Interview with Michael Galvin

The next few months we’ll be highlighting authors who have published in Culture, Medicine, and Psychiatry.

Dr. Michael Galvin is a Global Psychiatry Clinical Research Fellow and in the Department of Psychiatry at Harvard University and the Department of Psychiatry at Boston University. Dr. Michael Galvin is a global health researcher and psychotherapist.  His primary research interests center on mental health and the role that one’s environment, culture, and belief systems play in mental illness and treatment.  In particular, his work focuses on elucidating cultural models of mental illness and exploring relationships to pathways to care, with the goal of improving cultural adaptation of mental health interventions.  

What is your article “Examining the Etiology and Treatment of Mental Illness Among Vodou Priests in Northern Haiti about?

This article is about the way that traditional healers (ougan) conceptualize and treat mental illness in rural Northern Haiti.  While the vast majority of people with mental illness seek treatment from ougan in this region – as few biomedical services exist – very little research has examined what ougan actually do when treating patients.  The article also tries to understand how mental illness is viewed from the healer’s perspective, delving into the broader Vodou cosmology which remains very influential in rural parts of Haiti.

Tell us a little bit about yourself and your research interests.

My interests mostly center around mental illness and how we conceptualize it in different cultures and settings.  Historically, mental illness has always been hard for people to understand, getting wrapped up in ideas of spirit and demon possession.  Rarely have people thought it was something to treat like a broken leg or even a bacterial infection.  This is partly because there are no biomarkers to test for it thus patients recount what they are experiencing solely via self-report.  But it’s also because mental illness affects the basic ways in which people act and simply exist in the world.  When our loved ones have significant behavioral changes without physical symptoms of illness or infection it can often lead us to suspect the supernatural.

What drew you to this project?

I have been working and living in Haiti on and off since 2012 and knew I wanted to focus my dissertation research in Cap-Haïtien.  I found out about the Mental Health Center at Morne Pelé in 2018 and spent the entire summer of 2019 volunteering with them so we could get to know each other, for me to better understand what their work was like, and to start exploring different angles for my dissertation research which I conducted in the second half of 2020.  It was during the summer of 2019 that I learned about the extent to which patients held explanatory models based in Vodou and I knew that had to become a significant part of my research there.  I’m currently the director of the Mental Health Center at Morne Pelé’s new Research Laboratory so it’s very exciting to continue to collaborate together.

What was one of the most interesting findings?

One of the most interesting findings was this treatment called fiksyon that almost all the healers I interviewed used.  Barely anything has been written about these concoctions so this was really one of the first times they’ve been explored.  Fiksyon are different liquids – usually rum mixed with ground plants and animals – that are kept in large unmarked semi-transparent plastic bottles.  There’s a lot of mystery surrounding fiksyon with many people saying they have mystical properties.  It would be interesting to explore more about what is actually in them and the places where they are manufactured

What are you reading, listening to, and/or watching right now?

I’m reading a really interesting book that was written in the 1970s called Plagues and Peoples.  It’s a great dive into the history of pandemics over the centuries.  It’s not a hard read at all, very enjoyable and easy to understand with lots of nice anecdotes.  Apparently the findings have held up really well over the last 50 years too.

If there was one takeaway or action point you hope people will get from your work, what would it be?

That religion and culture have deep impacts in the way we conceive of mental illness.  That we still know relatively little about how mental illness develops, manifests, and is best treated.  That the relationship between our minds and our bodies is exceedingly complex and there are often no easy solutions.

Thank you for your time!



Interview with Katarzyna Szmigiero

The next few months we’ll be highlighting authors who have published in Culture, Medicine, and Psychiatry.

Katarzyna Szmigiero is a graduate of the University of Łódź, Poland. She is an Associate Professor at the Institute of Literary Studies and Linguistics of the of University of Jan Kochanowski, Poland (Branch in Piotrków Trybunalski). Her research interests concentrate on medical humanities, especially cultural representations of psychiatry and gender, and genre fiction.

What is your article “We All Go a Little Mad Sometimes:” Representations of Insanity in the Films of Alfred Hitchcock about?

The article deals with the way motifs connected with psychiatry (doctors/treatment/people diagnosed with mental illness or individuals displaying disturbing behavior/attitudes to mental psychopathology) are used in the films of Alfred Hitchcock. First of all, it tries to answer the questions why the director so often presented mentally unstable characters in his works. It also looks at how Hitchcock gently questioned the assumptions about mental illnesses and its origins that were dominant in his times. Finally, it briefly mentions the legacy of Hitchcock if the cinematic portrayals of insanity are concerned.

Tell us a little bit about yourself and your research interests.

I am interested in cultural representations of madness, gender studies, and popular literature.

