{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T17:35:47Z","timestamp":1787333747458,"version":"build-2736575974"},"reference-count":49,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Med Humanities"],"accepted":{"date-parts":[[2026,7,28]]},"abstract":"<jats:p>This article focuses on coercion in contemporary psychiatry through the autoethnographic account of Peter, a mental health peer worker who experienced psychosis and coercive psychiatric interventions. Using Peter\u2019s personal narrative and poetry as a prism, this study critically underscores the complex and multifaceted nature of coercion, which extends beyond overt methods and techniques into subtler, informal psychological pressures and systemic constraints that often go unaddressed. Peter\u2019s narrative also emphasises the harmful effects of informal coercion, particularly its links to past trauma, and how it perpetuates dynamics of power and control within psychiatric settings. His resistance to being labelled a \u2018chronic patient\u2019 was a crucial element in his recovery, underlining the importance of agency. Peter\u2019s poetic account bears witness to the power of creativity in processing experiences of psychosis and coercion. Overall, the study promotes a recovery-oriented and trauma-centred approach to addressing coercion in psychiatry. It calls for a transformation in psychiatric culture to reduce epistemic injustice and involve patients more authentically in their treatment and recovery processes. By co-creatively unravelling Peter\u2019s lived experiences, this article aims to foster self-reflection among mental health workers, policymakers and researchers, promoting a more compassionate, patient-centred approach to psychiatric care.<\/jats:p>\n                  <jats:p>This article explores the hidden and often overlooked forms of coercion in modern psychiatric care through the personal story and poetry of a mental health peer worker who has lived through psychosis and coercive treatment. His account reveals that coercion is not limited to forced hospitalisation or medication\u2014it can also appear in subtle pressures, unspoken expectations and systemic practices that quietly undermine patient choice and agency. The narrative highlights how these informal forms of coercion can be deeply harmful, especially when they echo past traumas, reinforcing cycles of power and control within psychiatric settings. Central to the story is the author\u2019s resistance to being labelled a \u2018chronic patient\u2019, a stance that played a vital role in his recovery and affirmed the importance of personal agency. His poetry becomes a powerful tool for making sense of his experiences, showing how creativity can support healing. This article ultimately calls for a shift in psychiatric culture towards more compassionate, trauma-informed and patient-centred care that values lived experience, reduces harm and genuinely involves patients in shaping their own recovery. It invites mental health professionals, policymakers and researchers to reflect critically on their practices and assumptions.<\/jats:p>","DOI":"10.1136\/medhum-2025-013490","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T17:20:22Z","timestamp":1787332822000},"page":"medhum-2025-013490","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Like a prism: making sense of coercion in contemporary psychiatry through autoethnography"],"prefix":"10.1136","author":[{"given":"Peter","family":"Tomlinson","sequence":"first","affiliation":[{"name":"Special Needs Education, Ghent University Faculty of Psychology and Educational Sciences, Ghent, Flanders, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evi","family":"Verbeke","sequence":"additional","affiliation":[{"name":"Psychoanalysis and Clinical Consulting, Ghent University Faculty of Psychology and Educational Sciences, Ghent, Flanders, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8601-1875","authenticated-orcid":false,"given":"Clara","family":"De Ruysscher","sequence":"additional","affiliation":[{"name":"Special Needs Education, Ghent University Faculty of Psychology and Educational Sciences, Ghent, Flanders, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,21]]},"reference":[{"key":"2026082110201631000_medhum-2025-013490v1.1","unstructured":"Beresford P. , and Wallcraft J. . 1997. \u201cPsychiatric System Survivors and Emancipatory Research: Issues, Overlaps and Differences\u201d. 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