#FreeBritney and #FreeThemAll

We can't view Britney as an anomaly; the mental health system is designed to chemically and physically incarcerate people

This is a guest post by Beatrice Adler-Bolton, author of the forthcoming Health Communism and host of the Death Panel podcast. To support this work, please subscribe.

On Wednesday of last week Britney Spears gave rare testimony on her own behalf during a court hearing, describing the shocking details of her now thirteen-year long conservatorship in which all aspects of her life, from financial decisions to who she spends time with, fell under the authority of her father Jamie Spears. For many people the issue of Britney Spears’ conservatorship has been a shocking introduction to the horrors of state ordered supervision.

The disabled and Mad community, however, have been raising the alarm over conservatorships for years, drawing attention to the fact that this is a much more widespread issue than the mistreatment of one exceptional individual.[1] The broader picture of conservatorship is a bleak one and, as we explained in a recent Death Panel podcast episode on the topic,[2] states do not even count how many people are living under these coercive legal agreements.[3] 

The history of competency determinations demonstrates not a “good policy gone wrong,” but a centuries-long deliberate practice of using legal guardianship or conservatorship frameworks to reorganize and redistribute family wealth away from individuals who do not meet a variety of norms, often to the financial benefit of a male relative.[4] Unlike Britney, most people under these easily-abused legal arrangements are never heard from. These are lives wholly made invisible by society, erased from history, and often barred from the community. As such, Britney’s court testimony offers an incredibly rare example of a person under conservatorship being allowed to speak for themselves, let alone to have their voice be heard by millions of people. 

Now, in addition to raised awareness about the horrors of conservatorship, Britney’s testimony has made millions of people suddenly aware of the practice of imposed antipsychotic medications. This presents a crucial opportunity to force a conversation advocating for the broader abolition of this widespread biopsychiatric method of discursive state control, known as ‘chemical incarceration.’

Britney testified that she had been receiving forced psychopharmacological treatment,[5] was not informed of her rights to petition to end the supervision of her finances,[6] was required to work and perform against her will,[7] and was barred from removing her IUD despite wanting to have more children with her partner.[8] The #FreeBritney movement can provide an important impetus for a larger conversation about the lack of moral justification for conservatorship, particularly when viewed through a disability justice framework, as I have argued elsewhere.[9] But the revelation that Britney has been forced to take the powerful mood stabilizer and antipsychotic medication, Lithium, against her will opens the door to expand this discourse to include a denouncement of chemical incarceration and carceral sanism.[10]

Much of the coverage of Britney’s case frames her experiences as an exceptional overreach of a normally rational system sparingly used to protect the vulnerable. This is far from correct. At best estimate, millions of people are under similar arrangements in the United States alone.[11] Britney’s self-described dehumanizing experiences at the hands of her father, the state, and the courts, are unfortunately not exceptional cruelties in the context of a bad faith manipulation of the practice of guardianship, but rather reflective of a centuries-old legal framework for stripping individuals of their autonomy and personhood working exactly as it is designed.[12] Britney’s experience should be an indictment not just of conservatorships but of the entire practice of chemical incarceration, from coercive treatment relationships to community treatment orders, to the laws we use to strip someone of personhood when the state decides that they are no longer “competent.” 

We must leverage Britney’s visibility and reject arguments for her freedom that are centered in the notion that she doesn’t fulfill the typical profile of someone who deserves to have her rights subject to legal authority. Instead, we must argue that all people, regardless of their means to support themselves or their material resources, deserve the right to have determination over their preferred care, deserve the right to housing, freedom, health, and protection from what Ruth Wilson-Gilmore calls “organized abandonment.”[13]

Calls to #FreeBritney have been steeped in the insidious rhetoric of productivity = worth = personhood, a framework often used against stigmatized populations. Britney in her testimony places much emphasis on her ability to earn money touring and performing, asserting that it should disqualify her from being subjected to imposed psychotropic medications, stating:

The whole conservatorship from the beginning  … once you see someone, whoever it is in the conservatorship, making money … and working, that whole … statement right there, the conservatorship should end … I shouldn't be in a conservatorship if I can work and provide money and work for myself and pay other people. It makes no sense. [14]

Her argument seeks to invalidate both the circumstances of her conservatorship and also the decisions that her guardians have made about her life and treatment. However, in asserting her right to freedom, Britney does so explicitly at the expense of others in similar circumstances who don’t happen to be the iconic face of a multimillion-dollar pop-cultural empire. What about the people who are under conservatorship and don’t make a lot of money, or any money? What if their only financial resources are in the form of state or federal welfare support? Do they not also deserve to be free or is this freedom reserved exclusively for the wealthy? This is why the disability and Mad Rights community has been so stringent about rejecting claims to #FreeBritney couched in positive declarations and affirmations of her competency, and instead have encouraged critiques of systemwide injustices which seek to liberate not just the most visible, but the most marginalized cases as well from these abusive, carceral, and coercive legal circumstances. 