What drew you to this project?

I have always loved Hitchcock’s films and saw Frenzy in my early teens, as it was my dad’s favourite. It was one of the most unpleasant and, simultaneously, hilarious film I have ever seen since.

What was one of the most interesting findings?

On the surface, Hitchcock appears to be following the psychoanalytic approach, especially in his American movies. However, he always undermines the official discourse on madness, proving that we are all, sometimes, a little mad and there’s nothing wrong about it.

What are you reading, listening to, and/or watching right now?

I am currently an avid reader of the retellings of the Medusa myth (as well as other chick lit fantasy books about antiquity).

Watch Hitchcock! Old films may seem dated, especially if you are not used to them. But his dialogues, designs, cast is often genius.

Thank you for your time!



Interview with Clare Killikelly

The next few months we’ll be highlighting authors who have published in Culture, Medicine, and Psychiatry.

Dr. Clare Killikelly is a Post-Doctoral Research Fellow in the Department of Psychiatry, University of British Columbia, and Department of Psychology, University of Zurich. Dr. Kilikelly’s research group examines the clinical utility and global applicability of the new Prolonged Grief Disorder. Her research seeks to better understand the nature of suffering and distress in different communities to develop accessible and culturally informed assessments and interventions.

What is your article “The New ICD-11 Prolonged Grief Disorder Guidelines in Japan: Findings and Implications from Key Informant Interviews” about?

Symptoms of mental disorder, including grief reactions, are found to differ across cultures. There are several examples where misdiagnosis of mental disorders, treatment gaps, and reduced help seeking occurs when culturally sensitive assessments are lacking. The identification of culturally unique symptoms of grief can improve the validity of mental health assessment.

We are the first to explore PGD symptoms in Japan from the perspective of frontline health care workers. We conducted in depth key informant interviews with cultural brokers (e.g. individuals who are part of the health care system but also have lived experience of the cultural group).

We had two main aims: first to explore experiences of grief to define both normal and abnormal reactions. Secondly, we assessed the acceptability of the ICD-11 guidelines to identify areas where cultural information is lacking. This would provide a unique viewpoint that is often overlooked in larger qualitative studies.

Tell us a little bit about yourself and your research interests.

I am interested in the role of culture in the presentation and treatment of mental health disorders. I believe that there may be cultural concepts that when unlocked can provide a key to better therapeutic outcomes.

After completing a PhD in Cognitive Neuroscience at the University of Cambridge, UK, I became interested in the core cognitive processes underlying psychopathology and the development of targeted psychotherapeutic interventions. I completed a Doctorate in Clinical Psychology at the Institute of Psychiatry, Psychology and Neuroscience, UK and explored the use of innovative mobile technologies to improve the acceptability and efficacy of therapeutic interventions for people with psychosis. Working as a psychologist with refugees in South London I became interested in the different cultural experiences and presentations of distress.

Currently, I have been awarded a Swiss National Science Foundation (SNSF) Post-Doc Mobility grant to work at the University of British Columbia to examine the relationship between grief, indicators of mental health and post migration living difficulties in refugees in Canada in comparison with Swiss, Dutch and German cultural contexts.

If you are interested in learning more about this research project, or possibly participating please check out the website.

What drew you to this project?

Prolonged grief disorder is the only mental disorder where people are expected to suffer. However, the intensity and duration of this suffering is bound by different cultural norms. For example, in German speaking countries it is common to observe a Trauerjahr (year of mourning) whereas in Syria there are 40 days of mourning. The new ICD-11 definition of PGD states that individuals must experience intense and prolonged symptoms of grief for over 6 months. Although there is robust research evidence that supports this time criteria in the Global North (e.g. North America and Europe), the current definition of PGD may be missing key symptom items and features that are more representative in different cultures.

Ultimately, we would like to develop a catalogue of culture concepts of distress (CCD) that could be accessed worldwide to help clinicians more accurately assess and diagnose PGD in different cultural groups.

What was one of the most interesting findings?

Part of the analysis focused on establishing common grief symptoms for disordered grief in Japanese bereaved. Participants described a range of emotional responses that are associated with both normal and abnormal grief responses. One unique emotional response was identified related to sadness: The sense of loss was described using a metaphor for distress ‘as a hole opening up inside the kokoro (heart).’

The in-depth qualitative analysis provided insight for clinical application, for example, due to

prominent values of emotional control, stigma towards mental illness, or lack of somatic items in the assessment measure, PGD may be underestimated in Japanese culture with the current ICD-11 PGD guidelines.

What are you reading, listening to, and/or watching right now?

I am currently re-reading ‘Snow Falling on Cedars’ by David Guterson which takes place on the islands neighbouring Vancouver and UBC. It is an excellent book but a harrowing story about the Japanese internment camps during World War II. This is also an often overlooked part of Canadian history.

