaining the power of medical authorities to define human worth in terms useful to capitalism.

When we express genuine anger at this oppression, when we reject psychiatric frameworks for understanding our experiences, when we claim the right to define our own realities - these authentic responses are themselves pathologized as symptoms of disorder. The system maintains its power by forcing us to choose between authentic self-expression and survival, between dignity and support.

“Reject the Frame” by JD Goulet

We must name this violence for what it is. Not just for those of us struggling against it now, but for all those who will face it in the future if we don't fundamentally transform how our society approaches human needs and diversity. The solution isn't better psychiatric labels or more efficient disability bureaucracies - it's recognizing that human diversity itself is natural and valuable, and that everyone deserves support and resources regardless of how well they perform normalcy for professional gatekeepers.

What do you think? If I print this manifesto essay off and hand it to my psychiatric evaluator, will my disability claim be approved or denied?

This was adapted from a newsletter originally shared via Substack, aka the Nazi bar. I'm trying this atproto blog out as an alternative avenue for making connections while avoiding the exploitation and surveillance of the technofascists' walled gardens.

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