There are numerous other means by which to push back on Britney’s treatment that do not come at the expense of broader solidarity and liberation. By way of example, Britney's imposed sedation is, according to her testimony, framed by her conservators and team as a response to her alleged “medication non-compliance” during rehearsals for a Las Vegas show in which she was being forced to perform against her will. Britney denies skipping her meds, pointing out that a nurse has been personally supervising the administration of her daily prescriptions first thing in the morning for over a decade. The circumstances of Britney’s imposed treatment with Lithium are very clearly not only arbitrary but an abuse of her conservator’s power. Merely questioning a dance move was quickly wielded as justification for chemical incarceration:

Three days later, after I said no to Vegas, my therapist sat me down in a room and said he had a million phone calls about how I was not cooperating in rehearsals and I haven't been taking my medication. All of this was a false. He — he immediately the next day put me on lithium out of nowhere. He took me off my normal meds I'd been on for five years. And lithium is a very, very strong and completely different medication compared to what I was used to. You can go mentally impaired if you take too much, if you stay on it longer than five months.[15] But he put me on that and I felt drunk. I really couldn't even take up for myself. I couldn't even have a conversation with my mom or dad really about anything. I told them I was scared and my doctor had me on — six different nurses with this new medication come to my home, stay with me to monitor me on this new medication, which I never wanted to be on to begin with. [16]

Britney was not prescribed Lithium for therapeutic purposes: Lithium was imposed upon Britney for not cooperating with her guardian’s wishes. Britney’s testimony gives incredible weight to calls to reject the preference for chemical incarceration. This is particularly urgent as expansions to imposed psychotropic medication protocols are commonly floated as a liberal half measure reform in response to movement demands to end mass incarceration, defund the police, or full and total abolition of the prison industrial complex. 

Chemical incarceration is the practice of imposing antipsychotic medications on people considered by psychiatric authorities to be “a danger to themselves or others.”[17] The term, credited to ethnographer and psychiatric system survivor Erick Fabris, refers to a variety of methods whereby antipsychotics and other sedative drugs are employed by state and medical authorities as alternatives to warehousing and incarceration, or as ways to impose sedation on a warehoused population to reduce the costs required to guard and surveil them. I want to be clear that this is not to say that these medications are not necessary for some conditions, or that treating “mental health,” madness, or any other mental difference with drugs is wrong, bad, useless, overused, underused, or anything of that nature. Pointing to the use of Lithium for practices like chemical incarceration could be erroneously interpreted as a condemnation of drugs; but pharmacology employed as a carceral tool must be understood as reflecting the issues inherent with carcerality, not with pharmacology.  

Imposed or coerced medication—chemical incarceration—has been declaimed by many lawmakers as an effective way to “keep society safe” since the mid-twentieth century. As Liat Ben-Moshe explains in her groundbreaking book Decarcerating Disability, which seeks to unite movements for disability justice and prison abolition, chemical incarceration has often been incorrectly credited with providing the pathway which allowed society to close insane asylums and still “be safe”:

… one of the most pervasive claims made in histories of deinstitutionalization and in public opinion is that the availability of psych drugs, especially Thorazine, was a major engine for deinstitutionalization of psych hospitals. It is cited in almost every study, historiography, or overview of deinstitutionalization in mental health, with some discussing it as the engine for change, and some as secondary to fiscal decisions leading to closure of psych facilities. It is used to discuss both the how and the why for deinstitutionalization in mental health. Many scholars, and laypersons, believe that deinstitutionalization happened mostly, or solely, due to the invention of psychotropic drugs, which enabled patients to leave the hospital and manage outside of an institutionalized environment … From the chain of events described, it is clear that there were many reasons for psych facilities to close (and be replaced by other mechanisms for treatment and control), including exposés, lawsuits, policy changes, and the ideological push from scholars and activists under the umbrella of antipsychiatry … But why has the advent of psychopharmacology been suggested as a forerunner of such complex processes and ideologies? Some suggest that the story of the efficacy of psych drugs was needed to justify the closure of psych hospitals or to accelerate reform in psych facilities that was already on the way … In contrast to popular opinion, the drugs, especially Thorazine, were not seen as a panacea, not just by those psychiatrized but by psychiatry itself. [18]