If there was one takeaway or action point you hope people will get from your work, what would it be?

We were able to identify new symptoms that are very relevant for the Japanese context that are currently missing from the ICD-11 PGD definition. For example, somatic symptoms are robustly endorsed in the Japanese context, however, these are largely missing from the PGD ICD-11 definition. On the other hand, yearning and longing for the deceased (a core symptom of PGD ICD-11) is considered a normal and encouraged process, related to the emphasis on continuous bonds. Clinicians will need to consider these possible cultural differences before diagnosing PGD in the Japanese context. Considering the deeper beliefs and values of a culture and how this may impact on the assessment of grief is of great importance.

Thank you for your time!


Other places to connect:
Website
International Counseling
LinkedIn

Interview with Sarah Rubin and Joselyn Hines

The next few months we’ll be highlighting authors who have published in Culture, Medicine, and Psychiatry.

Sarah Rubin is an Associate Professor at the Ohio University Heritage College of Osteopathic Medicine at the Cleveland campus. She is a medical anthropologist who studies motherhood in the US and South Africa. She’s an advocate for health equity and reproductive justice. She lives in rural northeast Ohio with her family.

Joselyn Hines is a fourth-year medical student at the Ohio University Heritage College of Osteopathic Medicine at the Cleveland campus and psychiatry residency applicant. She has held many leadership positions within her medical school and local community. She is an active advocate and leader for underrepresented minority medical students and marginalized patient populations. She is passionate about destigmatizing mental illnesses and connecting the community to proper psychiatric care.

What is your article As Long as I Got a Breath in My Body’’: Risk and Resistance in Black Maternal Embodimentsabout?

This article explores the everyday experiences of Black mothers in Cleveland, OH as they navigate pregnancy and postpartum in the context of the racially disparate risk of infant death due to structural racism. These mothers articulated awareness of ways that racism causes them stress as they strive to have a healthy pregnancy and birth and raise their children well. We describe an embodied orientation toward motherhood that we call “betterment” where women attempt to overcome the disadvantages and oppressions of structural racism by centering their children, reconsidering and reconfiguring the social support they need to raise them, and by focusing on the future.

Tell us a little bit about yourself and your research interests.

Rubin: I’ve always been fascinated by reproduction and motherhood and understanding “what it’s like” to mother in different contexts and circumstances. I work with mothers in South Africa as well as the US.  Ethnography is my favorite way of engaging in research, but I also enjoy the breadth and multidimensionality of interdisciplinary collaborations. My favorite way to do research, though, is by engaging and mentoring students.

Hines: I am passionate about research on chronic stress in Black woman and its impact on the maternal and infant mortality health disparity in Cleveland, Ohio. I am interested in women’s mental health, reproductive psychiatry and child and adolescent psychiatry.

What drew you to this project?

Rubin: When I learned about the great racial disparity in infant mortality around our campus in Cleveland, OH and the role of chronic stress in creating and maintaining that disparity, I wondered what it looked like and felt like to mother under those conditions. We started with that phenomenological question, and it led us to an understanding of how structural racism is experienced and resisted by Black mothers.

Hines: Black women’s voices are often silenced and objectified in medicine. This project amplifies the voices and stories of Black women and sheds light on the struggles and obstacles that black women face and overcome to successfully parent.

What was one of the most interesting findings?

The Black mothers in our study demonstrate a love and commitment to their children that defy pathologizing discourses like “Welfare Queen;” but they also disrupt the positive trope of the “Superstrong Black mother,” which renders invisible the hardship and grief of living and mothering in a racist society. Our findings forge a middle path by showing how Black mothers’ bodies are shaped by the chronic stressors of structural racism but are also a source of resistance, especially in service to their children.

What are you reading, listening to, and/or watching right now?

Rubin: I’m reading Birthing Black Mothers by Jennifer C Nash. It’s a fascinating analysis of “Black motherhood” as a political symbol. It’s prompting me to reconsider my own analysis of Black motherhood, and also my positionality as a scholar. I’m also watching Season 10 of the Great British Baking Show. It’s a hug, nap, and cup of tea all rolled into one flaky pie crust. A working mother’s salve.

Hines: The Deepest Well: Healing the Long-Term Effects of Childhood Adversity by Dr. Nadine Burke Harris

If there was one takeaway or action point you hope people will get from your work, what would it be?

Rubin: Listen to Black Mothers!

Hines: This project shows how social determinants of health are lived and embodied by vulnerable populations. Readers can use this information to better understand their perspective, provide holistic quality care, and to better advocate for systemic changes in society that can ultimately provide better health outcomes for and save the lives of Black mothers and babies.

