A condensed version of this interview appears in the Spring 2021 issue of Slingshot.
A few years ago, when I was living in Europe, I heard about a feminist healthcare collective called Power Makes us Sick (PMS). They were organizing and holding workshops, writing, printing and distributing zines, beautiful posters, and free resources, in different countries in the EU, in South America, as well as in the US. Being very curious and excited to hear about this project, I read and saw more of what they were sharing with folks, and putting out into the world, all rooted in an anti-authoritarian, anti-capitalist perspective, politics, and practice. And in the process, the PMS collective was creating and connecting broad networks of projects, communities, and individuals involved in various forms of healthcare, as well as various forms and fabrics of political struggle. I felt inspired to try to meet with some of them in order to learn more, and hopefully spread the word about PMS, who they are, what they’re about, and what they do.
What follows in this article is an interview with some of the members of the collective. Hope readers out there find this useful, and that we all deepen and solidify our networks and relationships of care in our own lives and communities. Stay safe out there, and take good care of yourselves and each other.
“Self-care can’t cure social diseases”
In solidarity,
Sarafina
Witch Militia Northeast
Who is PMS?
We are called Power Makes Us Sick, which kind of speaks for itself in a way. We’re an anti-national group that researches autonomous health practices and shares the good news about all the ways we can and do care for one another outside of and in opposition to the state and capitalism.
How does PMS relate to issues of health? Where do you fit in?
“We’re all a bit sick. In some ways we are healing. We’re all healers in some way. We’re all growing stronger or learning how to better act in the world through this collective and others. There’s a lot of little things that we’ve just accidentally found out along the way that we all have in common, they didn’t start off as rallying points.”
“Take what you need and compost the rest” is a slogan and an approach that inspires us.
Our work is centered around sharing skills, resources, and tools. A mutual aid with emphasis on the “mutual”. We offer our support to social movements and others fighting back against oppression. We make new friends along the way, we share strategies and lessons from their experiences and ours. They help us refine our tools, and then we bring all of that back to the group and are able to share new skills farther and wider.
What is autonomy? What is health? What are practices of autonomous health?
Autonomy, in our context, really doesn’t mean “solo” or on the level of the “individual”. It’s something that only begins to make sense in a collective context, and against repression, control, and institutional power. We see it wherever people are finding each other and coming together to directly bring about the kind of world they wish to see.
In terms of “health” it’s the kind of health we want to see in the world, not necessarily in the ways it is conceived of by those in power. If “health” is related in a certain context to work and productivity, we might refuse to be healthy. Alternatively, we might choose to say this or that aspect of the dominant society is profoundly “unhealthy”, sickening, sick…
Our working model of health encompasses the mental, physical, and social aspects and we want to incorporate an understanding of each part. We are inspired by an example given to us by our friends at the “group for an other medicine” (rough translation) in Thessaloniki, who say that if there is mold in a building and you’re only looking at the physical health of the individuals, you might treat the affected lungs, but if you understand health in a social context, you might come together to pressure the owner of the building to remove the mold. This is just an example of how the shift to the social can help address the issue at its core.
We too often feel that the dominant practices of healthcare ignore the health of the social body. By shifting the discourse to encompass the social, we can get a better picture of the things that are ailing us as a society, whether that be the way that capitalism makes us all very anxious, the way that industrial civilization itself encourages us to work ourselves to death, the way that patriarchy can make us feel very small (or gets us killed), the way that racism means we ignore the pain of certain people (or gets us killed), among a myriad of other social ailments.
While those in power may work to incorporate that in diagnosis and policy, there is a point beyond which their analysis and actions won’t go. Anxiety, depression or dependency might be portrayed as “mental health epidemics” with social causes and outcomes, but they will never be portrayed as a symptom of capitalism and various forms of exploitation, exclusion, and extraction. Giving ourselves the freedom to make that analysis can open up new spaces to work in. This consciousness doesn’t mean we can write and analyse our way to better health, but it can give us an edge, an organising basis, a direction to go in.
This is where practices of autonomous health comes in. Methods and means can be pirated and communalised, or found in already existing popular and folk contexts. In our zines, we share examples of what autonomous health care looks like in practice through articles, reportbacks, and interviews. The mental, physical, and social aspects are not necessarily distinct from one another, but we cover them all in each zine. In Issue #2 (2017) you can see physical health being addressed in a reportback from a DIY abortion workshop, as well as a comprehensive article about gut flora, probiotics, and microbiome health and resilience. In that same issue, emotional wellbeing is addressed in an article about how to perform a hex, and a guide to some acupressure exercises for stress and anxiety. The health of the social body is addressed via reportbacks from sex worker organizing), a report on an anti-surveillance makeup workshop PMS organized in Berlin, and more. You can download (and print for free, although we appreciate donations) that zine and others on our website.