As a result of this false narrative, chemical incarceration has become cemented in our popular imaginary as the means by which we must control “non-compliant” madness and Mad People in order to keep the fabric of “normal” society together. Un-medicated Mad People therefore become—de facto and de jure—unsafe Mad People within our political economy, reducing the political will to make available a variety of treatment options for those who are well within their rights to refuse medication. Rather than meet this recognized need with social safety net supports or mutual systems of care designed to meet the complex needs of those at the margins, we have made the political decision to impose medication not only as a means of therapy or treatment but also as a means of sedation and control.

Many industries exist and are supported by this framework; the warehousing, surveillance, treatment, management, and diagnosis of difference is an enormous sector of our economy. Yet few people have meaningful access to the supports they need to facilitate their survival, and the few options that are readily available is often stigmatized and comes at the expense of the best interests, freedom, rights, and needs of the recipient.[19] We not only rely on these systems of subjection, expertise, and authority to reproduce capital—it also becomes how the actual physical material of labor power is maintained, through the reproduction of the “mental health” and “wellness” of the workforce.[20] 

As Ben-Moshe points out, by the 1950s the trend towards broader psych asylum deinstitutionalization had already begun. As facilities closed, budgets for the remaining facilities got tighter and tighter—this circumstance facilitated a precipitous increase in the practice and scope of chemical incarceration and has contributed significantly to the cultural misperception that this widespread practice is ethical, safe, and in the best interest of recipients. 

How chemical incarceration was sold to lawmakers sheds crucial light on how this popular myth, which falsely portrays imposed medication as a “civilized” political solution to the “problem” of madness, was a very specific sales pitch which had nothing to do with a patient’s health. In 1954, the pharmaceutical company which held the license to manufacture Thorazine in the United States, Smith, Kline & French or SFK, started to lobby state legislators to increase the dwindling budgets of state mental hospitals—not to make the necessary and urgent facility repairs required, but to increase the financial resources devoted to chemical incarceration. At the time, Thorazine was the most popular drug used for chemical incarceration. SKF formed what was called the “Thorazine Task Force” and hired sales reps to be staffed at major psychiatric hospitals to promote the practice.[21] SKF’s pitch to legislators was that chemical incarceration was a cheap means of controlling the populations being warehoused with as few staff as possible, thereby reducing the state’s overhead. It was sold as a way to increase the efficacy of institutionalization as cheaply as possible, not as a medically necessary treatment which would improve the symptoms, lives, or health outcomes of the individual recipient.

 Most people who were prescribed Thorazine were unable to refuse as they were also deemed categorically non-competent to make decisions for themselves using the same kinds of legal frameworks later used against Britney.[22] As deinstitutionalization progressed these same procedures were codified into mental healthcare laws, and are most often encountered in our contemporary context through what are called Community Treatment Orders (CTO). CTOs are kind of like a baby step to guardianship or conservatorship, and are often pitched as a more “gentle” or “humane” alternative way to force medication compliance from someone recently released from hospitalization.[23] Under a CTO an individual’s rights to refuse medication are fundamentally different than the rest of the population.[24] Forced treatment like this is even more widespread than conservatorship and guardianship, which is why many in the Mad Rights movement have pushed for its full and total abolition. 

This is the context in which framings of Britney as “not actually crazy” begin to do harm. Legal analyst Lisa Green, speaking with NBC’s Today Show, even went as far as to explicitly frame Britney as someone who categorically—due to her wealth, whiteness, beauty, and pop-star fame—“doesn’t fit the profile” of the kind of person who would normally be under the care and supervision of court appointed guardians, let alone chemically incarcerated with Lithium. Green called it “a portrait of a dystopian nightmare for Britney,” pointing out that a “grown woman,” did not deserve this kind of treatment.[25] The question implicitly raised by coverage and commentary like Green’s is who exactly does fit the profile of someone who should have their life subject to the discursive control of state ordered guardianship? In declaring Britney’s case exceptional and undeserved, media accounts simultaneously construct an archetypal other who does deserve to lose their autonomy and does deserve to be forced into coercive treatments and scenarios against their will. If the reason that Britney’s highly visible and public case of conservatorship and chemical incarceration are rescinded on the grounds that Britney is “not crazy” it does nothing for the millions of others in similar circumstances who lack the power and leverage of celebrity.