Thank you for your time!


Other ways to connect:
Twitter: Sarah Rubin | Joselyn Hines
LinkedIn: Sarah Rubin
Other applicable website: Sarah Rubin

Interview with Anaïs Ogrizek

The next few months we’ll be highlighting authors who have published in Culture, Medicine, and Psychiatry.

Anaïs Ogrizek is a psychiatrist, M.D, Ph.D and Fellow in Child an Adolescent Psychiatry at the Cohin Hospital in Paris, France. She received her MD at Paris V University and did her residency in Psychiatry at the University Hospitals of French West Indies, and holds a Master’s degree in Transcultural Psychology from Paris XIII University. She focuses her research on often overlooked communities of vulnerable populations in order to raise the scientific community’s concern on their condition and suggest ways to improve them.

What is your article “The Cultural Hybridization of Mothering in French Prison Nurseries: A Qualitative Study about?

My article is about how women incarcerated during pregnancy or along with their babies in French prison nurseries are being deprived from their original cultural environment. They go through a process close to creolization regarding their maternal cultural habits, with in the end the emergence of a specific hybrid culture around motherhood, even though they gather multiple factors of vulnerability for full prisonization, as a form of forced assimilation to prison culture. The results originate from a qualitative study led in 13 different prison nurseries in France: 25 mothers and 5 pregnant women were interviewed and interpretative phenomenological analysis was used to explore the data.

Tell us a little bit about yourself and your research interests.

Passionate about traveling, I became interested in transcultural psychiatry early on in my career. After a successful education some of which was spent in London and New York, I decided to pursue my medical studies at Paris V Descartes University in France. During my six years of study there I completed internships in both India and Canada, as well as a one-year Erasmus exchange in Hungary. After completing my general medical curriculum, I decided to specialize in psychiatry and travelled to French overseas territories to complete my residency. In French Guyana I took part in child psychiatric missions in Amerindian villages and worked in general psychiatry in Martinique.

Following my return to Paris, I achieved a master’s degree in transcultural psychology before completing a PhD research in psychology on the theme of the “motherhood in prison”, with a specific focus on cultural traditions around motherhood. Since then, I have been taking on a fellowship training program in Child and Adolescent psychiatry at the Maison de Solenn, Cochin Hospital in Paris, known worldwide as a place of expertise in transcultural psychiatry.

I am currently working on mothers that have left prison with their children after spending some time with them in prison nurseries, in order to explore how they readjust to their lives as free mothers on every level (on personal and domestic ones as well as social and cultural ones of course). On cultural aspects, our main hypothesis based on our prior results is that the cultural gap created by prison between these women and their outside community regarding traditions around motherhood could lead, at their release, to issues similar to those faced by migrant mothers: they might become migrant mothers from an inner to an outside prison world.

Based on my prior results of motherhood in prison nurseries, I am also working on a new and more general concept of “the baby function” – as a parallel to the term of “maternal function” commonly used – in the sense of what the baby can offer to his mother, or at contrariwise what he fails to offer. I intend to develop this innovative concept in a future article.

What drew you to this project?

I have always found the carceral environment very intriguing, with often multiple entanglements with psychiatric problematics, regarding the endorsement of responsibility for one’s personal action but also regarding institutional organization that have been put forward by the emblematic Goffman in his book “Asylums”. When I randomly discovered that babies were born and raised by their mothers in such an institution I immediately wanted to know more about these mothers’ experience as it aroused so many questions regarding so many different fields of research: personal, domestic, social, cultural, judicial, and ethical.

What was one of the most interesting findings?

The most interesting finding was to observe that no matter where in France these mothers were incarcerated (Metropolitan France or French oversea territory), they all seemed to show a similar cultural hybridization to some kind of ‘‘motherhood prison culture’’ regarding motherhood habits.

I am currently reading the thrilling work by Orna Donarth “Regretting Motherhood: a study” I recently watched and loved “Woman” a film by Anastasia Mikova, and Yann Arthus-Bertrand. I also very much enjoyed Yann Arthus-Bertand’s previous film “Human”.

What are you reading, listening to, and/or watching right now?

I am currently re-reading ‘Snow Falling on Cedars’ by David Guterson which takes place on the islands neighbouring Vancouver and UBC. It is an excellent book but a harrowing story about the Japanese internment camps during World War II. This is also an often overlooked part of Canadian history.

If there was one takeaway or action point you hope people will get from your work, what would it be?

I would say that this work shows once again how culture is a fundamental need for every human being, and how no matter how hard an ethnic group is oppressed, he will put all its strength in making some of its culture survive in some way or another.

Thank you for your time!