What are the inspirations or prior struggles that PMS is building on?
We put together a very incomplete and eclectic list of instances that came to our minds. We have a lot to say about each of these inspirations and struggles, so if you want to hear more, perhaps you can read some of our report backs or otherwise get in touch:
- Greek solidarity clinics (particularly in Thessaloniki and Athens) post-2008
- Icarus Project (New York, et al.) [now Fireweed Collective]
- Health organizing from our past and in our own communities that we have left behind (personal failures within the Woodbine autonomous health track, the failures of so many accountability processes, the blockades, the occupations, the herbal mutual aid efforts that have come and gone, etc.)
- Out of Action (Germany) and Activist Trauma Support (UK)
- Black Mesa Indigenous support (Stone Cabin Collective)
- All of the sex work and sex worker organizing that so many of us have been involved with over the years
- Standing Rock med tent
- No More Deaths (so-called US/Mexico border)
- Lincoln Hospital occupations (South Bronx, 1969, 1970); Lincoln Detox (1970-78); Dr. Mutulu Shakur
- Socialist Patients’ Collective (Heidelberg, West Germany 1970- present)
- Radical Herbalism Gatherings (UK, 2014-present)
- The Gynepunks in Catalonia
- The Solidarity Apothecary / Nicole Rose / The Prisoner’s Herbal
- Pirate Care (Croatia / Europe / worldwide)
- Many people working in the ‘undercommons’ of the NGO-industrial complex
How do you all work together as a group, especially given that you’re all far apart?
Since we don’t get the chance to meet in person very often, a lot of our organizing is done online. We’d already been meeting over an encrypted video chat site for years, so once the pandemic started, we had a communication strategy ready to go and could continue meeting as usual (almost).
Sometimes we come together in person to work on projects or respond to specific calls for support. Actually, that’s how most of us who are with the project now have met each other, in doing the work along the way. We’ve been exploring new modes of emotional support for some time now, and most of the instances where we’ve been asked to support social movements have centered around bolstering different existing communities’ infrastructure for support in, and after, potentially traumatic events, such as actions and occupations that involve direct conflict with the state. Along the way, we met others interested in working on this topic and have expanded our networks and our collective through those relationships that have been made “on the ground”.
One key aspect informing our organizing is a prioritization of one another’s wellbeing over the productivity of the group as a whole. In practice, this means making time and space to check in before and after our meetings and following up with one another to offer support outside of meetings. We talk about emotional support, herbal remedies, or just brainstorm solutions to health-related issues that come up for us as people. This also means that a lot of what we do tends to move slowly as we give ourselves the time we need to work at whatever pace our own health needs require. We create spaces where we can be honest with one another about where we’re at and what our capacities are, so that we can do the work that we want to do together with intention.
What are some of the shared beliefs that have brought the group together?
“Action dries your tears! Self care can’t cure social diseases! Most of us are not doctors!”
We don’t have these set in stone, but there are definitely some common threads that come from our experiences and that we’ve encountered. There’s a few points that stand out as some kind of “tenets towards an autonomous healthcare”. These areas are consent, accountability, self-defense, and illegalism. They might be more open questions than core beliefs, but we certainly see them as crucial, and sometimes underdeveloped, in movements and initiatives we’ve been involved with.
How does the matter of consent come up in your work, and how do you navigate that?
Our approach to consent in care goes something like this: take measures to ensure that you are getting consent from folks before providing care whenever possible. Be conscious and respectful of the tools and practices that the individual (or community) in question might already be using. Honor and strengthen those practices and offer information about additional sources of support if it makes sense or it is requested of you. Always ask folks what help they need first and what they are already doing: they probably have a good idea of what support they need or want anyway. We look to harm reduction principles, which affirm that each of us is capable of determining what our own health, healing, and well-being could look like, and that these understandings are a valuable basis upon which care and support can be provided. Caring is a process; consent needs to be obtained and maintained throughout that process.
Beyond offering care, consent extends into the way we relate to one another in the group as well. We make decisions on the basis of consensus, which for us is about people in the group consenting to doing work that they feel called to, that coheres around their values, or simply that they feel good about. Consensus is not about unanimity, but unity, which is generated through shared commitment. It is about slowing down in order to take the time to consider and address everyone’s concerns, as well as their cool ideas. When we practice with consent and consensus in these little ways, like decision making, we learn what it feels like and can spread that farther and wider into the everyday.