It is crucial to recognize and reject these sanist and ableist framings when advocating for issues of “mental health.” It doesn’t matter if Britney is “crazy” or not. No one deserves to be placed under these implicitly carceral restrictions under the guise of society’s safety. Britney’s experience should be an indictment not just of her unique circumstances—but of the legal framework of conservatorships and the practice of chemical incarceration as a whole; from coercive treatment relationships to community treatment orders, to the laws we use to strip anyone of personhood. When the state decides that someone is no longer a “competent citizen” it’s not up to us to nitpick and determine whether the individual is deserving of organized abandonment and state subjection and defend their rights accordingly. Instead, we must demand to #FreeThemAll—no matter how mad they might be.


Beatrice Adler-Bolton is an artist, writer, and disability justice advocate. She is the co-host of the Death Panel, a podcast about the political economy of health, and the co-author of the forthcoming book, Health Communism: A Surplus Manifesto (Verso, 2022).

The issue of chemical incarceration is just one small facet of the broader context of #FreeBritney. In the Death Panel episode Free Britney, Free Them All (06/28/21), my co-hosts, Artie Vierkant and Phil Rocco, and I discuss the bigger story. We outline the legal history and contemporary frameworks for determining competency, conservatorship and guardianship, and how that translates to notions and framings of personhood and citizenship. We discuss how notions of citizenship are inherently tied to a Puritanical state preference for heterosexuality and how the media portrayal of Britney’s case as a corruption of an otherwise protective policy erases the fact that this institution as a whole must be abolished. 

Endnotes:

  1. See "Britney does not need to be protected from herself": How society treats those perceived as disabled by Kylie Cheung (Salon, June 26, 2021), https://www.salon.com/2021/06/26/britney-spears-disability-reproductive-rights/; Britney Spears is not the only young person stuck in a conservatorship, say disability rights activists challenging America's eugenics laws by Andrea Michelson (Business Insider, June 25, 2021). https://www.insider.com/britney-spears-not-the-only-young-person-trapped-in-conservatorship-2021-6; Britney Spears Says She’s Not Allowed To Remove Her IUD. Here’s What This Means by Elizabeth Gulino (Refinery29, June 24, 2021). https://www.refinery29.com/en-us/2021/06/10544132/britney-spears-forced-iud-conservatorship; “Free Britney”: Oops, we treated her like shit (again) by Shelby Lorman (Please Clap, August 19, 2020). https://awardsforgoodboys.substack.com/p/free-britney; The Darker Story Just Outside the Lens of Framing Britney Spears by Sara Luterman (The New Republic, February 12, 2021). https://newrepublic.com/article/161344/framing-britney-spears-review-disability-legal; and When will people like Britney and I get to control our own bodies? by Nylah Burton (Elite Daily, June 25, 2021). https://www.elitedaily.com/news/britney-spears-iud-conservatorship-disability-reproductive-rights; et al.

  2. Free Britney, Free Them All (06/28/21) by Death Panel Podcast. (Full Episode — https://www.patreon.com/posts/free-britney-all-52967262).

  3. State-Level Adult Guardianship Data: An Exploratory Survey (August 2006) by Erica F. Wood, American Bar Association Commission on Law and Aging for the National Center on Elder Abuse. https://drive.google.com/file/d/1IKYTZlkm-e2xJizC-yq4Xj1nlf8cwS2B/view?usp=sharing.

  4. “Property, Disability, and the Making of the Incompetent Citizen in the United States, 1860’s—1940’s” by Kim E. Neilsen, from Disability Histories (2014) edited by Susan Burch and Michael Rembis. University of Illinois Press. https://drive.google.com/file/d/1T4jahY3Q_vZ5sh4rzY2yiT5-2zd9jL9z/view?usp=sharing.

  5. Britney Spears: ‘I Just Want My Life Back’ by Joe Coscarelli (New York Times, June 25, 2021). https://www.nytimes.com/2021/06/23/arts/music/britney-spears-conservatorship-hearing.html.

  6. Read Britney Spears' Statement To The Court In Her Conservatorship Hearing (National Public Radio, June 24, 2021). https://www.npr.org/2021/06/24/1009858617/britney-spears-transcript-court-hearing-conservatorship.