Other places to connect:
LinkedIn

Interview with Katyayni

The next few months we’ll be highlighting authors who have published in Culture, Medicine, and Psychiatry.

Katyayni is a PhD Candidate at Brown University and has been researching and writing about health and healthcare since 2009. They are currently studying how families and healthcare professionals in the north Indian state of Uttar Pradesh (UP) take care of children who experience seizures.

What is your articleArtifacts of Care: The Collection of Medical Records by Families in North Indiaabout?

When a child in India suffers from a chronic illness, families are responsible for collecting and keeping the prescriptions and reports that doctor’s might use to understand the child’s medical and treatment history. In my article, I try to understand this form of documentation and recordkeeping.

Tell us a little bit about yourself and your research interests.   

I developed an interest in studying illness after I spent a few days as a patient in a government hospital in New Delhi. In my senior year at Colby College, a course on Historical Epidemiology taught by Dr. James L.A. Webb Jr. guided me towards the study of public health. After post-graduate studies on the subject at the Harvard School of Public Health, I worked as a researcher with the World Bank Group in India, learning about the planning and implementation of public health programs in the country. I decided to pursue a PhD in Anthropology because I was drawn to ethnography as a research method and was inspired by the writings of Lawrence Cohen and Sarah Pinto on UP.

What drew you to this project?

I wanted to study the provision of medical care in western UP. I am from Meerut, a city in the region and through my research wanted to understand an aspect of life in the region. My supervisor, Dr. Bhrigupati Singh, encouraged me to focus my research on a particular disease condition or type of practitioner. I chose seizures among children because a colleague had once shared with me their experience of meeting a child in eastern UP who suffered from seizures and had been given a poor prognosis by their doctor. Hearing my colleague’s thoughts on the child’s condition and their family’s ability to care for them made me want to understand how seizures among children are understood and treated in UP.

What was one of the most interesting findings?

This research is ongoing and so my findings are currently half-baked. Nevertheless, one aspect of caring for children with seizures that I have found noteworthy is the role of repetition in both familial and medical care practices. I am pursuing this line of inquiry to consider how the repetitiveness of multiple actions (for instance giving a child their daily medications, taking them for monthly medical consultations) coalesces into what we might call caregiving.

What are you reading, listening to, and/or watching right now?

I recently found the book, Here, by the illustrator Richard McGuire on my sister, deepani’s, bookshelf. And a good friend, the geographer Matthew Birkinshaw, gifted me the book, Deceptive Majority: Dalits, Hindus and Underground Religion, by the anthropologist Dr. Joel Lee. Both these books illustrate how intricate and multilayered histories can be told in ways that do not overwhelm their readers. I have enjoyed them very much.

If there was one takeaway or action point you hope people will get from your work, what would it be?

Through my work on medical documents I hope to have reiterated the value of studying materials that accompany the practices we want to understand.

Thank you for your time!


Interview with James B. Waldram

The next few months we’ll be highlighting authors who have published in Culture, Medicine, and Psychiatry.

Jim Waldram is a Distinguished Professor of Anthropology at the University of Saksatchewan. A canadian anthropologist with specializations in applied and medical anthropology, he obtained his PhD from the University of Connecticut in 1983, after completing Bachelor’s (University of Waterloo) and Master’s (University of Manitoba) degrees in Canada. He is the author of several books, including Hound Pound Narrative: Sexual Offender Habilitation and the Anthropology of Therapeutic Intervention (2012, University of California Press) and An Imperative to Cure: Principles and Practice of Q’eqchi’ Maya Medicine in Belize (2020, University of New Mexico Press). He is a Fellow of the Royal Society of Canada, the Canadian Anthropology Society, and the Society for Applied Anthropology.

What is your articleDoes “Susto” Really Exist? Indigenous Knowledge and Fright Disorders Among Q’eqchi’ Maya in Belizeabout?

This article examines the knowledge held by a group of Indigenous people – the Q’eqchi’ Maya of Belize – with respect to fright-related disorders. It challenges the idea that one particular fright disorder, known as susto, is essentially the same everywhere. Susto is well documented in cultural psychiatry, and the term appears in major psychiatric textbooks. But it appears to be an overlay of Indigenous knowledge by western psychiatric researchers, with the result that the complexities and nuances of Indigenous fright disorders are rendered invisible. This article takes that Indigenous knowledge seriously and uses it to talk back to susto, to question the rote applicability to Indigenous peoples of this particular western conceptualization of disorder.

Tell us a little bit about yourself and your research interests. 

I live in Saskatchewan, Canada, known for bright sunshine and long,hot summer nights, as well as cold, dark winters. So, researching in Belize is very nice! I have been working with a group of Q’eqchi medical practitioners, and their patients, for almost twenty years. I am intrigued by the concept of ‘healing’ and much of my work has examined therapeutic practice in settings such as northern Indigenous communities, prisons, clinics, and now southern Belizian Q’eqchi’ villages.  