Self-defense and health aren’t necessarily topics you would expect to see together. How do you see them relating?
For any movement to substantively or even marginally challenge capital, self-defense must be considered. The line between self-defense and care is quite blurred. How can movements survive without defending themselves from the many systems of exploitation, dominance, coercion, and oppression that we experience in our daily lives? And further, how can we defend ourselves without cultivating our own infrastructures of care to patch the literal and emotional wounds, both current and ancestral? In our zine on autonomous trans healthcare, we wrote of the Stonewall riots in 1969: “If you are so accustomed to fighting to exist on a regular basis, and fighting to keep your friends and loved ones alive, you are already so enmeshed in, and so concerned with a community self-defense that letting the brick fall on someone who is attacking you is simply not so far of a stretch.” We think this is how it starts; survival and self-defense are just so intertwined for so many.
Sylvia Rivera and Marsha P Johnson, who were involved with the riots, were founders of STAR: Street Transvestite Action Revolutionaries, a group focused on direct action as well as harm reduction and providing housing and food for other trans/gender-nonconforming people. It’s clear to us that these aspects of the movement are so much a part of one another that no distinction is clear. When self defense becomes care, when care becomes a riot, when these become interchangeable – that’s when it becomes revolutionary, when substantial change begins to happen.
How do you approach the question of illegalism? What does that mean to you?
In short, we are against the law.
It is an essential aspect of state formation to criminalize solidarity. In most contexts, like wherever there is a state, it is illegal to meaningfully take care of one another’s health without supervision. Acts of care are criminalized; such as sharing food with houseless people, providing shelter to those without the documentation the state demands, and distributing medication without a license. We are guided by our theoretical approach and stay grounded in the history of past projects of autonomous and illegalist care, but often it is most effective to learn by doing, bringing us into direct conflict with the state.
Solidarity means taking care of one another. When we learn to take risks for one another’s wellbeing, we learn to render the walls of division obsolete. Sometimes people are baffled by the idea that these seemingly trivial acts would be illegal, but of course they are. Taking action through seizure, distribution, or provision of what is necessary for survival in the face of oppression interrupts and challenges the state’s ability to maintain power. State power depends on the ability to decide who is a citizen and who is not, who deserves “rights” and who doesn’t, and ultimately who lives and who dies. That is whack, obviously, and so we aspire to shift the responsibility of care into the hands of the community.
This is why we don’t just passively skirt the law, but we support practicing in a way that essentially renders “the law” totally irrelevant. Remember, “you didn’t see shit.” We’re doing the work in a manner that DIRECTLY creates the world that we want to see. That means us being able to take care of one another’s bodies entirely on our own terms, with consent, with abundance, with nurturance.
Is that why you’re an anonymous collective? It seems this is directly connected to how you relate to legality.
Yes, anonymity is practical: we may allegedly do things that are not considered entirely lawful, or that the state considers a threat. Sometimes this looks like direct action; often these are simply things we do to survive. When we don’t connect our names and faces to our work, we can speak more openly in hopes of sharing our tools and strategies with others living lives that are similarly outside of the law. Some of us have faced doxxing by fascists or harassment by abusive people in our own scenes. You may see some of us at events or workshops, or out doing things in our communities, because some degree of identification is sometimes what’s needed to build connections of trust with others, but maintaining good security practices is essential for us.
Anonymity can be a tool for accountability: it may feel counterintuitive when we’re used to an emphasis on visibility, but speaking and moving as a nebulous collective means that no one can use our work to build themself a platform or gather social capital, or actual capital/money, for that matter. We have agreed to refuse to do so ourselves.
We recognise that being denied visibility can be part of the harm and repression inflicted on us by power. It can be degrading and demoralising when we don’t get recognition for our actions: either because care and healing are less visible and less valued than other forms of activity – or because we consciously chose (alleged) criminality and anonymity over taking credit.
Also, speaking from a position of anonymity doesn’t mean you speak for everyone. It might be necessary to be very clear about the standpoint you’re talking from. At least, it’s important not to speak for those whose experiences you don’t share.
These problems open up a strategic question about what kinds of visibility are useful as a means, but for us it’s never simply an end.
“Accountability” can be understood in a lot of different ways. Usually, in radical communities it is understood in a very specific context around harm. It sounds like you all might be intending for it to be understood differently. Can you elaborate on what this concept means to you?