  7. Britney Spears Rocked Album Sales in ‘Diva Pop’ Even Amid Conservatorship (TMZ, June 26, 2021). https://www.tmz.com/2021/06/26/britney-spears-album-sales-worldwide-diva-pop-conservatorship/.

  8. Is the Forced Contraception Alleged by Britney Spears Legal? by Jan Hoffman (New York Times, June 24, 2021). https://www.nytimes.com/2021/06/24/health/britney-spears-forced-IUD.html.

  9. Free Britney, Free Them All (06/28/21) by Death Panel Podcast. (Full Episode — https://www.patreon.com/posts/free-britney-all-52967262).

  10. For more on ‘carceral sanism’ see Psychiatric Imaginary: Madness, Fear, and Carceral Protectionism by Beatrice Adler-Bolton (Blind Archive, April 11, 2021). https://blindarchive.substack.com/p/psychiatric-imaginary.

  11. e.g., a 2013 AARP report put the “best guess” estimate of people in conservatorships nationally at 1.5 million; a 2011 study by the National Center for State Courts (NCSC) estimated the number nationally could range from less than 1 million to as high as 3 million people. Advocacy groups offer similar estimates ranging from 1 million to 5 million people. An exact count of how many people are subject to this legal framework is not something states, municipalities, or the federal government bothers to keep track of comprehensively, when the NCSC requested information, several states did not even respond to their data and record inquiries. As with many disability issues, not counting or measuring the material conditions of vulnerable populations and how many people are affected by systems of subjection is a political strategy to buy time for politicians unwilling to act. 

  12. Free Britney, Free Them All (06/28/21) by Death Panel Podcast. (Full Episode — https://www.patreon.com/posts/free-britney-all-52967262).

  13. Golden Gulag: Prisons, Surplus, Crisis, and Opposition in Globalizing California by Ruth Wilson-Gilmore. (University of California Press, 2007).

  14. Read Britney Spears' Statement To The Court In Her Conservatorship Hearing (National Public Radio, June 24, 2021). https://www.npr.org/2021/06/24/1009858617/britney-spears-transcript-court-hearing-conservatorship. Paragraph 35.

  15. Notice how Britney is terrified of what the medication could do to her. Stating, “[y]ou can go mentally impaired if you take too much, if you stay on it longer than five months.” Unfortunately, many of the points being forwarded by fans advocating to #FreeBritney have been explicitly at the expense of disabled people. The argument is made over and over that Britney is not disabled, and therefore doesn’t deserve to be treated this way. While there is no issue with Britney rejecting the identity of disabled, the problem lies in the contextual framing. If Britney doesn’t deserve this treatment becauseshe is not disabled, then that implies that disabled people do deserve this treatment. Calls for liberation that come explicitly at the expense of the subjection of other groups are anti-solidaristic. This is not just an issue of identity politics; it is an issue of the widespread ignorance of the ways in which eugenic logic shapes our society.

  16. Read Britney Spears' Statement To The Court In Her Conservatorship Hearing (National Public Radio, June 24, 2021). https://www.npr.org/2021/06/24/1009858617/britney-spears-transcript-court-hearing-conservatorship. Paragraph 13.

  17. Tranquil Prisons: Chemical Incarceration under Community Treatment Orders by Erick Fabris (Toronto: University of Toronto Press, 2011).

  18. Decarcerating Disability: Deinstitutionalization and Prison Abolition by Liat Ben-Moshe. (University of Minnesota Press, 2020). Page 60. 

  19. Capitalism & Disability: Selected Writings by Marta Russell. (Edited by Keith Rosenthal, Haymarket, 2019).

  20. “Illness—you point out—is the only possible form of life in capitalism. In fact, the psychiatrist, who is wage dependent, is a sick person like each of us. The ruling classes merely give him the power to “cure” or to hospitalize. Cure—this is self evident—can't be understood in our system to mean the elimination of illness: it serves exclusively as the maintenance of the ability to go to work where one stays sick.” — Turn Illness into a Weapon: A Polemic and Call to Action by the Socialist Patients' Collective of the University of Heidelberg by Sozialistisches Patientenkollektiv (SPK), 1972. (Anonymous (K.D.), Trans. Circa 2013, English Translation with Forward by Sartre). Page viii.

Decarcerating Disability: Deinstitutionalization and Prison Abolition by Liat Ben-Moshe. (University of Minnesota Press, 2020). Page 61.