What drew you to this project? 

I was invited by the Q’eqchi’ medical practitioners to research, document, and share their medical practice and knowledge, in response to efforts by evangelicals and others to paint them as satanic or charlatans.

What was one of the most interesting findings?

I had a notion of ‘healing’ as fundamentally about repairing social relationships and psychological harms, based on my work with Indigenous groups in Canada. I was surprised to find that the Q’eqchi’ medical practitioners – who some would refer to as ‘healers’ – are focused mostly on diagnosing and treating medical conditions and seeking a cure for their patients.

What are you reading, listening to, and/or watching right now?

I don’t have much time for reading outside of my scholarly pursuits and teaching. I do listen to blues music regularly, and I watch a great deal of football (Canadian style).

If there was one takeaway or action point you hope people will get from your work, what would it be?

It is imperative to take seriously the deep and complex knowledge of Indigenous peoples and allow their understandings and explanations to exist equally alongside those of western science. 

Thank you for your time!


Other places to connect:
Website
Twitter

Interview With Sarah G. Mars

The next few months we’ll be highlighting authors who have published in Culture, Medicine, and Psychiatry.

Sarah Mars is an Associate Professional Researcher at the University of California, San Francisco. She is an anthropologist and historian who has been researching substance use and policy for several decades. Her current research focus is the US opioid/overdose epidemic and she is the author of The Politics of Addiction: Medical Conflict and Drug Dependence in England since the 1960s (Palgrave).

What is your article ‘The High Five Club’: Social relations and perspectives on HIV-related stigma during an HIV outbreak in West Virginia‘ about?

During our qualitative research in a West Virginia town where an outbreak of HIV was happening, we found strong agreement among people injecting drugs that HIV-related stigma had greatly diminished among their peers since the outbreak. Using Cultural Theory we considered the social and material mechanisms that might underlie this change. West Virginia’s drug overdose death rates are the highest in the US amidst widespread uptake of injecting. Although spending time together, people living homeless and injecting drugs were divided and constrained by extreme poverty and the demands of drug dependence, fostering a fatalistic approach to life events and decision-making. This fatalism undermined individuals’ aspirations to forming a mutually supportive group, the “High Five Club” of the title. (The name is an ingenious pun for ‘HIV’ where the V=5 in Roman numerals.) Yet this fatalism also contributed to mutual tolerance and acceptance of those diagnosed with HIV.

Tell us a little bit about yourself and your research interests.

Substance use and the social and political responses to it have long interested me. I moved to San Francisco from London almost two decades ago and, as a migrant, find that a comparative perspective always helps to spark questions about what we are encountering out in the field or in archives. While some of my research has focused on the urgent questions of emerging drug use during the opioid epidemic, I am also interested in developing under-used theoretical approaches, particularly Cultural Theory. The new online Opioid Industry Document Archive also promises exciting new opportunities for research.  As well as work and family, I have spent many years researching cake making, particularly the chocolate varieties.

What drew you to this project?

Since reading Mary Douglas’ paper ‘The Self as Risk Taker: A Cultural Theory of Contagion in Relation to AIDS’ (1990), I have been intrigued about perceptions of risk and protection from HIV.  During research in Baltimore, Maryland in 2015, an interviewee commented that although they were engaged in sex work, they only went in their own circle. They saw this boundary as protective against HIV risk and it resonated with Douglas’ ideas about community boundaries as a protective barrier to contagion. I then developed this project as a pilot for investigating the use of Cultural Theory among people who use drugs

What was one of the most interesting findings?

Reducing HIV-related stigma is not only a matter of educating people to be more caring and empathetic. How someone reacts to another’s diagnosis depends on how they see their own place in the world. When unable to control key aspects of their lives, such as where they sleep at night or because of the daily demands of drug dependence, a person may develop a fatalistic viewpoint. From a public health point of view, fatalism can make preventing HIV particularly challenging if people who are considered ‘at risk’ believe the spread of the virus is out of their hands but fatalism may also help them to live in harsh conditions without self-blame and reconcile themselves to difficult news.

What are you reading, listening to, and/or watching right now?

I have been enjoying the BBC podcast of ‘In Our Time’, a discussion with academics of wildly disparate topics from the electron to the origins of the Atlantis myth or George Orwell’s 1984. For viewing, Shetland, a crime drama set on remote Scottish islands, is good for relaxing at the end of the day. For the written word, I recently read an excellent paper by Allison Schlosser and Lee Hoffer that discusses grief after deaths from drug overdose, a previously overlooked subject. (Schlosser, A. V., & Hoffer, L. D. (2022). “I don’t go to funerals anymore”: how people who use opioids grieve drug-related death in the US overdose epidemic. Harm Reduction Journal, 19(1), 1-11.)