Accountability is an elusive principle that we constantly aspire to develop and understand within ourselves, with each other, and in our communities. Why is it so hard? We could start by looking at two different ways accountability gets used. First is the view that seems common in activist, anarchist, queer, feminist communities. There, accountability is often seen as a response to harm, something that’s primarily invoked when one person harms another, often in the form of abuse and sexual violence. The second way accountability can be understood is as an ongoing practice of care, or as harm-reduction, a continual basis for healing and reparation(s), which may open up some new possibilities and directions.
What is the accountability model and what were some of the inspirations behind it?
Here we understand accountability as a kind of shared responsibility, specifically in relation to a person’s health. Being able to ‘account’ for each other. We have been developing a tool for groups to use to move towards collective engagement in the health of many individuals, in an overlapping web of smaller groups. We were inspired by some models that people were already using to reinvent how they thought about healthcare for themselves, including the clinic at Vio.me in Thessaloniki, the Icarus Project, and others. In Thessaloniki in the wake of “the crisis”, some newly-unemployed medical professionals were able to reinvent health care from the ground up by creating an experimental clinic in a factory squatted by workers. Later, some of those involved developed the “group for an other medicine” whose project was a system starting with an expansive initial interview that would take about three hours or “as long as was needed” with (1) someone from their community, (2) a ‘doctor’, and (3) a ‘psychologist’. They would use an exhaustive questionnaire to inform a comprehensive discussion about the person’s wellbeing, some next steps, and how to achieve them together. It also served as a kind of health record for many of the migrants who otherwise did not have papers of this type that they were in control of and could take with them. Drawing heavily from how inspired we were by what we saw of their process, we wanted to adapt this for folks who might not have access to a a physical clinic, whose networks might be more spread out, or for groups of friends and comrades in community with one another.
Our accountability model is a guide with suggestions for how people might form such a group themselves. It covers the types of commitments and boundaries participants might choose to make with one another, a series of questions for the long interview itself, and ideas about how to move forward and continue working on core issues once they’ve been identified. Right now, it also contains some practical suggestions around security and group process that would aid in keeping everyone safe and secure. The idea is to redistribute accountability for each other throughout the ties that exist between people who already share community with one another, and shift responsibility (and therefore power) into the hands of the community while mapping out and making visible the pre-existing relationships of care so that they can more heavily be relied upon. This means building ties based on accountability and support for the wellbeing of each individual in a pre-emptive way – building stronger relationships of care before people break under the burdens of capitalism and other oppressions, and the community is left to pick up the pieces.
What are you working on right now?
Our most recent zine came out last May and was a collection of preliminary ideas and resources in response to the Covid-19 pandemic – much of this is still relevant and reflects what we are doing right now.
As for our current public-facing work, we’re forming a new publication tentatively titled “An Abolitionist’s Guide to Autonomous Emotional Support”, which will focus on concrete models and tools to support the emotional wellbeing of our communities on our own terms. The general contexts we see are immediate and longer-term survival, combatting and deserting repression, isolation, “pathology”, and associated distress, harm, and capture. We are in an environment where psychological warfare is a primary mode of attack from the state and its allies (fascists, police, the border, the psych ward, the prison). These kinds of attacks aim to divide us and leave the most vulnerable among us to deal with the consequences. Combatting this means taking the responsibility for our collective wellbeing into our own hands through care with longterm treatment plans, navigating existing resources together, and community self-defense. If we really want to get rid of the logic of the prison, we have to take on the work of caring for one another, and it isn’t easy. The zine will include some ways to relate to our herbal allies, notes on how to navigate ‘big psych’, reflections on supports that have served us well (DBT, somatic exercises, on-the-ground emotional first aid, etc.), a toolkit for a “spa day” you can take anywhere, de-escalation and self-defense basics, an ‘ask me anything’ from an anarchist therapist, among other little treats.
If you are working on a project that coheres around these themes, we’d love to hear from you. We invite you to share tools and strategies that you have found useful in supporting the emotional health of your friends or community, or that have allowed you to find support in times of crisis.
How can people hear more, or how can people work with you or become involved in the collective?
All our zines and a bunch of shareable resources can be downloaded on our website. Our zines are made to be shared! Feel free to print them out give them to your friends, put them in your local infoshop, add them to your zine table, leave them strategically placed around your city etc.. We have a small social media presence, but we mostly rely on people spreading the word about what we do, sharing our zines, and reaching out to us personally. If you don’t have access to the internet, you can write to us and we are happy to correspond, and/or send physical copies of our zines to anyone who needs them.
PMS can be reached via e-mail at powermakesussick@riseup.net or powermakesussick@protonmail.com.
All physical mail can be sent here: PO box 234 Plainfield, VT 05667