If there was one takeaway or action point you hope people will get from your work, what would it be?

There is usually an internal logic to even the most bewildering human behavior but it may take some persistence to discover it.


Other places to connect:
University of California, San Francisco
ResearchGate

Interview with Julie Spray and Jean Hunleth

The next few months we’ll be highlighting authors who have published in Culture, Medicine, and Psychiatry.

Julie Spray is a Lecturer in Children’s Studies at the University of Galway. She is an interdisciplinary medical and childhood anthropologist who researches children’s perspectives on health and illness, public health policy and interventions, and health inequalities. She is author of The Children in Child Health: Negotiating Young Lives and Health in New Zealand (Rutgers Series in Childhood Studies, 2020).

Jean Hunleth is an ASsociate Professor in the Division of Public Heath Sciences at the Washingtion University School of medicine in St. Louis. She holds a PhD in cultural anthropology and a Masters of Public Health. Her work focuses broadly on care and caregiving across hospital and home settings in the United States and in Zambia. She is the author of Children as Caregivers: The Global Fight against Tuberculosis and HIV in Zambia (Rutgers Series in Childhood Studies, 2017)

What is your article “Breathing Together: Children Co-constructing Asthma Self-Management in the United Statesabout?

Paediatric professions tend to be oriented around adult caregivers in biomedical approaches to illness management, leaving children marginalised as passive “shadows” in things like policies, guidelines, and clinical models. But the anthropology of child health suggests children are active participants in their health who derive their own self-care practices. So in this article we shift the lens away from caregivers to center children, asking, what are children’s roles in their asthma management? We asked 24 children to show us how they manage asthma, contrasting their accounts with those of 12 health care providers. We heard from children how they actively co-construct their own “protocols” for dealing with asthma with a range of other actors, through relational processes of care and responsibility, and within the spatial contexts and constraints of everyday childhoods. We suggest children’s activities—which are largely absent from asthma guidelines—are foundational to successful asthma management.

Tell us a little bit about yourself and your research interests.   

We are both scholars working at the nexus of childhood and medical anthropology. Jean’s current studies are multiple, including a study of young people’s caregiving for adult cancer patients in the US, a study on bedside caregiving in a pediatric hospital in Zambia, a project to implement HPV vaccination into adolescent health services in Zambia, and a photographic examination of children’s experiences with health and care in the rural Midwest (US). These studies may seem quite different, but they are united by an interest in learning from young people to better understand care (in its varied definitions).

Julie has continued her long-term focus on paediatric asthma through a New Zealand based project about how health professionals, adult caregivers and children are differently thinking about children’s roles and responsibilities in asthma management. Additionally, her comic-making project The Pandemic Generation has investigated children’s representation inclusion and participation in Covid-19 public health promotion in New Zealand and, in the near future, Ireland.

What drew you to this project?

We were the two childhood medical anthropologists on an NIH-funded interdisciplinary team investigating caregiving for paediatric asthma. This article is the product of our relentless harping to the rest of the team that children matter too. The team very graciously trusted us to run a subproject working with the children of caregivers who had been previously interviewed for the main grant.

What was one of the most interesting findings?

Neither of us were surprised by our findings, because we knew from our respective previous child-centered projects children have agency and engage in their own self-care practices, and that those practices will be overlooked and underestimated by adults. But one thing we hadn’t expected was the role of drinking water in children’s protocols—so many of the children described drinking water as a firstline response to asthma symptoms. Adult caregivers had described a huge range of their own strategies but almost adult had mentioned water. We think this speaks to how much more constrained children are in their own health management—some of them couldn’t easily access inhalers at school, for example. Water is the one “health” product children have ready access to.

What are you reading, listening to, and/or watching right now?

Julie is reading Danya Gablau’s new book “Food Allergy Advocacy: Parenting and the Politics of Care” and thinking there are many parallels with asthma, and also food allergy would be another important area to investigate children’s own practices.

I (Jean) am reading The Scent Keeper by Erica Bauermeister. I find myself drawn to fiction narrated by child characters, and also fiction that offers new ways of thinking and writing about experience. The focus on scent is compelling to me as an anthropologist because my methods are so multisensorial. I think with fragrances often but haven’t quite figured out how to write them into my work.

If there was one takeaway or action point you hope people will get from your work, what would it be?

To critically consider how adult-centric their thinking is! The naturalisation of age-based bias is one of the few forms of prejudice that still seems unchecked. When we assume children are passive and caregivers are the only people that matter, that children cannot and ought not be responsible for their own health care, or that children’s activities are just “training” for future adulthood and inconsequential to the health of the present child, we do children a huge injustice and leave them without important supports for the roles they must and do play in their own health.

Thank you for your time!


Other ways to connect:
Website (Julie Spray) (Jean Hunleth)
Twitter (Julie Spray) (Jean Hunleth)

Interview With Boon-Ooi Lee

The next few months we’ll be highlighting authors who have published in Culture, Medicine, and Psychiatry.

Boon-Ooi Lee, Ph.D., is Senior Lecturer at the National Institute of Education, Nanyang Technological University in Singapore. He is interested in culture and mental health, in particular, indigenous healing systems, multicultural therapy, cultural psychopathology, alteration of consciousness, health beliefs, somatization, embodiment, and phenomenology.

What is your article “Spirit Mediumship and Mental Health: Therapeutic Self-Transformation among Dang-kis in Singapore about?

Early studies usually described spirit mediums as people with mental disorders because of their psychiatric-like behaviors, for example, dissociation, delusions, or hallucinations. But subsequent studies found that mediums were generally in good physical and mental health. To find out whether these positive findings are generalizable to dang-ki healing, a form of Chinese mediumship / shamanism in Singapore, we interviewed eight mediums and assessed their mental health status using psychological questionnaires. Our findings suggest that most of them did not suffer from mental disorders. In fact, they had spiritually transformed through the practice of mediumship, suggesting that dang-ki healing has therapeutic values for the practitioners themselves. It is therefore important to understand mediumship in its cultural context instead of pathologizing it from a Western psychiatric perspective.

Tell us a little bit about yourself and your research interests.

I am a counseling psychologist and researcher. I have always been fascinated by the cultural aspects of psychopathology, mental health, and alteration of consciousness in ritual healing. Research in these areas helps us to understand better the interaction between mind and culture.

What drew you to this project?

I became interested in the relevance of rituals and other indigenous practices to mental health after a relative shared with me her personal story. When she was a child, her mother took her to consult a fortune teller because of her frequent insomnia. According to the master, her sleep had been interrupted by a child spirit who wanted to play with her. To prevent the lonely ghost from entering her bedroom, he asked her mother to paste a talisman on their house entrance. Interestingly, my relative slept soundly after her mother followed the instruction. Whether her recovery is a placebo response, a coincidence or due to some unknown reasons, I don’t know. But I think some aspects of cultural beliefs can be integrated into mental health care or psychotherapy for people who subscribe to these beliefs. With this idea, I moved on to study dang-ki healing, a popular indigenous healing system in the Chinese Singaporean community.

Initially, I focused my research on people consulting dang-kis. Later, I became interested in the dang-kis’ own transformative experiences after reading a study on digital self-representation conducted by Yee, Bailenson and Ducheneaut (2009). They found that the characteristics of an avatar had shaped how a user behaved both inside and outside of a collaborative virtual environment. Although virtual online game differs from spirit mediumship in many aspects, I wondered whether the same transformation would happen to a medium who enacts the “role” of a deity in a particular context as some researchers have perceived spirit possession as a form of social role enactment. In this sense, the “deity” is like an “avatar” while the religious context functions as an online virtual environment. Since a deity usually represents an ideal self with positive qualities, I conducted the current study to find out if a dang-ki would transform by internalizing the divine qualities through recurrent possession.

This transformation may help to explain the therapeutic aspects of the mediumship practice. Although this seems to be the case based on our ethnographic study, I plan to conduct an experiment to triangulate this finding by using the technology of virtual reality to see if a person can modify her behaviors by embodying the disposition of a “deity”. For example, past research has found that immersive virtual reality may induce illusions of ownership over a virtual body (in this sense, a deity’s body).

What was one of the most interesting findings?

The possible internalization of the deity’s disposition, as mentioned earlier. This finding will help to understand the interaction between the mind and body in cultural context

What are you reading, listening to, and/or watching right now?

Mainly Western and Eastern philosophies such as phenomenology, existentialism, and Taoism. I am now reading “The Path: A New Way to Think about Everything” by Michael Puett and Christine Gross-Loh, “The Phenomenological Mind” by Shaun Gallagher and Dan Zahavi, and “How Forests Think: Toward An Anthropology Beyond The Human” by Eduardo Kohn. In the evening, I immerse myself in Tang Dynasty poems, sci-fi movies on Netflix, or Tess Gerritsen’s novels.

If there was one takeaway or action point you hope people will get from your work, what would it be?

To be open-minded, do not stereotype or even pathologize anything we are not familiar with, learn from people from other cultures, and there are local knowledge and healing systems relevant to mental health care.  


Other places to connect:
ResearchGate